Depression: Inward Anger?

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Emotions are a subject of considerable importance in most therapy settings.  It’s pretty hard to do any kind of useful therapy without bringing emotions into the picture in some way.  Traditionally, this equates to the old standby that therapy is just talking about your feelings.  Although this is partly true, it would be a great falsehood to claim that this is all that therapy is or can be.

Regardless, in my opinion, the core of all dysfunction stems from some kind of emotional ‘disturbance.’  This could take many forms, form as serious as a past traumatic event to the way that emotions were handled in the family you grew up in (arguably the only variable in life over which you truly have no choice).  For example, if you grew up in an environment in which emotions were regularly hidden or suppressed, you might be unlikely to be comfortable expressing outward emotions like anger or frustration most of the time.  Inward emotions, like sadness, might be more comfortable for you because they naturally lead to behaviours such as isolation and withdrawal from situations that may be overly stimulating.

In any emotion-focused therapy, one of the main goals can be to explore how problems manifest emotionally on different levels of awareness.  A lot of people are just not that familiar with their own emotions.  I have some theories on why that might be (like most things related to mental health, we’re not doing a very good job educating our children on emotions – despite the fact that they’ve been proven to be the same all over the world), but I’ll save that for another article.  Often times people will come to therapy with a problem, say depression, that seemingly comes out of nowhere, but often has to do with another emotion they’re uncomfortable with, for example anger.  Sometimes exploring how emotions are processed leads to insight about how the problem developed and how to move towards health.

Let’s consider the example of Rachel, a pretend case loosely based on an amalgamation of former clients.

Rachel grew up with a mother who worked at a demanding job, was often stressed out and irritable around the kids, and frequently had angry outbursts.  Rachel’s dad played the role of the even-keeled peacekeeper whenever a family conflict arose, and was pretty good at this seeing as Rachel can’t remember her dad ever really getting outwardly emotional.  Rachel quickly learned to navigate her interactions with her mom by taking after her dad and keeping as many of her emotions as she could on the inside.  It didn’t take her long to figure out that getting angry with her mom only made things worse for her, as mom would only get more upset in return.  Furthermore, she began to associate outward anger with her mom, and vowed (consciously or not) that she would not end up this way when she grew up.

Now in her twenties, Rachel (who no longer lives with her parents) starts to feel depressed.  This starts to affect her grades at school and her relationships with friends and roommates.  It’s not long before she’s dropped her classes, and as her depression gets steadily worse, she’s soon spending most days unable to even get out of bed.

This is the point that Rachel seeks therapy, something she has never done before.  Her therapist soon notices that although Rachel describes terrible symptoms of depression, hopelessness, and despair, she often smiles and speaks with a bubbly voice.  The only evidence of her ordeal is an occasional bout of stifled tears.  Through talking with her therapist, she begins to explore how she experiences emotions, and states that she is often “the conflict mediator” or peacekeeper in her relations with others.  Even in her darkest hour, she nobly (or perhaps stubbornly) attempts to downplay the magnitude of her depression.  She’s so used to being “the helper,” that being in a position of needing help is completely foreign to her.

Eventually, her therapist makes the comment that given some of what Rachel has experienced, it would make good sense for her to feel angry.  This comes as somewhat of an epiphany to Rachel, who had never thought of it that way.  With the help of therapy she was able to see how she actually was really angry.  The rub is that she didn’t have any way to express that anger healthily, and so it festered and grew inside until it became unable to be ignored.  But still, Rachel’s discomfort with the emotion of anger was too deep-rooted for her to notice what was going on.  Something had to give, though.  If Rachel wasn’t going to let herself experience anger, that anger was going to get out in a different way.  So, instead of going outward, it was turned inward, which appeared outwardly as sadness, an emotion that Rachel was much more comfortable with because she could hide it.

After realizing this, Rachel began to work on better differentiating her emotional states and working on ways to healthily express her anger.  It wasn’t long before the worst of her depression lifted.

This is just one example of how emotions can get in our way when we don’t know our way around them well enough.  Doesn’t have to be sadness and anger, although some have theorized that depression can be thought of as a kind of inward anger, as described above.  We all have emotions we’re more comfortable with than others, and we’re the only ones that experience our own emotions, so it can be hard to know when they’re getting us into trouble.

In general, emotions do us a lot more good than harm.  I guess the bottom line in this article is that knowing our emotional selves better can be a great way to capitalize on the good and minimize the harm.

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