01 Feb

ADDICTED AMERICANS: Do we need to learn how to accept suffering?

February 1, 2013

The New York Times reported last week that “painkillers now take the lives of more Americans than heroin and cocaine combined…Prescription drugs account for about three-quarters of all drug overdose deaths in the United States, with the number of deaths from painkillers quadrupling since 1999, according to federal data.” The studies make it clear that these painkillers are being abused, not used legitimately for post-surgical pain, for example. (Although many people have their first experience with opiates following some type of surgery or injury.) The hard question we need to ask is “Why do so many people continue to take prescription pain killers long after their physical pain has been eliminated or has subsided, or when there has been no physical need for them at all? Three thoughts immediately come to mind. First, is that we are in so much emotional distress that only something like opiates can ease the pain? Second, now that is has been decades since mental health coverage was adequate enough to cover longer term therapy and fewer and fewer people seek it out, do we no longer perceive professional help as a viable alternative to taking pain-relieving substances? And, third, are we lacking in the ability to accept a certain amount of suffering as normal? As a culture do we believe we are entitled not to suffer? I think the answer is all three. (Readers may have some additional ideas about this.)

As a therapist I am consistently surprised at how much guilt and shame many of my patients experience simply because they are in pain—especially if they are well-off financially. Even highly-intelligent, educated people often bear the burden of believing that being financially secure and physically healthy should automatically translate into happiness. Doesn’t being depressed or anxious mean they are deficient? Aren’t they simply whining instead of appreciating what they have? The flip side of this, of course, is that people who are struggling financially assume that if they only become more successful and wealthy, they will be happy. (The lottery fantasy.)

What Freud understood, and what social scientists have been confirming over and over again, is that happiness is elusvie and that our level of contentment has more to do with early attachments (mostly mothers and other family members) and how much they met our needs as developing children. We all tend to repeat the relational patterns we are familiar with and see the world as we first knew it. Which explains why within months after the occurrence of either a tragedy or a stroke of good fortune, our levels of contentment tend to return to previous levels. Amazingly, this applies almost equally to those suffering disabling injuries as to those who win the ever-elusive lottery.

Making changes in early-established patterns (which include the type of people we choose to be close to) is difficult and takes time. The neuroscience literature demonstrates that patterns of feeling and relating are literally laid down in the brain, and new patterns are established through a long process of self-awareness, modulating emotions, and seeing the world differently. This type of change occurs in a good therapeutic relationship, where attachment patterns and their accompanying emotions emerge and can be discussed and worked through. Even then, the changes that are possible are small, yet can change the course of a person’s life. (I will be writing more about this process in future postings.)

Buddhists believe that desiring pleasure, being materialistic and wanting to live forever are at the root of suffering. Yet it seems to me to be part of human nature is to indulge in these things at times. So finding a balance seems like a more realistic solution. It seems to me that minimizing excessive wants, along with accepting some degree of suffering, is more likely to result in a reasonable degree of contentment. Much of what people learn to do in therapy revolves around these ideas. As a therapist, I take pride in helping people to feel better when they enter therapy with intense emotional pain. Once that has subsided, my role is often devoted to helping them maximize their strengths, accept their weaknesses, and lower their expectations. Transformation is not about granite countertops or luxury cruises, as nice as either of those might be. It is about self-awareness, self-acceptance, self-soothing and finding meaning in everyday life rather than being constantly disappointed and feeling inadequate over failing to achieve unrealistic levels of happiness.

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