In my experience, a lot of pain has its roots in not feeling seen, recognized, or understood. Or, conversely, in feeling so vulnerable and visible that people intrude - almost as if you are transparent and others can see through you to your innermost thoughts, fears, and desires; having physical, mental, and emotional privacy and boundaries are just as important as not being invisible to those around you. Many have written on the significance of these matters.
If you have a wound, and it's bleeding, and you seek help from your mother or father or teacher or doctor or babysitter or spouse or older sibling or employer, and they refuse to acknowledge the injury, the pain you are experiencing from the original affliction is only likely to get worse. This is a commonplace scenario. Let’s say they claim it's not as bad as you're making it seem, or that they can't see you bleeding at all; that in fact, the injury is in your imagination - or worse, they accuse you of lying about it. Or perhaps they tell you not to complain because other people are bleeding more in other parts of the world, or they bled for so long during their childhood without making a peep, and that became a sign of strength and pride (bottling things up and putting on a brave face).
- As a side note, this approach can be useful in the short-term, because it can allow you to function, let’s say at work or school, or to complete a task that needs attention. But long-term it is problematic and will likely backfire because it requires a refusal to attend to something painful. And what is pain? It is your body’s way of telling you that something is wrong and you need to pay attention in order to heal, remove the source of the wound, or stop doing something that exacerbates it. This is true for psychological or emotional pain as well. Bottling things up tends to lead to explosions later, which can negatively affect or end relationships. It also can lead to physical symptoms of stress, like ulcers, breakouts on your skin, panic attacks, or worse. Putting on a brave face may feel more comfortable, but it requires putting a barrier between yourself and others who might otherwise be able to know you in a meaningful way. Even more problematic, sometimes it can become so automatic that you yourself no longer recognize what you feel and need. Both approaches are problematic because they require not engaging reflectively on what you think, feel, and need for too long, which has relational and existential implications. Also, it doesn’t work because these things tend to find ways of being expressed one way or another. It’s like that old saying where someone tells you not to think of something specific: don’t think about a green field with horses grazing. The effect is that you can’t not picture it. Attempts to deceive the self in this manner almost always eventually fall apart. -
Getting back to the matter at hand, let’s say in this metaphor that the person you confide in about your wound tells you that physical injury and bleeding are all a "part of the job" and people who survive in this environment learn to be okay bleeding. All of these responses have the potential to make the injury worse. The person might refuse to help you bandage your wound and demand that you go about work as usual. You might get dirt in your wounds and get an infection, or lose so much blood that you feel ill or pass out. What began as a minor ailment may end up requiring amputation or surgery if it is not attended to in a timely and conscientious manner. You may develop elaborate rituals around this pain and engaging with it that do nothing to resolve it. The point is that the situation gets worse when it's not addressed, when it is denied, or when you're berated for daring to acknowledge the problem out loud in the first place.
A lot of shame comes from fear about others' reactions to our pain. Fear that we will be a burden, or that we don't matter, or that we will feel humiliated for daring to be open about our wounds. That we might call out for recognition and be ignored, or find ourselves shouting into an abyss that yields no response, or that our plight might seem invisible to those around us no matter how loudly and articulately we describe it. When faced with this situation for long enough, we may begin to wonder whether we are who we think we are, whether we exist in the ways we think we do, whether we deserve to exist, or whether we exist at all.
The same can be said about sharing our joy: that others will belittle our achievements, criticize something beautiful, not join us in celebrating life or our selves, "burst" our figurative "bubble," or maybe even ignore the fact that something fantastic and meaningful happened at all. Instead of feeling invisible, there is humiliation in allowing oneself to be seen and not met with the appropriate level of recognition. It's like looking into a mirror and knowing who you are, but the reflection held up by others is not what you expect - it is a distortion of your truth, your character, your very reality - and the disconnection between who you know yourself to be and who others tell you you are is excruciating. And confusing. In this case, perhaps it might be safer to hide away in silence, protecting your pleasure, than to be seen (and dismantled) at all. This sensation will be familiar if you’ve ever gone through a moment in time where you felt you had to wear a mask in order to survive it. All people have the potential to feel this way. Our relationships are so crucial to how we see ourselves and our position in the world, that the experience of existence (the way we perceive being alive) is in many ways dependent on how we navigate these circumstances.
Psychosis, to many, is a scary word. It is an enigma, not readily understood. By definition, a person or situation that is psychotic has deviated from reality in some way, from agreed upon meanings. Therefore, its very nature defies others to comprehend it. But in many respects, psychosis is one manifestation of this relational and existential struggle just described. It has at its roots ordinary pain that has been magnified to the point that a disintegration of self occurs. Rather than calling upon different defenses to combat this relational conundrum (which might allow the person to feel hurt but not disintegrated by it), breaking with reality becomes an unconscious solution (or effect, or both) of the situation. In an attempt to avoid being destroyed by the magnitude of this situation, the solution leads to outward annihilation. Remember that wound previously denied? The one where everyone told you that you were not in fact bleeding, despite all visual and sensory evidence to the contrary? For you, the wound is real. In fact, as it festers and is denied or ignored, it becomes the most real thing you can truly know. Recognizing it becomes an urgent matter of survival, a need that eclipses all others. Denying it only means you are left to deal with it on your own. Anyone who tells you they know better cannot be of assistance because they are refusing to acknowledge your pain, and what you know to be the truth.
So when individuals experiencing psychosis says that they are a famous actor; own multiple mansions; can communicate telepathically; are being pursued by the C.I.A.; have secretly encoded messages being sent to them through the television or through radio waves; are actually a god who has been sacrificed and has returned from the afterlife; are being persecuted for their talents by people who want to thwart their success, etc., those persons are speaking a version of their truth that has previously been denied by core people, been denied by society, and so it is communicated in an encoded manner. Rather than say, "I am bleeding," and risk having someone respond, "You are crazy," the person instead tries to speak to their reality in a way that both conceals and reveals it simultaneously, if only the recipient listens to the message and really tries to understand; saying the speaker is illogical and the message is nonsensical only serves to drive a larger wedge in the already present schism between both parties. It also confirms for the person that they are correct in their withdrawal from trying to communicate explicitly in relation to another.
This same analogy (of a bleeding wound and others' denial of it; of the necessity of being recognized and understood; and of needing to be seen just as much as needing to not feel overly exposed) can be used to describe what is at the core of a wide range of psychological conflicts that constitute the human experience. Depression, anxiety, trauma of all kinds, personality disorders, loss & grief, etc. are all different manifestations of this similar form of pain. No matter what diagnosis a person carries, they are primarily a human being experiencing Life, with all its joys, splendor, heartache, confusion, chaos, change, and, hopefully, growth. In my years studying and practicing as a psychologist, I have come to believe that one of the most important means of therapeutic growth and recovery is in the ability to form a relationship where these things can be explored in safety, and the multitude of unseen wounds can finally be revealed. Then true healing can begin.