SHAME AND WORTHLESSNESS, ESCAPE AND REPETITION: "I FEEL GUILTY . . . ALL THE TIME, LIKE ASHAMED."
When I asked Lena what had been the worst aspect of her experience with depression, she replied, “Just not, just not wanting to do anything. Feeling discouraged, uhm . . . not, not caring enough.” Lena’s indifference about herself—what she described as “not caring enough”—actually resulted in a lot of self-destructive thoughts and behaviors. At its worst, her feelings caused her to skip school and sleep all day, contact strangers on the internet for sexual encounters, abuse alcohol, cut herself, and fantasize about suicide. Her “not caring” in many ways was a manifestation of the pain that had been met with her family’s indifference and misrecognition over the years. It was also an internalization of shame and worthlessness about herself and her position in her family and in the world:
I’ve been told by- well like this one counselor I have now, and like a therapist I had, in the past that like, they think like I’m very critical of myself, they like they think I punish myself and I mean, you know the first time I was told something like that I was like confused because I mean I guess, you know I was thinking so negatively for so long that that you know, for someone to tell me something like that it just- I, I don’t know I just, it never once occurred to me that like I could be doing that to myself but like I feel guilty like all the time, like ashamed.
When she was in high school, Lena’s feelings began to overwhelm her. She sought any means of escape. Ultimately, Lena began relying on alcohol to alleviate some of her negative feelings. One day, Lena caught one of her neighbors watching her with binoculars from across the street. Sometime later, in response to this incident, she stuck her middle finger out in the direction of this house, but unfortunately that family had moved and a new one had taken its place. Therefore, she ended up offending her new neighbors (when it had been the former residents who had used the binoculars), who responded by harassing her wherever she went. In reference to this incident (which she described earlier in this chapter), Lena said:
It messed me up for for a long time, like, uh I mean you already know how bad it is for me like living there, and it it got so bad that like I started drinking a little bit sometimes, well this was like a few years ago I don’t do any of those things anymore. And and ahm you know I you know I like met I would like meet up with people I don’t even know, and I would like fool around with them.
In regards to her alcohol use, Lena said she felt “very anguished, I just felt like desperate, I felt just very like powerless. That’s how I felt all the times I drank. And I mean, the times I drank I like I always did alone in my room.” I asked about the extent of her drinking, and Lena replied, “It’s not something that I did, like all the time, I guess like every few months I would but but uhm every time I did I would have a lot, like I would like finish up like some big bottle of something, wine, like liquor.”
“To the point of getting sick?” I asked. “Yes, and and I know it got so bad some of those times like I, well one of the bottles I didn’t finish I just dumped the rest in the sink because I just- you know I just wanted to stop.” I asked Lena whether she had ever thought about hurting herself, and she said,
I thought about hurting myself but I never actually went through with it like I’ve always been too scared to actually try anything. Like the most I’ve done- was like you know drink, drink and you know like just meet up with people like I didn’t know and and I did cut myself a few times.
Lena had actually been hospitalized twice for making suicidal statements. During our interview, the circumstances remained rather vague, but she did state that she was released shortly thereafter and she never acted on her suicidal ideas. However, these thoughts were a present force in Lena’s mental world. “I thought about just hanging myself, just like stepping in front of like some moving vehicle, j- you know like jumping on like train tracks, in front of a train. Uhm, taking a lot of pills, drinking myself to death, just a lot of different things.” One thing that Lena found particularly distressing was her sexual interactions with strangers at that time. It was also a source of shame and embarrassment for her. These experiences exacerbated her feelings of low self-worth, and they ultimately contributed to her suicidality:
I’m just I was like traumatized like the first time I did anything like it, I just remember, like on the same day that I did something with someone I was- I became deeply depressed and like I thought about killing myself, even I mean even though I never actually did- you know tried, made any attempts and like, just I was like very depressed for an entire week I was very traumatized by it, but I’m just I’m just glad uhm, when I remember when I remember these things I don’t like I don’t get that upset anymore. Like (exhales) I just I’m just glad that, I just that I was able to accept it.
Initially, when Lena began describing these interactions, she did not elaborate. When I asked her to explain in more detail what had occurred, she said, “Uhm, yeah I was like vague. I was like being pretty vague because like of how embarrassed I am by it.” She explained that these interactions were a reflection of her negative feelings about herself, and that she participated in them because she did not care enough about herself. “Yeah, ah . . . I you know I I was intimate with these people I I did it because I just, because I didn’t have, like I didn’t have any self-worth. I knew that none of these people cared. They all treated me like dirt.”
Often, people re-create core relational dynamics from their childhood with people later on in life. Freud (1914) describes this as a repetition compulsion, in which areas of conflict are repeated in an attempt to work through them or to arrive at a different result. The ways in which Lena spoke about her sexual encounters with strangers mirror the interpersonal experiences that she had had up until that point; just as she described feeling that her family was cold, distant, and did not recognize her as a person or validate her feelings, similar dynamics unfolded with these men:
I mean I am the one who decided to do these things, but like looking back on it, you know I I could te- you know they- none of them like actually- none of them really cared about me, they could care less and, and I’ve noticed like how they were with me, like they just seemed like cold, like distant. I mean they, they weren’t at they weren’t at all interested in talking or anything, and, I remember like at least one of them, like asked me if I wanted to drink a little bit to relax and, I mean I I I declined and . . . I mean I don’t see any of these people anymore and like most of those times it was just like a one time thing.
Lena felt objectified and used in these interactions, and they probably further exacerbated her feelings of alienation and worthlessness. “They didn’t care. They didn’t they didn’t care who I was they didn’t care about any of that.”