Tuesday, September 28, 2010

I Have a Cold Today

A number of years ago, before I had graduated college I was talking with my therapist, a psychiatrist, and mentioned that I thought the recent cold and rain had caused me to have a cold. He reminded me that the weather doesn’t cause illness. I was well aware that colds are caused by viruses, but still felt that my cold was associated with the unpleasant weather. If the weather was not related to colds, then why did cold and flu season occur during the fall, when the temperatures drops (and at least in DC where I was living) there tended to be more rain?

So now in my professional capacity as a therapist I think I understand the connection, at least partially. How we feel affects the immune system. This appears to happen on two levels. The first one is that when we feel bad it affects our brain chemistry, which in turn affects our immune functioning. Specifically, the amount of catecholamine neurotransmitters decreases, at least during prolonged mental discomfort. This is turn cause an increase in endorphins, which in turn decreases immune functioning. The second level appears to involve our endocrine system. During times of stress (real or imagined threat) our body allocates resources to address the threat—primarily through the flight or fight response. Immune functioning is not a high priority when under attack, so the cortisol the body releases suppresses immune functioning so that more of our resources can be directed at getting ourselves out of threat. As a consequence, the viruses and bacteria that we may normally fight off well get an advantage and we become more likely to become ill.

Granted, I am not a medical doctor and this is a simplistic explanation. However, it is worth considering that in the 20 years since my therapist told me that the cold and rain couldn’t cause my cold, we have discovered that my reaction to the unpleasant weather most likely made me more susceptible to the virus that caused my cold. I hope that we all take this into consideration as the cooler weather approaches—take care of your mental health and your physical health will follow.

Sunday, September 26, 2010

Love, Obligation, Familiarity, and Fear

I frequently have clients that recognize that they are in bad (or at least unsatisfying) relationships. When I ask them why they stay in the relationship, I typically get one of four answers: love, obligation, familiarity, or fear. They frequently tell me that they know they shouldn’t be in the relationship but cannot bring themselves to leave the relationship, for one of these reasons.

Love is a good reason to stay in a relationship. But when I ask my clients how they know they are in love, I am most frequently met with blank stares. I will grant that explaining the sensation of love is difficult. However, a desire to be with the person is fundamental to that. I do not mean a desire to continue the relationship or because “we have been together a long time.” These explanations are more akin to obligation (which I will get to next). What I mean is a willingness and desire to go out of your way to spend time with the person; a joy at seeing the person at the end of the day or at receiving a call or text from the person in the middle of the day. Love is an intense emotional attachment and longing. If you have been in love, you know the feeling. I would also caution that love is not simply being taken care of or treated well—that is being supported, a part of love granted, but not love.

A desire to continue the relationship, not because of feelings, but because it is the right thing to do is perhaps the most frequent reason I receive. This is particularly epidemic in GLB and non-traditional (poly, open, BDSM) relationships. There seems to be a feeling that we will have failed our community if we terminate our relationship. Within these communities there appears to be a feeling that we have an obligation to sustain one’s relationship in order to counter the stereotype that these types of relationships never last. There almost seems to be a prioritizing of being a good role model over being happy in one’s relationship. In what way is being miserable in a relationship being a good role model?

For others, this sense of obligation takes on a more personal form, usually in the shape of either owing it to the other or being unwilling to be in a failed relationship. I have some thoughts on the concept of “failed relationships,” but I will post those some other time. For now, I simply ask: “what is so horrible about having been in a failed relationship?” It is as if having made a mistake in either picking the wrong partner or in being unable to grow together says that the person is a bad person. Having a failed relationship is not the equivalent to being a failed person. In fact, I think it is easier to make the argument that staying a relationship in which one is unhappy is a bigger act of failing as a person than is leaving that relationship. With regard to owing it to a partner, I find it difficult to think of circumstances that would authentically oblige one to a life of unhappiness; I wonder what debt is worth spending one’s life distressed. Furthermore, it seems that being miserable with someone is a poor way to repay a debt.

I think familiarity and fear are really two sides of the same coin. Familiarity is the safety of the known. Frequently this takes the form of “I know the worst that this gets, but I don’t how bad it would be outside of this relationship.” I suspect that fear is, in fact, at the root of all of these reasons. The primary fear appears to be the fear of being alone. In other words, it is better to be actively miserable within this relationship than it would be to risk being passively miserable alone. Moreover, this thinking suggests that it is better to sustain one’s current pain than the pain of being alone, which also offers the option for a different, satisfying relationship down the road. Fear is a powerful motivator. I relate to wanting to be in a relationship—it provides both companionship and validation, or at least the concept of the relationship does. But if the relationship doesn’t actually provide meaningful companionship and validation, then you are not getting from the relationship what you are in it for, and you are miserable on top of that.

I don’t mean to say that relationships with problems are not worth working on and fighting for. However, I encourage people to ask themselves what they are actually struggling for. What is at the heart of the motivation? Perhaps most importantly, ask yourself early enough in the relationship—when problems first emerge—so that answer can genuinely still be Love, and not just the concept of love, obligation, familiarity and fear.