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.

Looking for that magic pill

“Isn’t there a pill that I can take to make these feelings go away?” It’s a plaint I frequently hear. The client, faced with powerful feelings, feels overwhelmed and is looking for a means—any means—of altering the feelings, making them go away. And I understand that impulse: who enjoys the experience of acute anxiety, or depression, or grief, or rage? The urge to change uncomfortable feelings is, I think, a very human one. However, I also think that strong feelings, when carefully managed, offer opportunities for insight, for creative solutions, for growth. I think that medications are not, in and of themselves, the sole means for dealing with powerful feelings. Rather, they may be part of a strategy—but usually only a part.

The search for a magic pill for managing difficult feelings has become more pronounced in the age of Prozac—one that appears to have become more urgent in recent years. While feelings of all kinds can be powerful and even seem overwhelming--especially uncomfortable feelings like anxiety, sadness, anger, and depression--they are less and less tolerated; we want to make them go away as soon as possible. Quite frankly, there are times when medications are necessary and effective. Medications provide relief when carefully prescribed and monitored. But there are other times when medications are mis-used. Sometimes the line between elevating mood and eradicating feelings is difficult to discern.

These days, though, there seems to be an increasing movement to medicate away any feeling of discomfort. Pharmaceuticals would seem to offer unlimited panaceas to all our ills, allowing us to live in worlds where there are easy solutions to life’s challenges.

It’s not that easy.

Most of us have developed beliefs about our feelings. That we label feelings as “good” or “bad” reflects some of our beliefs, as does the assessment that some feelings are more “appropriate” or “acceptable” than others. The impulse to make feelings “go away” also reflects beliefs about our relationships to our feelings (that they are alien to us and must be erased). Reaching for alcohol or a pill to alter our feelings reflects our dis-ease with some of our feelings as well as beliefs about our ability to cope with strong feelings. (And the impulse to self-medicate is an especially strong one in a culture where the chemical means to alter mood is so readily available. It’s also a tricky impulse: self-medication is a common path to addiction.)

Feelings just are. They are neither “good” nor “bad”. They rise and fall throughout the course of a day, an hour, even a minute. We don’t have much control over their existence, but we do have control over our responses to them. The trouble is, too many people respond to their feelings by trying to eradicate them instead of working through them, letting them teach us about ourselves, letting them lead us to insights and even change.

Mental health involves the ability to manage feelings. Sometimes managing feelings may require medical help. There are psychiatric conditions that are effectively managed with medications. Certain depressions, anxieties, and thought disorders respond very well to medical intervention. However, even these are usually treated most effectively with both medication and psychotherapy.

Let me be clear: there is a time and place for medications. Psychotropic medications have value and can be an enormously effective means for helping alleviate anxieties, depressions and other mental ills. Medications can be useful for helping people develop cognitive clarity, thereby supporting problem-solving efforts. However, medications by themselves do not usually lead to optimal mental health. For that, some combination of medication and psychotherapy is most effective.

In any event, I think that the question to ask yourself when reaching for a chemical solution to a difficult feeling is this: what is my intent? To erase a feeling? To develop greater clarity in my thinking? To support my growth? Talking about this with a professional might be a first step toward discerning an answer and working through to a solution.