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If you have a persistent, mild fever that has gone on for several weeks, you have a choice: You can take aspirin, which will remove the fever at least until the drug’s effects wear off, or you can go to the doctor for tests to see what the underlying cause is — and to fix whatever is wrong. Most of us will make a beeline for the doctor.
The same is true in the world of psychological problems. Everyone feels sad or anxious or angry or lonely or trapped at times. And most of us will, from time to time, consume too much food, alcohol, nicotine or perhaps drugs, or sleep too much, or lose our temper too often, or overspend, and so on. Often we cope with that by socializing, exercising more, eliminating stress, changing jobs and so on. But when that feeling or behavior goes on for a long time, and our normal strategies for feeling better or changing behavior aren’t working well, then it’s a signal that there’s something going on that is beyond the normal slings and arrows of daily life. And we ignore that signal at our peril.
Here are two cases (with details changed to protect confidentiality) of people who heeded the signal, and benefited greatly.
Frank
Happy, cheerful and outgoing, with a good job, Frank was the life of any party. Having moved to Hong Kong a year ago, he rapidly found himself a social circle and could always be found in a group of friends. But he had a secret: he gambled. And of course, he lost. And he gambled more, and lost more. He became depressed and extremely anxious. As his savings dwindled he promised himself he would stop. “But I’d be working on the computer, and the next thing I know I’ve gone to a betting site and placed a bet without even being aware of it. It was almost like I was sleepwalking.” Frank felt his life had been hijacked and that he was powerless.
After a few therapy sessions it became clear that Frank, despite his large circle of friends, was completely isolated and terribly lonely. His friendships were entirely superficial — he never spoke about his feelings to anyone, and no one was aware of his gambling compulsion. His family culture was one of secrets and keeping up appearances, and so his parents and siblings were equally in the dark as to his problems. Frank became more open with his family, volunteering information about his issues and inviting his brother to talk about his own issues with alcohol. He opened up to friends, and quickly found them opening up in return. As his connections to friends and family deepened, his need to numb himself with the excitement of gambling dwindled.
Beth and Charles
After ten years of marriage and three children, Beth and Charles had settled into a routine. But Charles became depressed, and Beth, being very efficient, got him to the doctor to get a prescription for anti-depressants. After an initial bump in his mood that didn’t last long, she realized that this wasn’t the answer, and decided he should try therapy next. When I asked about his marriage, Charles’ claims that all was well were belied by the stories he told about how they resolved conflict and how often they had sex. (Hint: not very often.) Individual therapy quickly morphed into couples work, and as the two of them worked through their conflicts, showed each other their vulnerability, and stepped up to support each other, Charles’ depression lifted almost immediately. Less isolated in his marriage, and feeling less overwhelmed by parental responsibilities, he began to socialize more, exercise more and sleep better. Beth, who had been soldiering on even though she too, was feeling terrible, also began to feel happier and less stressed. The positive change in both of them enabled each to treat the other with more kindness and consideration, which resulted in even more intimacy, better moods and, in a positive feedback loop, yet more kindness and consideration.
For each of these people, the presenting problem, as painful as it seemed, was actually a gift. It told them that there was something wrong in their lives that had to be addressed. The solution was not like aspirin for an ongoing fever. Frank didn’t need to stop himself from gambling, and Charles didn’t need to stop feeling depressed. The gambling and the depression were symptoms of another problem, a response to (and a method of coping with) other things that were going on in their lives. Once those issues were addressed, their symptoms disappeared. But without the symptom, they would each have stumbled through their lives, unaware of what they were missing and how unhappy they truly were.