Empathy is hard but also necessary

I’ve been thinking, and talking, quite a bit about empathy lately. Specifically, the difference between empathy and sympathy. According to Psychology Today’s website,

Empathy can be defined as a person’s ability to recognize and share the emotions of another person . . .. It involves, first, seeing someone else’s situation from his perspective, and, second, sharing his emotions, including, if any, his distress.

In contrast:

Sympathy (‘fellow feeling’, ‘community of feeling’) is a feeling of care and concern for someone, often someone close, accompanied by a wish to see him better off or happier.

* * *

However, sympathy, unlike empathy, does not involve a shared perspective or shared emotions, and while the facial expressions of sympathy do convey caring and concern, they do not convey shared distress.

Similarly, according to the grammarist.com:

When you understand and feel another’s feelings for yourself, you have empathy.

* * *

When you sympathize with someone, you have compassion for that person, but you don’t necessarily feel her feelings. For instance, if your feelings toward someone who is experiencing hardship are limited to sympathy, then you might have a sense of regret for that person’s difficulty but are not feeling her feelings as if they’re your own.

Up until now, my concern with these different emotional states has been self-centered. I have focused purely on my desire to have others empathize, rather than sympathize, with my situation (i.e. being diagnosed with late-onset bipolar after a year of unmitigated hell; having my trauma and newly diagnosed chronic illness lead me to step away from my successful career as an attorney; feeling like a failure for not being a working mom; feeling like a failure as a mother for not doing every little thing, with patience and kindness, but instead having days of hypomanic screaminess).

These are all significant, big-life-picture emotions that I would like the people closest to me to share. I want them to stand in my shoes, to the extent possible, and look at the world as I see it. To share in my fear and distress as if these were their own feelings about their own lives. And to love me, forgive me and speak with me from that place of shared experience.

Feeling sadness for me because of my current situation is not good enough. It is isolating and dismissive. It suggests that the upheaval I am experiencing is mine and mine alone to try to understand and deal with. The sympathetic person may cheer me on from the sidelines, but he remains removed from my struggle. There is no mutual effort to combat my emotional demons, because I am the only one who knows what they are.

In short, I would like my closest people to make an effort to empathize, rather than sympathize, with my situation. I would like them to learn as much as possible about my illness, to listen to me talk about my depression, my hypomania, my fears and my shame. And then I want them to try as hard as they can to put themselves in my shoes, to look at the world through my eyes using my mind; I want them to see and feel what it is like to be me. 

Then, and only then, can we have a meaningful conversation about how to go on.

Without detracting from anything above, I recognize that empathy cannot be a one-way street. I cannot demand empathy from people without haven empathy for them, without putting myself in their shoes when faced with my request.

I need to feel the difficulty and frustration of trying to share the experience of mental illness when such an experience is totally foreign; and when the person requesting empathy is unable to fully communicate her own experience.

I am often at a loss for words to explain what it feels like to walk around with my mind doing what it does. Frequently, there are not adequate words to communicate how mind-numbingly dark, hopeless and repetitive depression is. Nor are their words for the tortuous struggle between wanting to feel “normal” and do “normal” things and never being able to because your anxiety makes the world feel like a giant fist pressing down on your chest until you die. And the shame. There is so much shame in knowing that from the outside you appear to be an otherwise functional human who is choosing self-pity, to give up, to be a pessimist, to run away, to hide, to give in to fear rather than face it. And there is the shame of knowing these outside impressions are not true, yet sometimes believing them yourself.

Conveying all of these feelings in a coherent way to a person with no direct, or even indirect, experience with mental illness is extremely difficult, if not impossible. But if I can’t explain my experience, how can I expect another person to empathize with me? Such a request would likely feel like an unfair, impracticable ask.

And, if I can’t explain my experience of mental illness in a coherent way, being with me must feel incredibly frustrating. Looking at me from the outside, with none of the internal context, it likely feels like I am a determinedly negative person who fails to appreciate what a wonderful life she has, no longer believes in herself, is afraid of her own shadow and constantly wallows in her illness. None of those things are true, but I can understand how a person might have those feelings based on how I act sometimes.

Even if my experience with bipolar disorder could be adequately explained, I expect it would feel incredibly painful to have to share in my distress. No person wants to see someone they care about hurt, let alone experience that hurt with them. Trying to avoid this pain would probably be most people’s first reaction; I know it would be mine. 

But I also know, from past experience, that my first reaction would not be my final one; that I would do whatever painful work needed to be done so that I could share my friend or partners’s painful experience and emotions. That is what humans do for the people they care about.

I understand that people have varying degrees of empathy, and while the ability to empathize can be improved, such improvement is not an easy or fast process. Asking someone to fundamentally change the way they act in relation to other people’s negative emotions, is not a small request. Even so, I believe it is a reasonable one, something I have the right to ask for from those closest to me. 

In short, do not bring me a casserole. Instead, come sit with me, hold my hand, listen, ask questions, say you are proud of me, ask how you can help. Be there with me, not just physically but emotionally, too. I need you to be in this with me, no matter how hard that might be for you.

There are no words

I have read a number of stories, blog posts, etc. about Chris Cornell and depression over the past few days. His death is an incredibly sad cultural loss and personal loss for his loved ones. It also exemplifies the simple truth that depression is indiscriminate. It does not affect a certain type of person; it is not the result of a character flaw or a lack of personal ambition; it does not care what you have achieved or how much you are loved. It is an illness caused by a chemical imbalance in the brain, a chemical imbalance that exists among millionaires and rock stars as well as the people who live next door. It effects the moms and dads and grandparents and teenagers who you know and even love. It is so much more common than you realize. Knowing this fact, really internalizing it, is a very important, powerful step towards de-stigmatizing mental illness and providing true support, even empathy, to those who suffer from it.

Even so, simply recognizing that depression is an illness is not enough. We need you to believe that depression is not something that can be “fixed” through personal effort or optimism. We need you to acknowledge that dealing with depression requires serious, often long-term treatment. It also requires fucking hard work just to survive. Many people who suffer from depression, myself included, put in more emotional work just to get to “normal” each day, than many people expend simply living their lives.  Having someone we love truly believe these truths about depression is an incredibly validating experience. It makes us feel seen and heard. It makes us feel less alone.

I have found the most difficult part in bridging the gap of understanding between myself and my loved ones is my inability to adequately describe what my depression feels like. Yes, it is caused by a chemical imbalance, but an imbalance that doesn’t cause any adverse feelings would be irrelevant. It is the feelings caused by the imbalance that make depression what it is. And those feelings are different for each person. However, in an effort to give some sense, some words to what depression can be like, I offer up my personal experience and feelings:

  • Depression takes me back; it examines every mistake I’ve ever made and forces me to physically and emotionally experience those past events. I feel the chest tightening, heart-wrenching pain of every loss. I feel the waves of shame starting in the pit of my stomach, traveling through my chest and then my face. I examine every major decision I ever made and sob at the imagined joy I may have missed.
  • Depression critically examines my current life circumstances and meticulously points out every area in which I am failing. It tells me, viciously and repeatedly, that I should be a better, more patient and loving mother who spends more quality time with her children. It tells me I spend far too much time on the mundane tasks of day-to-day household management rather than with my family. It make me feel like an inferior partner to my husband, who I now depend on financially; that I ask too much; that I don’t contribute enough; that I am a burden; that eventually he will leave me.
  • Depression also robs me of hope for the future. It tells me that my pain and regrets will never go away. I feel as though nothing will ever change or get better; that I will spend the rest of my life feeling overwhelmed by mothering three children, satisfying my husband’s emotional needs and keeping my own head above water. Depression makes me feel like no matter what treatment I seek, or how religiously I adhere to any doctor’s recommendations, I will never feel better, not in a sustained way.

Depression makes me feel all of the above, day in and day out, nearly everyday of my life. It is exhausting. It feels so unfair. Even though I know it is not my fault, even though I constantly preach that message, I still feel like it is my fault much of the time. How can I not? It is my own mind after all. Why can’t I just control it?

But I can’t, I can’t control it, or stop it, or fix it. Believe me, I’ve tried. Depression is part of who I am. It always will be. It is my monster. My internal demon that I will never be able to truly share with anyone else. I bear the burden. I will carry it, always. I will carry it as far and as long as I can.


My therapist is better than yours

Saying goodbye is hard, whether it’s to a loved one, a dear friend or your therapist. Earlier this week, I said goodbye to my therapist, who has become a dear friend.

There was nothing wrong with our relationship. She is, hands down, the most delightful and helpful therapist I have ever worked with. But, she does not have expertise regarding my specific illness, an illness neither of us knew I had until well into our relationship. Recently, we agreed I should meet with someone (a friend of hers actually) who has such expertise to see if a change would be beneficial to me. I had the meeting and decided a change would be best for my health. I will gain the benefit of a therapist with a tremendous amount of knowledge about my condition, including how to minimize my symptoms and improve my quality of life. But I will lose the benefit of an incredibly empathetic, validating and funny therapist, who has seen me through the hardest emotional period of my life.

I found Dr. Kerry by chance on the internet. I was searching for a psychologist who practiced ACT (Acceptance and Commitment Therapy) and wasn’t too far from my home or work (since I didn’t have any time to spare). When I discovered Dr. Kerry was an ACT practitioner, with an office six minutes from my house, who specialized in family dynamics and family related issues, I was elated. At the time (early spring 2016), I believed my anxiety and depression symptoms were primarily related to my responsibilities as a mother of three small children, particularly my less-than-one year old twins. I thought that if I could just learn how to feel less anxious, overwhelmed and hopeless about mothering, then everything would be okay. So I called Dr. Kerry.

I probably got out half a sentence about the reason for my call before I started crying. I kept talking though and she kept listening. Once I had gotten most of it out — about the three kids, the law job, the busy husband, the mountain of household responsibilities, the ever present anxiety and depression, the panic attacks and all the different meds that didn’t work — Dr. Kerry (with more empathy in her voice than I had heard in what felt like forever) said, “Oh honey, you must be so tired.” Hearing those words broke my heart wide open. I sobbed and sniffled and sobbed some more, overwhelmed with gratitude for this woman I had never met. Dr. Kerry was maybe the first person in my life to understand how hard I was working just to keep my head above water and how much it was costing me.

I think we spoke on the phone that day for close to an hour. Honestly, I think she was worried about me and wanted to make sure I was in a safe place, mentally and physically. We scheduled an appointment for that week and I have continued to see her weekly, or bi-weekly, ever since (except for my few weeks in outpatient treatment).

Seeing Dr. Kerry was like spending an hour with a fun friend who also happened to have expertise in mental health. She taught me the invaluable lesson that what is real, what feels real to me, is not always true; that I can validate my feelings as my feelings and still reject them as untrue (i.e. I feel that I am an incompetent mother because I become anxious and overwhelmed when alone with my children. In reality, I am a competent mother who experiences feelings of anxiety related to her children, as do many other mothers.).

Dr. Kerry always laughed at my jokes, which is essential to being my close friend. She also defended me against the mean part of my own mind. She encouraged me to nickname it to differentiate it from my actual self. I proposed Bitchy McBitchface but that proved to be too long given how often we talked about her. So, I shortened it to Becky. Man, I hate Becky (almost as much as she hates me). Dr. Kerry gave me homework, and you all know how much I love homework (really, I really do). And she forced me to meditate.

Meditation has never interested me because (1) I hate being still and (2) I hate being in my own head. These seem to be the two major components of meditation. Therefore, I had less than zero interest. But Dr. Kerry insisted that learning to be mindful, including by having a regular mediation practice, would improve my quality of life. It would force me to slow down, to pay attention, to just breath without doing or thinking about doing five other things. I felt my time was better spent doing the five things.

Since I am a lawyer and also a pretty good liar, Dr. Kerry had me download a specific meditation app which would time my daily meditations. I was to start with five minutes each day and she would check my timer each week. Of course, I could have just let the timer run without actually meditating, but I am honor-bound to do homework in the proper way. So I started to mediate, first five minutes a day, then 10, then 15. I found guided mediations most effective, because then I could listen to someone else speak rather than the voices in my head. And Dr. Kerry was right. Meditating did help me to be more present and still. I still don’t have a regular practice (which I should) but it is a skill I use when I need to feel more stable and less like a headless chicken running around my own life.

Dr. Kerry also taught me to pay attention to the way I talk about myself and my life. A single word can reveal a vast underlying dichotomy, such as what tasks or activities are okay/allowed/useful for me to do with my time and which are not. When all the “nots” turn out to be self-care that costs money and benefits no one else in the family but me, this is not a healthy state of mind. It suggests I do not value myself; that Becky is still there with her list of my insufficiencies and failures. It also directly contradicts my strong belief that what I do at home and with our children is just as valuable a contribution to our family’s well-being as my husband’s paycheck. All of this and more became apparent because Dr. Kerry noticed I used the word “allowed” during session. One word, one session, and I learned a valuable lesson that will benefit me for as long as I use it.

Direct identification of problems and proposed solutions were a hallmark of Dr. Kerry’s practice. If I didn’t feel safe, I needed to specifically identify and contact at least three safety people. If my home life was triggering my illness and making my symptoms worse, I needed to identify and implement specific changes that would alleviate my anxiety and depression. Week by week, Dr. Kerry helped me to survive my life. She gave me hope that things could get better. No words can adequately express my gratitude for these gifts, but I could not move forward without some expression of thanks for what I have been given.

Thank you, thank you, thank you for all the things. I miss you already and wish you the very best of all my wishes.