‘Too much suffering!’ I say, quickly, determinedly, almost angrily, in response to the therapist’s question. She wants to know what my biggest problem is right now. She wants to figure out how to focus down on what we try to deal with this session. Which strand of wool shall we pull from the tangled mess in front of us that is me, today, here, now?
My answer hasn’t really helped her.
She smiles sympathetically and lowers her eyes. Mine are radiating challenge, fury, and acres of self-pity. Right now, I want to lay into anyone I can justifiably blame for my suffering. Anyone, that is, apart from the people who caused it – that still doesn’t feel safe. But I’m hot with agitation, I’m aching with abandonment, and I have that edgy, dangerous sense of wanting to destroy something. Preferably myself.
The therapist pauses, waits, calms. She’s sucking the energy out of my fight. She’s not looking directly at me, but slightly off to one side, and her upper body is languidly angled away from me too. There’s a soft gaze on her face, her wrinkles crumpled together full of pink lifefulness. She’s present and real and human and here, and it’s all I can do not to be defused by her. I want to fight her, I really do. She’s just not rising to it.
‘I see your suffering,’ she says, the words melodic and gentle. Now she’s looking at me, and she’s evidently not scared of me. She’s wiping down the space between us with tenderness. ‘Tell me about your suffering.’ Something about her softness breaks my aggression and I look down, and sigh. There’s pain in that sigh. It burns to breathe in again.
‘It hurts,’ I say, and I’ve gone flaccid and sad. ‘I can’t explain it. It’s like a pain in my chest, all night and all day. Like I’m breaking apart on the inside. I don’t want to move too fast, in case it hurts more. I don’t want to be still, in case I notice it. I don’t want to be alone with it. But I can’t be with people with it. It’s unbearable. It’s just suffering – suffering – suffering. All I can feel, all I can breathe, all I can smell is this pain. And I don’t even know what it is. I don’t know why it is. It’s just … just a kind of heart-brokenness. Like all the sadness in all the world has been smushed into a ball and I’ve been made to swallow it.’
I wish I had some tears, but I’m beyond that. It hurts too much for emotion.
This suffering has perched within awareness ever since my breakdown, years previously. Prior to that, I had dissociated from it. Then it erupted, sticky and hot and a poisonous, sulphurous stench, from behind my amnestic walls. It had always been there, but I had been switched off from it. But this torturing slew of post-traumatic affects – flashbacks, switching, high-pitched distress, the low, mad-making whine of constant despair – has blanketed every waking (and most non-waking) moments for so long now that I cannot remember any more what it is like not to wake up nauseous with dread, terrorised by my own feelings. It is all I can do, every single day, to merely get through each day, and to do so without killing myself.
I can’t describe how she responds. She’s not silent, but she doesn’t use words either. I don’t know if she even makes a sound. There’s just something that comes back to me, like a modulated echo. I feel my pain radiate out from me, and I feel her absorb it, and then back it comes towards me, but diluted. Smaller. More pastel.
I feel heard.
I feel understood.
I feel held.
And for just a moment, the pain eases, and moves back a few inches. It’s still there but it’s muffled. It’s more bearable, less intense, and its edges blur.
I don’t know how she does it, especially without words. It’s something about presence. It’s some silent communication between her nervous system and mine. It feels primitive. It is wordless.
It’s a relief for the pain to recede, if only a little. I don’t want this moment ever to end. But of course it will. Even still, it gives me hope. I realise, in this moment, that this suffering is fluid. It’s not solid, and unchanging. It can move.
Previously, the therapist may have said, ‘Just notice’ but she doesn’t need to, because I have, and she knows it. So we sit a little while longer.
‘What am I feeling?’ she asks, when the silence has run its course.
I look up, surprised. I didn’t think therapy was about her. I’m baffled. Why are we suddenly talking about what she’s feeling? What’s going on?
She catches my surprise.
‘Bear with me,’ she says, and there’s a steadiness in her eyes, like she’s sure of what she’s doing. ‘I want you to notice what’s going on here right now. I want you to try to mentalise and think about what’s going on in me right now. Not for my benefit, but for yours.’
I settle back down out of my alarm-at-novelty reaction and consider this. What is she feeling? And I realise, with greater alarm, that I have no idea. Do therapists feel anything at all during sessions? Do they even feel anything outside of sessions? It’s as if I’m used to seeing through her, and I’ve never stopped to consider the here-ness, the now-ness, the real-ness of her emotions. In a way, I didn’t think they mattered. I feel embarrassed at my self-absorption.
‘I have no idea what you’re feeling,’ I say, quietly enough that I hope she won’t hear me.
She half-smiles an acknowledgement, but continues to pierce into me. She’s right there, right in my face, challenging me, pushing me, whilst also hanging back, supportive, empathic, giving me space.
‘Have a think,’ she says.
I stare at her blankly. How do I even go about figuring out what she’s feeling? I am totally at a loss.
‘Do you think I’m feeling good or bad?’ she says, breaking it down. ‘Or neutral?’
I shrug my shoulders hopelessly, feeling way out of my comfort zone. ‘Neutral?’ I guess.
She pushes a noisy air-smile out of her nose. ‘No, not neutral,’ she says. ‘Most definitely not neutral.’
But I just don’t know how to know. I am, at this moment – as at so many moments – emotionally blind.
‘I’m feeling compassion for you,’ she says at last, sensing my stuckness. ‘I’ve got a huge big pain on the inside of me for what you’re experiencing.’
I look at her, astonished. I still don’t understand.
She speaks slowly, allowing each word to drip into my startled brain.
‘It’s a tight ball of fire in my chest. It’s a feeling like I want to act and that I have to act. And it’s painful. But it’s also vaguely hopeful. It’s a feeling,’ she says, looking away for a moment to find the right word, ‘like I need to see your suffering eased, and I’m also strangely hopeful that it can be. It’s a warm feeling, even though it’s painful.’
She takes a long look at me. I’m stymied in confusion.
‘How does that make you feel?’ she asks.
I shake my head and clutch myself smaller.
‘Ashamed,’ I say.
Her head bobs down and she makes a noise that is full of pain. I haven’t understood her words, but again I understand that sound. It goes right into me. Something seems to split apart inside me, in my chest. It is both painful and pleasurable. I don’t understand it.
‘Why ashamed?’ she asks. ‘Do you know?’
Suddenly there are words, although I don’t know where they’ve come from.
‘I feel ashamed,’ I reply, ‘because I don’t deserve for you to have compassion. I feel ashamed because I don’t want my pain to cause you pain. I feel ashamed because … because it’s like a feeling on the inside of me that wants to run a million miles away from you now. You’re being kind, and yet somehow it feels dangerous. Somehow it feels scary. Somehow it feels unbearable, and I want you to leave me alone …’ I trail off, appalled at my confession.
She nods, as if she’s not surprised. It’s unnerving to work with someone who is less surprised at what I say than I am myself.
‘The feeling of shame makes you want to pull back from me?’
She nods again.
‘Let’s look at it another way,’ she says, and I get the sense that she is manoeuvring around behind me, like a sheepdog guarding the stragglers from bolting away through a gap in the hedge. ‘If you told me that you’re suffering,’ she said, ‘and I looked bored, and I began to fidget, or I got up and started doing something else’ – she play-acts it out slightly, to make her point – ‘then how would you feel?’
This isn’t real, so I find it more comfortable to engage with. I like hypothetical. It gives me the space I need to down-regulate from the intensity of intimacy.
‘I’d feel hurt,’ I say, and my confidence rushes back in.
‘And what about if I told you that you were overreacting and that you needed to pull yourself together, and that you needed to just get over yourself and get on with life?’
‘I’d feel ashamed … or maybe angry.’
‘What if I cut you off in the middle of it all and started to tell you that, well that’s nothing, because I’m going through a far worse time than you, and then I went off on one, and told you an elaborate story about my own circumstances?’
I laugh at the preposterous possibility that this kind, gentle, attuned human being could be so suddenly self-centred.
She smiles back at me, but there’s fire in her eyes still.
‘How else could I respond to your pain and suffering, but with compassion?’ she asks, and it’s so simple now that I see it.
‘And isn’t that want you want?’ she asks. ‘Isn’t it what everyone wants, when they’re in pain?’
‘I suppose so.’
But this is a new idea to me. My life has been full of so much pain, such endless, tormenting suffering, both the abuse itself and then the fall-out from it, and only now, in therapy, am I consistently experiencing compassion in response to it. It seems like such a rare commodity in life, in society, even amongst friends.
‘How often do you respond to your own suffering with compassion?’ she asks.
Again, she’s not making sense. I didn’t know this was a thing. I’ve heard of self-compassion – mainly from this same therapist, who seems to have shares in it – but I’ve never been able to apply its relevance to me. It’s just jargon. I don’t see it as real.
She sees my confusion.
‘Think about what I’m saying,’ she says, blocking off another gap in the hedge. ‘You told me about your suffering. It impacted me. It hit me in my heart and in my guts, like I’d been punched. It made me want to do something for you, to relieve this pain for you. It brought a wave of emotion up through my chest, and into my throat. It made me want to cry. And we just sat together with that sadness, with me acknowledging your pain, and maybe holding it for you a bit, didn’t we? And what happened in you?’
I am unusually frank. ‘It helped,’ I say. ‘The pain eased a tiny bit. It felt hopeful. It felt warm. Even safe.’
She nods, unsurprised again. ‘That’s the power of compassion. It really is transformative. It doesn’t take the pain away, but it makes it easier to bear. While your nervous system was struggling to cope under the weight of it, I lent you mine, and for a little while – even if only for a little while – it relieved some of the pressure for you, didn’t it?’
‘Yes.’ As ever, I don’t know how she reads me so effortlessly. It’s like we sit in this room together and there is a one-way mirror between us: she seems to see into me, feel what I’m feeling, sensing what I’m thinking. And in return she is a blank wall. It’s helpful that she’s spelling it out for me like this. I know that she wears her emotions on her face. It’s just that I am illiterate to them.
‘So how would it be,’ she continues, pressing ahead, herding me into the livestock pen, ‘if you provided that experience for yourself?’
The idea sounds appealing, but I still don’t know what she means.
‘I don’t know how to,’ I say. ‘I’m too disconnected from myself – from my selves.’ This, after all, is why I carry a label of dissociative identity disorder. Can I play this now as my trump card? ‘I don’t know how to do connection.’
‘Yes, you do,’ she says. ‘You’re connected to me, here, now.’
I shrug, but look away. ‘Maybe.’
‘Why are you? Why do you feel connected to me?’
She’s not going to let this go. I might as well go with it.
‘Because you’re here,’ I say, vaguely. ‘Because you’re listening. Because you care.’ I feel embarrassed almost to the point of unconsciousness to say this last one.
‘You sense my compassion?’
I can’t deny it. I really, really can’t deny it, however much I want to. ‘Yes.’
‘So compassion is a bridge towards connection?’ she says.
I shrug and nod and feel confused.
‘If you want to connect in more with yourself – with your selves – maybe you need to show yourself more compassion?’
Her suggestion sits like a fused firework between us. I feel a surge of abhorrence, and terror, and shame.
‘I can’t!’ I say, suddenly agitated.
I don’t wait for her to prompt me with a why. I plunge right into it, to allow the words to come before I’ve censored them away.
‘I can’t. It’s too scary. It’s too much. If I get in touch with this pain, with the pain that my dissociated parts hold, I’ll be swept away by it. That’s why I dissociate, isn’t it? – because it’s too much? It’ll be overwhelming and I’ll be destabilised and … and …’
‘And …?’ Because there’s something more that I haven’t articulated yet.
‘And it’ll just make me feel so ashamed …’ – this word, stretching out like tarpaulin over rotting bodies, to hide the stench of how I feel deep inside me – ‘… because I won’t be able to do anything about it. I won’t be able to manage. I’ll lose the plot. I’ll go mad …’
This is the fear resident in the depths of me: that I couldn’t cope with my pain when the trauma was happening, and that I can’t cope with it now. My only strategy for surviving it was to dissociate: to block it out of consciousness, to burrow it away in a segregated self-system, away from the realm of daily life, where it can’t disable me. This pain, this suffering, this trauma – it sits like a radioactive core within myself, leaking out its carcinogenic fall-out into my life, killing me slowly. It feels inevitable. But to open the casket and bring it up to the surface feels like psychological suicide.
She’s nodding, eyelids pursed together, draining out of every word I speak its full meaning, its emotion, its truth.
‘I can’t be compassionate towards myself,’ I say, pushing the stake into the ground and daring her to cross it.
We sit again for a while and I at least feel heard.
Eventually, I look up at her, because I’m waiting for her challenge, but it hasn’t come. It’s as if she doesn’t want to force it onto me, so she’s waiting to be asked. I know my belief is born of terror. I don’t want it to be true. So I ask. Only with my eyes, but I ask.
‘I think …’ she says, slowly, like tiny drops of rain announcing the arrival of a thunderstorm, ‘I think you can be compassionate towards yourself – that you can learn to be – and that you need to be compassionate towards yourself. Because the alternative is that you continue to suffer this unbearable pain. And that’s not an option. At least, not for me.’
Ouch, but good ouch.
A spark lights on the inside of me.
‘How?’ I simply ask.
‘I believe,’ she says, the raindrops falling heavier, ‘that compassion is an innate human capacity. I have it, you have it, everyone has it. But there are things that get in the way of it. And it’s also a skill that we need to develop, so that we can respond to people’s suffering, but without overwhelming empathic distress.’
I raise both eyebrows, indicating both questions.
‘Maybe we could look firstly at what gets in the way of compassion for you, and then we could look at how you avoid being overwhelmed by empathic distress?’
I settle in for today’s psychoeducation masterclass. This has a double benefit: not just the insight and awareness that I need to move forwards, but the emotional down-regulation from the intensity of emotion between us, which was beginning to push me overboard. She knew it, and that’s why we’ve reverted to the safety of facts. There’s only so much compassion I can receive in one go and the box is full for today. But my front brain is zinging with anticipation and I can feel my guts relax.
We talk about the barriers for compassion. Fundamentally, I am afraid that it will overwhelm me. That if I go there, I’ll never be able to come back. In my mind’s eye, I see the suffering from my childhood trauma as an incandescent rage, an uncontrolled fire burning in an office block. If I go near it, I will die. If I open a door, it will belch out at me, and reduce me to ash. That’s my mental picture. And I realise, first and foremost, that the image I have of it in my mind is adding to the problem. I see it as huge, and myself as incapable. That’s the first thing I could change: I could repaint the picture.
‘And I’m scared of being compassionate,’ I add, ‘because it’s like saying that I’m not allowed to be angry at what happened to me.’
She tilts her head and furrows a questioning look towards me.
‘It feels as if there are parts of me who don’t want my compassion,’ I explain, as these thoughts burst upon the surface of my mind for the first time. ‘That if I say ‘there, there’, it’s as if I’m expecting them to just let it go. But they were hurt. They were traumatised. They were abused. ‘Compassion’ feels like I’m asking them just to get over it.’
I don’t really know what I mean by this. It’s more a stirring on the inside of me than a fully formed thought.
‘Compassion isn’t ‘there, there’,’ she says in response. ‘Compassion involves an energy to want to act, along with the stillness and the centredness to ‘feel deeply with’. Compassion is the ultimate validation of your trauma because the hurt from the wrongness of it is being felt. Your view of ‘compassion’ seems to be from your mother’s, which wasn’t compassion. It was dismissive. It was controlling. It wanted to shut you up as quickly as possible so that it wouldn’t bother her.’
I’m alert with the newness of this. I urge her on with my eyes.
‘True compassion isn’t trying to get you to get rid of your feelings,’ she explains. ‘True compassion feels your feelings with you. True compassion has a sense of wanting to relieve your suffering, but by sitting with you in it, not by wiping it away. True compassion validates every ounce of pain you’re feeling, and gives you hope that it can be soothed. False compassion says ‘there, there’ to get you to shut up about your pain, because the person can’t bear it themselves.’
‘Your parts maybe feel like you’re saying ‘there, there’ to shut them up from their pain, rather than being willing to feel it with them,’ she says, with aching gentleness.
I nod. ‘That’s exactly it. I don’t know what to do with their pain, how to cope with it, so every time I try this self-compassion thing, it’s like it gets thrown back in my face. Like parts are telling me where to shove it. So I stop trying.’
‘These traumatised parts of you need you to be as compassionate towards them as I am towards you,’ she says.
Oh, oh, oh.
Could I ever be as compassionate towards anyone as she is towards me? I hurt with the yearning and yet the impossibility of it.
‘But how do you manage it?’ I cry, perturbed, exasperated, and mildly overwhelmed. ‘How do you manage to sit with someone else’s pain and not be overwhelmed by it? How do you manage not to run away?’
She smiles and wraps her fingers together. ‘I don’t always. Sometimes it is hard to bear. But this is the issue of empathic distress. Compassion is a skill. We modulate it, so that we don’t feel so much empathy for another person that we become overwhelmed by their suffering. We have to be able to connect with it deeply, whilst also remaining deeply centred within ourselves. So we never forget that this is the other person’s pain, not ours. If I feel myself getting overwhelmed, I remind myself to breathe, and I’ll turn my focus away, just for a few moments, onto my diaphragm, and I’ll notice my chest expanding with the in-breath, and sinking with the out-breath. Just for a few moments. I modulate the pain, by shifting my focus. Then I can turn back to the client again and be fully present to them and to their pain again.’
I’m struck by what she’s saying like it’s a thunderclap of new insight into how other people manage their feelings. It has never occurred to me before, that a simple technique, or skill like this, could help to manage emotion. And it has never occurred to me, either, that she is feeling my pain while I’m talking, and that sometimes it overwhelms her. Or that she has a strategy for managing it. I thought she was just born this way. She’s too clever, I think, and of course then rebound into I’m so useless by comparison.
But I don’t want to lose this insight, so I press my brain into applying it.
‘When I feel the distress from my traumatised parts,’ I say, tentatively building my thoughts, ‘my default reaction is to look away. It’s to block them out. I dissociate from them.’
She nods. This much is obvious.
‘Because I don’t feel that I can handle their pain. I can’t take on board their suffering.’
‘And so they suffer even more, because they feel abandoned.’
I look at her, surprised again by this new idea.
She presses on. ‘What worse abandonment is there than from yourself? You are with yourself twenty-four hours a day. And yet you are also absent from yourself most of that time. You suffer, but without self-compassion. That then feeds the vicious cycle of dissociative identity disorder, which requires you to separate from yourself in order to cope with unbearable suffering. Without a compassionate response, it grows and grows, and feels too much to engage with. And so you dissociate from yourself more and more.’
Aaaah. This is it. This is my life. This is me.
‘But you’re saying that I can learn skills to manage this empathic distress, so that I can offer myself – my selves – some compassion for their suffering, rather than just blocking it out?’
Yes. This is about-turn for me, but yes.
‘It’s not easy,’ she adds. ‘But the first step is for you to experience it in our relationship, here. When you experience compassion from me, that creates new neural networks in your brain. You have the basis then to build on those networks, and to start applying that compassion to yourself. You need co-regulation before you can develop self-regulation.’
This helps. This reduces the shame of why I’ve not managed it before. I haven’t had the right circuitry, because I’ve never had the experience of compassion until now. My experience of compassion in the room, here, in therapy, with this therapist, is providing the building blocks for me to develop self-compassion towards myself. Slowly but surely.
‘Your parts need you,’ she adds, glancing at the clock. ‘Compassion is a necessary response to suffering. Without it, our suffering persists. Compassion begins to close it off. You need compassion from me, and you need compassion from yourself.’
‘But what if the suffering is ongoing?’ I say. I need to pinpoint all possibilities.
‘Then the compassion needs to be ongoing,’ she says. ‘Suffering and pain and distress are part of this world, part of our lives. At one level they will never end. We have very little choice over that. But what we do have a choice over is how we respond to our suffering. Compassion is the only right response to suffering.’
‘I’m in therapy to ease my suffering, aren’t I?’ I say, seeing it for the first time. ‘I’m here to try to relieve my symptoms, which are suffering. I’m here to try to become a better version of me, because who I am right now is full of suffering. I can avoid some suffering with better choices …’ – I’m thinking of the thousand crazy things I do each week which exacerbate my distress, back-brain driven reactions and impulsions – ‘… but for suffering that I can’t avoid, I can only manage it with compassion. With self-compassion.’
But from inside comes the dread feeling again, like a turning away.
‘Not false self-compassion,’ I add, directing the reassurance inwardly. ‘Not ‘there, there, now shut up’ compassion. But ‘I hear you, I’m with you, I’m for you, I’ll sit with you’ compassion. It doesn’t take the suffering away, but it does ease it a little. It’s like gas-and-air. You still feel it, but it’s further away and less distressing.’
All my life, unconsciously, I have been seeking compassion. In all the myriad ways I have sought help, or support, or sympathy, or empathy, what I’ve been looking for is for someone to hear my pain, and validate it, and sit with me in it. At times I’ve wanted to shout it from the rooftops. I’ve wanted the whole world to know how much pain I’m in. And mostly I’ve heard only silence in return. Because the world is not good at compassion. I’m not good at compassion. And I’m needing this experience, now and here and week by week, in therapy, of receiving compassion from an attuned, empathic, grounded human being, so that I can know what it is, so that I can grow the neurobiological substrates to be able to express it towards myself. This is the start. I have the capacity for compassion, because I am a human being, and to be human is to be compassionate. We are built to bear suffering – both our own, and other people’s.
I couldn’t manage my suffering when I was a child, because it was too much, and because I was only a child. My brain hadn’t developed fully. I didn’t have the space inside me to bear that kind of pain. But I’m an adult now. My parts often present as child-like, but the way through this suffering is not to continue in my childhoodedness. It’s to grow upwards and forwards into the fullness of the adulthood of me, where I am resilient enough and capacious enough to sit with myself in my suffering, and be compassionate. This is my challenge. This is my goal.
‘I guess I need to choose compassion,’ I say, as I stand up, and begin to get ready to leave. ‘I need to adopt it as a mindset, as an attitude. So that I can learn how to do it. I need to see my suffering, and respond to it well.’
I feel unexpectedly resolute, even hopeful.
But I’m aware – acutely, almost painfully – that one discussion about compassion has not suddenly given me the skills to do it. And yet, as with so many things that happen in this room, the first step is insight, the second step is intention, and the third step is implementation. Steps, steps, steps. As long as I keep taking steps, I’ll move towards my destination.