Being in a relationship with your mental illness
After working with a client for a period of time, I run into an all too familiar wall of dissonant thought.
Whatever the motivation to come into therapy, the goals are generally the same. People are trying to find ways to alleviate the pain, struggles, and tension of living with a mental illness everyday. Whatever the route, whether it is uncovering a relationship from the past that they refused to let go, to gaining insight to patterns of destructive behaviors, people are seeking the basis for their pain.
Early in treatment, people remain on this trajectory. If someone went through the pain of finding a good therapist (which is a monumental task itself), to finding one that fits, to creating time in your schedule to actually go, they are really wanting the help.
But then that wall appears.
It’s always been there.
Most client’s have never seen it.
Early in my career, I didn’t see it either.
By the time someone is sitting in the chair across from me, they’ve been suffering with their symptoms for a long time. It’s become personal to them. It knows the intimate and vulnerable essences that make the person tick. It is what you wake up to and go to bed with. It slowly becomes more and more of who you are. It used to be a nuisance, but now it guides your day to day.
To ask someone to challenge it, to start going down a different path, is like asking someone to break up with someone. No matter how bad the match, the partner, it’s not the easiest thing to do. We’ve all been there. We’ve all had friends, where every time you go out, you hear about their boyfriend/girlfriend.
“He doesn’t listen”
“She’s so dismissive”
“He makes me unhappy”
The same advice is given. “If you’re not happy, get out of the relationship!”, “You deserve better!”. How many of you had friends take that in and call you the next day telling you that they’ve ended it? I’d guess that the number is pretty low.
It works similarly with mental illness. For a period of time, life as you know it, was seen through this filter of this partner. To move on to something new, is asking someone to imagine life without it, which for the person is almost impossible to do.
It was disheartening to see many of my clients, after having a session filled with hope, optimism, and goals, to come back the following session and report that they’ve remained in their patterns of destructive thoughts and behaviors. Not once, giving a chance to the goals set in the session prior.
Dissonance is defined as: a tension or clash resulting from the combination of two disharmonious or unsuitable elements. This cognitive dissonance lives in all of us.
In one hand, this person is sitting across from me, is desperately seeking answers in hopes of feeling better. In the other, is this all too familiar pain that they’re unconsciously unwilling to let go, almost feeling lost without it.
I have to say, this is not implicating people in not wanting to feel better. I completely understand the difficulties in healing. It doesn’t happen overnight.
But the truth is, when I hit that wall with the client, this is what’s happening. Many of the thoughts and patterns preserved them. They wouldn’t be in my office if not for these choices in coping. A long time ago, the client in front of me utilized a coping strategy, no matter how detrimental in the long run, and found it to be super effective in the moment. It prolonged the inevitable suffering which has culminated into them coming into my office.
It’s hard for a person to say goodbye to something so familiar, because they have been primed by the same issues to fear the pain of the unknown.
What if it’s worse?
You can’t really answer that for them. No one can. And that’s what keeps them in this terrible relationship with their mental illness.
This colors how I interact and work with my clients day to day. I 100% believe that they want to feel better but I also 100% believe that pushing them to remove themselves from this toxic relationship is not easy, and in essence, seems impossible in their own heads.
Just as I’m pretty sure that my friend won’t call their partner right after meeting with me because of the sage advice and empowerment I imbued on them, I shouldn’t expect my clients, even after having an aha! moment to part from something so intimate.
When I reach this wall, I explain to all of my clients about how I see this.
I am asking them to take a risk and try something new.
And when they’re ready to go down that road, I’ll be there waiting.
Here are some other articles:
5 Things to remember about me, your therapist
Steve is a program director at a residential facility in Southern California. He is aspiring to become a fighter of stigma in mental health, by sharing personal stories, stories of others, and what he (believes) he has learned through his work.
