Hungry for Connection

Over the course of the past several months, I’ve written about self-medication—medicating those uncomfortable feelings that arise in response to life’s challenges. One of the feelings that often arises in psychotherapy, especially in the treatment of depression, is the feeling of emptiness. However, when I ask clients to try to describe their experiences of emptiness, their responses often reflect very different feeling states: numbness, the feeling of being overwhelmed, helplessness, paralysis. Indeed more often than not, the emptiness clients describe is not the absence of feeling. Rather, it is often quite the opposite: at its core, it is a painful hunger for emotional connection and nourishment. Emptiness signals a desire that has been subverted. Responses to emptiness, emotional hunger or deprivation can take many dysfunctional--even destructive--forms: addictions, compulsive behaviors (i.e., compulsive shopping or spending, gambling, compulsive sexual behaviors). Indeed, people with addiction often struggle with acute feelings of hungry emptiness—using substances or other compulsive behaviors to sate the hunger. Unfortunately, filling the emptiness with substances or compulsive behaviors usually fails because the substances (or compulsive behaviors) are poor substitutes for nourishing emotional connections. Indeed, there are never enough drugs (or alcohol, or sex, or money, or material goods) to satisfy the hunger.

The themes of emotional abundance and deprivation thread through psychotherapy sessions. Early family experiences with emotional deprivation reverberate throughout our lives, coloring our experiences of ourselves, our relationships, and the world. How our basic emotional needs were met (or not met) in early childhood form us and inform our beliefs about ourselves, our relationships, and our world. These beliefs are largely unconscious, but exert a powerfully out-sized influence on how we live. These unconscious dynamics inform the decisions we make for ourselves and drive a great deal of our behavior.

Moreover, the experience of deprivation brought about by prolonged confinements, profound losses, isolating illnesses, and other traumas magnifies the experiences of hungry emptiness, especially when the trauma puts you is in a position of having to actively suppress or repress your needs. When these experiences are coupled with earlier experiences of deprivation, the hunger--the need--can seem overwhelming.

One of the goals of therapeutic work is to identify and address unmet emotional needs--those gnawing hungers, the emptiness, the sense of deprivation. And as work on those issues progresses, other issues related to the theme of emotional deprivation emerge. Indeed, a question that will eventually arise: “what will be enough?” What emotional nourishment do I need that will ameliorate the pangs of hunger? How much emotional nourishment do I need? Will the nourishment I receive today be enough? Obviously, figuring out how to meet one’s emotional needs is also important, but the question of adequacy is one that also comes into focus.

Seeking emotional sustenance is really the whole of therapeutic work. And meaningful answers to these questions will vary from person to person and will probably emerge only over a long period of time.

It seems reasonable to start with the here-and-now. What can I do to meet my needs today? What will it look like to have my emotional needs met? How will it feel to have my needs met? To whom do I turn to meet my needs? Who do I trust with my needs? How can I meet my needs without engaging in an addictive or compulsive behavior, without getting hurt or without being betrayed? How can I manage when my needs are not met?

However at some point, the therapeutic work must turn to the past, looking at the origins of the addictive/compulsive behaviors and the feelings of emptiness/hunger that drive them. Approaching the search for origins with curiosity with a therapist can yield surprising insights, lead to the ability to accept your emotional needs, and even find new ways of addressing and satisfying them. Indeed, the connections made in therapy with the therapist and with yourself may open paths on to new connections that sate those hungers.

Medicating Feelings

“I can't stand all this stress. I just want these feelings to go away.” And so, he typically pours himself a double martini and downs Valium (or two) in an attempt to make them go away. The trouble is the feelings don’t actually disappear; they just become alcohol-soaked and distorted.

It doesn’t have to be alcohol, though. There are as many ways to medicate away emotions as there are people. Some people drink; others use marijuana, cocaine, Oxycontin, Xanax, or some combination thereof. Still others eat their feelings, using food to find comfort. Sex can be another means for medicating feelings, as can gambling, watching TV, looking at pornography, playing video games or surfing the Internet for hours and hours.

Medicating uncomfortable emotions—making them “go away”—is a fairly common means of coping. It’s a quick “fix”. Unfortunately, self-medication does not offer viable, permanent resolution to the stressors of life. And in fact, self-medication often creates additional problems, addiction being most prominent.

I realize I've written about self-medication before (see Looking for that Magic Pill). However, the impulse to medicate away feelings through a variety of means is a common theme in my practice, one that clients return to again and again. And so, I return to it here.

We tend to make judgments about our feelings, deeming them “good” or “bad”, trying to exorcise them with “shoulds” and “oughts”, and sometimes developing habits designed to alter them. Uncomfortable feelings—pain, loneliness, anger, grief, anxiety, sadness, shame, guilt—are judged with special harshness and severity; they are the emotions we most want to be rid of and they are the emotions around which habitual self-medicating behaviors are likely to develop.

Significantly, we also develop beliefs about our feelings and self-medicating behaviors:

“It is not OK to feel certain feelings. My feelings are bigger than me and can destroy me. I’m not competent enough to cope with strong feelings and therefore need something to help me. I don’t have enough strength to manage. If I don’t immediately do or take something, I will be in the grips of this feeling forever.”

Or, "if it feels good, it must be OK."

These beliefs are often reinforced when we self-medicate. Habitually reaching for alcohol, turning on the television, surfing the web for internet pornography (or however we try to alter our emotional state) to escape or alter feelings has a subtle, but powerful, impact on how we think about and experience ourselves: our perceptions about ourselves and our thinking becomes distorted. We begin to believe that the power to cope, the power to soothe ourselves rests outside us. We begin to believe “I am not enough. I am inadequate.” On a deep level, we identify with powerlessness.

Self-medication—whatever form it takes, however it is done—often impedes our ability to live fully. It is a common path to addiction.

(A word about prescribed medications. There are psychiatric and medical conditions that necessitate the prescription of medications. These medications have a particular purpose and are typically monitored by psychiatrists, physicians, or other licensed medical professionals. These medications are meant to help regulate body and brain function and are not meant to eliminate emotional states. While these medications take the edge off anxieties and depressions, they are tools that support behavioral change and emotional coping. These medications are not prescribed to take away feelings.)

Feelings are part of life. Feelings give human life texture, color, and shading. Most of the time, we are not fully aware of our feelings. It is usually only when our feelings are strong that they command our attention. Nonetheless, feelings are in constant flux: they come and go, rising and falling naturally throughout the course of the day. Feelings do not last forever.

Feelings can be great teachers. However, they can only teach us if we are willing to be present with them, pay attention, and cultivate curiosity about them. Much of psychotherapy’s work centers on attending to the landscape of our feelings: learning about their nuances, discerning the pathways feelings travel, discerning relationships among feelings, and developing insights about them--insights that can transform our lives. Psychotherapy will also address the patterns of self-medication. Indeed, understanding those patterns can open a door onto the deeper feelings that are otherwise hidden, suppressed or distorted by self-medication.

Many people enter psychotherapy hoping that the therapist will “make the feelings go away.” Those seeking a quick “fix” will surely be disappointed. (Even prescribed psychotropic medications take time to begin working. There is no magic pill.) But those willing invest the time and energy to cultivate curiosity about their feelings will find their efforts rewarded with lives fully experienced.

Psychotherapy offers alternatives to self-medication. Therapy can help you learn to accept feelings and help you manage their rising and ebbing. Therapy can help you develop perspective on feelings and develop new beliefs about them. And therapy can help you develop insight into your feelings—insights that can eventually transform your life.