Dr Divya Parashar

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It's called a breakthrough, not a breakaround

I have heard this often when a person in emotional pain is sitting across from me in a session:

“I hope you have a magic wand that can make my pain go away.”

I wish it was that simple. I wish I could get into people’s heads and make their distressing thoughts, feelings, memories, urges, impulses go away. The fact of the matter is I can’t. No one can. Not even them. We like to believe that we have control over our thoughts and feelings, but we don’t, at least not enough; and the sooner we realize it the better.

We can distract ourselves with music, and breathing exercises, food, walks or runs, or alcohol and other substances, even work, or whatever else you engage in to suppress or avoid those painful thoughts, feelings, memories, but they will come back with a vengeance. It’s like trying to push a plastic ball beneath the surface of the water. Your hand will eventually tire itself out, and the moment you let go of your hold, the ball bounces right back up, maybe higher than ever before.

And in a culture which extols “busy-ness,” where we are told “not to think about stressors,” “look on the brighter side,” “think positive,” “try and control yourself—the way you think and feel and behave,” “move away from the pain,”  you might even experience short-term benefits such as relief from sadness or anxiety. But then I ask this: “Is your pain less or more since you started using those strategies?”

What ends up happening as the days, weeks, and months go by as we struggle with the pain is that we may start becoming high functioning “depressives.” On the surface, we appear to have everything “sorted” with our lives to an observer’s eye, but within we are silently screaming through our psychological suffering.

So, back to that magic wand which people expect of me or any other mental health professional, I am taken back to something another person I worked with in therapy had said in our closing session.

“Sometimes I think depression is like cancer. There’s no one quick-fix. You can only tackle it with a multi-pronged approach. It takes time, the commitment to stay the course, and a supportive ecosystem in addition to a therapeutic approach that is tailored to each individual. And above all, never losing sight of a purpose in life, regardless of the obstacles. ”

Recovery from any psychological suffering, whether one that you struggle with as an individual or one that appears as conflicts and strains between family members, requires learning to understand what it is about in the first place. What are the bottlenecks that exist in the way of us leading a rich, meaningful life? What are the signs and symptoms of the suffering and what are some antecedent events (situations or events, and resulting thoughts and feelings) that may have preceded the onset of the symptoms? These are imperative so that we have a better understanding of what the recurrent triggers and themes are that may emerge as a result.

Let me illustrate this with an example that happened in a conversation with Ami (name changed) today.

Caught in the intense grip of her grief—across a journey that went from the diagnosis of her husband’s terminal illness to losing him a few months later—Ami was deeply distressed and had intrusive thoughts of self-harm. Whenever she would see a set of kitchen knives, or a box of matches, she would want to use them on herself. But she had a child to take care of, so the thing she did was to clear her home of objects that she could use to harm herself.

Ami reached out for therapy 8 years after her husband’s demise. Over the course of a few sessions, we reached an understanding that she was experiencing Persistent Complex Bereavement Disorder.

Over the next few months, Ami worked through her grief, and not around it.

In numerous ways she would seek not to suppress or distract herself from the pain and the memories. And her symptoms of anxiety and depression started abating and her overall sense of well-being started to increase.

Today she wanted to come clean, break with the demons of the past. She shared her discomfort even now around when she chops vegetables or lights a lamp. The painful memories of the past, and the fears around it return, and while she is able to let them go, there still is an iota of “fear” left from the shadows of that past.

“I know I am in a much better space than I was 8 years ago. I know I am much stronger mentally and emotionally. I don’t even know if it makes any sense to talk about it, but it helps to just drop this here with you and to hear what you think about this,” Ami told me.

Ami has shared a lot over the months, as and when she has been comfortable. Some memories have been painful, some have taken immense courage to bring up, and after making space for her pain and grief, she has embraced her fears. This is the part where the healing begins to occur; when the perspectives shift, when the light starts shining in the darkness, and when one begins to do the real work in therapy, on a path of self-discovery, one which includes understanding aspects of the self and taking responsibility for one’s own healing.

From that same past, Ami had also developed an intense fear of doctors and hospitals and would do whatever she could to avoid going for a health check-up. On her husband’s death anniversary this year, she decided to brace her fears and went to the hospital where she had spent several months taking care of her husband and where he eventually passed on. She walked past the nursing station, stood by the door of his former room, spent hours there till she felt she was able enough to confront her fears without the anxiety and the panic arising. Ami mindfully walked the hallways, and when she came home, she messaged me that she had taken this big step. Her daughter was a huge support for her throughout: the ecosystem that truly makes a difference.

In confronting her past, Ami reinforced a fundamental lesson.

Fear makes us avoid triggers, makes us feel incapacitated in the grip of the anxiety that ensues, and further makes us feel guilty and angry about why we feel this way.

But when you look at fear in the eye, it realizes it’s lost the battle and whimpers away.

You just have to learn to make your faith and belief in yourself bigger, and you take that one step towards fortifying yourself.

Ami started stepping out of the shadows of her grief and anxiety, and realized there was a world waiting for her; the one she had wanted to build but never got down to doing: of getting back to work and enjoying it, of reclaiming her emotional and physical health, of redoing her home, building a garden, and getting back to her favorite hobbies of embroidery and textile painting, and a whole lot more that she wanted from life and was working towards.

The knives and matchboxes awaited next, and she willfully took that challenge on. I will know the progress in our next session.

I reflected on Ami’s journey after we ended our call today and realized how telling that parallel between depression and cancer is.

We can’t wish it away, there is no quick fix, you may need more than one resource person to help you through, a therapist who can customize their approaches to suit your needs and requirements. It takes willingness to walk the talk, to endure the pain that comes along, the commitment to stay the course across time, sometimes a multi-pronged approach, and, yes, it takes a supportive ecosystem.

But above all, whatever the suffering may be, what’s important is never losing sight of a life that brings richness and meaning, regardless of the obstacles that may be hurled at you. However difficult the path may seem, when your internal world is able to brave the emotional storm, and you don’t wish away pain or crumble under it, or hide from it, but see it as a part of life, you learn to anchor yourself to stay steady. And that’s when you realize what you’re truly made up of.

This breakthrough transforms you within.