09/10/2021
Guide dog or Black dog?
Emotional pain, which most of us would prefer to avoid if we could, is really a valuable internal warning system.
We can see emotional pain as our guide dog rather than the “black dog of depression” which emotional pain can become if we try to press it down. Pain, physical or emotional, can lead us to pay attention to what needs help and healing in our past and present lives.
Dr. Tony Bates in conversation with Brendan O’Connor has a very interesting perspective on it.
His notes which follow are also very helpful if you prefer to read rather than listen to the clip below.
THE IMPORTANCE OF EMOTIONAL PAIN
Tony Bates| Brendan O’Connor Show
People have gotten better when it comes to taking care of their mental health (we accept that our mental health depends on our connections with people and nature and it’s more acceptable to ask for help when we need it). However, I’m not sure we’re as good at engaging with mental and emotional pain.
When we have a physical pain, we go to the doctor to find out what is causing it. When we have emotional pain, we go to the doctor and ask him or her to take away our pain.
Pain is a very important part of being human. It signals that something in our lives needs attention. However, nobody wants to be in pain, especially emotional pain. Grief can be shattering. Depression, however we understand it, is horrible. You hurt all over, you feel awful, hopeless, trapped, cut off from everything that used to matter. There is also pain in being afraid, or ashamed or full of anger.
Each of these different forms of pain throws our brain chemistry out of balance. For example, Seligman in his Learned Helplessness experiments showed that living in a prolonged stressful situation over where you have little or no control (think lockdown), lowers Dopamine levels in the brain, and impacts on several other neurotransmitters.
But let’s be clear, when someone is hurting emotionally they are caught up in a story that is much bigger than a chemical imbalance.
As with physical pain, our emotional pain is always trying to tell us something. It too is a messenger. Our pain is that part of us that is trying to tell us something in the only way it can. So rather than thinking there is something wrong with us when we get upset, we need to ask ourselves: “What’s happening here?” “Is what I’m feeling some old wound?” “Or is it someone said or did very recently”? “What is making me feel anxious and threatened right now?”
Mental and emotional pain is mostly triggered by stress or trauma in our history or by our current social circumstances. Yet when someone feels deep mental or emotional pain, we are often too ready to assume there is something wrong with them, that they have a disease, some brain abnormality. Rarely do we listen to what our pain may be trying to tell us. Rarely do we consider that our symptoms often represent our best attempt to mitigate emotional pain. For example, avoidance of specific situations in someone with an ‘anxiety disorder’ may be their best attempt to cope in a world where they don’t feel safe; the emotional ‘flatness’ (anhedonia) in someone depressed may reflect a general attempt to ‘depress’ pain inside that they haven’t been able, or allowed, to put into words; and flashbacks in someone with PTSD, may reflect the mind’s attempt to releasing some emotional pressure that builds up from suppressing painful memories.
How can we respond helpfully to our emotional pain?
Engaging with emotional pain begins with steadying ourselves and accepting that we are upset. Feelings have to be acknowledged, at least to ourselves, and be allowed to play themselves out until we understand what they are about. If we deny them or ignore them, they fester and we know no peace.
What they need is our awareness. To know that in this moment, ‘I am feeling grief’, ‘I am feeling anger’, ‘I am feeling guilty or sad or hurt or angry or frightened’. Talking to a friend can help a lot to steady us and allow us our feelings to open, when our tendency is to curl up into a tight ball and shut
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them off. But sometimes we find ourselves alone and need to know how to steady ourselves and take time to sit with how we’re feeling. We may need to talk to ourselves in a calming and reassuring way. The last thing we need is an attacking shaming voice. What helps is that we speak to ourselves in a soothing encouraging voice: “This is hard, this is very hard. But you can survive this pain and learn something important from this experience.”
Our emotional storms still have to run their course, the pain has to be felt, but that part of us that can know what we’re feeling, and choose to feel that feeling rather than run from it, that awareness itself has an independent perspective that is outside of your suffering.
When we can be aware and accept our pain, we stop fighting with ourselves. Our feelings are no longer happening to us, like an outside force; we take responsibility for what we feel, knowing that while the pain we feel is not what we would wish for, it has something important to teach us.
Awareness also helps with what we say and do in the heat of a crisis; Knowing what we feel and feel provoked to say or do - which may be understandable but not smart - can save us from saying or doing something in a moment which makes things worse.
Let me tell you a story that illustrates what I’ve been saying.
This is about a man we’ll call Tom. Tom was a very familiar face in the Dept of Psychiatry. He had had many admissions over a period of 20 years. He accumulated quite a few labels, each one sounding more ominous than the one before: paranoid schizophrenia, hallucinogenic psychosis, schizoaffective. Which meant he was a person who was very sensitive to stress and easily overwhelmed by it.
During one of his admissions, he approached me in the corridor and asked if he could join my mindfulness class. I knew a little of his history and didn’t feel very optimistic that mindfulness could help much. But he seemed very keen, his team were happy for him to do what they saw as ‘relaxation” classes so I said ‘climb aboard’. I ran 8-week courses, about 90 minutes a class. It took Tom a while to settle in. When the course was over, he asked if he could repeat it and I said ‘sure’.
Mid-way through the second course, I took him aside and asked him how things were going generally and whether he felt he was getting anything from mindfulness.
He looked at me with a strange look. Almost as though I’d offended him. He said, “Tony, I can’t believe you’re asking me this!” He detailed a number of changes that had happened since joining the course: His medications had been halved, he’d moved into independent, but supported, accommodation; he was volunteering in a local community centre, and had signed up to finally do the leaving cert. As if I needed more convincing, he told me the following story.
He had recently taken the DART from city centre to visit a friend in Bray. Sitting in one of the carriages as the train moved from one station to the next, he started worrying about all he had to do in the days ahead. He became absorbed in his thoughts and less and less aware of people around him. He described a moment where some sound, perhaps the screech of wheels on tracks, startled him. He looked up and what he saw terrified him. Some of his fellow passengers in the carriage had rays of blue light streaming from their eyes and beaming up at the ceiling.
His first instinct was to get away as fast as he could. But in that moment, he recognised what was happening. He remembered what he had learned in our mindfulness classes. He planted his feet on the floor, lowered his gaze, and focused on his breathing. He allowed the simple rhythm of his breathing to gradually steady him. After a few minutes, he spoke to himself in a kind soft way: “You’re stressed; you’re doing too much. You keep pushing yourself to do more. Your life has changed so much and so fast. You need to slow down and give your body a chance to catch up.”
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He continued to sit there with his eyes closed until the steady rhythm of his breathing calmed him down. In his own time, he opened his eyes and looked up. The carriage was still full of people, but there were no blue lights.
As we spoke about this experience, Tom emphasised this very different to how things normally went for him. “Before I learned to recognise and take care of my stress”, he said, “that story would have had a very different ending. I would have reacted to seeing lights by standing up and changing carriages at the next station. In the new carriage, everyone’s eyes would have had blue light streaming out from them. I would have jumped out of the train at the next stop and ran all the way home, because I wouldn’t trust any form of public transport. I’d have locked myself in my room, climbed under the covers, and my fears would have taken hold of me. After a few days, the community nurse would be called and I’d have been admitted to hospital. Where I would stay for up to nine months.”
Mindfulness training had been a lot more than relaxation training for Tom. It showed him how to steady himself in a crisis, to breathe and ground himself, and not run away from his distress. With awareness and kindness, he could see what was happening and talk himself down. The alternative for Tom had always been to disown his distress and project it out into the world. Whereupon, his projected pain made the world feel like a cruel and hostile place. Being able to hold his distress in awareness, to speak to himself in a kind way, allowed him to contain his pain and not allow it to contaminate the world around him.
What I would like to see happen in this month where we are thinking about mental health:
1. I’d like us to respect the importance of emotional pain. In many ways, it’s a gift. Not to feel pain would be to completely fall apart. Our pain is what prevents our life from coming apart. It’s our warning system. A friend of mine said recently he didn’t see his depression as a “black dog” anymore. He saw it as a ‘guide dog”, because listening to his pain led him to discovering who he was.
2. I would like our services to move away from asking someone in pain “What’s wrong with you?” to asking “What happened (or is happening) to you”. To listen and work with people to craft a bigger story for why they are feeling and behaving the way they are. One that fits their experience and makes sense of it. Truth, while often hard to take, speaks to the most vulnerable part of us and restores stability and dignity. Respecting our pain will direct our attention to what needs healing and resolution in our past and present lives.
3. Mental pain is a deeply personal experience, where we struggle with our worries and our fears, our sorrows and our frustrations. And while it’s important that we listen to and respond to each person’s distress in a personal way, it’s also important that we recognise this is not only a personal crisis. Many other people may be involved, in both helpful and unhelpful ways. Besides key relationships, there are key social circumstances that can trigger and maintain mental pain. One of the consequences of attributing our mental and emotional pain to a disease process in the brain is that we sideline social context. I would our services to recognise the critical role that family friends and carers play in our lives and include them in whatever intervention or recovery plan they offer that person. I’ve met too many good parents who feel very excluded and disempowered when it comes to care of their teenage sons and daughters.
4. Finally, I would like us all to acknowledge vital mental health resources in our communities. Sometimes a person needs MABS more than meds - it’s impossible to heal emotional pain with the shadow of financial debt hanging over your shoulder. Or a person may need to connect with their local men’s shed, or some group activity that encourages exercise and contact with nature. Re- connecting people back into their lives should be part of every recovery plan.
Tony Bates, 3-10-202
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The Sanctuary’s 31 Day Meditation Challenge
The Sanctuary’s 31 Day Meditation Challenge
Join us this October to embark on a challenge that will encourage your Wellbeing and Good Mental Health!
World Mental Health Day is celebrated each year on the 10th of October.
For each day of the month of October, you will receive a guided meditation that has been recorded specially by The Sanctuary’s own experienced teachers in Mindfulness and Meditation, such as Sr. Stan Kennedy, Dr Tony Bates, Jane Negrych, Mary Jennings, Niamh Bruce, Dominic Cogan, and more.
What does it entail?
The goal is to meditate every day for the month of October. That’s the only rule! You decide on the time and the place.You will receive one meditation each day during the month of October that you be able to watch, listen to and download.
go to: Sanctuary.ie
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https://www.rte.ie/radio/radio1/clips/22012318/
Clinical Psychologist Tony Bates discussed Emotional Pain today.
