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.

The Hurt Underneath

Something happened to trigger the client's rage just before group was to begin, and the client came into the group in a fury. He had enormous difficulty reporting the incident. But once the details emerged, it became clear that his angry response was out of proportion to the actual event: loudly explosive, with an energy that signaled an imminent loss of control, mere steps from actual violence. Over the years, I’ve had a lot of experience with helping angry clients, but I felt a bit anxious in the presence of such volatility, concerned about being able to insure safety while helping the client and the group manage and work through it. Nonetheless, the group helped the client regain enough control so that he was able to recognize what had happened. He spoke of feeling that “my brain is like scrambled eggs right now”—a vivid image that illustrated the level of his activation as well as his confusion and his experience of being out of control. He described his rage as “like being suddenly trapped in a space that gets smaller and smaller. I’m determined to get out and will do whatever it takes to get myself out of it.” Another client commented that “When I get angry I hurt people. I know how to hurt people; getting mad and getting violent is how I survive. I hurt them so they wouldn't hurt me, or so that they would stop hurting me. I don’t want to hurt people, but it’s what I do when I’m in that space." Yet another client said "I don’t get angry; I go right to rage. And when I’m in that place, I lose sight of all the consequences that can occur. When I think about it, it really scares me because I realize that I’m capable of anything. And then when the anger is over, I regret what I did.”

These men have all experienced rage; they have all experienced the consequences of out-of-control anger. They are slowly, painfully learning about their anger’s triggers, patterns, and nuances; and they are learning specific techniques for better managing it, without violence or negative consequences. They are learning about and trying to change their own thinking. Indeed, the group’s members are encouraged to look at their beliefs about anger while also developing new skills for managing it. And they are admitting that they are actually frightened of their anger.

But the most challenging aspect of the work centers on perceiving the connections between anger and the pain that anger can mask. The hurt underneath the anger is acute, and getting at that hurt is a slow, delicate process. The hurt underneath is a vulnerability. For most of us, acknowledging the pain, fear and vulnerability that arises in tandem with anger/rage is very difficult.

It’s all too easy to see only the anger. It’s dramatic and gets attention. The trouble is, anger is an effective means for hiding pain. Anger can be defensive. It can push people away, preventing anyone from touching what is most painful. Quite frankly, anger and rage can be scary. (The men I've quoted know just how scary they can be; they know just how frightening they appear to others, and they know how close they can come to outright violence—and most of them are afraid of themselves when they feel themselves veering toward rage; they are afraid because they often feel powerless to control their anger.) Paradoxically, what many people—the men in the group included—really want is to feel connected with others so that they can safely connect with and heal their pain. However, it’s hard to be around angry people, and most of us keep angry people at arm’s length whenever we can. And so the deeper pain remains raw and unhealed.

Anger that is out-of-proportion to its immediate cause almost always has roots in deeper conflict and pain. So too with displaced anger. Psychotherapy—both individual and group therapies--reaches for that pain and tries to help each person understand it; psychotherapy helps clients understand how pain manifests as anger, and learn how to manage anger and pain’s impact in the present. The pain can be rooted in traumatic events, unresolved conflicts, profound losses, abandonment. Identifying the hurt beneath the anger is an important step toward healing and being able to manage anger in a healthy manner. Many of the men in the group have difficulty acknowledging, much less being in touch with, the pain underneath and instead have learned to enact it—usually with terrible consequences to themselves and others. But until the hurt beneath the anger is identified and worked through, explosive, destructive anger will continue to manifest.

The group helped the client understand that the anger he was expressing was largely rooted in his past, and that the immediate trigger merely tapped into all that repressed anger. The group helped him separate the past from the present and helped him develop strategies for managing the here-and-now anger, and encouraged him to work through the older anger in individual psychotherapy. At the group’s end, he thanked his peers for helping him and expressed hope that he could continue the work that would help him “be a better man.” The group had done its job.

*Note: In order to respect and protect the confidentiality of the clients, I've omitted identifying information. I've drawn upon and condensed material that had developed over a long period of several group processes. I received permission to quote the men. As one of them said, "if my experience helps someone else, it's important to share it."