It's called a breakthrough, not a breakaround

I have heard this often when a person in emotional pain is sitting across from me in a session:

“I hope you have a magic wand that can make my pain go away.”

I wish it was that simple. I wish I could get into people’s heads and make their distressing thoughts, feelings, memories, urges, impulses go away. The fact of the matter is I can’t. No one can. Not even them. We like to believe that we have control over our thoughts and feelings, but we don’t, at least not enough; and the sooner we realize it the better.

We can distract ourselves with music, and breathing exercises, food, walks or runs, or alcohol and other substances, even work, or whatever else you engage in to suppress or avoid those painful thoughts, feelings, memories, but they will come back with a vengeance. It’s like trying to push a plastic ball beneath the surface of the water. Your hand will eventually tire itself out, and the moment you let go of your hold, the ball bounces right back up, maybe higher than ever before.

And in a culture which extols “busy-ness,” where we are told “not to think about stressors,” “look on the brighter side,” “think positive,” “try and control yourself—the way you think and feel and behave,” “move away from the pain,”  you might even experience short-term benefits such as relief from sadness or anxiety. But then I ask this: “Is your pain less or more since you started using those strategies?”

What ends up happening as the days, weeks, and months go by as we struggle with the pain is that we may start becoming high functioning “depressives.” On the surface, we appear to have everything “sorted” with our lives to an observer’s eye, but within we are silently screaming through our psychological suffering.

So, back to that magic wand which people expect of me or any other mental health professional, I am taken back to something another person I worked with in therapy had said in our closing session.

“Sometimes I think depression is like cancer. There’s no one quick-fix. You can only tackle it with a multi-pronged approach. It takes time, the commitment to stay the course, and a supportive ecosystem in addition to a therapeutic approach that is tailored to each individual. And above all, never losing sight of a purpose in life, regardless of the obstacles. ”

Recovery from any psychological suffering, whether one that you struggle with as an individual or one that appears as conflicts and strains between family members, requires learning to understand what it is about in the first place. What are the bottlenecks that exist in the way of us leading a rich, meaningful life? What are the signs and symptoms of the suffering and what are some antecedent events (situations or events, and resulting thoughts and feelings) that may have preceded the onset of the symptoms? These are imperative so that we have a better understanding of what the recurrent triggers and themes are that may emerge as a result.

Let me illustrate this with an example that happened in a conversation with Ami (name changed) today.

Caught in the intense grip of her grief—across a journey that went from the diagnosis of her husband’s terminal illness to losing him a few months later—Ami was deeply distressed and had intrusive thoughts of self-harm. Whenever she would see a set of kitchen knives, or a box of matches, she would want to use them on herself. But she had a child to take care of, so the thing she did was to clear her home of objects that she could use to harm herself.

Ami reached out for therapy 8 years after her husband’s demise. Over the course of a few sessions, we reached an understanding that she was experiencing Persistent Complex Bereavement Disorder.

Over the next few months, Ami worked through her grief, and not around it.

In numerous ways she would seek not to suppress or distract herself from the pain and the memories. And her symptoms of anxiety and depression started abating and her overall sense of well-being started to increase.

Today she wanted to come clean, break with the demons of the past. She shared her discomfort even now around when she chops vegetables or lights a lamp. The painful memories of the past, and the fears around it return, and while she is able to let them go, there still is an iota of “fear” left from the shadows of that past.

“I know I am in a much better space than I was 8 years ago. I know I am much stronger mentally and emotionally. I don’t even know if it makes any sense to talk about it, but it helps to just drop this here with you and to hear what you think about this,” Ami told me.

Ami has shared a lot over the months, as and when she has been comfortable. Some memories have been painful, some have taken immense courage to bring up, and after making space for her pain and grief, she has embraced her fears. This is the part where the healing begins to occur; when the perspectives shift, when the light starts shining in the darkness, and when one begins to do the real work in therapy, on a path of self-discovery, one which includes understanding aspects of the self and taking responsibility for one’s own healing.

From that same past, Ami had also developed an intense fear of doctors and hospitals and would do whatever she could to avoid going for a health check-up. On her husband’s death anniversary this year, she decided to brace her fears and went to the hospital where she had spent several months taking care of her husband and where he eventually passed on. She walked past the nursing station, stood by the door of his former room, spent hours there till she felt she was able enough to confront her fears without the anxiety and the panic arising. Ami mindfully walked the hallways, and when she came home, she messaged me that she had taken this big step. Her daughter was a huge support for her throughout: the ecosystem that truly makes a difference.

In confronting her past, Ami reinforced a fundamental lesson.

Fear makes us avoid triggers, makes us feel incapacitated in the grip of the anxiety that ensues, and further makes us feel guilty and angry about why we feel this way.

But when you look at fear in the eye, it realizes it’s lost the battle and whimpers away.

You just have to learn to make your faith and belief in yourself bigger, and you take that one step towards fortifying yourself.

Ami started stepping out of the shadows of her grief and anxiety, and realized there was a world waiting for her; the one she had wanted to build but never got down to doing: of getting back to work and enjoying it, of reclaiming her emotional and physical health, of redoing her home, building a garden, and getting back to her favorite hobbies of embroidery and textile painting, and a whole lot more that she wanted from life and was working towards.

The knives and matchboxes awaited next, and she willfully took that challenge on. I will know the progress in our next session.

I reflected on Ami’s journey after we ended our call today and realized how telling that parallel between depression and cancer is.

We can’t wish it away, there is no quick fix, you may need more than one resource person to help you through, a therapist who can customize their approaches to suit your needs and requirements. It takes willingness to walk the talk, to endure the pain that comes along, the commitment to stay the course across time, sometimes a multi-pronged approach, and, yes, it takes a supportive ecosystem.

But above all, whatever the suffering may be, what’s important is never losing sight of a life that brings richness and meaning, regardless of the obstacles that may be hurled at you. However difficult the path may seem, when your internal world is able to brave the emotional storm, and you don’t wish away pain or crumble under it, or hide from it, but see it as a part of life, you learn to anchor yourself to stay steady. And that’s when you realize what you’re truly made up of.

This breakthrough transforms you within.

Freedom is...when you have nothing left to lose*

Freedom.

Of the many nuanced and insightful concepts I encounter in my work as a psychotherapist, freedom has so many different meanings and shades. It evokes so many emotions and feelings…sadness, joy, fear, exhilaration, excitement, optimism, hopefulness, strength, resignation. It all depends on the person seeking that freedom for him- or herself.

“Dear Divya, I read your email several times over this week since our session. I agree with your pointers, about not clouding my mind with expectations and wishful thinking from my spouse. It’s these expectations that have led to so much disappointment and sadness in these past few months. I have tried communicating from my heart but it falls on deaf ears. I realize I need to focus on what I can take charge of and I have started doing that. This self-care work is difficult, to be honest, but if I don’t take care of myself, and if I don’t shower myself with love then I will be stuck in this loop of wanting and expecting from others. Thank you for pointing me in that direction. The work has started. ”

I reflected on this email from a wonderful, kind person I work with in psychotherapy. I was taken back to my own fleeting feelings of sadness from two weeks ago, when I felt the lack of support from loved ones in the moments that grief ripped me from inside yet again. Most of us have felt let down by family and friends, people who are supposed to care and be there, who  sometimes are so far removed from the goings and comings in your life, where the chasm is so wide that you wouldn’t even know where to start. That’s when the loneliness and separation fester. I made note of these feelings and let go.

“Dear Ma’am, the sadness engulfed me. I woke up sad, I was sad throughout the day. It’s been twenty years with this crippling feeling of being numb and lost. I feel worthless, useless, a failure. Countless years of antidepressants and several therapy sessions with several people, and I am still stuck. You are the fifth therapist I am reaching out to. I want freedom from this suffering. Where do I start yet again?”

And so the list goes on…I want freedom from:

- My panic attacks
- The misery inflicted by my in-laws, my parents, my friend, my lover, my boss, my…
- My distress inducing thoughts and the loop they get into
- The sadness caused by failed expectations.
- The way I self-deprecate, judge myself so harshly
- My heart ache
- These suicidal thoughts and impulses
- The pain caused by emotional attachments
- My anger/guilt/resentment/failures
- My failed relationship (s)
- My addictive behavior patterns
- (Whatever else you can think you want freedom from)

These are the reasons people have reached out for over and above “I just want to be happy.”

When you think about it, the very definition of freedom is simple: the absence of things that constrain us. So how do I approach the concept of freedom in my work with my clients?

Our initial conversations steer towards bringing about a sense of emotional regulation first, and then onto our inherent search for what brings meaning to our lives. Questions like “What really matters to you, deep in your heart?” “What do you want to do with your time on the planet?” “What sort of person do you envision yourself to be, and would like to strive towards?” “What personal strengths and qualities do you want to develop?”

I take stock of how many of these individuals struggle with low self-worth, a low self-esteem. I usually don’t call it out because they don’t need anyone else saying what’s “wrong” with them. Empathy, kindness, compassion, authentic presence are far more healing.

I ask for their strengths and victories, and that’s when it gets interesting.

Because I get blank looks.

“I never thought of those.”

Failures, mistakes,  regrets, guilt, resentment make it to the list of top things one is grappling with. Strengths don’t even make the cut! And when our relationships with the people around us and the world are flailing, we further fall into the depths of despair.

“Everything can be taken from a man but one thing: the last of the human freedoms—to choose one’s attitude in any given set of circumstances, to choose one’s own way.”

Viktor Frankl said it right in his 1946 book “A Man’s Search for Meaning” where, as a prisoner in the Nazi concentration camps during World War II, he chronicled his experiences. He spoke of hope, and identifying a purpose to live, which would be used as a guide post to survive the atrocities they experienced.

Purpose. Meaning. Happiness. Inner potential. Choice.

What do these even mean? I love having these conversations with people in my sessions because that is where they start shifting the focus from the suffering caused by external situations to what truly matters and how they can take charge of their own selves.

We often talk about “treating” depression, those panic attacks, overcoming those fears. For most people their therapeutic journey may stop there. They are emotionally feeling fine, the situation causing the distress is resolved, and they go back to living life as they know it, as it existed before the episode came by.

But what if there was more to life than just living? What if life can be lived well, authentically, like a spring that just flows effortlessly, around the stones, and the rocks, gurgling along, mindfully? This is where the real work starts and my constant hope is that people would give themselves the opportunity to get to know themselves better.

But how can we know where to go and how will we know if we’re heading in the right direction?

The North Star doesn’t appear to move around the sky like the other stars do. It seems like a fixed point, one which mariners and navigators use to find out which way they are headed. We all have a North Star within us, which translates into the realization of our potential for happiness. And once we know what that purpose is, however much we may fall by the wayside, if our sight is set on our own North Star, we will get back on course.

Supriya (name changed) experienced multiple panic attacks in a day to the point that she would cry in frustration because she felt so out of control, which further led to her feeling clinically depressed. She expressed an intent to harm herself because she was exhausted and tired of the struggle within. Medications were suggested by previous clinicians which she refused. As incapacitated as she felt though, she reached out to me and started talking about leading a life which was not connected to her own true, authentic self. She had a history of complex childhood trauma, her marriage was on the rocks, she was feeling stuck in an unfulfilling job which didn’t tap into her creativity and she really wanted to start her own work. Life as she knew it seemed like drudgery.

So how did she start the process of self-discovery, about what truly mattered, what was important to her life? It began with her observing where the vitality was draining and where it was surging, identifying pathways that would move her closer to the way she wanted to be and live, and having her commit to walking the path. The next step was to show her sense of personal agency, that she was her own best change agent.

Developing resilience along the way, creating a self-care toolkit, recognizing and working through the several thoughts and feelings we would often “hook” onto and be tugged and pushed and jostled around wildly, and gently “unhooking” to return to a sense of equilibrium and presence were helpers along the way. As the journey went on, her panic attacks started disappearing and her mood was lifting. We often focus on these as the treating points, but in my observation, these are the symptoms of a larger cause.

It starts, as I said earlier, with focusing on finding a purpose. But as much as singular purpose is the presence of a mindful awareness of what matters, it is also freedom—or the absence of all that actually doesn’t matter.

I had started this post talking about “freedom.” We seek it, we want it from the outside in, but did you ever realize, that the source is you, the receiver is you, and the sooner we take ownership of our own selves, the sooner we can feel liberated?  

If only we loved ourselves more than just giving in to others and expecting them to love us in return. If only we honored ourselves more, stood up for what we believe in, operated from our core authentically. If we spent more time getting to know ourselves, the good, the bad, the ugly and what it would take to live a life of meaning and purpose, we would know what a transformation of the mind, and a healed, happy heart looks like.

Free from what gnaws at us from outside and inside. Filled with meaning and purpose.

“Difficult,” “Impossible,” “But what’s the point of being in close relationships if you can’t have expectations?” “Are you suggesting we live like an island?” are questions I get asked incredulously. And on the journey we discover the answers to exactly these questions, because in the end we all embrace the fact that only we can create our own peace of mind, and walk our own path resolutely.

PS: * The title of the post is modified from a lyric of a song “Freedom’s just another word for when you have nothing left to lose” written by American singer-songwriter Kris Kristofferson. The name of the song is “Me & Bobby McGee.”