How to understand a personal crisis.

John* was a young man and suicidal. He had recently split from his partner and had spent three days drinking. His sleep was erratic, and his mind playing over the same thoughts of guilt and anger. He had begun to feel anxious, his heart beating hard in his chest. The only solution seemed to be under a train, and he had been pulled from the tracks by police officers. How did he get here?

A crisis can occur when our reflection is shattered

Often in psychiatry, we see those who have reached the end of their coping mechanisms, and as such only see one escape. But to understand them, and to help, requires knowing something about the nature of ideas and the mind. This cannot be separated from someone’s experience, and so it means knowing very much about them and their story. This is John’s.

The nature of John’s suffering

John was an idealistic young man who had difficulty relying upon others but was in denial of his need for personal connection. There was a lack of trust developed from his early relationships with his parents and this drove him to seek independence from early on. He could not trust love but relied on recognition from others for his achievements.

How we present ourselves and our truth may differ.

He found a career that suited his need to exert control, which helped to quiet his constant feelings of inadequacy. His ideation and motivation became one of seeing a change because it helped to distract him from himself and remind him that he ‘was good.’

At times he had turned to drink when things did not quite add up and became heavily reliant on the security offered by his partner as a non-judgemental locus of support. His life was reliant on praise, and he could only feel good when he was admired. When he felt low, he drank, as this numbed the pain.

But when things fell apart for John, he was left with years of internalised ideas about being a failure, and when his coping mechanisms and fantasy could not provide an alternative, this anger turned inwards and he began to blame himself for what can happen naturally to all of us.

He felt impotent, powerless, and hopeless.