Sunday, 21 July 2013

A Life Unexamined? - Physician, Know Thyself!

     A healthy, conscious relationship with one's own emotional life - ie self-awareness & self-acceptance - is rare, not just in patient populations, but equally among clinicians. Unconscious emotions continuously manifest themselves, to our detriment, influencing our thoughts, mood, speech, behavior, and our physical & emotional health.
     As mature adults, we owe it to ourselves & those around us to intentionally, intelligently, gently, progressively, cultivate self-awareness & self-acceptance. Mindfulness meditation is an evidence-based way of doing precisely this. Physician, it's time to know thyself! 
     See: http://mindfulnessforeveryone.blogspot.ca/2013/07/373-how-free-is-our-free-will.html

     "When feelings are frightening, conflicted, or deemed unacceptable they generate anxiety & defence mechanisms that act to blanket this anxiety (Fig. 1). This is usually the fate of emotions in children traumatized, abandoned or neglected by loved ones, who then have feelings of love mixed with rage and guilt about the rage. When these mixed feelings are unconscious to the patient, the subsequent anxiety and defences are also outside of awareness or unconscious. In essence, the rage or anger is turned inward into somatic symptoms both to protect the other person from the rage and to serve as a form of self-punishment for having the rage to begin with. Thus, the child develops the pattern of turning anger inward and is thus prone to somatic complaints, including abdominal pain, headache, depression, personality problems and other conditions. When later life events raise the threat of emotional pain and abuse, the rage is ‘turned inward’ into acute or chronic anxiety & somatization. The other person in the relationship is safe from the rage, but the process exacts a high toll for the adult sufferer through the range of symptoms and behaviours required to contain these emotions."

        Abbass A, Lovas D, Purdy A. Direct diagnosis and management of emotional factors in chronic headache patients. Cephalalgia 2008; 28(12): 1305-14.


Fig 1 - Relationship between unconscious feelings, anxiety, & defenses

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