We have taken a look at a number of aspects of moods and emotions and have considered how many human feelings can be necessary and positive. It is very important to now consider those emotional reactions that simply hurt too much and can be overwhelming. In this chapter, we’ll also see that sometimes what “feels” overwhelming initially, can, in fact be faced. Finally, we will consider those emotional responses and psychological disorders that are caused by changes in brain chemistry.

Psychiatrist Mardi Horowitz and his colleagues have developed a simple and useful model for understanding emotional experiences. People can respond to significant life experiences in one of three ways:

States of emotional control represent those times when people are in fact encountering significant stress in their lives. However, when in emotional control, emotions are held at arm’s length. People may certainly know that inwardly they have very painful or distressing emotions. However, in this moment they do not directly feel it. Emotional control is an essential aspect of coping.

Let’s say that Jim’s daughter has leukemia, her prognosis is guarded, and Jim oftentimes feels consumed with grief and worry. However, when at work as a high school teacher, he always manages to stay focused on his work. His inner anguish stays contained during the workday. Fortunately, he has a very good marriage, and often, when in the privacy of his home, he lets down his guard, and openly cries as he speaks with his wife about their daughter. He is able to control his emotions at work and also has the emotional strength to be open with his feelings when with his wife, and sometimes also with his best friend, Mike.

People maintain such control in a number of ways. Some keep distracted with work or by watching sports on TV. Some anesthetize themselves with alcohol or tranquilizers.

Lots of people consciously try to fight off feelings, often attempting this by engaging in a sort of internal self-talk. Here are some examples:

Sometimes those efforts to avoid feeling painful emotions work. Sometimes they don’t.

Many people in very automatic and unconscious ways simply don’t feel their inner emotions. Here defense mechanisms play a role. Defense mechanisms are psychological functions that block out or mute emotions. By definition, defense mechanisms are automatic (they are not willfully or consciously chosen). An example is when someone experiences a tragedy, such as the sudden loss of a loved one. Some people will appear to go into shock … they feel numb. They absolutely know that this event is terrible and yet feel nothing. They may be very perplexed by their lack of emotion. Here, defenses have repressed emotions.

Emotional control is a natural and normal way that most people react to painful life circumstances. It is not inherently good or bad. In many circumstances, as we saw with Jim, his ability to keep control over emotions at work helped him cope. However, a problem can arise, one that is extraordinarily common: emotional control can become pervasive.

Here, people do not have access to inner feelings. In a sense, they are constantly emotionally gritting their teeth. Excessive over-control almost always leads to problems. Common outcomes include a significantly increased risk for developing severe depression, anxiety disorders, and psychosomatic illnesses (e.g. high blood pressure).

Dyscontrol is not just feeling strong emotions. It is a state of mind where feelings are so intense that they lead to a disorganization of the self. In the midst of dyscontrol, people may become very confused, may experience psychotic symptoms (such as hallucinations), and completely lose the ability for critical thinking. This massive emotional meltdown can lead to desperate actions such as very severe substance abuse, suicide, rage and violence toward others, or self-harm (such as burning or cutting oneself). Psychologists call this decompensation. In popular lingo, dyscontrol is a full-blown “nervous breakdown.”

It must be emphasized that true dyscontrol is relatively rare. It most often occurs in people who have psychotic illnesses, such as schizophrenia or severe mania, or in people who have very weak ego strength. In psychiatry, people who have chronic ego weakness are often said to suffer from borderline personality disorder. Dyscontrol can sometimes be seen at least transiently in emotionally sturdy individuals who have been exposed to catastrophic traumas.

When people move from over-control into the zone of emotional tolerance, they then begin to feel their emotions. But a very important difference between this state of mind and dyscontrol is one of tolerance. In this zone of emotional tolerance, feelings may be incredibly intense, yet the person does not become psychotic or experience severe fragmentation of the self. As we saw in Chapter 3, this is a sign of ego strength.

Many people try to hang on to emotional control to an excessive degree. This may be something they consciously intend to do, or it may be occurring completely at an automatic and unconscious level.

It is not that they cannot tolerate strong feelings; the truth is that ultimately they can. But generally the tendency to maintain excessive emotional control is either because people are afraid of being overwhelmed (e.g. “If I start crying, I won’t be able to stop”) and they are afraid of the intensity of their feelings, or they anticipate extreme vulnerability, shame, or embarrassment should they open up to their feelings, especially in front of others.

One very common experience people have in the course of psychotherapy is eventually opening up to the truth of inner emotions … experiencing and expressing strong feelings, yet truly understanding that it does not kill or overwhelm them. Likewise, a frequent experience is initially feeling shame about certain feelings, only to, at some point, have the shame begin to evaporate. Most times this is accompanied by a sense of relief and a new view of oneself where the emotions are now seen as very difficult or painful, but understandable.

The lessening of defenses and openness to inner emotions is at the heart of emotional healing and growth. But this is not for everyone, and can, in fact, be very risky for people with weak ego strength. Also, even for very emotionally sturdy people, it’s generally not a good idea to dive into the deep end of the pool. Sometimes emotions just hurt too much.

Thus the pathway to noticing and expressing inner feelings oftentimes needs to be taken with gradual and cautious steps. Moving too quickly can feel overwhelming.

Another metaphor is this: the thermostat in your home is set at a particular temperature. This is pretty much the temperature that you want to maintain to feel comfortable. When changes in the weather make it either cooler or warmer in your house, the thermostat automatically monitors this change, and it either turns on the heater or the air conditioner. There is input, perception, and output (a response). If the thermostat and your heating and air conditioning system work, then you are able to create a living condition where there is comfort control.

Likewise, all human brains automatically do the same thing. The goal is to stay safe and to maintain a particular emotional comfort zone.

Sometimes there is a neurological equivalent of a thermostat malfunction. Often this is due to a genetic predisposition for or vulnerability to particular psychological conditions such as depression or anxiety disorders. And as we have seen, temperament and early life experiences (such as severe neglect) can also contribute to increased risk.

These vulnerability factors do not invariably cause the disorder; they simply increase the risk of developing the disorder (for example, children born to a parent who has a history of suffering from severe depression only have a 25 percent risk of developing depression themselves; thus the majority of offspring do not get depressed).

Those with a genetic risk (who may have parents that have suffered from psychiatric disorders) may not initially experience the disorder themselves; however, at some point, significant life stressors might hit the person, and the disorder emerges. This is akin to a bridge that has some structural flaws, but for years has safely carried the weight of thousands of cars and trucks. However, if a hurricane blows into town, the additional stress on the bridge is more than it can handle, it may collapse during the storm or it’s damaged in ways that then make it unsafe for vehicles to cross.

The following psychiatric disorders are at least somewhat influenced by genetic predispositions. Furthermore, each of these disorders is due to or accompanied by abnormal chemical functioning in the brain. Thus they are often referred to as neuropsychiatric disorders. In each disorder, the particular symptoms of course differ, but all of them represent a sort of biologically based, malfunctioning emotional thermostat.

The following list contains the most common psychiatric disorders that have a biological basis and mentions the most common symptoms of each disorder. The reason for mentioning them briefly here is so you can take a glimpse at these major symptoms and see if you are experiencing any of them. If so, then you will find more information about the diagnosis and treatment of these disorders in Chapter 26.

Please note that there are some biologically based psychiatric disorders that are not addressed in this book, such as schizophrenia or other psychotic disorders, autism, attention-deficit disorder, severe substance-abuse disorders, or dementias (e.g. psychiatric conditions associated with Alzheimer’s disease). Of course, these disorders are significant and a source of great emotional suffering. However, a discussion of these disorders is beyond the scope of this book.

Depression:

Bipolar Disorder:

Panic Disorder:

Obsessive-Compulsive Disorder:

Post-traumatic Stress Disorder (PTSD):

To the extent that at least some aspects of emotional disorders are tied to abnormal brain chemistry, emotional coping becomes considerably more difficult. Also, if you are suffering from one of these disorders, it then makes sense to consider treatments that focus on normalizing brain chemistry. As we’ll see in Chapter 26 and Appendix D, some of these treatments include psychiatric medications. However, there are also a number of nonpharmacological approaches, which we will also explore.

The Least You Need to Know