Overcoming Defenses

It is no big secret, I work in healthcare and so have access to loads of policies, organisations, data and people in all areas of public health and medicine. This feeds brilliantly into two of my primary defenses: intellectualisation and hypochondriasis. I've acquired a haphazard yet impressive amount of medical knowledge. When people marvel at how much I know ("You know everything!") I simply say I know only what pertains to me. But this intense (and often obsessive) devotion to knowing everything about my body is only an attempt to control it and to avoid the more challenging aspects of being human: namely, my feelings.

As Winnicott said, "a compulsive preoccupation with intellectual knowledge is an attempt to mother the self exclusively with the mind" .. which is obviously unproductive muchless "emotionally impoverishing." Freud discussed "patients who practice the art of sheering off into intellectual discussion...who speculate a great deal and often very wisely about their condition and in that way avoid doing anything to overcome it." This is of course why I have this quote on my desk at work. This is the very theme running through the heart of my blog:

"To do things differently, we must see things differently.

When we see things we haven't noticed before,
we can ask questions we didn't know how to ask before."

-John Kelsch
Quality Healthcare in America Project

I work on the assumption that my instincts, my reactions, my feelings, my thoughts.. they are not without reason. But this reason does not imply inevitability.

Through meditation, I learned to go to the source of my thoughts and just let them flow, without following them. Through observing myself in this process, I learned how easy it was to let myself flow with the thoughts and feelings that presented themselves. A thought would trigger a feeling which would trigger a thought and so on. But I didn't need to pay attention.

I had a choice whether to pay attention.

I use this skill to walk up-river through my muddy river of thoughts and feelings when trying to parse out the 'order of things.' Sometimes the river is a massive waterfall, a huge vertical drop, which is too painful and too difficult to reverse. I save my energy for easier rivers and I learn my patterns in calmer waters. Then, when my knowledge and skill improves, I can tackle faster rivers, stronger triggers.

A river is a river. A trigger is a trigger. I could give up, fall downstream, get broken and bloodied by the chaos of emotions, feel out of control, grapple desperately for any hold, blame the wind, blame the rocks, blame the water.. but all of that undermines the fact that I have arms to hold with, legs to stand with, a mouth to shout for help with, eyes to see what's in front of me, ears to listen for help, and more. I am still me and I still have the resources to find stability, no matter how confusing or overwhelming the mess. If I blame myself, and who wouldn't, I just let the blame float downstream away from me. I might meet the blame another day, when I'm feeling stronger, but for now I have other needs. And that's okay.

Eventually, I will have the strength to stand under the waterfall without being washed downstream. I might even have the strength to climb up the wet rocks, with all that water pushing me down. It's okay that I'm not there yet. It's okay that I'm afraid. There will always be rocks and quiet beaches and floating logs for me to rest on.

So if I have a choice, what do I pay attention to?

This is precisely why listening to your body (ALL of your parts) is so important. If you habitually ignore yourself, as I learned to do, you will never be able to answer that question with any bit of confidence or success. Hence, dissociation is so dangerous in the long-term: we are ignoring our own needs and therefore condemning our parts to developmental stasis.

So my first task was to listen. My first task is always to pay attention.

Through this practice, I've learned to recognise and prioritise several 'states' that communicate to me my own needs.

If I sense anxiety, my priority is calming down.

If I sense detachment, depersonalisation or derealisation, my priority is grounding myself with social contact or peppermint tea.

If I notice obsessive or interjecting thoughts, I practice thought suppression and respond with self-validating thoughts.

If I am overwhelmed by emotions, I distract myself with games/books.

If I am in a depressed mood, I do something nice for myself or work on small easy projects to bring a sense of achievement.

If I have suicidal thoughts or feelings, I acknowledge the desire to die in the context of the horrible things I've experienced and I ask myself what else I am feeling that is making me so scared.

I am learning to accept myself as I am. That is the top priority. It doesn't mean I don't change my behaviour but it does mean that before I respond to anything inside me, I first pay attention.

I step between my emotional parts (child parts) and my parent parts (Inner Bully and Control Freak) and simply accept they are all mine.

This is a very difficult thing to do, and perhaps unless you are at a certain level of skill in self-awareness or meditation you may not know how it feels to simply accept everything in a very mindful way. I am certainly no more than a novice. But I do believe this is the ticket to overcoming that powerful dissociative defense. If we learn how to sit with our feelings and our thoughts, even our shame and our terror, the ability to dissociate is no longer needed.

Instead of fighting against the dissociation, I'm overcoming it by reclaiming my emotional desmesne. Slowly, but surely, at a pace set by my own strength and capabilities, I push my walls out further and further. I am committed to this painful process. It is painful. It hurts. I am exhausted daily by this complex self-management. I am making decisions for myself that are incredibly scary. I am making decisions despite feeling incredibly scared.

And I suppose that is the point: not letting my terror stop me from exploring what makes me happy. Being EP-Happy, but also being EP-Sad, Control Freak and Inner Bully. Helping each of them to think differently. Helping myself.


Read on the NHS Choices blog.