MINDSET
Karen Stewart retired in October 2021, after more than 40 years of practicing psychology. She cares deeply about this planet and all of the people on it, especially the marginalized, socially excluded, and disenfranchised. She believes we are al one and we sink or swim together. She still has something to say.
She can be contacted at:
By Karen Stewart, MA

My life work professionally and personally has been dealing with inner painful experiences—that part of us that is hidden, available only to us, unless we choose to share it. Everyone carries inner pain. Inner pain may range from brief and transitory and easily processed to long-term, 24-7 and brutal.
In the last issue of Health&Healing, I wrote about the hidden pain of grief, loss, and anger caused by deaths, separations, betrayals, traumas, personal diminishments, and difficulties in relationships. I described a process to work through feelings involving accepting and acknowledging them, feeling them in our bodies, validating them, and having deep compassion for our experiences.
In this issue, I want to focus on a different kind of inner pain—the persistent, intractable, and harmful thoughts and emotions related to excessive anxiety, depression, self-deprecation, and self-harm.
Anxiety and Depression: Silent Suffering
Shame about these feelings make them especially hard to talk about. We suffer in silence. Friends and family may have no idea that we suffer such pain. We may be successful, competent and have a good life and still feel and still feel anxious, depressed, and badly about ourselves. We move through the world, engaging with others, working and playing and hiding deep inner pain. While acceptance, validation, and compassion are essential in all healing, these kinds of thoughts and feelings may require other important tools available in talk therapy.
Anxiety and depression often have a genetic component, and thoughts of self-harm may be so threatening that they require medication to help alleviate suffering for talking therapy to help. All kinds of inner suffering involve some cognitive distortion but in severe anxiety, depression, low-self-esteem, and self-harm the distortions are usually much more significant. How do these distortions arise?
Sources of Pain
Children learn about themselves and their world from birth onward. Caretakers provide safe environments and serve as mirrors to their child. Parents gaze at their child with love, wonder, and awe and the infant feels loved and beams that love back. In health, infants are cherished, shielded from hardship, and provided with age-appropriate experiences that help them develop. They grow into competent children who know they are safe and loved. They accept and are grateful for their gifts and talents and learn to handle disappointments and even failures. Of course, no one has a perfect situation but there is a lot of wiggle room for success. Even with naturally occurring hardships and environmental challenges, children can develop into resilient adults who generally accept and like themselves while recognizing things that would be helpful to change and working to do that. Growth continues over their lifetimes.
No one’s mirror is without distortions because, as parents we are human beings with flaws and blind spots. We suffer from inner and outer stresses that make us unable at times to be fully present and responsive to our children. However, most of us are “good enough” a phrase coined by child psychiatrist Donald Winnicott a long time ago. We provide nurturing “holding environments” and mostly see our children through to eyes of love. Our children grow up reasonably happy and healthy.
Sometimes, however, children’s mirrors are very distorted, their environments are not safe and secure, and their experiences are not age appropriate and overwhelm them. Children are resourceful and develop ways of understanding what is going on and handling it (defenses) which help them survive. Those defenses may or may not be very successful. Defenses, while essential are developed by very young little beings doing their best but without a mature understanding about who they are or mature perceptions of their environment. What serves children may cause many problems to adults. We stumble around with distorted, negative views of ourselves and our environment, mistrustful and fearful of others often with misperceptions of reality and our place in it. Our ability to interact successfully may be impaired or we may learn to act appropriately but remain anxious and depressed, carrying very negative feelings about ourselves.
The Power of Talk Therapy
To make use of tools like acceptance, validation, and compassion we may need talk therapy to help us look back at our childhoods and understand what happened and how it affected us. In the safe harbor of a skilled and competent therapist, we can talk about our experiences. A belief in being part of something beyond us, bigger than us, may be of tremendous help in the process as well. We can learn to see ourselves more clearly and come to love and accept ourselves, to be our own best friends, to form healthy relationships with others and to develop a meaningful satisfying life.
This is hard work and takes great courage and perseverance. Healing may be our most important work in this life. We do it for ourselves, for our children and grandchildren and for the world. I have done the work myself and I feel honored to have accompanied many others on their journeys. I want to close with a poem by Joy Harjo, poet laureate of the United States in 2019. She was the first Native American appointed to that position and is a member of the Mvskoke/Creek Nation. I am thinking of you dear readers and whatever hidden pain you are experiencing. I am also acutely aware of the deep pain many of us are experiencing after the last election. May this poem bring some comfort to you as it has to me.