On being “Good Enough’

We might consider that at the core of therapy is the idea of self-awareness. At times of vulnerability – whether that be heartbreak, stress at home or work or generally feeling unable to cope we may find ourselves suffering from unbearable feelings and want to block these out. However, avoiding the sensations we feel can increase our vulnerability to being overwhelmed by them.

Becoming aware of the ebb and flow of emotions within our bodies can put us in touch with our inner world. In noticing our feelings of anger, irritation, nervousness or desperation we become able to shift our perspective and open up new options other than our automatic, habitual reactions. Mindfulness puts us in touch with the transitory nature of our feelings and perceptions. When we pay focused attention to our bodily sensations we can recognise that our emotions are not set in stone and hopefully increase control of them.

The paediatrician and psychoanalyst Donald Winnicott, observation of mothers and children focused amongst other things on how the mothers held their babies. He proposed that these physical interactions lay the groundwork for a baby’s sense of self, and with that their capacity for self-regulation. ‘The ability to feel the body as the place where the psyche lives.’ In the majority of cases Winicott believed that mothers were able to be ‘good enough’, but in cases where the mother cannot meet her babies needs and impulses ‘the baby learns to become the mother’s idea of what the baby is’. Children who lack physical attunement are vulnerable to shutting down the direct feedback from their bodies.

As adults in order to learn how to become available to our bodies feedback we need to change how we deal with difficult feelings and increase our awareness of inner experiences. Allowing our minds to focus on sensations and notice how in contrast to feelings that might feel overwhelming our physical sensations are transient and respond to slight shifts in bodies, such as how we hold ourselves, our breathing and even our thinking.

The next step might be to label our physical sensations. Practising mindfulness calms down our sympathetic nervous system, so we are less likely to be thrown into a flight or flight response. Learning to observe and tolerate what we are feeling in the moment, is a prerequisite for safely being able to revisit the past. It is possible to tolerate a great deal of discomfort if we are able to remain conscious that our bodies’ reactions are constantly shifting. Mindfulness has been shown to have a positive effect on a number of psychosomatic and psychological issues. It has also been shown to activate the brain regions involved in emotional regulation and lead to changes in the regions related to body awareness and fear.

Our need for meaning.

From its conception, psychoanalysis has been as much about a therapeutic method for treating neuroses as a theory of the mind. In this way it considers some of the major questions around our continued search for meaning expressed through literature, music and art.

‘How to live in a world in which justice and power, right and might, often seem to have nothing to do with each other? How to deal with the fear that my own aggression and violence will overflow and violate all that I care about? How to confront my own death, and the deaths of those I love? How to act responsibly in the absence of freedom? How to make this inhumane world a more humane place and so comfort myself, and offer comfort to others.’

Alford 1992 The Psychoanalytic Theory of Greek Tragedy

Viktor Frankl, a psychotherapist and contemporary of Sigmund Freud, developed his therapeutic skills in an impossible setting. He was among those sent to the concentration camps by the Nazis, and he used his skills to inspire prisoners to fight for their survival by finding meaning in their suffering.

He states “As a professor in two fields, neurology and psychiatry, I am fully aware of the extent to which man is subject to biological, psychological and sociological conditions. But in addition to being a professor in two fields I am a survivor of four camps — concentration camps, that is — and as such I also bear witness to the unexpected extent to which man is capable of defying and braving even the worst conditions conceivable.”

In the clip below Frankl speaks to young people on how he came to formulate his ideas. And states – “Between stimulus and response, there is a space. In that space is our power to choose our response. In our response lies our growth and our freedom.

Frankl’s book ‘ Mans search for Meaning’ provides an extraordinary example of how humans are able to survive through some of the darkest hours and the most crushing situations imaginable and provides inspiration to us all.

Yeatsian Geometry

Turning and turning in the widening gyre
The falcon cannot hear the falconer
Things fall apart; the centre cannot hold;
Mere anarchy is loosened upon the world.
Yeats.

“We need to open our eyes. There are over two million illegal immigrants bedding down in this state tonight! This state spent three billion dollars last year, on services for those people who have no right to be here in the first place. Three billion dollars! 400 million dollars just to lock up a bunch of illegal immigrant criminals… Our border policy’s a joke! So, is anybody surprised that south of the border, they’re laughing at us? Laughing at our laws?”

These are originally the words of Derek Vinyard, the Neo-Nazi protagonist of Tony Kaye’s cinematic masterpiece, American History X. The film tells the story of Derek Vinyard’s gradual realisation that the bigoted beliefs he has held for most of his adult life are mistaken. He then tries to prevent his little brother Danny from following in his footsteps and becoming embroiled in the race-related gang-violence that was rife in parts of the US in the 1990s. These words were terrifyingly more recently used by Donald Trump at one of his election rallies.

The film is over 19 years old yet its themes couldn’t be more relevant to our current political climate. We only have to look at the Brexit’s rabble-rousing rhetoric to see how closely related these sentiments are to the type of white supremacist vitriol that Vinyard preaches during the film.

We are now witnessing the highest levels of movement on record. About 258 million people, or one in every 30, were living outside their country of birth in 2017. A 2003 projection anticipated that by 2050, there would be up to 230 million international migrants. The latest revised projection is that there will be 405 million international migrants by 2050.

The experience of moving from one country to another tends to increase the likelihood of the use of primitive defence mechanisms as a protection against the difficulties of everyday life and in relationships in the new country. The danger of this social development is an increase in the use of splitting and in the use of ‘psychic retreats’ in an attempt to uphold an idealised inner and outer world without pain or conflict.

Today, we live in an age of anxiety about ‘post-truth’ politics. ‘Fake news’, targeted messaging and seductive persuasion are rife. Digital technologies have created extraordinary new possibilities But many of our contemporary concerns about the new dark arts of political persuasion have a longer history. In the mid-20th century, psychologists’ curiosity and dismay about our susceptibility to manipulation and control crystallised. Their work offer us food for thought in a new age of economic development, population movement and populist fervour. In the 1940s, the psychotherapist Money-Kyrle was worried about the power of radio and other mass media to reveal and provoke our worst selves. In his essay, ‘A Psychological Analysis of the Causes of War’, he explores the roots of conflict

‘The study of cases of melancholia, paranoia, and homicidal mania helps us to recognize psychological mechanisms which are present, to some slight extent, in all of us. These mechanisms may not greatly influence us as individuals; but they sometimes have a great influence on us as members of a state.’

In the 21st century, he would have been looking at our use and the incredible power of the Internet.

Vinyard-esque remarks are now a part of the mainstream. Hostile, political rhetoric that’s used all too often as a part of our normal political process and so it seems the important message of American History X, that “hate is baggage” and that “life’s too short to be pissed off all the time”, has been forgotten by many. The politics of division are thriving across the world, and we will all suffer for it.

‘In the space between chaos and shape there was another chance’.

Jeanette Winterson, The World and Other Places:

Life transitions are challenging because they force us to let go of the familiar and face the future with a feeling of vulnerability. Whether positive or negative, a transitional space can force us to adjust to new ways of living, being and working. How we deal with these changes can feel quite challenging to our sense of well-being and our emotional health.

Many significant changes are triggered by regrets about unfulfilled dreams, a discontent or dissatisfaction with how life has turned out or a feeling that you are not at peace with the passing of time.

When we consider change in our lives, we might think about the work of the psychoanalyst Donald winnicott, who wrote about the important transitions an infant experiences in separating from her mother.

He believed that our sense of self emerged through our interpersonal relations, especially through early interactions between the main carer and her infant. In order for the infant to develop, the caregiver must gradually allow disillusionment so that the infant feels she is a separate individual but also feels safe and empowered. As this process occurs she begins to sense that her needs and emotions are not immediately met because her mother is not an extension of herself.

Healthy separation happens when the infant’s emotions are reflected back to her and adequately held without crisis occurring. This mirroring and holding creates what Winnicott called a transitional space, a container where the infant feels safe enough and powerful enough to navigate and integrate her needs and emotions allowing her to develop a stable sense of self that can develop authentic emotional connections in everyday interactions with others while still feeling some sense of control.

At some point we all have to deal with times of major life transition, which require adjusting to new identities and new perspectives. These changes are not always smooth, but it is helpful to appreciate that they happen for an purpose and can be important to allow us to grow as individuals developing resilience and self belief.

They perhaps attempt to signpost us in the direction of being closer to who and what we want to be and hopefully allow life to feel more meaningful and authentic.

Using Winnicott’s concept of a transitional space is helpful in navigating these times of change. The strength in these situations is knowing when we need to ask for support from those around us. – Whether that be family, friends or seeking the help of a professional. As I have gone through my own transitions in life, I have decided where I am going to focus my attention and what support I need. I know that I cannot manage significant change myself and I am open to help. Being proactive, aware and vulnerable are important characteristics to successfully negotiating the significant changes that life has a habit of throwing up.

‘The real issue with speed is not just how fast can you go, but where are you going so fast? It doesn’t help to arrive quickly if you wind up in the wrong place’. Walter Murch

On Anger.

My white therapist calls it my edge, I hear
Angry Black Women. She says, Strength
of Wilful Negative Focus. She says, Acerbic
Intellectual Temperament. I copy her words
onto an index card. She wants
an origin story, a stranger with his hand
inside me, or worse. I’m without
linear narrative and cannot sate her. We
perform rituals on her living room floor. I burn
letters brimming with resentments, watch
the paper ember in the fireplace, admit
I don’t want to let this go. What if anger,
my armour, is embedded in the marrow of who I am.
Who can I learn to be without it? Wherever you go,
there you are. She asks what i lose
if I surrender, I imagined a gutted fish,
silvery skin gleaming, emptied of itself-

Rage Hezekiah

“Otherwise” Jane Kenyon (1947-1995)

I got out of bed
on two strong legs.
It might have been
otherwise. I ate
cereal, sweet
milk, ripe, flawless
peach. It might
have been otherwise.
I took the dog uphill
to the birth wood.
All morning I did
the work I love.
At noon I lay down
with my mate. It might
have been otherwise.
We ate dinner together
at a table with silver
candlesticks. It might
have been otherwise.
I slept in a bed
in a room with paintings
on the walls, and
planned another day
just like this day.
but one day, i know
it will be otherwise.

Jane Kenyon (1947-1995)

Book review – The Recovering: Intoxication and its Aftermath. By Leslie Jamison.

Jamison describes addiction and particularly the dynamic of the female addict, bouncing between her own story and the tales of others who have battled alcohol and mental illness.

The mythic male drunk manages a thrilling abandon —the reckless, self-destructive pursuit of truth —his female counterpart is more often understood as guilty of abandonment, the crime of failing at care. Her drinking has violated the central commandment of her gender, Thou shalt care for others, and revealed itself as an intrinsically selfish abnegation of that duty. Her self-pity compounds the crime by directing her concern away from an implicit other —real or imagined, child or spouse —and funnelling that concern back toward herself.”
― from “The Recovering: Intoxication and its Aftermath”

She highlights and questions when an ordinary craving become pathological…suggesting perhaps this is when it becomes tyrannical enough to summon shame. When it stops constituting the self and begins to define its lack.

“For shame is its own veil,’ Denis Johnson wrote, “and veils the world as much as the face.”

When it comes to alcohol, women lose the battle of the sexes on almost every front. More and more women are struggling with heavy drinking and alcoholism, a disorder that was once believed to be primarily a man’s issue. The disease is in many ways more physically detrimental to women, who, for example get cirrhosis of the liver at twice the rate of men. Even so, they seek treatment less often. The female addict sits in a tremendous amount of guilt and shame, and is afraid to tell even those closest to her the truth about herself. She views herself as a “bad” person needing to become “good,” not as a sick person needing to become well. Many others will view her this way too and it will keep her from seeking treatment.

Addiction is a very patient disease; it lies in waiting, is stealthy and manipulative. Jamison is able to convey the struggles of being in recovery, someone haunted by her past, yet also in some way nostalgic for it.

Our sense of self is never really fixed, yet we tell ourselves one historical narrative, constantly rewritten to make sense of the changes in our lives. It can be all too easy to look back on the person that we “used to be”, with a fondness and regret that are often misplaced

The book highlights the simple truth; that stability is indeed a humble, and messy process which can feel like an immense struggle within a culture that craves simple narratives about addiction and sobriety, genius and madness.

Yes, your gut is speaking to you…..

There are many clear benefits to talking therapies in improving our wellbeing, understanding our internal selves and helping us to deal with the more difficult moments in our life.

However, there is a relatively new area of development in the field of mental health, which I have become increasingly interested in – that of Nutritional Psychiatry. Focusing on a shift in thinking around the role of diet and nutrition in mental wellbeing whilst developing a comprehensive, scientifically rigorous evidence base to support these ideas.

The use of anti-depressants has more than doubled in recent years. In England 64.7m prescriptions were issued for antidepressants in 2016. This is an increase of 3.7m on the number of items prescribed in 2015 and more than double than the 31m issued in 2006. Sadly, our approach at the moment suggests that poor mental health caused by social, environmental or personal conditions is primarily treated by dispensing drugs.

Of course, there is no doubting that drugs can be very effective and have a necessary place in the treatment of mental health. However, there are potential side effects and many people are understandably reluctant to become reliant on medication. As with all medications they may help in some situations, and not in others; shown to be effective for moderate, severe and chronic depression, but less so for mild depression.

The link between poor mental health and nutritional deficiencies has long been recognised by nutritionists working in the complementary health sector. However, psychiatrists are only now becoming increasingly aware of the benefits of using nutritional approaches to mental health,

It is now known that many mental health conditions are caused by inflammation in the brain, which ultimately causes our brain cells to die. This inflammatory response starts in our gut and is associated with a lack of nutrients from our food such as magnesium, omega-3 fatty acids, probiotics, vitamins and minerals that are all essential for the optimum functioning of our bodies.

Research has found an inverse association between healthy dietary patterns (those with high intake of fruits, vegetables, whole grains, nuts and seeds, fish, and minimal intake of processed foods) and the risk of depression.

Since the consumption of omega-3 fatty acids from fish and other sources has declined in most populations, the incidence of major depression has increased proportionally. Epidemiological data and clinical studies already show that omega-3 fatty acids can effectively treat depression.

In addition to omega-3 fatty acids, vitamin B (e.g., folate), and magnesium deficiencies have been linked to depression. Randomized, controlled trials that involve folate and B12 suggest that patients treated with 0.8 mg of folic acid/day or 0.4 mg of vitamin B12/day exhibit decreased depressive symptoms.

Serotonin is a neurotransmitter that helps regulate sleep and appetite, mediate moods, and inhibits pain. Since about 95% of your serotonin is produced in your gastrointestinal tract, and your gastrointestinal tract is lined with a hundred million nerve cells, or neurons, it makes sense that the inner workings of your digestive system don’t just help you digest food, but also guide your emotions.

When people take probiotics (supplements containing the good bacteria), their anxiety levels, perception of stress, and mental outlook have been shown to improve, compared with people who did not take probiotics.

As the days grow shorter and for many of us, the colder, darker months feel more difficult navigate, it may be worth supplementing our diets with these additional vitamins and minerals to maintain our gut health and help our minds and bodies function more effectively on both a physical and emotional level.

Peace, Love and Ahimsa.

“Ahimsa,” the Sanskrit word for non-violence asks us to be kind to others and the Earth, but most especially to ourselves. For how we treat ourselves reflects how we treat others.

In order to practice ahimsa, we must attempt to lay down our preconceptions, ignorance and stereotype’s. It is, in many ways, easier to navigate the modern world in a haze, to become oblivious or even numb to the long-term effects of our actions, to consider the real cost of our behaviours and relationships. Yoga asks us to put this tendency aside and look clearly at who we are and what we do. From a place of simplicity, we can focus on our desires and the nature of our attachments, our consumer habits, and our need for excess and ask ourselves whether the benefits outweigh the harm to others.

Ahimsa asks us to be mindful of thoughts and feelings. Thoughts naturally move in and out of our minds. Whilst these don’t necessarily cause harm, excessive rumination, negative beliefs and toxic dynamics can translate into acts of ‘violence’ in how we engage in the world and with people.

We can live our lives in an outwardly healthy way, eating well and exercising and whilst these are, vital to our wellbeing, if we are engaged in a space that feels negative from within this can still impact on our mental health. Negative thinking sends out messages to the body that trigger the fight or flight response. Thoughts do this even if there’s no real outside threat.
The fight or flight response secretes cortisol, often referred to as the stress hormone. This, in turn, lowers the immune system, and makes us more likely to experience physical and emotional difficulties, ill health and exhaustion.

The purity of ahimsa is three-fold. It asks of us to express no harm in thought, word, or deed. Speech is perhaps the hardest aspect to consider. The modern lexicon has come to include a specific phrase to describe the many ‘insignificant’ ways that we infuse our speech with violence, often very subtle violence, termed micro-aggressions. When we are caught up in our ego, in the delusion of our special self, in order to protect this idea we may we fall back on ways of speaking and engaging, which belittle or diminish others in order to provide ourselves with a sense of importance or omnipotence.

A little known practice; a precursor to mindfulness, I imagine we could all do with a little Ahimsa in our lives.