Category Archives: General Interest

Suicide -Wounds that Don’t Heal

Suicide is the single most self destuctive act. It means that all the attachments in the person’s life have not been enough to contain their hopelessness, rage and despair. 

People become alone and isolated internally.  They may be angry with those around them who they could not connect with. More often, they feel hopeless-unable to see past their present issues. The sense of self value hits a new low. Thoughts such as, ‘I am better off dead’, ‘my family will benefit from my insurance’, ‘I really don’t matter’, ‘they will know how low I was feeling’…..

Then a prevailing depression hits a new low – a sense of uselessness, the pain of not being connected with is turned on themselves…..taking action against the low and depressed feelings feels empowering. So, planning their suicide becomes an empowering experience against the experience of prevailing hopelessness and not being of any value.

A perceived rejection, unfair and cruel acts done towards them can all be reasons to kill oneself. The suicide can be saying, ‘you misjudged me’ ‘you thought I was making it up’. In any suicide case, it is clear that the person did not feel there was hope in life and they did not see any way to go on.

Freud and Klein explored the idea of the death instinct which opposes the life instinct. Death instinct produces sabotaging tendencies and if left unchecked, the person withdraws from the external world because it is too much to bear. The underlying psychology would be something like, ‘I will rest in peace…I won’t have to struggle anymore’. ‘Others will be benefit from my passing…they won’t have to deal with my poorly self’. Here you can see how hopeless it has been-the person has felt hopeless and is projecting it onto others. They are probably also not feeling they can be helped.

Our relationships anchor us to this life and this world. Relationships that are attuned and able to touch the deeper core of strong emotions within us, keep the channels of communication open and reduce the chances of strong fixations taking hold. The life instinct becomes paramount and manifests in good relationships, creative hobbies and pursuits.

For the suicidal person, somewhere, connection has been lost and paranoid-schizoid feelings dominate. People become deeply disturbed, suspicious and angry with their near and dear ones. These are not necessarily people who are physically alone. They experience loneliness even among others.

They do not feel understood. Their anguish remains a silent scream inside – full of anger and resentment.

Others seem to forgive everyone around them before dying, passing on their mixed feelings to those who survive them.

The thought of ending the anger and loss they are feeling becomes paramount. It becomes an ideal, a fixation.

Grandiose thoughts of how their death will finally get them the attention and empathy they lack are some of the compensatory phantasies.

Broadly, there are two kinds of suicidal people – the first may attempt it a number of times and learn to use it to get the attention they sorely need for their deep psychic wounds.

With the other type, they have made up their minds that they are going and it is a secret. A powerful one.

Depression-Not so Blue ?

The predominant medical view is that depression is a mental disorder and anti depressants and psychotherapy maybe prescribed to manage it.

Depression is characterised by sad mood, the inability to derive pleasure from activities such as seating or sex, and changes in psychomotor, sleeping, and eating patterns.

This may sound all doom and gloom but research is re-evaluating depression and asking some important questions. The unusually large numbers of people who now get diagnosed with depression leads to the question whether it is not a bit of over-diagnosis and can we step away from resorting to medication where possible.

Therapy seems to be a more healthy alternative and can be a good space to take inner rumination to, avoiding too much isolation.

According to an article in the American Psychological Review (2009) ‘The bright side of being blue: Depression as an Adaptation for Analyzing Complex Problems’, the authors (P.Andrews and A. Thomson Jr ) suggest that depression maybe a natural response to help an individual avoid outside stimulus and apply his/her mind to resolving complex inner problems.

They say, ‘Depression is the primary emotional condition for which help is sought. Depressed people often report persistent rumination, which involves analysis, and complex social problems in their lives.

Depressed people may withdraw into an internal state of preoccupation where they seem to ruminate. They may slowly isolate from others and insulate themselves from the outside world.

According to the article, ‘Analysis is often a useful approach for solving complex problems, but it requires slow, sustained processing, so disruption would interfere with problem solving.

The analytical rumination hypothesis proposes that depression is an evolved response to complex problems, whose function is to minimise disruption and sustain analysis of those problems by (a) giving the triggering problem prioritised access to processing resources, (b) reducing the desire to engage in distracting activities (anhedonia), and (c) producing psychomotor changes that reduce exposure to distracting stimuli.

In other words, the authors suggest that a certain amount of preoccupation and privacy may be required to think about and resolve life’s complex problems, whether it is at the workplace or in domestic life.

As a society we have ensured that workplace meetings be relatively without interruptions and have maximum privacy. This is to encourage a more focused and deeper thinking about workplace issues by avoiding all other distractions.

However, popular ideas which dictate how social and family life should be do not make space for such a condition. The sometimes stereotypical mingling with others is encouraged to fight what is considered an illness and anyone who wants to opt out maybe considered either ‘boring’, a misfit, unwell, antisocial or unpopular.

It is difficult to live with someone who is depressed. Family and close friends begin to feel the pinch of being with someone who is quite unavailable emotionally. They may experience useless, angry and pent up feelings.

According to the authors, depression as it is defined medically, is prevalent in industrialised societies where such a study was held but it also exists in small societies wherever it was possible to conduct such a study.

They go on to say ‘such evidence suggests that much of what is currently classified as depressive disorder represents normal psychological functioning (Horwitz & Wakefield, 2007).

One likely factor contributing to over-diagnosis is that clinically significant impairment is not conclusive evidence of disorder (Spitzer & Wakefield, 1999). Impairment can be caused by biological dysfunction, but it can also be caused by properly functioning stress response mechanisms.’

Though clinical and severe depression over a long period of time is not to be taken lightly, the usual bouts of milder depression maybe seen as a human and natural response to the need for resolving complex issues.

Anxiety-Simple Things to do

Anxiety is a symptom which tells us that something is feeling out of control and/or feeling unsafe. It feels unpleasant and puts brakes on things we would like to do or think about.  The body, mind and heart feel at odds with each other. You can ask yourself three questions:

1.Why am I feeling anxious today? Why do I feel anxious when this or that happens? Just these simple questions can lead to some form of self reflection, a key ‘skill’ in overcoming overwhelming feelings. Starting a dialogue with oneself is one of life’s great achievements. 

2. Is it affecting my body-stomach, head…?

3. Is it affecting my relationships?  

Normal anxiety is inevitable in all our lives, and trying to understand yourself in your own time is a good habit to cultivate. However, too much anxiety begins to cramp your lifestyle. You may find yourself taking lesser risks and avoiding anxiety provoking situations. Some of it is good as it shows a certain sobering self awareness-of what one can do and not do and what to avoid ! 

But if you find your circle of life shrinking and the list of things you can do becoming too restricted, seek help. Talking to a professional or engaging in a group activity where there is a considerate facilitator can be helpful.  At times, anxiety can lead to substance misuse -a false bravado further incited by peer acceptance, can take away anxious feelings for some time. Such debilitating habits may threaten your financial security and from thereon, the fall can be damaging and at times, irretrievable.

Restricting your temptations and not gratifying cravings is something of a ‘muscle’ one builds through life.  Bodies are great things. They adapt to you not having cake just as much as they will adapt to you eating only cake so we do have control !

Taking pleasure in simple things which don’t cost money- a walk in the park, a friendly chat with the neighbour down the road, and having time for a little thought to cherish the interactions you have, even if it is  a small one with the corner shop till worker, can add incrementally to one’s ‘muscle’ for reduction of anxiety. 

In other cases, anxiety is provoked in situations like a much awaited job interview; a driving test; meeting a difficult boss; having difficult relations. Anxiety is not all bad, and with a little care it can be understood and limited. On one hand, increased anxiety tells us that something needs doing; you may be anxious before a driving test, but it may help you to prepare more, see it through and, in fact, make you proportionally elated. On the other hand, your increased anxiety may be telling you that something unpleasant is going to happen. It is a signal to say that we are ‘charged up’ with something, because either the situation demands it or we have ‘sussed out’ internally that we cannot cope with it. For example, people in a fragile state (like those who are convalescing or have been bullied) may find it difficult to even shop in the local market. Everything might feel too much because the mind needs to recover just as much as the body. At times, removing yourself from an unbearable and unbeatable situation can be the only, and perhaps the best, resort.

People come for therapy with anxious symptoms and have not thought of the various links to issues which seem apparently random. The job of the therapist is to find these links and facilitate perspective. Maybe in the past one was not ready for an extraordinary situation (illness, bereavement etc), or that it was of such proportions that it bypassed any skills one had to deal with it at the time (for example recession, bereavement, fatal disease, earthquakes). Clients seek therapy for a number of issues that seem sometimes to happen all at once: for eg, father passed away; redundancy; break up of relationship. Such experiences can make you anxious and timid about forthcoming events for a long time. All anticipation of events is experienced with anxiety. 

The death of important figures in one’s life can create grief for years, coupled with anxiety about leaving that internal self isolation. One can never prepare for the loss of someone who you communicated with often and shared your world and took guidance from. One can carry that grievance for a long time, a grievance against life’s treacherous acts of taking away what you cherished the most. 

Facing the prospect of dealing with people (in workplace or socially) who are like the ones who have triggered our anger, despair and helplessness in the past will trigger anxiety in the present. It could be a bullying school mate, a dominant family member, even an abusive person from the past. Not being in touch with such links may create confusion. Sometimes clients say, “I am anxious, but it cannot be just because of …”.  This is a sign of not being in touch with and therefore feeling ‘cut off’ from important but unbearable feelings.  Let your therapist aid you with it.  Friends and family may not be trained for the job.

We are so used to coping with unbearable situations that we don’t realise at times that we are just coping! Last but not least, our health and any negative variance in it, will trigger our deepest anxiety. Google searching helps and hinders this heightened preoccupation with one’s health in the last decade.  It helps to allay silly fears for the healthy and it hinders living life without having to be anxious about silly fears. 

Summing it up, 

1.Grieve well for those who were important but put a boundary and start living again.

2.Complete that driving test but you don’t have to bungy jump (really not very important and certainly not a sample of bravery). 

3.Increase the muscle not to eat cake. The body will adapt.

4. Walk to the corner shop and chat with someone when you are eft by yourself for too long. Cherish the encounter and walk back home with a smile, don’t go in and buy another bottle.

5. Try not to google too much when you have a headache and don’t self diagnose BPD either. Instead, get some fresh air. 

6. And yes, breathe deeply…it does help.

Anxiety ! Workshop

Anxiety and fear affect daily life. To say that we live in the grip of fear and anxiety and have brief phases of contentment and leisure, would not be an exaggeration. Development and growth are that great and rare human achievement in the face of such difficult and debilitating emotions. This workshop gets to grips with fear and anxiety, primal emotions, through a psychoanalytic lens. In the therapeutic space of group and individual work, you will be able to understand the enormity of the task you do as a human being and practitioner, in helping people manage their anxiety.

“While she was in a state of great anxiety, she had attempted to pray but could find no words. At last a few words of a child’s prayer in English occurred to her.” (p.10) – Josef Breuer and Sigmund Freud (1956). On the psychical mechanism of hysterical phenomena (1893) in International Journal of Psycho-Analysis, 37:8-13.

“After all, the reason which brings patients into analysis is fundamentally that they cannot manage anxiety. Though it does not, of course, mean that the patient is consciously aware of this.” – Joseph, B.(1978). Different types of anxiety and their handling in the analytic situation in International Journal of Psycho-Analysis. 59: 223-228.

This workshop will help participants to understand anxiety as explained by psychoanalytic thinkers, and it’s function in normal and abnormal conditions. This workshop will cover the effect of fear and anxiety on possibilities of growth and development and understand how one helps/does not help clients become less anxious and more contained.

There will be a workshop leader presentation on anxiety and theory from a psychodynamic perspective, as well as clinical discussion of its presentation in the consulting room. This will include some exploration of anxiety both within a historical context and its modern manifestations. There will be a discussion of case studies and use of social dreaming exercises to explore anxiety. The workshop leader will also use clips from films to illustrate the material and ideas.

This workshop is suitable for qualified and training psychotherapists and counsellors and mental health practitioners. The primary theoretical focus of the workshop will be psychodynamic, but practitioners of other modalities are welcome to atten