Changing your life through insight, honesty

The past is never easy to deal with, but in Keith Ablow's new book “Living the Truth: Transform Your Life Through the Power of Insight and Honesty,” the best-selling author and renowned psychiatrist warns that pushing painful memories under the rug can do all sorts of damage, including negatively affecting your relationships. Ablow encourages readers to examine their lives and offers techniques on how to change pain into power. Here is an excerpt:

Living in denial

Four months before she came to see me, Nicole, forty-six, would have said her life was very nearly perfect. She had been married nineteen years and had a healthy daughter, seventeen, and son, fourteen. She worked part-time as the office coordinator for her husband, Grant, a successful Realtor. She was in close touch with her sister, forty, and both her parents. She had friends, a dog, two cats, and a Volvo SUV.

Sure, she sometimes wondered whether drinking a glass of wine or two to get to sleep could be a problem, but plenty of people didn't sleep well and plenty of people enjoyed their wine. And yes, there was also the way she went on shopping sprees to lift her mood when she felt down for more than a day or two, but a few extra dresses or pairs of shoes didn't seem like the end of the world. Even the fact that she didn't have much interest in sex anymore didn't seem so weird. After all, she'd lived and worked with the same man for nearly two decades — not exactly the ultimate recipe for passion.

Then, shortly after her daughter, Kelley, was accepted to a nationally recognized design school, Nicole's mood really started slipping. She was thrilled to see Kelley pursuing her dream, so she couldn't understand why she wasn't on cloud nine with her. She figured maybe with all the excitement and worry of the application process, she had simply given way to fatigue. Maybe visiting schools had been more exhausting than she knew. She remembered feeling the same way after her wedding, when the ceremony and celebration and honeymoon were over.

This time, however, turned out to be different. Her mood continued to slip. Within three months, despite Kelley's growing excitement about going to college, Nicole found herself tearful at times. She felt exhausted and couldn't concentrate at work. She began arguing more with her husband, especially when he bothered her about her drinking. She was up to three glasses of wine at bedtime, usually around nine o'clock, earlier when she could think of an excuse. She had no sexual desire whatsoever. In dark moments after midnight, she even doubted whether life was worth living.

She began to wonder if her real problem might be her marriage. She certainly didn't feel anything close to romantic love anymore. When she thought about it, she probably hadn't for many years. But she didn't want to think about it.

By avoiding the pain in her life, Nicole was no different from most of us. In working with thousands of patients over the last fifteen years, I have found that human beings have a reflex reaction to psychological pain no different from their reaction to physical pain. We withdraw from it. We try to avoid thinking about not only the painful aspects of our lives today but those in the past, all the way back to childhood.

This should come as no surprise. No one wants to feel bad, and the human instinct to seek pleasure and avoid pain (including painful recollections) has been a central principle in philosophy and psychology since the time of the ancient Greeks. Sigmund Freud called it the "pleasure principle."

Indeed, we accept the notion that the mind uses many "defense mechanisms" to distance us from bitter realities — we repress our emotions, we rationalize our behaviors, we distort past events. Chief among these mechanisms is denial, in which we unconsciously ignore distressing facts about ourselves or others. Denial can make us "look the other way" in the face of evidence that our spouses are unfaithful or our children have turned to drugs. It can make us immune to feedback from friends and loved ones who warn us about our addictions or other self-defeating behaviors.

Nicole might never have come to see me, in fact, were it not for her fourteen-year-old son, Nathan. Nate was a high school football player and all-around jock, not one to talk about his feelings, so when he got choked up and told Nicole he felt as if he had "lost his mother," she decided it was high time she tried to "find herself." She heard me interviewed on a local radio station, called my office, and booked an appointment.

The first time we met, I could see that Nicole wasn't just well put together — she was perfectly put together. Everything was in its place — her designer clothes, her jewelry, her makeup, her hair. She was physically fit and looked younger than forty-six. But she also looked worried. She avoided eye contact. And more than once, she clenched and unclenched her fists, as though to wring the tension from her hands.

I nodded at them. "You're having a hard time," I said.

She looked down at her hands and let out a long breath. "I never thought I'd be saying this," she told me, "but I think I may need something."

"You mean, a medicine?"

"My sister's on Zoloft. She says it helps her."

I knew why Nicole was asking for Zoloft right off the bat: part of her was still searching for some way to cover up the trouble in her life instead of getting to the bottom of it. Sitting with a doctor whom she knew had made it his life's work to help people get to the truth, she was making a last-ditch effort to avoid that very process.

"Zoloft might be part of the answer," I told her, "but I'd have to understand much more about you and your life to know."

She clenched her fists again.

I leaned toward her. "Tell me what's wrong," I said.

That was enough to make her eyes fill up. "Nothing," she said. She twisted her engagement ring back and forth. "My marriage. The way I am around my kids ... losing my temper. I'm a complete mess."

"You're a person," I said. "That's always messy."

She looked directly at me for the first time.

"What's happening in your marriage?" I asked.

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