Friday, October 16, 2020

Reflections on somatizing our emotions...

Editor's Note: N.B.

(The writer does not write as a doctor, and is without medical training. My formal training is exclusively in chaplaincy, pastoral counselling and teaching of Literature. This piece comes from personal experience, professional experience, private research and reflection.) 

Much of this space has attempted to point out how we deny, avoid, dissemble, or merely withdraw from tension within and/or with others. Another, highly impactful attitude that millions, it seems, suffer from, is described in ‘street language’  as 'hiding our feelings’ …..None of us want to show weakness, or what we think and believe others will consider weakness; none of us wishes to get hurt, a notion based on previous experiences in which our emotions were manipulated by other; all of us have something described as a ‘lack of confidence’ at least in certain areas of our lives.

While this dynamic is often discussed at the water-cooler, sometimes in a counsellor’s office, infrequently in a clergy’s office, and increasingly in a family doctor’s office. We might find a rash, or a protracted head or stomach ache, or some other physical symptom which seems to have no direct and observable ‘cause’ like a fall, or an accidental cut, or a specific incident that impacted our body.

Some four decades-plus ago, I experienced a dramatic loss of weight, (24 pounds in 2 weeks) and experienced considerable fatigue. Our family physician quickly referred me to an Internal Medicine specialist, who, upon diagnosing a hyper-active thyroid, admitted me to the ICU. After treatment for three months by propylthiouracil, a treatment but not a cure, I was then referred to a radiologist  who administered 9 millicuries of I 131, Radioactive iodine. While in hospital, I was ushered into medical rounds, and asked a question that has echoed in my memory ever since: “Did you experience a trauma approximately six months ago ,that might have triggered this onset?”

Immediately, I responded in the affirmative, recalling an especially dramatic phone call from a troubled mother, some of whose in-laws were levelling ‘mental illness’ judgements on her. “You think I am crazy just like the rest of them think, don’t you?” She bellowed into my ear, late in a spring afternoon, as I listened in my study, some one hundred miles distant. “No, I do not!” I repeated several times, each time growing louder, over her protests, “but I do think you need help!”

Even as recently as the seventies, anything smacking of mental illness was like a social, political, ethical and moral sentence of alienation, ostracisim, abandonment by family and friends and potential endangerment of continuous employment. Now nearly a half-century on, anything smacking of psychosomatic illness is considered in the dismissive and contemptuous phrase even medical doctors deployed, “it’s all in your head,” given that medical school had taught them that a considerable proportion of their patients would make office appointments based on a psychosomatic ‘illness’.

Nevertheless, adhering to the pace of the observable formation of glaciers (prior to global warming and climate change), medical research has conducted considerable research into what is now being termed the ‘somatizing of emotions’ an involuntary process whereby the experiencing of strong emotions, that cannot or must not be displayed for any of a variety of reasons, beliefs, perceptions and attitudes, are “expressed” or displayed by some perceivable rash, pain, muscle contraction, in the body. Note the word, “involuntary” as a highly significant, yet too often ignored or denied component of the process commonly known as “hiding our feelings”.

Was my onset of hyperthyroidism a somatizing of a blocked emotion of frustration, anger, hopelessness, and concrete resistance to my protests that my mother was not “crazy” but needed help? “Crazy” had been a word bandied about on the street, and in casual conversation, as part of the innocent and ignorant character assessment of a local person who could more legitimately have been dubbed eccentric. In Canada, for sure, and also in other countries, we do not take kindly to eccentricity, and we tend to take a wide berth around people who dressed, spoke and/or acted in ways we did not understand, appreciate or seek to discover. Such a culture was and still is obviously and tragically reinforced by religious institutions and religious ‘passivity’ as well as the silence of religious retreats linked to a denial of especially desired tastes like chocolate, (withheld during Lent, for example). Emotional disclosure has been rendered antithetical to religious discipline, silent prayer, sanctuarial decorum, and sacristy-enforced propriety, only to be underlined by the frigid, detached expression of especially highly intellectual interpretations of scripture from the pulpit. This equation may have melted a little, yet much more slowly than the melting of the glaciers in the Arctic and Antarctic.

As western “Christian” culture has been and continues to be dominated, perhaps slightly less overtly in the last decade, by men and the male psyche, the gates that can unlock emotions within western men are welded shut, through centuries of disavowal, denial and relegating those human emotions to the “file” entitled, “woman”. As part of their legitimate initiatives to enter the workplace, at all levels, women have, understandably adopted what they perceive as attitudes, expressions  and behaviours that imitate those in power, the men. In domestic situations, too, women, wives, and mothers, have repeatedly found that any attempt to peel some of the hoar frost from their husbands’ and fathers’ and especially grandfathers’ emotional vaults has only irritated that ‘beast’ and too often provoked ever further withdrawal.

While my mother displayed unimpeded release of her emotions, her husband withdrew into passive aggressive patterns. His sisters, like most females in the mid-twentieth century, withheld their emotions, except those of care and compassion, especially of their brothers. It is plausible to infer that, had my mother been prepared to smother her emotions, thereby denying her identity and her needs, she would have been characterized by more “repressed” family members as ‘normal’ and therefore much more tolerable, predictable, and less volcanic.

It is not only among the ecclesial community that raw emotion is frowned on, there is a long tradition of what has been variously termed “professional” and “objective” performance in the medical and legal professions. How practitioners in both fields “feel” about their clients and their respective circumstance, including obvious causes of readily preventable illnesses, or criminal or civil behaviour that is difficult to explain and/or justify, matters as little as those practitioners can manage to “detach”. And certainly, it is a rare legal appointment or a medical consult that witnesses a disclosure of the emotions of the professional practitioner.

In the academic field, too, how teachers “feel” about the respective traits, attitudes, wardrobe, and even language (inside conventional boundaries) of their students is expected to be deleted from their performance in class, in the gym and on the playing field. So too are they expected to both monitor and sanction the “unwarranted” display of emotions, particularly those that might endanger, or more recently, emotionally hurt another student. Humour, if appropriate, is naturally tolerated and appreciated; anger, intense frustration, however, are regarded as signals to be watched, and open weeping is often considered as cause for pastoral comforting intervention.

In recent years the DSM-5 has come to regard what previously was considered ‘normal’ and natural grief as a condition needing professional treatment. Whether that treatment involves pharmaceuticals, or ‘talk therapy’ depends on the practitioner and the respective needs and wishes of the client/patient.

Nevertheless, given the long history of medical assessment, diagnosis, and treatment at the physical level of humans’ lives, and the lagging interest and research attention to the vagaries of the emotional, spiritual aspects of being human, there continues in North America to be a primary focus by medical practitioners on the physical symptoms, measuring them, comparing, photographing them, and naming their nuanced and often highly complex characteristics with other similar but different symptoms.

One example of this tradition appears in the evolution of the treatment of Parkinson’s in which research between neurologists and psychiatry have shown evidence of enhanced living among patients who are offered both pharmaceuticals and cognitive behavioural therapy. As one patient recently commented, “I am much more than Parkinson’s!” in a legitimate push-back to being categorized as a specimen of the disease, in the eyes of the doctors.

Given the highly intimate and complex relationship between our minds and our bodies, and the flow of highly nuanced information of chemical, biological, neurological and thereby emotional content into the various organs, including the skin, and according to considerable evolving research, into and through the auto-immune system, we (all of us, including our medical practitioners and researchers) are faced with growing evidence of what is termed somatization of our emotions, or under a previously popular rubric, psycho-somatic illness.

Hiding our feelings, whatever our conscious and unconscious motivation for the concealment, can have a serious impact on our relationships, as well as on our personal health, including a rise in the risk of death. Communication that needs the free, and yet respectful, flow of authentic emotions can be disrupted and dissipated if emotions are kept under wraps. Those emotions can build up, often without are even being aware of the mounting pressure. Naturally, strains will show up within relationships in which honest and authentic emotions are withheld and research indicates that the potential for heart attack, stroke and even death rises under such pressure.

There are also multiple other implications from the somatization of our emotions, including skin irritations of various kinds, lupus, fibromyalgia, depression, alcohol dependency, sleep disorders, and potentially even thoughts of suicide. Given the complexity of this field of both study and experience, our genetic identity can also play a significant role, as can our experiences in our family of origin, as well as the culture in which we were raised.

For example, how a culture considers, and participates in (or refuses) in any kind of conflict, (fight-flight-freeze reflex) is another of the relative aspects of any individual’s potential for somaticizing of his or her emotions.

Studies have been conducted that disclose the relative numerical incidence as well as the severity of somatic illness among men and women. And depending on the circle in which we all circulate, there can be a wide range of options as to how individuals ‘inside the circle’ do or do not express their authentic emotions first to themselves and to the others.

Having witnesses literally dozens of women undergoing what were clearly agreed to be emotional blocking, and the impacts on their health, and also having walked near or immediately after male suicides, I have to guess that some of the individual pain all of these men and women were experiencing overlapped some kind of emotional obstruction.

Having spent a quarter century in English classrooms, where I observed generally that young women were both more open and more willing to share their “feelings” about the literature under consideration, and young men were resistant, shy and even indifferent to such self-disclosure, I nevertheless, along with a battalion of other English instructors, persisted in pursuit of dialogue, as well as reflective review in assignments like movie and book reviews, as well as attempts to foster a disciplined critique of the various qualities of a memorable poem, play, novel or short story.

While we can all recognize the fallacy that loqaciousness is not always indicative of integrity (think trump) and in fact can be deployed as a means to manipulate others, thereby eroding any potential respect for self-critical reflection and disclosure (especially among men), there is nevertheless a deep and predictably long-lasting pool of people whose lives are currently being impinged by their/our willing/unconscious engagement in a process of self-effacement.

That is not a medical term; nor is it a theological or ethical term. In fact, self-effacement as a method of political correctness (and personal concealment) is often considered a sign of modesty, maturity, respectability and trustworthiness. There are times when it is clearly appropriate to withhold deep and poignant emotions, especially in a public venue. And there are other times when such “public” repression carried over into family and intimate situations is a risk not only to the health of the “repressor” but also to the health of the relationship(s).

A question looms for each of us, especially during a period of extreme turbulence, danger, risk and unpredictability…Can we each begin the process of identifying if and when we are repressing how we feel, (even from ourselves in our self-talk) and then tentatively walk into the beach of beginning to trust that someone will be open to actively and sensitively and confidentially listening and actually hearing our deepest fears, hopes, dreams, and anxieties. We might just be surprised to discover that our “friend” has had, or is having, similar emotional experiences, and welcomes the opportunity to release his/her own pent-up feelings.

This experience/exercise/journey has no ideology, no specific faith or religion, no ethnic boundary and no class fences. Nevertheless, our courage to begin to explore this vast and intricate and intimate complexity of our whole human identity, beyond the empirical, the physical, holds an authentic promise and reward that is memorable, personal and life-giving. It also holds the promise of a shift in our we take care of ourselves, enhancing our perception of our own courage, our capacity for risk and our creative imagination to see ourselves as normal, natural and even more worthy of self-respect and dignity, from within.

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