The past is never easy to deal with, but in Keith Ablow's new book “Living the Truth:
Living in denial
Four months before she came to see me, Nicole, forty-six, would have said her life was very nearly perfect. She had been married nineteen years and had a healthy daughter, seventeen, and son, fourteen. She worked part-time as the office coordinator for her husband, Grant, a successful Realtor. She was in close touch with her sister, forty, and both her parents. She had friends, a dog, two cats, and a Volvo SUV.
Sure, she sometimes wondered whether drinking a glass of wine or two to get to sleep could be a problem, but plenty of people didn't sleep well and plenty of people enjoyed their wine. And yes, there was also the way she went on shopping sprees to lift her mood when she felt down for more than a day or two, but a few extra dresses or pairs of shoes didn't seem like the end of the world. Even the fact that she didn't have much interest in sex anymore didn't seem so weird. After all, she'd lived and worked with the same man for nearly two decades — not exactly the ultimate recipe for passion.
Then, shortly after her daughter, Kelley, was accepted to a nationally recognized design school, Nicole's mood really started slipping. She was thrilled to see Kelley pursuing her dream, so she couldn't understand why she wasn't on cloud nine with her. She figured maybe with all the excitement and worry of the application process, she had simply given way to fatigue. Maybe visiting schools had been more exhausting than she knew. She remembered feeling the same way after her wedding, when the ceremony and celebration and honeymoon were over.
This time, however, turned out to be different. Her mood continued to slip. Within three months, despite Kelley's growing excitement about going to college, Nicole found herself tearful at times. She felt exhausted and couldn't concentrate at work. She began arguing more with her husband, especially when he bothered her about her drinking. She was up to three glasses of wine at bedtime, usually around nine o'clock, earlier when she could think of an excuse. She had no sexual desire whatsoever. In dark moments after midnight, she even doubted whether life was worth living.
She began to wonder if her real problem might be her marriage. She certainly didn't feel anything close to romantic love anymore. When she thought about it, she probably hadn't for many years. But she didn't want to think about it.
By avoiding the pain in her life, Nicole was no different from most of us. In working with thousands of patients over the last fifteen years, I have found that human beings have a reflex reaction to psychological pain no different from their reaction to physical pain. We withdraw from it. We try to avoid thinking about not only the painful aspects of our lives today but those in the past, all the way back to childhood.
This should come as no surprise. No one wants to feel bad, and the human instinct to seek pleasure and avoid pain (including painful recollections) has been a central principle in philosophy and psychology since the time of the ancient Greeks. Sigmund Freud called it the "pleasure principle."
Indeed, we accept the notion that the mind uses many "defense mechanisms" to distance us from bitter realities — we repress our emotions, we rationalize our behaviors, we distort past events. Chief among these mechanisms is denial, in which we unconsciously ignore distressing facts about ourselves or others. Denial can make us "look the other way" in the face of evidence that our spouses are unfaithful or our children have turned to drugs. It can make us immune to feedback from friends and loved ones who warn us about our addictions or other self-defeating behaviors.
Nicole might never have come to see me, in fact, were it not for her fourteen-year-old son, Nathan. Nate was a high school football player and all-around jock, not one to talk about his feelings, so when he got choked up and told Nicole he felt as if he had "lost his mother," she decided it was high time she tried to "find herself." She heard me interviewed on a local radio station, called my office, and booked an appointment.
The first time we met, I could see that Nicole wasn't just well put together — she was perfectly put together. Everything was in its place — her designer clothes, her jewelry, her makeup, her hair. She was physically fit and looked younger than forty-six. But she also looked worried. She avoided eye contact. And more than once, she clenched and unclenched her fists, as though to wring the tension from her hands.
I nodded at them. "You're having a hard time," I said.She looked down at her hands and let out a long breath. "I never thought I'd be saying this," she told me, "but I think I may need something.""You mean, a medicine?""My sister's on Zoloft. She says it helps her."
I knew why Nicole was asking for Zoloft right off the bat: part of her was still searching for some way to cover up the trouble in her life instead of getting to the bottom of it. Sitting with a doctor whom she knew had made it his life's work to help people get to the truth, she was making a last-ditch effort to avoid that very process.
"Zoloft might be part of the answer," I told her, "but I'd have to understand much more about you and your life to know."She clenched her fists again.
I leaned toward her. "Tell me what's wrong," I said.That was enough to make her eyes fill up. "Nothing," she said. She twisted her engagement ring back and forth. "My marriage. The way I am around my kids ... losing my temper. I'm a complete mess."
"You're a person," I said. "That's always messy."She looked directly at me for the first time."What's happening in your marriage?" I asked.
She smiled even as a tear escaped her eye. She wiped it away. "Not a lot — which is kind of the problem. We're ... existing." She shook her head as though trying to stop herself from saying more. The impulse to keep one's truth — especially one's pain — secret is among the most common, powerful, and toxic elements of human nature. "Grant is a wonderful person," she said. "He's been a great provider for almost twenty years. He's never hurt me."
If all my years as a practicing psychiatrist have taught me one thing, it's this: listen for what people do not say. All Nicole could come up with at the moment about Grant was that he made money and wasn't abusive. That left out a lot of other desirable qualities.
I knew Nicole needed permission to tell me what she was really feeling. And since she had already hinted at her reality, I gave her an opening. "He's wonderful, but ..."
A new look came into her eyes, a kind of sudden, unblinking focus I had seen take hold in other patients once they became convinced I really wanted to hear their truths and would not judge them. "But I'm bored to tears," she said flatly.
"And have been for how long?""Honestly?"I waited."Probably since I've known him."
Nicole had come in asking for a prescription, maybe thinking that she had slid into a depression over the course of a few months, and we were already journeying back twenty-three years, to when she first met Grant. "What did you think of him when you met him?" I asked.
"That he was a real gentleman," she said. "That he would make a good husband and father — even if he was pretty, well, predictable." She squinted as if looking back all those years — which, in fact, she was. "I'd been through a really bad breakup just before I met him," she said. "I wanted someone stable."
"Who had you broken up with?" I asked.
"Oh, God." She laughed and actually blushed — more than twenty years later. So much for those who would deny the power of the past. "He was a complete mess."
A complete mess. Those were the same words Nicole had used to describe herself just moments before. And that was no coincidence. Listening carefully to Nicole had led me to my questions, which had led directly to the unconscious connection she now felt with her lover from decades before. "What kind of mess?" I asked.
"The worst kind," she said. Her expression brightened, and she suddenly looked ten years younger. "A troubled artist. Your typical bad boy."
" 'Bad,' meaning ... ?""You know. Wine, women. Not to mention the fact that he was broke.""You weren't about to go there," I said.She chuckled, shook her head. "I'd already been there.""How so?""With my dad."
Nicole had come in for what she thought would be a quick fix — Zoloft — and come face-to-face with unresolved feelings about her father. We had traveled thirty or more years in about thirty minutes.
"Your dad?" I asked."Ancient history," she said. She looked away again."Doesn't sound like it," I said. "Here we are, talking about him."
"What can I say? He was a lot more interested in his scotch, the track, and other women than he was in my mother, my sister, or me."
It was worse than that one-liner might indicate, though, and Nicole told me the rest during a few more sessions. Her father would disappear for days at a time. Other women would call the house, setting the stage for screaming matches and occasionally even physical fights between her parents. Sometimes her dad gambled away everything he made as a laborer, leaving the family without food.
Once I knew that "ancient history," I knew why it seemed so important to Nicole to look perfect. She felt anything but perfect inside. Part of her was still the little girl whose father might be sober one night, drunk the next, smiling and generous when he came home from the track a winner, violent when he had lost everything. No wonder Nicole would have traded passion with a troubled artist for the predictability and stability Grant offered. She couldn't risk that her artist-lover would turn out to be no different from her dad. And that's one reason she would have felt somber after exchanging marriage vows — those vows were motivated partly by fear. They were partly about living life and partly about avoiding it.
"It doesn't help anything," Nicole said, "that I work with Grant and live with him. We're together 24-7."
"Why did it turn out that way?" I asked.
She shrugged. "He needed the help, and I didn't have much of a plan," she said. "I mean, I had fantasies about interior design or whatever, but I had no training or anything." She laughed. "I figured I'd at least know where he was all the time."
"Unlike your father," I said.She stopped laughing. "I suppose," she replied."Did you ever pursue your love of design?""Just stuff in our house," she said. "I'll leave the rest to Kelley."
My skin turned to gooseflesh, as it does whenever the past becomes palpable in the present. It was clear to me now why Kelley leaving for design school had triggered Nicole's depression. Kelley was living out dreams that Nicole had once had for herself, dreams she had buried in order to create the safe family life she craved. Now, with her daughter off to design school, where she might even fall head over heels for an artistic, romantic, unpredictable man, Nicole was feeling the loss of what she had given up in exchange for stability — pieces of herself.
Why did it take Nicole almost losing herself entirely — thinking she might not want to live — before she gathered the courage to begin to find herself again? Because she thought she could avoid her pain. She had decided — partly consciously, partly unconsciously — to use alcohol, material possessions, great attention to her physical appearance, and even her commitment to her marriage vows to avoid thinking about why she had opted out of passion and why she had traded her own professional goals for the chance to keep an eye on her husband.
The reason was obvious to me, but I wanted to make it obvious to Nicole. I wanted to bring her face-to-face with the truth she had run from her whole life. Only that kind of reckoning with the early chapters in her life story could leave her free to imagine, and then live, wonderful chapters in the future. "So what do you think your dad loved more," I asked her, "the gambling, girls, and booze ... or you?"
She sat in silence for several seconds. Her eyes filled with tears again. "Not me," she said finally. "I guess I never really wanted to admit that. I mean, I was the one by his bedside every day for six months after he was diagnosed with cancer. I think I just wanted to hear him say ..." She stopped herself.
"... that he loved you," I said.Tears ran down her cheeks."Had he ever told you that?" I asked.She swallowed hard. "No," she said. "And he never did."She looked down as though ashamed.I let a few moments pass. "You know the worst part?" I asked Nicole.She looked at me.
"Part of you still thinks he was right — that you're not lovable. That's what any little girl would think, growing up with a father who was incapable of caring about her. And that's the same part of you, by the way, that tells you that you have to keep tabs on your husband to keep him honest, instead of challenging him to grow if he wants to keep you around. It's the same part of you that won't express your passion for design. There's always that little voice in the back of your head saying maybe you're not worthy of love — not even your own."
"So how do I get that voice to stop?" she asked.
I smiled. "By listening to absolutely everything it has to say."
Excerpted from “Living the Truth: Transform Your Life Through the Power of Insight and Honesty” by Keith Ablow, M.D. Copyright © 2007 by Keith Ablow. Published in May 2007 by Little, Brown and Company. All rights reserved.