Advice from the Trenches: Autoimmune Brain

Dear C and Dr. B:

My wife gets really down on herself – she self flagellates. She takes everything personally and feels it is her job to make the world a better place, and if something goes wrong, she just cant let it go. She can’t bear to disappoint anyone. Right now, she feels that she hates her job, but I think she just hates herself. With every job she has ever had, she’s done the same thing – playing the scenes over and over again, trying to get things just right. 

It’s ruining her sleep and affecting her mood and energy level. She loses her ability to focus and get others things done. She’s been in therapy multiple times and tried a number of medications – all without change. What else is there?    

 – Howard

Dr. B says:

Recently science has discovered the guilt and shame center in our brain, called the habenula. It is a negative reinforcer – its purpose is to beat us up emotionally in an effort to keep us safe by causing us to avoid behaviors which have brought us negative results. It works via an on and off switch – an environmental stimuli can turn it on. Life can be fine, then suddenly and instantaneously you feel horrible, crushed, devastated. It stops you in your tracks.  It is the emotional equivalent to what happens when you put your hand in a flame. 

We are only now developing medications that address this switch. But since this has been part of human nature since the beginning of time, we have already developed many different cultural approaches to suffering. The default current American culture advocates self-love and compassion. Buddhism teaches that suffering is an inevitable part of being alive and it advocates that we treat it with neutrality.  Psychotherapy would ask us to understand the root of our suffering and learn from it, that we should sublimate or transform this energy into something meaningful and useful. Cultural Judaism (as in the Woody Allen approach) teaches us that suffering is random and meaningless – it is nothing personal, so we should learn to laugh at the slapstick comedy of it all. 

If her other attempts have failed, your wife needs to find a therapist who takes a different approach. If that fails, then I suggest you find a psycho-pharmacologist who specializes in newer medications. 

C says:

Howard, you have described nearly every woman I know. Your wife is, granted, an exaggerated, neurotic version, but the behavior you describe is hardly abnormal. The need to make sure everyone and everything is alright is pretty much burned into our female genes. 

This behavior wouldn’t be a problem if your wife could put her drive into something that produced results, but what she seems to be doing instead is turning her own energy against herself. It’s similar to what happens when a person has an auto-immune disorder – their own cells turn on each other.

It is tough to handle a drive that is being constantly generated inside. But I think it would help if you took a look at this from another angle. 

Are you familiar with search dogs? These are some of the most heroic creatures on the planet. Do you know where these dogs come from? Animal shelters; generally on death row. They were abandoned by owners who just couldn’t deal with them anymore. Ironically, the very drive that makes them superheroes and savers of lives also makes them the family pet from hell. 

Search dogs need a job, and if they don’t have one, they will eat your sofa. If you throw them a stick they will NEVER stop fetching it and if you lock them in the closet they will chew their way through the door and then find the stick and bring it back to you.

Your wife is a search dog without a cause. That must be a bitch to live with. But rather than putting her on psychiatric meds, I suggest finding her something to channel that drive into. All the talk therapy in the world won’t do a damn thing to neutralize nervous energy. She needs to learn to live with it and simple solutions can be remarkably effective  – a regular, rigorous exercise program would probably do more to help her turn off her brain at night than anything you’ve tried. 

Historically, medicine has always taken a rather misogynist approach to “female hysteria,”

somewhat along the lines of “OMG, calm the bitch down, quick!” But a personal drive always needs a target and a task. It is when there is no direction or purpose that our thoughts begin to turn on us instead.

– Cathren Housley 

You can visit Dr. B’s blog at drbrilliantcliche.wordpress.com