Home sweet home

I just got back from a four day trip to New York with my sisters.  I've been looking forward to this trip since we planned it several months ago.  Most of us identify traveling as something we'd like to do at some point in our lives.  We envy others when they talk about the exotic and far away places they've visited.  We all have somewhere we long to go, to see, to experience.

Most of us also have some excuse why we can't.  Probably the most frequently cited reason for being unable to go where we long to go is lack of money.  I use this excuse myself all the time.  There is some truth in it -- I don't have money to throw around.  However, I could probably get a credit card with a $10,000 limit and six months without interest, splurge for a big trip, and try to pay it off over the next six months.  That would, however, require a lot of sacrifice on my part.  Instead of buying myself a new outfit on pay day or going out with my girlfriends for dinner I would have to pay off the credit card instead.  So not having the money isn't the real reason I don't travel very much; the real reason is that I'm not willing to sacrifice my everyday comforts.

Another common excuse - "I don't have the time."  Again, it's all about priorities.  Most of us can delegate our responsibilities long enough to take a vacation.  In fact, if we're honest, we've all probably covered for a colleague or fed a neighbor's cat while they were out of town. 

It's important to remember that we all have only one life to live.  We can choose to make excuses for why we don't spend it doing the things we'd really enjoy but at the end of the day that is all they are -- excuses.  Many of us talk about being able to do the things we dream of doing some time in the future.  The problem is that none of us know what our future holds.  We don't even know for certain that we will have a future.  We always, however, have the present moment. 

One other thing I've noticed, at least about myself, is that no matter how much I enjoy a good vacation I am ALWAYS and without fail ready to go home when the time comes - sometimes even before the time comes.  Why is it that I should spend months looking forward to a trip yet be so eager to return home in the end?  Just something to think about...

Fear of happiness

I'm always looking to explore new ideas and new concepts.  That's the beautiful thing about the internet; you can go online with only a vague topic of interest in mind and come away having identified a whole list of related ideas you've never been exposed to.  Recently I read an article that talked about the fear of happiness.  Initially, it seemed like an oxymoron to me.  "Aren't we all striving to be happy?" I thought.  The pursuit of happiness is the driving force behind almost everything we do.  We want to be successful because we equate success with happiness.  We want to have children because we equate family with happiness.  We want to help others because we want to live a good life; we want to  live a good life because doing good things makes us happy.

The more I thought about it though the more it made sense to me.  On the surface most of us desire and seek happiness.  The fear of happiness is rarely a conscious thing.  (There is an exception to this.  Apparently, there are people who suffer from cherophobia, an irrational fear of merriment, gaiety, or joyfulness).  People who fear happiness typically do so on a subconscious level.  Things never seem to go their way and they aren't happy but if you ask them they will tell you that they want to be happy.

It seems to me that a person who fears happiness does not actually fear the feeling of being happy (with the exception of a cherophobe).  Rather, that person fears what happiness will bring with it.  For some, happiness brings with it a fear of losing the things in life that have brought about that happiness (or a general fear of losing the feeling of happiness, for whatever reason).

For some, happiness comes with increased responsibility and expectations from others.  For example, suppose a person is unhappy doing a mundane job that requires no thought or skill and offers no challenge.  That person might hesitate to apply for a job that would be more challenging and more fulfilling.  The person lacks confidence and fears failure.  Yes, he would be happier in this new job, but he would always be worried about measuring up and would be fearful about making mistakes.  Perhaps his worries and fears would consume him so much that he would become more unhappy than he was at the boring job.

Others may fear that happiness will breed laziness.  They worry that if they allow themselves to be happy where they are then they will never live up to their full potential.  They will become complacent and will lose their drive to do all they can do and to be all they can be.  These people will tell you they want to be happy but they keep setting the bar for what will make them happy higher and higher; it will always be just beyond reach.

So what do you do if your subconscious fears sabotage your efforts at happiness?  What do you do if you have achieved the goals to which you aspired but are still not content?  Start by asking yourself what you are afraid of.  Of course your conscious desire is to be happy.  However, you should not assume that having the conscious desire to be happy means that you cannot have another, subconscious desire (or fear) that is in complete conflict with your conscious desire.  They can and frequently do coexist.  (For more on this, see Eva Pierrakos' lecture No. 45 at www.pathwork.org/lectures/unedited/045.pdf).  Once you identify what it is that you fear you simply observe the fear and any other emotions or thoughts that accompany it.  Do not try to force the fear away; your attempts would be futile and would cause more harm than anything else.  It is simply not possible to force a feeling away at will.  You might believe you have forced it away because it seems to be gone but all you've really done is covered it up.  Now you are unaware of the fear, which means it is free to come and go as it pleases without scrutiny.  If instead you observe the fear (and all that comes with it) without judgment, over time you will find that it diminishes on its own.

States of mind

I thought I'd share a story today, but first let me explain something that will be relevant to my tale.  Marsha Linehan, Ph.D., renowned for developing Dialectical Behavioral Therapy, describes three states of mind - the reasonable mind, the emotional mind, and the wise mind (which consists of equal parts emotion and reason).

Obviously the goal is to spend as much time as possible using your wise mind.  For me, I spend more time in my wise mind than ever before in my life; alas, no one can dwell there all the time.  This story is about a recent incident that took me FAR from my wise mind...

We'd just spent a long and stressful day at court.  (My husband and I have been back and forth to court several times over the past few months, as he is embroiled in a battle with his ex-wife over custody of their five year old daughter).  Court always makes me anxious and I always seem to be irritable when the day is over.

There have been a few other highly stressful things going on at home too.  There is one issue about which I have been extremely stressed and frustrated for the past two or three months.  It's something my husband recognizes is a problem and he and I have spoken about it many times.  I have explained to him how stressed and overwhelmed the issue is making me feel and he has pledged to do everything he can to remedy the situation.

We got home from court and were sitting down to a late dinner.  Somehow, we started talking about the aforementioned problem.  The discussion got heated and at some point I just lost it.  I think I caught my voice of reason napping.  The second I started yelling at my husband - REALLY yelling -- my voice of reason jolted awake.

"Um, Melody," she said.  "You should probably stop.  This isn't a good idea.  And you're not being very nice."  I know, I know.  It seems like my voice of reason is a little on the weak side, huh?  But she's really not.  She gets a lot of exercise on a regular basis so she's actually quite strong.  It just happens that she's also been doing a lot more work than usual lately (due primarily to the stressors I mentioned earlier) and she's worn out.  That's probably why she was asleep in the first place!

Needless to say, the emotional part of me was in no mood to listen to my voice of reason.  All the while I'm yelling there's a heated debate going on in the back of my mind.  My voice of reason cautions me to stop yelling before I say something I'll regret later.  My emotional voice has her own thoughts about this.  "I've tried it your way," she tells my reasonable voice.  "I let you do most of the talking most of the time.  I only put my two cents in when it's helpful to you.  Obviously, he [my husband] isn't understanding how important this issue is to us.  Your way isn't working.  It's my turn to try."

My reasonable voice - being reasonable - listened to my emotional voice and considered what she'd said.  She decided that emotional voice had a point.  Reasonable voice had been talking to my husband for weeks about the issue we were now arguing about.  Unfortunately, very little seemed to have changed as a result of her efforts.  Her strategy just wasn't working.  Maybe emotional voice would have better luck.

I think that's why I lost it - not because my emotional mind hijacked the rest of me but because getting emotional actually seemed like a reasonable option, at least at the time.  Plus, I've been under a lot of stress lately.  My reasonable mind has had to work a lot harder than usual to keep things in balance.  It's overwhelmed.  I'm overwhelmed.

The next day, my husband and I sat down to talk about (and to try to resolve) the argument.  I'd already apologized the night before - I've never been one to stay angry very long and I also believe in saying sorry when you make a mistake.  "You were acting like a crazy person!" my husband said to me.  Not what I like to  hear, especially as a mental health professional.  I can't beat myself up though; we're all human.  Like everyone else, I am a work in progress. 

I don't do magic

I suppose it's only normal to become frustrated with patients at times but I hope I can eventually learn to approach it with equanimity.  What frustrates me?  I find it exceedingly difficult to work with people who expect me to do all of the work.  It's like they come to therapy expecting a magic cure;  I'll wave a wand, say a few words, and - voila - they'll be better.  It doesn't bother me that people arrive with these expectations.  Most people have no idea what to expect when they come to therapy.  Part of my job is to explain to patients what they can expect from me and from the therapeutic process.  I typically share just the basics.  After all, I don't really know what to expect from the therapeutic process with a given individual; everyone is different.  Most people readily embrace therapy as a two-way process that requires a certain level of commitment and effort from both parties involved.  These are the people who seem to make the best use of therapy and who generally receive the most benefit.

Then there are people who seriously consider what we discuss in individual sessions and store it away for future reference.  They might not run home and immediately try to make changes in their thoughts and/or behaviors.  Over time, however, they keep referring back to the past conversations they've stored away in their minds.  For these people, change tends to happen very gradually and in very subtle ways.  Still, they make use of our time together; they listen to and seriously consider what takes place in session.

Then there are people who keep showing up to session every week or two, just waiting for me to make them better.  They make no effort to do anything different in their lives outside of session and return the following week complaining that they still feel the same.  In session, it's frequently obvious that they aren't taking anything in.  They cling fervently to their pre-existing beliefs and are not open to exploring where these beliefs came from, how they are affecting their lives, or whether or not they are accurate.  Attempts on my part to engage in such exploration are met by defensiveness or by blank stares.

Often times, this type of patient has worked with other therapists before coming to me.  Recently, I even had a patient who revealed that he's been seeing another therapist on an almost daily basis in between our weekly individual sessions.  (Although it might seem to be the case, having more therapists does NOT equal getting more benefit.  It can, in fact, be counterproductive, particularly if the therapists are unaware of each other or if they are using different approaches that, on the surface, appear contradictory).  I was not at all offended by this revelation.  In fact, I was hopeful.  I was getting nowhere with this patient.  Maybe things were going better with the other therapist.  Since we are not permitted to offer duplicate services, patients are not allowed to have two therapists.  I was sort of hoping to transfer the patient's care to the other therapist.

Alas, this was not meant to be.  Upon inquiry, the patient indicated that treatment with this other therapist was not beneficial.  "I don't think it's helping," he said.  Actually, this was the exact same thing he said to me about our therapy as well, about a week earlier.  In fact, before he started therapy with me he was involved in another treatment program.  After two days, he asked to try something different because he didn't think the treatment was working.

This patient has had three treatment providers in the past month and has reportedly gained no benefit whatsoever from any of them.  What's going on here?  The first thing that comes to mind is that the patient isn't making a real effort to take anything from therapy.  He's waiting for a "magic cure."   He has decided that getting better is not HIS responsibility.  Rather, he has placed that responsibility on other people.  He does not say to himself, "I'm not getting better."  He says to himself, "This treatment is not making me better."

To me, this is the most likely scenario.  However, there is this nagging voice in the back of my mind that will not allow me to buy completely into this.  For one thing, it causes frustration.  It also leaves me with no viable course of action.  Even if this interpretation of the situation is accurate it is not helpful for me to think about it this way.  It's a dead end.

So I've decided to take a different approach.  Maybe this guy has some serious issues that require an exceptionally skilled therapist and some kind of intense, targeted intervention.  There's always the possibility that he is what we refer to as a "complicated case."  If so, then I have a couple of options.  The first thing I'm going to do is to move completely outside of my comfort zone.  I've done some research and have identified some new (or new to me) interventions that I'm going to try with him.  In the end, at least I can say that I've given this patient my best effort.  If this doesn't work, I'll probably refer the patient to another provider with more experience (most likely a Ph.D. or Psy.D. psychologist).

I guess the challenge for me in this situation is not to allow my frustration to interfere with my work.  Even frustrating patients deserve the best treatment I can give them. 

Emotions as motivation

Have you ever noticed that the happier you are - the more content with life, the more satisfied - the less driven and active you become?  Or maybe it's just me?  I think that the people that make the biggest impact on the world are those who are discontent with the way things are.  I guess this speaks to the invaluable function of negative emotions -- they can be very motivating.  Think about it.  If you're unhappy with your current circumstances then you will probably take action in an effort to change things.  You might have a lot of good reasons for taking action and making changes but the most powerful of these is the desire to get rid of your negative feelings.  You want to make changes that move you to a place where you'll be happier and more fulfilled.

Obviously this is a good thing.  How many people are driven by the feeling that something is missing?  Throughout history, the great leaders of social change movements have been those on a quest to find that "something more."

But then what?  You see, that's where I'm "stuck."  For the most part I am content with my life right now.  It has by NO MEANS always been this way so it's definitely a pleasant place to be.  And yet I have no drive, no motivation to seek out that "something more," no idea what more I'd even want in my life right now. 

Then I think that maybe positive emotions serve a function just like negative emotions do.  Maybe my happiness IS motivating me; instead of motivating me to do something different maybe it's motivating me to keep doing exactly what I'm doing.  If that's the case, I can definitely handle that.

How other people change us

It's striking how much of what we do is in response to or shaped by other people.  I mean, our personalities are essentially shaped by our early interactions with our caregivers.  (That's not to discount the role that biology and heredity play in who we are; I am a firm believer that both nature and nurture are involved in personality development).  Even after our personalities are fully formed our patterns of behavior, our thoughts and beliefs, and the way we look at things continue to be influenced by the important people in our lives.

Of course this has all sorts of implications for therapy, which I'm not going to get into right now.  Actually, I'm thinking about how this plays out in my own life.  I got married about five months ago and I've already noticed little things about myself changing as a result of my interactions with my husband.  For example, I've always been fiercely independent.  Once I reached the point where I could take care of myself I came to the conclusion that my problems = my responsibility.  Now I'm fortunate enough to have very supportive parents who didn't mind taking on some of the burden when things came up that I couldn't handle on my own. 

Still, I had a completely new experience when my car broke down a couple of months ago.  I called my husband and said, "We have a problem.  How am I going to get to work tomorrow?"   It was quite a relief, actually, to realize I didn't have to figure out what to do on my own.  It was our problem, not just my problem.  Actually, my husband pretty much took care of the problem himself without much assistance from me.  He had an idea about what was wrong with the car, took me to the store to buy the part, and spent the next hour putting it in the car while I sat in his car reading a book. 

I really liked not having to stress myself out.  It was such a pleasant experience that I started thinking maybe I didn't have to handle all the problems that come up in my life by myself.  Maybe I could delegate some things to my husband.  And so gradually I've become slightly less independent.  There are even some things I am perfectly capable of doing that I used to do before I got married (including non-problematic things like mowing the lawn) that I just don't bother with anymore; I let my husband take care of it.

Another thing that's changed for me is timeliness.  Now I'm a very structured, routinized person (some would say anal); I always have been.  However, I've never been great at getting to places on time.  I tended to be about five to ten minutes late just about everywhere I went.  My husband is NOT a structured person at all.  He finds routines to be boring; "not enough variety," he says.   He's also from Jamaica, a place where, like on most islands, they operate on "island time."  "Island time" is sort of a new concept for me.  Like most Americans, I'm pretty impatient and always in a hurry to get things done.  Apparently, people living on islands take a much different approach to time management.  People don't "schedule" events to start at a specific time.  Things start "around" a certain time and there really is no such thing as being late.  Life on islands is slower paced in general than life here in the States. 

In keeping with this, my husband NEVER arrives ANYWHERE on time and he's frequently more than just a few minutes late.  (This is how I learned about "island time."  I realized my husband's frequent tardiness was a cultural thing when many of his family members arrived late to and missed half of our wedding ceremony.  There were even a few people who arrived just as the ceremony was ending).  I quickly learned that if I was ever going to arrive anywhere with my husband anywhere close to on time I was going to have to offer frequent reminders and encouragement for him to stay focused and to move more quickly.  This meant that I needed to be ready to go early so that I had time to make sure he was ready to go on time.  As a result, I've gradually become more conscientious about being on time in general.  I've actually started getting to work a few minutes early every day as opposed to a few minutes late.

Anyway, it's just interesting to see how I'm changing as a person as a result of my interactions with another person.  It's raised awareness for me of how much we as people influence one another.

Need to know

I've been thinking a lot lately about the seeming need of human beings to understand things.  If something is wrong psychologically or emotionally people always want to know why.  They are reluctant to take a given action unless they understand the reasons for it.  They are frequently unwilling to make a decision unless and until they can determine why one option is more favorable than another. 

Sometimes human curiosity is a good thing.  Throughout history it has led to the development of amazing technology, driven the discovery of treatments and cures for all sorts of physical and mental ills, and has helped to expand the ways in which we interact with our environments and with each other.  There is no question that the human drive to understand has been a useful quality that has likely given us an edge over other species and propelled us to the top of the food chain.

What stands out to me is not the quest for understanding that leads to something useful and adaptive.  Rather, what strikes me as odd is that we apply our desire for discovery to endeavors that are completely useless.  We look for reasons in situations where finding them would have no practical implications.  If there is no chance that knowing why a particular problem exists in its current form will help us to better deal with or solve the problem in question then honestly, what is the point?!?

And yet this need to know has such an impact on our behavior.  For example, time and time again people come to me wanting to know why they are depressed, anxious, emotionally unstable, etc.  I can understand the desire to know -- it is, after all, human nature.  So I am willing to spend a little bit of time on identifying possible contributing factors.  Most people are satisfied with the explanation that there are a number of factors that might have played a role in creating their current situation.  They are typically content to identify a few of the most likely culprits before moving on.  But there are some people for whom this is not enough.  They return again and again to the question, "Why am I like this?"  They spend excessive amounts of time and energy thinking about and analyzing their past experiences.  The reality is that there is no specific, identifiable reason.  Even if such a reason existed, what good would come from discovering it?  It would tell us nothing about how to resolve the problems the person is facing.  Knowing how you got there will not show you how to get out.

That's just one example of how frustrating the human quest for reasons can be.  I could come up with a million others, but I'll refrain.  The point is, there comes a time when the need to know why becomes part of the problem.  Frequently people want to know why a particular thing is before they are willing to accept it.  Non-acceptance inevitably leads to suffering.  When you refuse to accept what is you begin to fight against it.  You get caught up in wanting things to be different than they are.  Not only does this create a lot of negative emotions it also prevents you from figuring out how best to cope with reality.  If you can't accept it then how can you cope with it?

The solution?  I suppose it is being willing to let go.  Accept that things are as they are and that it really doesn't matter why.  You will have to do this again and again; the urge to ask why will continue to come back up.  Whenever it does, you will again have to remind yourself that chasing that urge is a fruitless endeavor.  You will have to make a conscious choice to simply allow things to be as they are.

The need to express yourself

You always hear that you shouldn't keep your emotions "bottled up," that it's "bad for your health."  What you don't hear a lot about is what to do instead.  What do you do if you can't express your feelings in a given situation because it's not the right time or place?  What if you're so angry that expressing that anger might unleash a violent storm with negative consequences for yourself or the people around you?  What if leeting another person know how you feel would do more harm than good?

I am fully convinced that "bottling up" emotions is not healthy.  I believe that emotions usually -- but not always -- need to be expressed in order to keep them from hanging around only to reveal themselves at inappropriate times or in inappropriate ways.  If, however, it is not possible to express an emotion for whatever reason, at the very least it should be acknowledged.   Ignoring or suppressing emotions won't make them go away.  They will inevitably return, although they may manifest themselves in different ways (perhaps as an unexpected angry or violent outburst or maybe as physical pain such as headaches, ulcers, or stomach problems).  Acknowledging a feeling brings it into your conscious awareness.  Once it's there you can make a decision about what (if anything) to do with it.  If an emotion is not acknowledged it remains unconscious.  It is still there but you no longer have control over what it does.  (I think that one of the reasons people reach a point where they have no control over their emotions - or where their emotions are in control of them - is because they've suppressed, repressed, or otherwise kept their emotions from consciousness for so long that they've accumulated, grown, and joined forces until they've become a powerful and destructive force).

In terms of expressing emotion - while it may not be appropriate to express an emotion at a given time, in a given place, or to a given person, you can at least take a moment to recognize how you are feeling, choose to keep that feeling to yourself for the time being, and return to it later when you are able to express it.

Expression does not always have to be verbal, although verbally identifying an emotion has been shown to make that emotion more manageable (and sometimes less intense).  Art, music, or physical activity are also potential conduits for emotional release.  Still, humans are social creatures by nature; perhaps that is why - at least in terms of the most intense or troubling emotional experiences - we seem to benefit most from finding someone supportive to share them with.  Studies have shown that after a distressing experience people tend to seek out others to share their emotions with.  People with diagnosable depression, however, do not show this tendency.  This suggests that not sharing such emotions with others contributes to, exacerbates, or serves to maintain depressive symptoms.  In addition, avoiding emotions related to a distressing experience or experiences is a factor that has been shown to contribute to both the development and the maintenance of symptoms of PTSD and other anxiety disorders.

I realize that I have repeatedly warned of the perils of emotional avoidance.  Still, I don't think it's possible to over-emphasize this.  If we are to lead a psychologically healthy and emotionally fulfilling life we have to find ways of expressing - and sharing - our feelings.  This will probably be uncomfortable at times but in life what is good for us is not always comfortable.  Maybe we don't want to get immunizations because we don't like needles but we do it because it prevents us from getting life-threatening diseases.  We might not enjoy a colonoscopy but at age 50 we go get one because it could prevent us from getting colon cancer.  And women - we may not enjoy our yearly female exam but we get it done because we want to make sure we stay healthy.  When you look at it this way there is absolutely no reason not to engage in healthy emotional expression.  Yes, it may be uncomfortable to share you feelings at times; however, rarely is it as bad as getting a colonoscopy.  Keep that in mind next time you have the urge to bottle up your emotions.

Avoidance

Awareness of and acceptance of emotions have been important concepts in psychotherapy since its inception.  Freud proposed that unconscious defense mechanisms served to keep distressing and intolerable emotions out of the patient's awareness.  The goal of therapy (psychoanalysis at that time) was to help bring these feelings into the patient's conscious awareness.

While it can be useful at times to avoid the experience of emotion (whether by conscious or unconscious methods), a large body of evidence suggests that doing so on a regular basis causes, contributes to, and/or maintains a wide range of mental (and physical) health problems.  An increasing number of therapeutic techniques -  from DBT to ACT to exposure based therapies -  feature acceptance of uncomfortable (and comfortable, of course) emotions and experiences as one of their primary interventions.  The irony in this is that acceptance itself and for its own sake is often the goal of these treatments.  In fact, accepting negative emotions with the goal of making them go away is not really acceptance at all  and is counterproductive.  If acceptance of emotions is applied merely as a strategy for getting rid of these emotions then can you really say you are accepting them?  Or is part of you engaged in not-accepting (trying to get rid of them)?  The very act of identifying ridding oneself of negative emotions as a goal is itself not accepting.

The opposite of acceptance is avoidance.  People who cannot or will not accept their internal experiences tend to engage in efforts to avoid them.  Examples of avoidance include denial, distraction, repression, and suppression.  Drinking or using drugs are also examples of avoidance if they are used in order to decrease the experience of negative emotions or to mask these emotions via their mood-altering effects.  People may also avoid situations, places, people, or events that generate distressing emotions.

Avoiding unpleasant internal experiences seems like a common sense goal.  After all, who wants to feel unhappy, anxious, or angry?  However, if these negative emotions emerge with any frequency a person can end up spending all of his or her time and energy trying to avoid them.  Eventually they become so consumed with avoiding that it prevents them from living a meaningful life.

It wasn't until I recognized the role avoidance plays in mental illness that I began to see the relationship between ancient eastern religions (like Buddhism) and modern psychology.  Followers of Buddhism have recognized for centuries that mindful, nonjudgmental attention and acceptance of thoughts and feelings reduces suffering and improves the quality and meaning of life.  Modern psychology has only started to recognize this over the past 150 years or so.  Better late than never, I say.

Even though people have recognized for centuries that avoidance leads to suffering there is little awareness of this in western society in general.  We cling fast to the idea that normal = happy and that anything else is wrong and should be corrected.

For me, learning to accept internal experiences has made a radical difference in how I live my life as well as in my work with my patients.  I try to pass on what I've learned to others in the hopes that they too will pass it on.  The more people who choose to be willing to accept their thoughts and feelings the less suffering there will be in this world.

Secrets

"I've never told anybody..."
"I don't want anyone to know..."
"Nobody would understand..."
"If anyone found out..."

I can't tell you how often people tell me things like this.  They have some burden they've been carrying with them for years and it's finally become too much to bear alone.  The nature of the "secret" varies from person to person, as do the reasons they haven't told anyone.  The response when they finally share what they've been hiding for so long, however, is almost universal - relief.  They feel relieved at having someone with whom to share their burden.  They feel relieved at having revealed their deepest-held secret and not being rejected.  They feel relieved that the look of horror and disgust they expect to see on my face when I hear what they have to say never appears. 

I am no fan of secrets.  There are all sorts of negative connotations associated with keeping things hidden.  When we do something wrong as a child we try to hide it from our parents.  When an angry mother stands before her child and asks in an accusatory tone, "Who broke the lamp?" the child shrugs his shoulders and declares, "I don't know.  It wasn't me."  Nobody has to teach us to do this - it's instinctual.  We know we've done something wrong, we feels ashamed, and we want to hide it.

It doesn't change much as we get older.  Criminals frequently try to cover up (hide) their crimes.  They plead "not guilty" even when they're guilty as hell.  Cheating spouses try to hide their infidelities.  Thieves often try to conceal or sell their stolen goods in order to "get rid of the evidence."  We hide things because we are ashamed, because we are afraid of the consequences of getting caught, or both.

So when a rape victim tells no one she's been raped, when a sexually abused child grows up and hides his past from his new wife, or when a soldier refuses to talk about the fact that he killed people in battle they do it for these same reasons - shame and fear of consequences.  The difference between these and the earlier examples is that these people haven't done anything wrong.

Why fear consequences if you've done nothing wrong?  First of all, these people believe they have done something wrong.  They blame themselves, even though their blame is misplaced.  Secondly, the consequences they fear aren't prison or punishment.  Their fears are of judgment and rejection.  They fear that others will condemn them the way that they've condemned themselves.  They fear that if people know "the truth" about them they will no longer want anything to do with them. 

Shame and guilt are heavy loads to carry.  It is difficult to be happy when you feel the need to constantly punish yourself for some imagined wrongdoing.  Over time, you lose all perspective on the original incident or incidents.  All you remember is what you did wrong and what you could have done differently to prevent it (even if there really isn't anything you could have done differently to prevent it). 

Carrying secrets like these creates so much suffering.  Just the act of telling someone can be very healing.  It is, of course, important to find the right person to tell.  Some people are not able to be supportive or accepting because of their own emotional issues.  Some people are uncomfortable hearing about things over which they have no control.  This kind of person will probably not be receptive to hearing another's long-held secrets.

The other day I had a patient who had been depressed for many years.  He was engaged to a woman he loved very deeply.  He was afraid if he told her about his struggle with depression she would leave him.  Finally, he got up the courage to tell her.  In recalling the incident he said that he was shocked at his now-wife's reaction.  Not only did she not leave him, his sharing brought them closer together.  She was flattered that he loved and trusted her enough to share something so personal.  She offered her support and acceptance and continues to do so.

I suppose my message is this: don't keep secrets.  People hardly ever react the way that you expect them to when you share and the sharing itself often brings people closer together.  People rarely judge us as harshly as we judge ourselves.  Maybe it's time you heard from someone else that it's not your fault.