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    Not Getting Better? Insist Upon The Biopsychosocial Model (Part 5)

    Begin to Untangle Your Life

    Perhaps, like Sandra, you lost a parent at a young age; or have a loved one who lived through this traumatic experience. When a child prematurely loses their mother or father, it may feel like the world as they know it has been turned upside down, or has ended. The stage of one’s life when the loss occurs, and the availability of loved ones to provide comfort and support, influence the emotional effects of losing one’s parent. If your loss occurred at a very young age, it may have affected your ability to trust and to develop a secure and stable “self.” As a result you may be left with the feeling that your self is fragile or even perishable. [ix] [x]

    In addition to the biologic effects of early loss, which places one at risk for major depression and anxiety disorders later in life, [xi] [xii] you may have difficulty establishing and maintaining relationships that are stable and durable, and may fear the fragmentation of yourself as you sustain separations and disappointments in these relationships. To begin to untangle your life, it is important that you provide honest answers to some pointed questions about how you behave in love relationships. To better understand yourself, please take out your workbook or a clean sheet of paper and write down your answers to the following:

    Step 1 – Are you exquisitely sensitive to separation? Do you get extremely angry or depressed at these times? Do you suffer from ongoing feelings of anxiety or depression, and/or problems with focus and memory, that interfere with your functioning at work, or at home? Describe in detail.

    Step 2 – Do you feel jealous possessiveness where you are unwilling to allow your loved one to be fully separate and independent of you while they still feel love for you? If so, please cite some examples.

    Step 3 – Do you get stormy and volatile frequently in these love relationships and act like a “drama queen or king?” Again, please give examples.

    Step 4 – Do you repeatedly sabotage these relationships by behaving in ways that drive the other person away? How do you behave toward them?

    Step 5 – If your answer to one or all of these questions is “Yes” then it may not be possible for you to solve your emotional distress by yourself. You could begin by first recognizing the pattern and pointing it out to yourself and your lover and/or close friend and explain that you believe that it relates to the loss of your parent, and apologize, saying that you are going to work on this issue. Write down the triggers of your exaggerated emotional responses and self-sabotaging behaviors, and how you typically react.

    Step 6 – In response to these triggers, perhaps related to perceived loss, separation, or disappointment, you can learn how to walk away from angry confrontation, cool off, tell yourself that your loved one is not betraying you or abandoning you (the way your parent did), and come back and reengage when you calm down. Try out this technique and write down what transpires.

    Step 7 – You may facilitate the grieving process by first writing down good memories of the parent you lost, and then your feelings of sadness and anger over their illness and death, and how you felt abandoned and lost. Please write this out at length. It can be rough going to take this on by yourself, and you may want to find emotional support in talking with a sibling or your surviving parent (if you have that sort of relationship with them). Your delayed grieving may then take place without the need to see a therapist, and you may be able to let go of that pain and feel freed up to be in the current relationship in a more stable and durable way.

    Step 8 – If you have tried these earlier steps, and if you believe that your “self” is not stable, and you feel that you may be falling apart at times of separation and loss; or if you have unremitting symptoms of anxiety or depression that may include cognitive impairment; or if you are suffering from suicidal feelings; it is essential that you obtain professional help. As illustrated in the story of Sandra, a psychiatrist can evaluate and treat the biologic contributors to your symptoms using an integrative approach under the Biopsychosocial Model.

    Step 9 – To complement the biological treatment, a caring and empathic therapist can help you to come to terms with your grief and loss, and can help you develop and strengthen yourself in ways that immunize you from such profound reactions.

    Sometimes this treatment can take the form of what is known as “Dialectical Behavioral Therapy (DBT)” which can also help you learn new ways to manage your extreme emotions by identifying the triggers that elicit these emotions, and being taught coping mechanisms such that the emotions no longer control your behaviors and feelings about yourself. [xiii]

    If the loss occurs later on in the teen or young adult years, when you have begun to go out into the world and explore relationships with others, and at a time when you are trying to separate from your parents, form an identity, and individuate as your own person, the effects on you may be somewhat different. [xiv] [xv] Perhaps you have a chronic sadness or mild depression that just won’t go away. [xvi] Perhaps your depression is more serious and you really struggle to get to school or do your work, and have withdrawn from others. You may be acting out by drinking too much alcohol, using drugs, or being sexually involved with multiple partners with casual unprotected sex.

    Step 10 – If you are acting out in self-sabotaging ways, it is important that you try to put your feelings over the loss of your parent into words with someone that you trust, rather than acting out or becoming consumed by them. Please write out the ways that you are sabotaging your life and what you are feeling, to form the basis of what you can begin to share.

    While each person grieves in their own way, [xvii] sometimes the mourning process has been blocked, and you are emotionally stuck at the time of the original loss. Try reminiscing with one or more members of your immediate family. You may be reluctant to bring up your memories and feelings with them for fear of making them sad or depressed. Ask them how they would feel if you began to explore your loss together. If you have a really close friend – one with whom you can share anything – he or she may be another option.

    Sometimes a flood of feelings will come out all at once and at other times they will come in fits and spurts. You may feel stuck or lost in grief, and looking at pictures of yourself with your parent, playing music that you had enjoyed together, or traveling to a place where you shared some wonderful times, may help you to get unstuck. Whether you pursue these experiences on your own or share them by bringing along someone else that you love can be determined by what makes you feel more comfortable.

    Step 11 – If you are in treatment and still not fully recovered, insist upon a comprehensive evaluation including laboratory and genetic testing (perhaps to include a nutritional and functional gut evaluation as well); and if your doctor is unwilling to work with you in this fashion, seek out a second opinion.

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