When upset about something some people say to themselves, ‘This is too upsetting to me, and so I will not think about it. I will not talk about it. I will not let this thing bother me. I will be strong. I will divert my attention to something else. I will do my best to forget it.’ Painful emotions are transferred from the mind (the balloon) to the hidden mind (soda bottle). The balloon shrinks, the brain chemicals go back to their normal state, and stress symptoms disappear. One feels calm once again. Now he believes he has coped with his stress well, when in fact, all he has done is to transfer his emotions from his mind to the hidden mind. Once in the hidden mind, the painful memories are forgotten.
This process of forgetting is called bottling-up or burying. Psychiatrists use the word repression to explain it. (Repression is not same as suppression. In suppression one is fully aware of how he feels but he chooses not to disclose it.) Now one has fooled himself into believing, ‘Hey! I am O.K.! I handled this upsetting situation very well! I have calmed myself down. I was strong through this entire ordeal!’ As you will see, this is only a self-delusion.
The habit of coping by burying painful emotions usually starts in childhood as children have difficulty in processing and expressing their painful emotions. But it is not uncommon to start burying in adulthood under trying circumstances. Burying is greatly facilitated by distractions such as vacations, cruising, skiing trips, trekking, etc. that take people away from the source of their stress. Through these and other multitude of mindless activities such as jogging, hot tub baths, driving around aimlessly, people often try to forget their pain.
That is why you will find hordes of people who will swear by these activities. ‘Drowning’ one’s sorrow in alcohol; getting ‘stoned’ with illicit drugs; ‘numbing’ the mind with tranquilizers are also some of facilitators of burying. Burying gives fairly immediate relief from emotional pain. This quick relief further reinforces the habit of burying. In the long run, however, burying is bad news for its practitioner.
To make bad matters even worse, our society today holds up people who bury emotions as an example of courage, strength, fortitude, and what not. Such misguided praise prevents one from normally expressing his painful emotions for fear of letting others down. ‘I had to be strong for my children,’ or ‘I did not want my dying husband to see me fall apart,’ ‘I just could not let myself look ridiculous in front of all these people at the funeral,’ are common statements I hear from people who ended up with depression and anxiety disorder weeks or months after the bad event.
No one wants to be branded a chronic complainer, whiner, sissy, softy, milk toast and whatnot. Burying thus becomes a socially sponsored, promoted and reinforced habit. The type of burying we are dealing with here is habitual and permanent in nature, not temporary, as some people do to cope with an emergency situation.
What are the consequences of habitual burying’
While burying calms one down fairly quickly, it has many long-term disastrous consequences. It is inevitable that we get upset from time to time as life is full of bad events and problems. If burying becomes the standard way of coping with stress, soon one begins to feel as though the soda bottle is becoming saturated.
The hidden mind/soda bottle does not have limitless capacity to stuff things in it. As time passes it becomes harder and harder to bottle-up emotions. The shock absorbing system now begins to break down. The result is that the hidden mind now becomes ‘saturated’ with painful, toxic emotions. The foundation for stress-related disorders is thus laid. Saturation of the hidden mind has two great negative consequences:
Gradual return of stress symptoms: Over time one begins to notice that it gets harder and harder to shrink his balloon and to calm himself down. Emotions entering the balloon stay there and add to the ones in it already. As the balloon inflates, brain chemicals begin to change and stress symptoms begin to reappear one by one. Irritability, snapping at people, sleeplessness, sleepiness, anxiety, tension, sadness, poor concentration, memory problems, aches and pains, headaches, etc., follow. As the balloon gets closer to its breaking point, these people become increasingly intolerant of stress. When they get upset, they stay upset for longer and longer.
How do we know this is happening’ Listen carefully to people in this unfortunate predicament. They often make statements such as: ‘Some years ago nothing used to bother me. Now I get upset at least little things, and I stay upset longer and longer!’ ‘I can’t take things like I used to any more!’ ‘Nowadays when I get upset, I stay upset. It takes me a longer time to calm myself down.’ ‘I am irritable all the time. I explode at least little things. I never used to do that before. I snap at people for no good reason.’
‘I can’t stand noise or raucous any more.’ ‘I used to be a patient person. Now, I have no patience at all.’ All these mean the same thing: One is not able to shrink his balloon any more; the balloon is getting fuller; one is not able to stuff things in the soda bottle anymore. These people now have low stress tolerance syndrome and are often labeled ‘burned-out.’ This is one step away from a full blown stress-related disorder such as major depression and panic disorder.
How do people with low stress tolerance behave’ People in this unfortunate predicament avoid stressful situations as though they instinctively know that their balloon is just ready to pop. They become increasingly intolerant to sensory stimuli such as noise of children or dogs, driving on high traffic highways , horror movies, crowded grocery shops, football stadium, etc. So they become increasingly ‘withdrawn’ from various activities, especially social activities, which have potential to upset them.
This is their defense against anything that might pop their balloon. Unable to tolerate the tumultuous nature of full life, many of them sleep a lot and become recluses. They actively avoid parties and gatherings. They stop inviting people home for entertainment. They become less and less productive at work. They look increasingly stressed-out to others around them. Unable to focus in their work, many start making mistakes. Their productivity at work goes down. Over time they become dysfunctional at work as well as at home.
If the unfortunate person seeks psychiatric help at this stage, depending upon predominance of his symptoms he would get one of many diagnoses. If one complains primarily of depressive symptoms, he could get a diagnosis such as ‘dysthymic disorder’ (minor, chronic depression); if one mainly complains of tension, nervousness and anxiety, he would get a diagnosis of ‘generalized anxiety disorder’ (low grade chronic anxiety); one reporting diffuse aches and pains would get the diagnosis of ‘fibromyalgia’; one complaining of severe tiredness or exhaustion would get the diagnosis of ‘chronic fatigue syndrome.’ Some are diagnosed with high blood pressure. Others are diagnosed with irritable bowel syndrome. You get the idea.
Almost all of these people deny they have any stress in their life, or, if by fluke they admit to it, they minimize its importance. Common statement I hear goes something like this, ‘Oh! This is not stress. My mom had it. It is my genes! It is chemical imbalance!’ Or, ‘Of course I have some stress. Who doesn’t’ I am handling it quite well!’ Careful review of their past, however, tells a different story. Most of them had been trapped in a chronic, difficult-to-solve, life-problem such as bad marriage, bad job, financial problem, etc. And they had coped with their life situation stoically (being strong). By the time they see a psychiatrist, they have suffered from various stress symptoms for years.
Some of these people’s balloon finally pops triggered by an upsetting new bad event or problem. This triggering event or problem is called the precipitating event. A precipitating event is the proverbial straw that breaks the already overloaded camel’s back. A precipitating event could be a major bad event such as death of a loved one; or a minor event such as loss of a purse. In the latter instance, the seemingly minor precipitating event brought up old buried trauma, and the fizz (buried emotions) spewing up into the balloon from the soda bottle caused it to pop. Now they suffer more serious symptoms. Again, depending upon the predominance of symptoms, this time around they get more serious diagnoses: Major depression; panic disorder; bipolar disorder; psychotic disorder and the like. As to what major disorder one comes down with depends upon one’s genes.
Here is an example: A middle aged woman became severely depressed following the death of her 2nd husband of 6 years (her balloon popped). Her first marriage, which lasted for 16 years, was marred by severe verbal and physical abuse. She had coped with it by denying (making excuses) and burying (not thinking about it). By the time she divorced her first husband 8 years ago, her bottle was full and her balloon was almost full. She suffered from chronic low grade depression and anxiety for many years. Only because her second husband was supportive and kind to her, she was able to tolerate her symptoms and go on with her life. When the second husband died suddenly, the stress of his death caused her balloon to pop and she came down with a major depressive episode with psychotic features. Her diagnosis now was ‘Acute on chronic depression.’
Sudden reappearance of stress symptoms: Burying has another undesirable consequence. As we read before, a current precipitating stressful event could cause sudden resurfacing of buried emotions related to a bad event in the remote past. This means, the balloon gets a blast of painful emotions from the pump (a current precipitating event) as well as spewing up painful emotions from a major past trauma (fizz from the vigorously shaken soda bottle). When this happens, the balloon inflates fully instantly and one suffers sudden and severe symptoms, far out of proportion to the triggering event. Very often this leads to popping of the balloon and precipitation of a major disorder such as major depressive disorder or panic attack. Most people suffering from this double whammy are not aware of the role of the past trauma in their current misery. It is the job of the therapist to explain the same to the patient. More than 75 percent of emergency visits to my office are due to a double whammy.
Example: A woman who had completely forgotten the trauma of sexual abuse as a child suddenly developed massive panic attack after discovering that her eight year old daughter was inappropriately touched by her boy friend. She was very upset over her daughter’s sexual abuse (current precipitating event, coming from the pump); but this bad event also caused resurfacing of the long-forgotten trauma of her own sexual abuse as a child (fizz from the soda bottle) by her stepfather. Unable to withstand the double whammy, her balloon popped. The result was a massive panic attack resulting in a visit to the local emergency room and subsequent hospitalization.
Another example: A middle-aged man became very depressed and suicidal two weeks after he was promoted to the position of the manager upon his boss’s retirement (current event). He was never depressed before. He was completely baffled by his symptoms. He said he was very happy with his promotion. The real reason for his suicidal depression was discovered in the interview: He was very close to his boss, who was a mentor and father figure to him for over 30 years. At age 8 the patient had witnessed his own father’s accidental death from electrocution. Now, forty-two years later, the loss of a father figure triggered resurfacing of those buried old traumatic emotions related to his father’s tragic death. This was a heavy-duty double whammy which popped his balloon resulting in suicidal depression. How do we know this to be the case’ Well, once the patient became aware of it, he grieved over both losses, shrank his balloon and got on with his life. Smart man.
Here is another interesting story: A forty year old woman, mother of two boys, woke up one fine morning and felt an irresistible desire to shoot herself in the head. Her husband found her in bed with a loaded gun to her head, sobbing uncontrollably. She was brought to my office on an emergency basis. When asked why she wanted to die, she said she did not know. The only precipitating event was her 18 year old son leaving home to join the navy a week earlier. She said she was very happy for him as that was all he wanted to do.
Further digging revealed that she herself was in the navy 19 years earlier. She had met a navy man with whom she fell in love. One day, while they were enjoying a cold, snowy weekend in a warm motel room in a big city away from the navy base, she told her lover that she was pregnant. At this, her lover got up from his bed, put on his navy uniform, told her, ‘I will be back shortly’ and disappeared into the snowy night never to be heard again. She waited in bewilderment for two days for him to return. He neither called, nor returned. She quietly buried her rage in her hidden mind, quit navy, moved in with her parents in a distant city and moved on with her life. Later, she married another man. Now nineteen years later, the occasion of her son joining the navy brought up a tsunami of buried emotions leading to popping of her balloon. She got well after she expressed her anger, disappointment and outrage in therapy, and moved on once again with her life.