10 Jan

A Therapist’s View Of Human Suffering

“We are the hollow men
We are the stuffed men
Leaning together
Headpiece filled with straw. Alas!Shape without form, shade without colour
Paralyzed force, gesture without motion;…”
(“The Hollow Men”, T.S. Elliot)

Across the years of offering psychotherapy  with thousands of patients, I have been continuously struck by one remarkable and puzzling phenomenon. Almost without exception, psychotherapy patients seem to have tremendous difficulty in presenting the subjective experiences associated with their reported problems.

For example, they might say they are sad, but they smile; they say they are angry but they cry. At first glance, this may seem to suggest an intentional hiding or distorting of what they actually feel, a willful attempt to disguise or hold back.

In fact, this is not the case.

Let me try to clarify.

At the start, most patients are eager and willing to “talk” about their problems: their careers, their spouses, or whatever else they feel is causing distress in their lives. With a little encouragement most are also willing to “describe” their feelings surrounding these events; “I feel depressed”, “I feel angry”.

But these same people are very cautious and even reluctant to allow these experiences to actually manifest in our sessions (i.e. they say they are angry but they appear very calm). And sometimes, when feelings actually do surface they are often not congruent with what the patient described (i.e. they say they are angry and smile at me.)

But why should this happen? Why should a person who may have been suffering for many years have such difficulty in actually allowing that suffering to be present during our sessions? And why, when certain emotions do show through, do so many patients seem embarrassed or anxious, as though something slipped out that wasn’t supposed to.

This apparent difficulty and reluctance in presenting more than a superficial amount of one’s subjective experience to another is not an uncommon phenomenon, and is certainly not restricted to the interaction between therapist and patient. Rather, it seems to me quite clearly a “normal” quality of social life, an accepted and expected part of our day to day interactions.

Ask someone, anyone, how they truly and deeply feel about themselves, or their partner, their parents, or you, and see what happens. Not far beyond the simple explanations, the pat answers and the clichés, there seems to be an amazingly sensitive and protected area of subjective reality; a restricted access zone seldom offered to anyone.

The significance of this issue is not simply that we are careful about letting anyone get too close to us. Rather, it is that we are remarkably uncomfortable about even letting ourselves get too close to us. As strange as this may sound, clinical and personal observation confirms that we are basically and fundamentally uncomfortable with , if not afraid of ourselves; with precisely those experiences that centrally define what it means to be ourself.

In truth we don’t know what we really feel because we won’t allow ourselves to feel it. We don’t show this to another because we can’t.

Depending on your relationship to your own subjective reality this observation may seem puzzling, perhaps even inconsequential. But it is not. Consider this following observation by Rollo May, a psychoanalyst in New York City, who defines the chief problem of people in the 20th century as “emptiness”. As he describes it,

not only do many people not know what they want, they often do not have any clear idea of what they feel. When they talk about their lack of autonomy or lament their inability to make decisions, it soon becomes apparent that their underlying problem is that they have no definite idea of their own desires or wants. Thus they feel swayed this way and that, with painful feelings of powerlessness, because they feel vacuous, empty”.

Indeed, the significance of this phenomenon has been recognized, discussed, and debated for hundreds of years by every major thinker of the human condition from Kierkegaard, to Rank, Jung, Freud, and Maslow, as each has attempted to explain this curious and remarkable fact.

The real world significance of this issue is far reaching. Regardless of whether we are talking about personality disorders, depression, anxiety, physical illness, domestic violence, or social unrest, there is always some connection back again to this central aspect of the human condition. Call it alienation, existential anxiety, repression, disassociation, emptiness, or any other term that points in this direction. The failure to recognize and deal with the fact that we are all strangers to ourselves, and by extension,  with others, has lead to immense human suffering. This is a remarkably complex subject requiring considerable clarification. In subsequent issues I will present some of these ideas in more detail.

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