Treating emotional disorders
Treatment for mental illness is a paradox. You must have more of your emotion before you have less of it and you must do it in the right way. The answer to mental suffering is curiosity and compassion.
Mental illness is the only type of illness where you go to the doctor to get relief from a symptom and your doctor prescribes you more of that symptom. It doesn’t make sense. It’s reasonable to be confused and frustrated about your treatment plan and your treatment progress. Let’s talk more about this paradox.
You typically see a medical professional for structural disorders caused by pathology or injury. You need penicillin for an infection and a cast when you break your arm. Your eye doctor will prescribe you glasses as your eyesight declines; your dentist will give you a root canal for a decaying tooth. You are vulnerable to the effectiveness of your doctor, because something is wrong and someone else needs to fix it.
Treatment for emotional disorders involves some important differences.
The first difference is that the experience of anxiety or any other painful feeling is not a structural problem caused by pathology. You don’t have an infection that we can treat with medication. In fact, medication that completely sedates your capacity for emotion would be problematic for you, because it would also sedate all of your other feelings. The appropriate role of medication for emotional disorders is to decrease your sensitization enough to give you the chance to slow down and turn towards your own experience. If you are so overwhelmed by your symptoms that you don’t have the psychological resources to try something different, medication can support you and give you more access to your innate psychological resources.
The second difference is that the experience of anxiety or another painful emotion is not a structural issue caused by an injury. You didn’t break your legs or teeth. There might be a traumatic injury (such as a car accident, chronic lack of emotional attunement in childhood, or a terrifying panic attack) in your past, but talking about that narrative doesn’t fix the distress you have about it in the way a root canal fixes a tooth.
The third difference is that we cannot fix the way your anxiety operates the way a physician sets a broken bone. What maintains suffering long after trauma or bewilderment occurs is the way you respond to it. The role that we play is to help you observe the subtlety of that response pattern and motivate you with curiosity, compassion, and humor to try something different.
What we have in common with other medical professionals is our thinking about blame. A good physician doesn’t blame you for vomiting when you have the flu; I don’t believe that how you respond to your emotion is your fault. In fact, the way you responded and continue to respond was and is your best option at that moment. For instance, if it was actually unsafe for you to be vulnerable about your feelings with your parents while you were growing up, it’s completely reasonable for your system to feel uneasy and anxious when you try to be vulnerable with new people now. What used to be a threat is no longer a threat. It takes a lot of self-awareness and self-compassion to shift the way your mind and brain reacts to something that still seems like a threat. If, in the present moment, despite intellectual awareness of the patterns that maintain your anxiety, you still have trouble doing something different, I assume there is a stuck point we haven’t discovered yet.
What this means for the treatment of emotional disorders is that we have to work together to intentionally create circumstances that trigger your emotion with an attitude of curiosity and compassion, so that we can observe what’s happening and figure out the stuck points.
We need to give you the opportunity and practice feeling something uncomfortable, deciding whether it is a threat, and then proceeding with confidence in your decision.
We want you to expose yourself to emotion to learn how to love yourself, not to make it go away.