Emotional Intelligence, Family Issues, Language, self-perception, Uncategorized

One nebulous advantage of being a Marriage & Family Therapist, trained in family systems theory, is that we have ample opportunity to explore our own origin stories, as well as those of our clients. We gain new perspectives or information that reframes our understanding about where we come from, and how that changes our perception of who and how we are in the world.

In psychotherapy, there are generally some firm boundaries around “safe and effective use of Self” for therapists that are all about understanding and/or mitigating how WHO we are impacts HOW we are in our work with our clients. Understanding the formative and often invisible impacts of our families of origin can be a part of that work, as our early models often influence our values and inter-relational patterns in all kinds of relationships. We don’t use it necessarily as an excuse to talk about ourselves in client sessions, though careful and limited use of personally-relatable anecdotes can be a useful tool for illustrating to clients just how much we do (or don’t) *get them*.

Then again, I’m also a writer by trade long before I was a therapist, and a principle tenet of writing is to “write what you know”. Since people are often curious about how therapists wind up becoming therapists, I thought I’d for once break the silence around personal stories, and share my own origin story. In doing so, it also helps me recognize that a lot of this has the ring of well-honed narrative, meaning that every time I tell some of these stories, I’m (subtly, perhaps) reinforcing those storylines and their underlying values in my head. I’m also giving myself an opportunity, however, to reflect on those storylines a little more and see whether there’s anything to be altered in the current moment, applying years’ worth of reflection to temper something I’ve been telling myself, in many cases, literally all my adult life. As an exercise, I’m going to bold the parts of it that are the internalized scripts, the narrative lines that I’ve carried and polished the longest.

WHO AM I, a story by Karen, age 50 and 3/4

To start with, my family structure itself was odd. My parents met in Toronto in 1965 when my recently-divorced mother and her four-year-old daughter were trying to make a new life for themselves. The mid-60s weren’t exactly hospitable years for divorcees and single mothers, and my mom has admitted that what she was looking for was financial support more than romance. My mother’s first daughter was a handful, however, and sometime just before my parents met, my mom made her daughter a ward of the Crown; in short, voluntarily relinquished her into the fostercare system. Mom had also had a second child out of wedlock after the marriage ended; he was given up for adoption at birth.

My father was working as an industrial architect with a side passion for big-band jazz. I’ve got ancient newsclippings of my dad on an upright base playing with a then-unknown black kid by the name of Oscar Peterson on the piano. My dad was 17 years older than my mom. They connected through unknown-to-me circumstance. Two years later, they had me; I was planned. I grew up knowing about my half-sister, as she came and went from my life on whirlwind visits. I don’t remember how old I was when I discovered the birth documents for my half-brother, probably around 8 or so, but thereafter I know I internalized the idea that “I was the one she/they kept”. I also internalized the idea that if they gave away two other babies, obviously they could give ME away any time they wanted, too.

As a young adult, I took to describing my homelife as a “Cold War zone”. My relationship with each of my parents was okay and as “normal” as one might expect for the 70s and 80s–their relationship with each other was a different story. Of note: my parents were never married; they both commented over the years that having each been burned by previous marital heartaches, there seemed no good reason to go through the motions a second time. The scripted line was, “They lived together for 19 years, and hated each other for 17 of them,” which, while lacking in the accuracy of the minutiae, certainly encompasses the overarching tension of my homelife. My parents never slept in the same bed, and round about the time we moved into a small town when I was 7.5, they didn’t even sleep in the same room on the same floor of the house. Mom always maintained it was because of Dad’s snoring (which was prodigious), but I never believed that was all, or even the bulk of her reasoning.

It’s worth noting: I never knew my dad’s family. His parents were long dead before I was born, as was one of his sisters (Scarlet Fever in her case); what family he had through his remaining sister was scattered on the East Coast. I have a vague memory of meeting a couple of his cousins or nephew/niece when I was very young, but I remember their dog better than I remember them. I also met the daughter of his first wife once in my early teens when she came west to visit, but that once was all the exposure I had until I tracked her down through FB last year to inform her of Dad’s passing. My mother’s family is its own tale of dire dysfunction, including her alcoholic mother with undiagnosed suicidal depression (though some of my mother’s tales ring the bells of Borderline Personality Disorder); my mother tells of the day my grandmother tried to kill herself by driving the family car off the road… with my mother and her younger brother loose in the back seat. My grandfather was unwilling to confront or deal with his wife’s obvious mental health issues, so he didn’t intervene even when she beat her daughter or emotionally terrorized either child. MY mother finally fled as a teenager, as soon as she was old enough to work to support herself. She married young; her first husband was an abusive alcoholic. She was 20 when her first daughter was born.

Both of my parents were high-functioning alcoholics. My mother also suffered from undiagnosed depression. Neither of my parents finished high school. Dad enlisted in the army at 18, which got him to Europe for the last rounds of WWII. His work ethic meant both a workaholic, emotionally-unavailable father-figure, and that my university education was paid for long before I graduated high school, about which I was constantly reminded, and an investment I promptly lost by failing out of my first year of university. I was the first generation of the family to attend university; between my mother’s and her brother’s kids (her 2 daughters, his 2 sons), only two of us completed undergrad. I’m the only one with a post-grad degree. None of us has had a stable, successful marriage (including our parents). Only one of the four of us ever had kids. The eldest in both sets of siblings has significant mental health issues including drug or alcohol issues and numerous run-ins during “troubled youth” with law enforcement. That left myself and my younger cousin to be the “good kids” in a widespread system of familial dysfunction. My running joke for a long time was that David (said cousin) and I were the white sheep of the family, notable for our rarity.

So… that’s the bare-bone systemic model in which I grew up. Even glossing over so many details about the intergenerational and inherited trauma normal to family systems, that’s a lot of self-defining scripting I’m carrying forward into my adult life, the echos of which still occasionally rattle the windows and shake the walls of my current life.

When we dig into the narratives I’ve bolded, there’s an incredible amount of tension touching on several aspects of my core family dynamics:

  • The incredible pressure of growing up as “the one they kept”, believing that if they could give the other children away, I had to be EXTRA GOOD to make sure that didn’t happen to me.
  • The weight of expectation tied to my going to university, even if I proved terribly unready for the responsibility of “being launched”.
  • Being the Adult Child of Alcoholics (OMG, I don’t even know where to start with what I’ve learned about this one, but here’s a good suggestion).
  • The dynamic of seemingly overbonded mother and underbonded father (and let me tell you, THAT dynamic has been a major undermining factor of EVERY heterosexual relationship I have ever had, including both my marriages).
  • Undiagnosed mental health issues galore, up to and including my own until-recently-admitted depression and anxiety.
  • The “Cold War” aspect of my parents’ relationship as the foundational model I took away for “how intimate partnerships should look” (and my own deeply-disconnecting behaviours when stressed in relationship).

It’s not uncommon that “relationship issues” such as faltering intimacy or communications challenges in relationship are what drive an individual or partners into a therapist’s office. One of the reasons the family of origin snapshot is such an integral part of my own intake process is that it shapes for me a picture of the significant early and formative influences on the participants in the current conversation.

Having spent so much time navel-gazing my own origin story, and listening over the years to how I tell my origin story, I’ve learned something about how to listen for those polished-sounding phrases, lines and phrases that crop up time and time again in conversation. I can’t always put my finger on what it is about a particular choice of wording in a client’s story that sets my Spidey-senses tingling, but my accuracy is (in my not-so-humble opinion) better than just average in catching the tones. There’s just something about a precise choice of words; or something about how they all run together like a phrase we haven’t actually had to think about constructing for a long time, dropped in the midst of an otherwise thoughtful conversation.

(I’m not ruling out the idea that I’m just projecting onto my own clients, at least some of the time; on a good day, I’m self-aware enough to be aware that’s a potential inadvertent-thing-wot-therapists do, yo.)

We all have these stories, these pieces of personal narrative we just carry with us as shorthand descriptions of things that actually carry an incredible significance to those willing to get past the polish and gleam of scripting. I joke sometimes that my job as a therapist is to be a “professional disruptive influence”, and more often than not, what I’m looking to disrupt is the attachments we invest in those safe scripts. Scripts around our origin stories, like any other experience, in many ways function as cages that contain complex emotional experiences. Language is a tool we use to define and shape experience into something we can wrap our heads around. Dispassionate versus passionate language and delivery, for example, is discernible through listening to word choice as well as tone. Applying language to an experience is, in and of itself, a very cognitive process, and in pushing emotional experience through cognitive filters, we already begin to separate ourselves from the immediacy of the lived and felt experience. Our word choice actually informs our brain how we want to qualify and quantify that experience; we can use language to embrace or distance our selves from the feelings. Our origin stories are the stories we have been practicing and polishing the longest of all our scripts. Sometimes we need to just scrape off the years of accumulated polish to see the actual grain and bones of the experience underneath, to understand what happened in different lights and perspectives, and maybe learn something new about ourselves in the process.

Mental Health, self-perception

Something I’ve been thinking about lately:

About a week ago, I was speaking with a client about depression, exploring “the lies that depression tells us”. It’s a standard externalizing narrative framework clinicians use to help clients put a little emotional distance between themselves and whatever’s afflicting them; it’s an approach that works for a lot of different things. But I made a mental note in the back of my head that in my own mind, something had started to ring a little hollowly around that particular narrative construct (not for the client; the client ran with the externalization like it was tailored for them). It’s taken me most of the week to figure out what the mischord is. When we talk about depression and “the lies it tells us’, the implication is there’s something inside us that whispers or talks to us and fills us with narratives that are neither helpful nor healthy. This implies that depression functions as a cognitive process, operating in the part of the brain where language and thought processing occurs. When clients respond well to the idea that “depression lies” or tells us things about ourselves, we’re operating in the cognitive realm. We define the cognitive realm this way:

This domain includes content knowledge and the development of intellectual skills. This includes the recall or recognition of specific facts and concepts that serve developing intellectual abilities and skills. There are six major categories, starting from the simplest behavior (recalling facts) to the most complex (Evaluation)
http://serc.carleton.edu/introgeo/assessment/domains.html

I absolutely believe that this definition of depression as a cognitive dysfunction (with all its standard attendant physical byproducts and related chemical imbalance) rings true for a very great many sufferers.

It is most decidedly not, however, true for me. My depression doesn’t talk to me, and I’m increasingly certain it never has. And the more I work with other depression sufferers, the more convinced I am that there’s an entire constituency for whom there is no (or no signficant) cognitive aspect to the their depression at all. For example, my depression says nothing to me about my worth or value. It says nothing to me about my happiness or misery, nothing about the value of doing anything I would normally do, energy I would normally expend. I increasingly suspect that part of the reason why I failed to recognize depression in myself for what it is for as long as I have is precisely BECAUSE the entire internal “demon narrative” has been conspicuously absent. This suggests some forms of depression might operate predominantly, perhaps exclusively, in an affective state, manifesting physically and exclusively without the cognitive narrations::

The Affective domain includes feelings, values, appreciation, enthusiasms, motivations, and attitudes.
http://serc.carleton.edu/introgeo/assessment/domains.html

What I get is something like a gravity well; a thing I fall into in which the weight on my mind and body just increases until I have no tolerance, no strength to move past it. Emotionally I still feel happiness and joy, though muted; I still feel engagement. I’m still reasonably high-functioning, though compromised in scope and sustainability. It’s like something sits on my chest and weighs me down. It can be hard to breathe sometimes, it’s definitely nigh-unto-impossible to move. It’s easier to just stay still, or better yet, just sleep. There’s no judgment, no scripted storyline about what it means; I don’t know if it was always like that. I know I beat myself up fairly heavily the first spring I failed to get back to walking like I had been the previous fall, but that failure and self-recrimination narrative was as much disappointment over lost momentum and gear investment costs as it was anything else. All things considered, it was easy to let go of that cognitive process once I figured out what was going on.

My depression doesn’t talk to me, and I don’t talk to it. At the deepest points of the gravity well, it doesn’t whisper to me to kill myself, that the world would be better without me or that no-one would notice. I actually like my life; I have a mostly-healthy connection with my world and the place I have made for myself within it — not without challenges, but hey, I’m still human. At the deepest points, where people start to have urgent conversations about suicidal ideation, the sensation has been more what I imagine drowning swimmers eventually reach when they are too tired to keep struggling up past the weight of the water to the air, too tired to keep pushing their own waterlogged bodies to draw in breath, and they just… succumb. There’s the instinctive urge to breathe and stay alive, but eventually we can’t keep fighting against the weight and resistance of the surrounding elements. It seems to me that there’s not a lot of internal narrative in those moments, beyond “so tired” and “just let go”. I’m reasonably certain the only thing that pulled me through those times was the utterly unconscious, instinctive urge to keep breathing. In those moments it’s not so much that one consciously care much about living or dying; we can’t battle the weight any more, but autonomous bodily functions keep going. It occurs to me, this is likely where a big part of the mantra that has been a core operating principle for the last five years is rooted: “One day at a time, one breath at a time; one foot in front of the other.” Think no further ahead than the next breath; there isn’t enough energy to invest in speculating any further ahead than that.

A clinician friend in Boston this morning pointed me to the works of Edwin Shneidman, an American psychologist and author who wrote extensively on his work with the suicidal mind. Specifically, she was correlating my thoughts on depression as a predominantly non-cognitive, felt experience rather than a mental, narrative one, with Shneidman’s description of suicidality as a “psychache”, language that I suspect may resonate strongly with affective depression sufferers (even those nowhere near the point of suicidal ideation):

“As I near the end of my career in suicidology, I think I can now say what has been on my mind in as few as five words: Suicide is caused by psychache (sik-ak; two syllables). Psychache refers to the hurt, anguish, soreness, aching, psychological pain in the psyche, the mind. It is intrinsically psychological – the pain of excessively felt shame, or guilt, or humiliation, or whatever. When it occurs, its reality is introspectively undeniable. Suicide occurs when the psychache is deemed by that person to be unbearable. This means that suicide also has to do with different individual thresholds for enduring psychological pain.”
(Shneidman, 1985, 1992a).

Looked at through this lens, we have the option now of language that supports exploring depression as a form of psychache, one with a scope of tolerance for enduring the affective or physiological experience, and how the client is able to function within the threshold of that experience. For clients who get frustrated by trying to use cognitive, narrative process to relate to their depressive experience, we can instead use bodywork language from the likes of Eugene Gendlin or Bessel van der Kolk (whose groundbreaking work on bodily retention of traumatic experiences is a go-to resource for many clinicians). This affective approach also opens up the options of a dialogue with clients around other physiological variables that can impact the physical and affective states. Western psychology sometimes skirts the edge of this holistic understanding when we press clients to consider their sleep/diet/exercise (any energy expenditure) habits in light of their depression, but often stops short of giving legitimacy to depression as potentially being a *wholly* affective state for some people. (The more I recognize this in myself, the easier it becomes to see this as an option for other depressive clients).

So now we can observe when the default cognitive “depression narrative” approach seems to sit badly with clients and others, and offer them this as an alternative to consider. Humans are narrators and interpreters and story-tellers by design, but I think sometimes the words actively get in the way of simply being *IN* an experience, especially if the experience itself is frightening in some way. If we can describe an experience–if we can safely box it up in words and interpreted meanings–then we feel we understand it. We feel we have a handle on it… we feel we have, in that handle, some measure of control, however slim. And therein we find comfort. We’ll invent entire mythologies simply because we experience fear when we don’t know why the sky flashes and rumbles at us.

Sometimes a cognitive, narrative *isn’t* the right approach. Sometimes it *doesn’t* encapsulate the experience. Sometimes it actually distances us from it. Recognizing the physical experience of my depression this week was a massive shift for me. There is no internal discussion or discourse, no whispered threats or seductive emanations. There is simply a force of gravity that is very localized; some days I function at Standard Earth Gravity, and sometimes I am flattened by Jovian Pressure so forceful it feels like it would be easier to stop breathing completely than expand my lungs against my crushing ribs one more time.

Even those words don’t capture the experience. Those are words and narrative elements that only fill in the blanks after the fact, for the most part, when I’m having to describe the experience to someone outside my own head. Most times, it never gets past the sensation of just stopping, letting my eyes close where I sit or lie, and letting sleep take me the rest of the way down into the pressurized deeps of that gravity well.

Now at least I have language to explore that with others as well. See? Even clinicians can learn new (and hopefully useful!) things.