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.

Bad News

It’s been a week of bad news. A woman with newly diagnosed lung cancer. A man who learned that the Interferon treatment for Hepatitis is not working and will be discontinued. A man who was turned down for a much-needed job and is starting the job search process all over again, after having been unemployed for nine months. A woman who learned that she is losing her job. A man who’s wife decided to leave him. A man whose parents were suddenly killed in a car accident in the Mid-West.

Each of these people is experiencing unspeakable pain: loss, threat of death, anxiety, loneliness, a new awareness that the future is limited, angry helplessness, a sense that “I’m not in control anymore.”

I’m often asked, “what do you say when someone shares bad news with you?” Indeed, what do I say to someone in enormous pain? What does anyone say?

I think that the question is a bit misdirected and signals a helpless anxiety many of us experience when we are faced with painful life events. But are we being asked to say or do anything?

Most of us, when hearing the bad news another is sharing, feel an impulse to rescue, to somehow find the words that will make the teller (and the listener) feel better, or to make the situation better. The impulse is a very human one, and is understandable: we identify with the other person and sympathize with their feelings. We feel helpless ourselves and finding a means for “making it better” enables us to feel less helpless and, by extension, less anxious. And while we may end up feeling better, the other person is often left with the painful feelings.

What, in fact, is being asked of us?

When people share their bad news with us, they usually are not asking us to solve their problem, or even to make the pain go away. On a fundamental level, they know that what they are facing is not a problem to be solved but a life event that must be gone through. They want to know and feel that they are connected and are valued; they want to know and feel that they matter, that their lives and their experiences have meaning—even though the meaning may not be clear and may never be clear. They want to be seen, and they want their stories to be heard.

And so, when people share their experiences of pain and uncertainty, I think that they are asking us to simply be with them. We are being asked to listen, to bear witness to the unexpected in their lives. We are being asked to hold them—sometimes in the physical sense, but more often in a figurative sense: we are being asked to be with them as they feel their feelings. We are being asked to have a relationship with them that can expand to include the unknown. We are being asked to intimacy. (A very dear Buddhist friend recently reminded me that “Not knowing IS intimacy.)

Not everyone can tolerate intimacy. Not everyone can tolerate not knowing. Not everyone can listen without rescuing the other from their pain. In fact, most people can’t. But listening in a deeply intimate way—one that does not provide answers but that invites exploration that may lead to answers—is the essence of psychotherapy. It involves meeting you in the intimate place of not knowing—of not having an answer—and being willing to help you live into that space so that meaning—and even hope—may be created. Psychotherapy can provide the space where painful feelings can be felt—without judgment, without changing them, without “making them go away.” Eventually, psychotherapy may help you come to terms with the bad news and the feelings that arise.

Sometimes there are no comforting words. But there can always be a comforting presence. Bad news reminds us that we need each other, that we need relationships. And while our presence won’t prevent bad things from happening, it can certainly help those we care about move through them. Our presence is all that is asked.