But why am I like this?
“I just wish I knew why I’m like this?”
I hear variations on this theme a lot, and in private practice we have the luxury of time, so we can take as long as it takes to work this out.
From the outset I ask a lot of questions; we talk about thoughts, feelings and physical sensations, current concerns, recent events, past events, diet and exercise, drugs, alcohol, day to day life, future hopes and dreams, and so on. Many people have complex and messy lives, or very demanding jobs, difficult relationships, and/or issues from the distant past that will have shaped them for better or worse.
A thought that often strikes me is: ‘What would it take for me to feel just as bad as this person sitting in front of me now?’
One day of not drinking enough water? Followed by maybe two days of not eating, or only eating crap? Three nights without any quality sleep, followed by a day or two indoors without any exercise? Then add a hit of caffeine in the search for energy, or a drop of alcohol to relax, ease a craving, and/or some sort of illicit substance in the hope of a bit of an escape, or maybe just out of habit. Already the old biochemistry is really struggling, and the results can be quite confusing … a list of ‘symptoms’ that look and sound very much like anxiety and depression in fact. Or exhaustion, or burnout, or an anger problem. So, without any external or historical source of stress (as if!) there’s already enough there to explain and understand a whole heap of distress.
Of course, that is all sitting within a tangle of evolved predispositions (absolutely not your fault), and then your own personal history (most often and mostly not your fault either), your social context (maybe some changes could be made here?), and maybe there are some beliefs about yourself, others or the world that don’t help. And the head might be getting very fast or very slow now, and the output of the brain may not be altogether reasonable?
Then there might be a mildly challenging situation: car trouble, a crying baby, running late, harsh words with a friend or a colleague, looming exams, pressure to achieve a certain outcome in the workplace or someone you care about is ill. And there’s the evident truth that life can be unfair, bad things happen to good people and it can feel like very hard going at times.
And then there are all of the habits you picked up along the way which, by the way, always make sense when understood in their original context, e.g. over thinking, over exercising, over working, people pleasing, perfectionism to name but a few.
Add it all together and now it’s very confusing. And you might have been prescribed something by your GP which is again, another thing for your body to contend with.
We can untangle all of this together over time. What I would like to emphasise though, is that you can save yourself and your therapist a huge amount of time, maybe even years, if you just attend to the basics first: drink water, eat decent food, exercise a bit and chill. Honestly, look for the easiest problems to solve first and we can build from there. If these basics are not attended to, the ‘distress signals’ sent out by the body and brain in the form of thoughts, feelings and sensations could keep the best of therapists in work for years.