I have been wanting to write this post for quite a long time. It is a subject about which I feel very strongly; so strongly that I have basically built a career on it. Perhaps that is why it has taken so long for me to commit it to actual words. It is important enough to write about, but so much so that I want to be sure to do it justice. I guess it just hadn't yet been the right time. Then, Robin Williams died. It is now time.
We live in an unpleasant emotion-aversive culture and this has long concerned and grieved me. I thought about a fancier way of saying it, like, "Fallacious Fear of Foul Feelings Phobia" In any case, I'd hate words to distract from what I see as a significant problem. As a professional therapist, a good deal of my job involves listening to, allowing and validating people's anger, hurt, grief and fear. Many of the people who come for counseling are often looking not so much for a trained therapist with knowledge and experience with complex disorders and expert techniques, but rather someone who will sit with them in their hurts, fears and outrage and tolerate those feelings without eagerly or compulsively looking to dismiss, minimize, or placate them away. Mindlessly repeating familiar cliches, reciting bible verses or dispensing other brief, trite comments, intended to make the person "feel better", however true and ultimately helpful they may be, usually do anything but.
In a fundamental way, it makes sense that we desire to make others feel better. However, it's as if we believe all pain is harmful. Yes, if you keep your hand on a hot stove, it will continue to burn and terrible damage will occur. The pain, thankfully, prevents us from doing this. In some rudimentary sense, it seems we believe all pain is like hand-on-hot-stove pain. Think about it. A significant focus in our medical community is around relieving pain. Somewhere along the way, pain relief and pain management has shifted to a strong investment in pain elimination. For many benign physical discomforts or in the case of chronic misery, this is reasonable. However, has our obsession with alleviating pain gone too far? After all, pain is often an alert telling us that something is wrong which needs to be dealt with. Imagine if we put our hand on a hot stove and we didn't feel pain? The pain helps us intervene to ensure we not incur further damage.
During the hospital procedure after my second miscarriage, some things went wrong. I was required to stay in the hospital for a couple of days to be monitored. I was given a blood transfusion and immediately afterward, I experienced a sudden, painful sharp headache. Hardly intolerable, I decided to tell the nurse in case it meant that I was having some adverse reaction they should know about. Within moments of my reporting this, the nurse silently administered something into my intravenous line and before I got a chance to ask what she was doing, I felt myself immediately begin to go to that calm, "don't care" benzodiazepine place. She gave me Ativan. I didn't want it. She didn't ask me if I wanted pain relief and she didn't even tell me what she was doing. She just did it. I got a strong "this will shut you up and stop your complaining" vibe from her action and subsequent attitude. This intervention was not about my pain relief, it was of hers. The message: When it comes to pain, avoid it, eliminate it, fix it and if all else fails, silence it.
Its really quite the same thing when considering our responses to people's emotional pain, The tendency is to approach it in a "if it can't be fixed, pretend it's not there" fashion. For people going through difficulties, this lack of acknowledgement can be yet another knife in the heart. I'd like to think that people who approach friends and loved ones this way, and they are many, don't realize the additional heartache this causes. Unfortunately, they are also likely unaware that their investment is probably more about their own discomfort than anything else. The movie "The General's Daughter", starring John Travolta, demonstrates the far-reaching and tragic lengths someone will go through to have their emotional wounds acknowledged, as well as the sad and shallow investment some people have in maintaining ignorance of reality. In our own lives, usually in less dramatic ways, this message is usually heard loud and clear, "keep the pain to yourself" So, people usually do.
What we learn as psychology students is that in most cases of emotional pain, avoiding, eliminating or ignoring it is unhealthy and will inevitably, eventually, lead to dysfunction of one sort or another. Pretending it is not there actually increases its destructive power. If any part of us knows this, our discomfort and disdain for the pain along with a culture all too willing to support denial, minimization and a plethora of ways to effectively "cope" with (avoid) the pain, makes it all too easy to inhabit the oblivious land of make believe. Many a drug addict or alcoholic will tell you that they have found an effective way, albeit high priced, to avoid emotional pain. They each have a tale to tell you how they got there. I've worked with many men and women in recovery for the first time in their adult lives who struggle with believing something is wrong if they feel "bad". Many of them are so used to immediately finding relief that they have a good deal of difficulty tolerating normal distress. In some cases, even relatively common and inconsequential annoyances create an almost panic feeling followed by the search for a quick solution. This helps to explain the high relapse rate. Interesting to note is that when many of these former substance abusers reflect on spending years avoiding pain, they realize they also missed out on joy.
The overwhelming multitude of articles written since Robin Williams passed have paid tribute to the kind and talented man, expressed shock and grief at his loss and have put much needed focus on the issues of clinical depression, suicide and mental illness stigma. Indeed, these are good and worthy subjects. I would like to expand the concern beyond mental illness stigma to the stigma around displaying emotional pain, essentially, a societal intolerance to virtually any expression of unpleasant emotion.
There is much speculation and talk about what was going on with Robin Williams which would lead him to take his own life. We can't seem to help it even though we all realize that we will never really know his thoughts and feelings leading up to and at the time of his final act. Perhaps he got substandard treatment, wasn't taking his psychiatric medications or was on the wrong ones. Perhaps a dangerous mix of abusable substances and medication led to his hopeless state of mind. Could there have been an adverse reaction to Parkinson's medications? Or, maybe his life circumstances combined with his long-term mental health challenges created the perfect storm leading to suicide.
A couple of days ago, I heard a clip on the radio of a now 10-year old interview with Robin Williams and an unknown to me interviewer after Robin had been out of rehab for a couple of months. I tried to find it online but have been unsuccessful so far. In the interview, it sounded very much like Robin was trying to be serious, to convey a message of gravity and encouragement to listeners who may be struggling with mental illness and/or substance abuse. It became instantly apparent to me that the interviewer was not interested in this and was persistent in pursuing comedic input from the somber star. Robin stated that he had contemplated suicide in the past when he felt his most despondent and hopeless. The interviewer kept trying to make it a joke and Robin eventually conceded, after several attempts to shift the interview into a more stigma crushing, demystifying and supportive outreach opportunity. The finishing blow to the topic came when the interviewer responded to Williams' statement about thoughts of suicide with a chuckling, now eery "you wouldn't have the guts to go through with it" He was in it for the laughs, and Robin Williams ultimately delivered. His comedic genius shown bright, successfully hiding the grim reality he was clearly trying to reveal.
We are often struck by the frequency of dark experiences and moods of our most beloved comedic entertainers (Jim Carey, John Belushi, Chris Farley, Larry David and others have all reported struggling with clinical depression ) but Williams proved himself a brilliant dramatic actor as well. Was he attempting to show a part of himself in these more serious movie roles that he otherwise couldn't. Comedians, in this sense, almost seem the opposite of the kid who misbehaves to get attention. People don't want to hear about the pain and despondency, so they get the attention they need by giving people what they want. Like a drink or a drug, it only works for a little while. It is a skimpy bandaid used to attempt to cover a gaping hole.
It would be fantastic to obliterate the stigma of mental health diagnoses, but any progress made will likely be minimal or superficial, in my opinion, until we can learn to willingly deal with emotional pain in smaller ways. How can we empathize and even begin to understand the complexities and struggles of a stranger, famous or not, who battles clinical depression if we can't face the friend at church who lost her husband a few months ago or we feel compelled to avoid the neighborhood couple who just suffered a miscarriage? As long as we treat situations such as these like life threatening motion sensor bombs, how can we think a friend considering suicide would reach out to us?
There has come in recent years to be strong evidence in the study of emotions which reveals that some people are born with more sensitive nervous systems as well as areas of the brain less active resulting in greater challenges in emotion regulation. Additionally, Dr. John Gray, known for the bestselling, "Men are from Mars and Women are from Venus" notes how the emotional part of women's brains can be up to eight times more active when upsetting stimuli are present than men's. Perhaps those "too sensitive" people are simply, sensitive.
The things I have heard in response to some of my expressions of emotion from people who are clearly uncomfortable with this are striking. Some acted as if even a reasonable amount of angry or sad expression for a specific upset or circumstance amounted to impending catastrophe. After my first miscarriage, I was entirely unprepared for how more than one person, about a half dozen at least, acted like nothing happened. No condolences. Avoiding any conversation. Even avoiding eye contact. It was extremely painful. It actually felt quite selfish. Once, a coworker was speaking about attending the wake and funeral of a six year old boy who was tragically killed when struck by a car while riding his bike. Speaking of the services, he said "You would've never been able to handle it" The implication that there is a preferred or superior "way" to handle such an occurrence. I replied with a question, "How exactly ought one handle the death of a six year old child?" This feeds the mistaken but commonly held notion that not feeling or expressing vulnerable emotions is a strength, somehow an admirable demonstration of character. That's nonsense! A close family member noticed my daughter's early development was off, but we learned of these concerns from a virtual stranger, a newly hired childcare worker. When the family member learned of this, they shared that they thought about sharing those same concerns, but decided not to because, "I know you cry easy so I didn't want to get you upset" The logic here is ridiculous, but these types of things happen often by otherwise seemingly intelligent caring people. I was speaking with a ministry leader at my church about an upsetting situation I experienced in my role as therapist with another (non-client) individual. My reactions to mistreatment and disrespect included anger and tears. Instead of validation and supportive input, I was given a lecture which essentially communicated: when people come to a therapist, they expect someone who is not emotional. Really? Says who? I take offense to this presumption, which would probably earn me the label of "too sensitive" I have concerns that in some ways the Christian church has taken the fruit of the spirit "self-control" (Galatians 5:22-23) and the multiple verses peppered throughout scripture urging us to "be slow to anger" (Proverbs 16:32; James 1:19) too far, often carelessly promoting stoic suppression of valid God-given emotions. There needs to be more balance. This is, however, a subject for another post.
When someone as famous and as loved as Robin Williams takes his own life, the world stops and all attention is focused on the stark reality. We fully experience the strength and destructive power of a stampede of a thousand herds of elephants. Well, there is an elephant in the room folks and sooner or later, it is gonna get hungry. The elephant is not just in rehab programs and inpatient units. The elephant is not deterred by church walls or unspoken family rules. The elephant is no respecter of persons be it race, class, gender or any other factor. Some elephants are small, but they grow. They are all around us: anger at injustices, sadness despite being blessed, guilt with or without cause, disappointments, setbacks, fears. They are hidden behind smiles, behind jokes, behind masks of all sorts. Ignoring the elephants is at the peril of all of us.
It turns out that Robin Williams was an even greater actor than any of us ever knew.
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