Unbearable feelings

Some feelings are too powerful to bear alone. If this is so, they remain not only unexpressed but unacknowledged. However they have to go somewhere or be dealt with in some way, so human beings employ defences like denial, repression, displacement being the most familiar, or they get split off and attributed to someone or something else.

One of the ways of admitting to psychic pain is to admit to undiagnosed physical symptoms and pain. It would appear that somehow it seems acceptable to ask for help with physical illness and yet not seek relief from psychological pain or discomfort.

Psychosomatic pain

Karen Hitchcock, in The Monthly in June 2014, writes of the patients attending the hospital at which she practices as a physician. Many of these patients present with physical ailments but don’t really have an organic illness that can be identified. ‘Approximately 30 to 50% of patients attending specialist clinics have symptoms that have no organic cause. That is, they are psychosomatic in origin, “all in their head”.’ (P 17) Hitchcock recognises that these patients, or these people, need attention and connection; they need to talk to someone and be acknowledged and thought about. So they go to hospital to get relief for what feels like physical pain. And somatic pain doesn’t mean it isn’t painful; it certainly is. It is just often pain that cannot be held in the mind, so it is held in the body (with gratitude to Wilfred Bion). If we recognise how linked knowing and pain are, how the fear or anticipation of a painful realization can lead one to avoid learning from experiences, we can entertain the prospect of people experiencing their pain in a physical way. Karen Hitchcock goes on to say ‘A lot of terrible disability, sickness and waste remains untreated or maltreated because everyone – except that ever-dwindling enclave of psychoanalysts – has abandoned an understanding of the human being as more than robotic, more than animal, more than genes plus protein and water’. (P 17).

Separation of brain and mind

Far too many practitioners of all hues think we can treat the brain as though it is a separate entity from the mind. Thus there appears to be almost some pleasure, some importance, to having something wrong with your body or your brain – as though you then had nothing to do with it and it is just bad luck – because your mind or psyche has been dismissed; it is not a weakness then. It is certainly not a weakness to be sad, but our society has evolved in such a way that it is easier to treat it as depression. Give the body and brain a pill, a quick fix, and then one will ‘get better’ is a modern mantra. Well it doesn’t really. The sadness, feelings of abandonment and unfairness, the anger, resentment, and the disappointment with life is suppressed certainly but it doesn’t go away and it isn’t fixed. Medication (especially for serious depresssion) and medical procedures are helpful and at times and essential at others but they don’t get at the underlying psychological presenting issues. Hitchcock continues with the following statement : “ Modern psychiatry has reduced the wonders of our mental life to the mush of the brain. For treating the brain, the organ, is prestigious. Having something wrong with your body is prestigious, because the psyche has been relegated to the bin. We have lost – in medicine and everywhere else – the understanding of the human as a complex, language-bound mix of consciousness and unconsciousness whose bodily suffering may well have meanings and functions we cannot interpret via a blood test”

Individual experiences

Human beings are constantly struggling to make sense of life and the puzzle of existence and every single human being is different. So one form or medication or treatment might suit one person and not another. In our contemporary society humans need to be treated as individuals to have their concerns and doubts taken seriously. Often a diagnosis of a particular illness or condition fails to take into account how each particular individual experiences their illness or condition.

Lack of awareness of the value of talking

Unfortunately not everyone has the disposable income to go and get relief from talking about their not clearly perceptible discontent to someone who will give them undivided attention. Instead they block or deny the feelings because either they are too uncomfortable or they are inconsistent with the image they have of others and themselves. So often discomforting feelings fail to penetrate consciousness and many people land up in hospital desperate for attention for something that can be identified as tangible or concrete. The feelings that are giving rise to such psychic pain are actually split off from their consciousness; they are not aware of these as problems. That doesn’t mean there is some sort of storage place for unused thoughts, rather as Freud explained, the unconscious can be conceptualised as a space of dynamic activity. That is ideas may be hidden from consciousness but they are still actively and constantly pushing for release. In this sense they never go away. An unhappy person often requires the presence of another mind to think clearly about themselves. Not everyone has access to a sympathetic mind. So for some what option remains except to go to a hospital where perhaps your symptoms will be taken seriously and you might get some relief. It is known now that we all need another mind to accept, absorb, and transform experiences into meaning. This is not going to happen in the emergency ward at a hospital – it is not a problem that can be treated by modern medicine.