Mental Health

Bad News

It’s been a week of bad news. A woman with newly diagnosed lung cancer. A man who learned that the Interferon treatment for Hepatitis is not working and will be discontinued. A man who was turned down for a much-needed job and is starting the job search process all over again, after having been unemployed for nine months. A woman who learned that she is losing her job. A man who’s wife decided to leave him. A man whose parents were suddenly killed in a car accident in the Mid-West.

Each of these people is experiencing unspeakable pain: loss, threat of death, anxiety, loneliness, a new awareness that the future is limited, angry helplessness, a sense that “I’m not in control anymore.”

I’m often asked, “what do you say when someone shares bad news with you?” Indeed, what do I say to someone in enormous pain? What does anyone say?

I think that the question is a bit misdirected and signals a helpless anxiety many of us experience when we are faced with painful life events. But are we being asked to say or do anything?

Most of us, when hearing the bad news another is sharing, feel an impulse to rescue, to somehow find the words that will make the teller (and the listener) feel better, or to make the situation better. The impulse is a very human one, and is understandable: we identify with the other person and sympathize with their feelings. We feel helpless ourselves and finding a means for “making it better” enables us to feel less helpless and, by extension, less anxious. And while we may end up feeling better, the other person is often left with the painful feelings.

What, in fact, is being asked of us?

When people share their bad news with us, they usually are not asking us to solve their problem, or even to make the pain go away. On a fundamental level, they know that what they are facing is not a problem to be solved but a life event that must be gone through. They want to know and feel that they are connected and are valued; they want to know and feel that they matter, that their lives and their experiences have meaning—even though the meaning may not be clear and may never be clear. They want to be seen, and they want their stories to be heard.

And so, when people share their experiences of pain and uncertainty, I think that they are asking us to simply be with them. We are being asked to listen, to bear witness to the unexpected in their lives. We are being asked to hold them—sometimes in the physical sense, but more often in a figurative sense: we are being asked to be with them as they feel their feelings. We are being asked to have a relationship with them that can expand to include the unknown. We are being asked to intimacy. (A very dear Buddhist friend recently reminded me that “Not knowing IS intimacy.)

Not everyone can tolerate intimacy. Not everyone can tolerate not knowing. Not everyone can listen without rescuing the other from their pain. In fact, most people can’t. But listening in a deeply intimate way—one that does not provide answers but that invites exploration that may lead to answers—is the essence of psychotherapy. It involves meeting you in the intimate place of not knowing—of not having an answer—and being willing to help you live into that space so that meaning—and even hope—may be created. Psychotherapy can provide the space where painful feelings can be felt—without judgment, without changing them, without “making them go away.” Eventually, psychotherapy may help you come to terms with the bad news and the feelings that arise.

Sometimes there are no comforting words. But there can always be a comforting presence. Bad news reminds us that we need each other, that we need relationships. And while our presence won’t prevent bad things from happening, it can certainly help those we care about move through them. Our presence is all that is asked.

Feeling Feelings

“How does that make you feel?’ This question has become equated with psychotherapy. In popular culture, it is often posed ironically, and in the media it has become a signal for a superficial therapeutic intervention. Yet the question is important, one therapists ask in all seriousness. We want to know. More important, we want our clients to know what and how they are feeling. Feelings have meaning.

Feelings are elusive and change throughout the course of a day, an hour, even a moment. Sometimes, feelings arise and fade so quickly that we are not fully conscious of them. Sometimes we experience our feelings so forcefully that we become disoriented and destabilized.

Feelings arise from body sensations: butterflies in the stomach, tension in the shoulders, arousal, abdominal fullness, a lump in the throat. We interpret these sensations, labeling them as nervousness/anxiety, anger, desire, happiness, sadness. Often, we do not pay too much conscious attention to them. However, there are times when these sensations are so powerful that they command our full attention.

We develop beliefs about our feelings, and we often make judgments about them, especially when the sensations are uncomfortable. At times, the feelings seem so powerful that we believe that our feelings will disable us. Explosive anger, paralyzing anxiety, oppressive depression are all experiences of overwhelming feelings. These are the feelings we tend to avoid and, often, want to medicate away.

A few weeks ago, a young man said to me “I feel too much.” I wondered aloud what he meant, and he elaborated “I have too many feelings, and I get so caught up in them that I have a hard time doing anything.”

Feelings can indeed be quite uncomfortable, but I tend to think the discomfort is less about the sensations themselves than the fact that we often do not understand them. This seems especially true with powerful feelings. Sometimes the power with which feelings manifest seems out of proportion to the circumstances that gave rise to them—a signal that the root of the feeling goes deeper than the triggering situation. Indeed, feelings are often attached to memories and other unconscious material--material that may be repressed, material we defend against because it is too painful or disturbing to examine. When a situation triggers feelings, those memories or repressed material may also be triggered, and the feelings associated with the material become unlocked. The result: overwhelming feelings and a sense of anxious confusion.

Feelings can be powerful teachers, if we give ourselves permission to sit with them and explore them. “How does that make you feel?” acknowledges that feelings arise and invites an exploration into the experience and meaning of feelings. Psychotherapy is a place where you can safely feel your feelings, learn the lessons they have to teach, and develop insights about how feelings work.

It takes courage to feel feelings. There are risks involved, of course. But the rewards for feeling and understanding your feelings are innumerable.