Pathology from “Us”

Sometimes a dichotomy is a good way to understand where you stand on an issue.

Here’s one: Mental disorders are either tied up in the individual OR it is tied up in a relationship.

What’s your answer? And How would your answer to this questions affect treatment of a mental disorder? Whatever you answered, this is something we can explore at some later time when we are together.

All I can say is that for your answer to matter in our relationship there has to be an “us”. I believe that mental dis-order is tied up in the relationship. We do not exist by ourselves. Even when we physically do, we end up with an inner dialogue. So, the answer for me is always going to include an other; specifically an other and myself; an “us”. That is my premise for treatment of mental dis-order: Treat the “us”.

The “how to” in treating the “us’s” in our lives, surprisingly enough, occurs with many of the same skills we tried to figure out starting as early as 5 years old:

  1. Share.
  2. Forgive.
  3. Apologize.
  4. How to handle when not everybody’s gonna want to play with you.
  5. Feelings are not bad, what we do with them can be harmful.
  6. Tell someone you trust about how your feelings got hurt.
  7. Tell the person that hurt you to stop doing what they are doing — learn to say no.
  8. Request that the person treats you differently.
  9. Learn what to do with yourself when they refuse to treat you as you request.

Chances are you can think of at least one place in this line of lessons that catches you in a bad way. The result of the painful stuck-ness we experience in any of these categories can be labeled clinical depression, anxiety, PTSD, etc. Whatever people call it, it hurts.

Pain is opportunity. Pain is growth. Pain is telling us to do, think, or be differently. However, the natural response to pain is typically banishment, avoidance, and numbing. It is less typically taken as an opportunity to learn and become something more. This is what I hope my therapy trains you to do. To express your pain. All of it. Then learn something from each pain and become something greater for it. The truth that I traumatically have learned over and over again is that there is no option of life-without-pain. There is only one version of life, and it comes with pain. Because life has no “pain free” mode, it is an imperative that we learn to do something with it. Expect pain, use it as an opportunity to learn, and you will increase your trauma recoil.

In the work I have done with adolescents over the years I am reminded session after session of the choices we are presented with: “Which pain do you want?”, I continue, “Do you want the pain you currently have? Or a different one? Can your pain be any worse? If you know it can’t feel worse than wanting to die everyday, what risk do you have in telling [person] _____________________ [insert massive insecurity here].” The pains that kill are the known, unexpressed, un-purposed, unaccepted and uninterpreted pains. It is important to know emotional pain in two main categories: the “killers” and the “requesters”. Pain that is accepted, interpreted, purposed, expressed and utilized as a mentor is a pain that requests change of us — a lesson on the path to unknown future pains. While great difficulty is experienced with this pain, it is possible to live with. Though it may remain present for our entire lives, we watch it become less intense or at least change in its function. Pain that is known, unexpressed, un-purposed, unaccepted, uninterpreted, and seen as the source of suffering is the pain that kills us.

We all will die. In the meantime, love others and educate people on how to love you. If you cannot recognize and understand when you feel loved, you won’t be able to seek that out. And if you are unable to seek that out, you may come to only know hurt. This will lead to death — either an ending of physical life or the kind of decay where you continue to live without purpose.

The conversation in therapy usually starts with how someone in your life needs to stop doing or saying things that hurt you. People do hurt us. However, usually focusing on those people isn’t what allows you to find the people that heal you. I am okay starting with that conversation, but I want to also talk about: how you can teach someone to start doing or saying things that heal you, how to set boundaries that will cut out those who hurt us and include the people that can heal us, and then how you being able to do this will allow others the same opportunities. My goal in therapy is to heal all the hurt us’s out there and that work starts with you and I.

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