Sarah cried today. Tears while holding back full sobs. Today, she knew what she was crying about – unlike those times not so long ago when drops of clear liquid would come from her eyes and roll down her cheeks, and she wouldn’t know why or what they were…to her, they were just disembodied secretions.
Tears…they can be signs of deep unremitting depression, and they can be signs of relief, release and healing. Sarah’s today were the latter. I confess I believe strongly in tears. They are a sign of being in touch with pain and sadness that has been suppressed, compartmentalized, defended against. And they can mean real growth and progress.
I have always felt this way. I can remember early in my training, coming home to my wife and brightly saying, “I was a good psychiatrist today. I made someone cry!” It reminds me of a patient long ago who would hold back tears to the point of puffy eyes and headaches – so shamed she had been for having them growing up. As time went by, it all became easier and looser; she could cry and release without the tension and the headaches.
Being easy and loose. That’s one way of describing what I want to help people to be. Not to be rigid and armored against emotion. Making what is frozen be able to move. Make what is hard soft. As another patient has said, “You’ve made me mooshy inside…instead of the hard obsidian it used to be.” When I heard this, there was a feeling of pride and satisfaction and success, because this is what I always wanted to do for people – even decades before I was a psychiatrist. When I was a young man, that was my vision and my calling…it was one of the reasons that I played and wrote and sang music. Movement, motion, emotion, flexibility, feeling, passion…. all of it. It was what drew me to art and creativity – because they would deal with process and expression and experience without analyzing or abstracting it. That was my problem with psychiatry, psychology and all the academic disciplines.
I once wrote in a song called “Revolution” of the difficult turning around, the shedding of old skin and he exposure of new… the breaking of the armor and the exposure of soft, sentient flesh.
And in a joyous or playful mode, I wanted to be the Mad Boopler…going through the world “boopling” people – making them alive, playful, feeling, emotive, joyful.
These were years ago…but all iterations of the same thing I do now with my patients, with the people I work with…using my skills and instinct and patience and care to help them transform from the hardened or spaced out or intellectualized beings they had to become to survive childhood into soft flesh and beating hearts. That is my calling…be it writing songs, drawing fishy creatures, inspiring others, doing “therapy”…it’s all me in here.
So, tears. They are one manifestation of melting. There is sadness and pain that comes from lots of places and is part of life…. what is antithetical to life is the not feeling of them….
Today, Sarah talked to me about what she was doing to help her 3 year-old daughter, Annie, with two situations at school, and I was moved by how patient, attuned and helpful she was.
The first had to do with a boy who wanted to play with her, but Annie did not want to play. The boy insisted and said she had to. She came home crying – and this morning didn’t want to go to school. So, Sarah took 45 minutes to find what was wrong and, and help Annie to understand, explaining it in the most remarkable way: Who makes the rules at home? (mommy and daddy) Who makes the rules at school? (the teachers) and Who makes the rules for Annie? (I don’t know) Well, it’s Annie who makes those rules. So, when the boy wants you to play, what do you say? You say, thank you for asking but I don’t want to play right now, I just want to be alone and draw…good. Now, what happens if he doesn’t listen? (Annie doesn’t know) … well, Sarah says. That’s when you go to the teachers and get help. Oh. OK. And Annie went off to school.
The other was about Annie and her friend “getting into trouble” because they play during circle time or story time. Sarah talked her through what happens, Annie telling how she really likes to play with her friend. But what happens? Well, the teachers tell us to sit still and be quiet during circle time. Ok, and what happens if you don’t. Then they separate us. And you don’t like that? No. So, Sarah explains, if you play, you get separated. And you don’t like that? Right. So you could tell your friend that if we don’t play, we can still sit together…
The other day, the teacher reported to Sarah how she had overhead heard Annie telling her friend just that, and Sarah laughed, because she knew where it came from. But I will say, how remarkable. This little 3-year-old sponge, innocently taking in what she has been told by her trusted mommy. That taking in and trying out – what a little person does so naturally. So much a part of how we function as human beings and how we become the adult human beings that we are.
When Sarah finished, having told these stories with joy and love, I gently told her what a good job she was doing. “I’m trying…” was the reply.
Then she said, “Why do I do that? Why do I say, ‘I’m trying’ instead of taking it in that I’m doing well? What’s that about?”
This was a bit of a mystery, but I had a sense.
It had something to do with a phenomenon I have seen all my life, that I have experienced, and that I see with patients. The tears when something good seeps in.
So, together, we explored, peering into the deeper parts of her mind and body. What was in the way of taking it in? She didn’t know. We talked about several things….and as we did, I began to have a feeling – literally a sensation – of sadness. This led me to a sense that perhaps if Sarah took it in she would experience a profound sadness in herself. Now I have known her a long time and know that she has a central sense of being bad or not good enough.
But it was, as it turned out, more subtle than this.
She told me that the feeling she had had all week was, “I’m grieving.”
I knew what she meant. I knew that she had not been seen or known throughout her childhood. She came from divorced parents, each of whom remarried and had children of their own. She was told that she was so fortunate to have 4 loving parents. “I thought I was the luckiest kid in the world…other people only had 2 parents to love them. I had 4! I had twice as much love as anyone else.” But as we have worked, we have found a different truth. In one family, there was emotional abuse and terror inflicted by the parents as well as being sexually abused by her older stepbrother. The other family did not have abuse as we usually talk about it, but there was a high level of non-attunement and shame inadvertently foisted by brilliant and logical parents who did not really understand emotion…only rationality. That left her terribly shamed and alone deep inside beneath the sunny, energetic, enthusiastic exterior she presented to the world. And through our work, what was happening now was the grieving of the love and security she never had…deep sadness that could wrack her body in sobs.
Partly what amazed me as I listened to the stories of her being with her daughter was – where did this ability to empathize and communicate come from? This astounding attunement to her 3 year-old’s state of mind and her patient reflection and help she was able to give her when Sarah had had so little help of her own.
It also was not lost on me that, in giving her daughter the strength and power to say “No” politely and firmly to the boy who wanted to play, was providing her daughter something that she, Sarah, hadn’t had in the house of abuse. She couldn’t say no, and if she had, he (the stepbrother) wouldn’t have listened. So, she was making a safer world for her child than she had had herself.
When I mentioned that, I worried momentarily that I would stir up the trauma of the abuse and that we would be sidetracked from the grieving, but that didn’t happen. Instead, she was quiet. In a few moments, I could see her eyes glisten, I could see the furrowing of her forehead, the arches of her eyebrows coming together, the downturned mouth, the struggle to contain what was now uncontainable, holding her breath and then, the tears. The tears came despite the holding on, and she cried as she tried to talk, the intakes of breath shuddering through her.
I sat. We felt. She knew what was happening. And soon, with another level of stifled sobs, said that she was giving her daughter what she, Sarah, had never had…and with that, I understood better than ever before the mystery I have wrestled with for years…it was simply that…if you take in the goodness, it exposes the emptiness and pain, and tears come. They are not so much the tears of happiness or joy; they are the tears of grief of what never has been.
This is why I cried at the movie where the son hits the home run to win the game and the father is so proud. This is why we weep at long-lost contact being made between parent and child. This is why we cry at happy endings. This is why I fall apart when the father and son play catch at the end of “Field of Dreams”. In all of us there are pockets of sadness of something we missed, that didn’t quite happen right, and when we see and vicariously feel the goodness coming in, we weep. The is why Wes, one of my other patients, scrunches up with tears when he feels connection and acceptance and approval from me, looks at me through the pain and says, “Why does that make me sad?”
Tears.
But this leads down another road….the simplicity of emotion and the physicality of it. I have almost forgotten through all these years and medicine and psychiatry, which tend to focus on things other than emotion, the centrality, the physicality of crying and laughter and the whole range of emotions that we as human animals experience not just in our minds but in our bodies. So I want to look at the muscles in the face, in the throat, in the chest and see the genesis not just of the sadness, but of all the muscular armor, tension, resistance to feeling and showing that sadness. This is a big topic, which I will briefly touch on here.
There is an ethology of emotion in the whole organism. So, in addition to all the molecules and pathways and membranes and chemical messengers and genes that make up a nervous system that is part of a sentient being, I want to include something that happens in the musculature of the body, the experience of i the lt,iterature of it and the science of it and the music of it…And, especially, the simplicity of it. How I have long hated the theories and diagrams and construct of the psyche…making complex what is simple…
So, there are actually 2 topics here: one, muscles and emotion; two the simplicity of feeling as opposed to the complex theories and diagrams of the mind and the psyche.
More to follow.