When we look at the alarming rates of severe mental health experiences, and suicide, the thread of fear seems to steadily weave its way through. Fear of: rejection, not living up to a certain persona, not meeting expectations, not mtg family needs, the future, taking risks, speaking up, being exposed, death, being vulnerable, not fitting in, not feeling safe & grounded, and inescapable painful memories. When heavy emotions and experiences go unprocessed, the feeling of suffocating and having nowhere to turn may take its toll. Without the natural flow of these meaningful and painful experiences, there often is a buildup of avoidance, anger, sadness, isolation, control, and will eventually derail one's life leading to serious challenges managing day-to-day.

Dr Bert Karon, who was a psychologist for over 50 years, talked about fear and terror being the heart of the matter with mania, depression, and psychosis. In my opinion, Dr Karon's comments could extend even further into our families, communities, and the systems we are part of. As you’ll read below, many of us could substitute our own description of how we compensate and avoid fear and depression.

Dr Karon stated, "mania is an attempt to compensate for the depression, to avoid the depression. And it usually involves a lot of anger. And they usually know that when they are manic it scares the shit out of other people. If you listen to them they know it scares other people and they enjoy it - it's often people they want to scare, although they won't take responsibility for it. Sometimes with manic people you can't control them, but the one thing we know about manic people, and depressed people, is that if you don't do anything with them, except put them in a safe place, 80-90% will get completely better - without any kind of treatment - just keep them from hurting themselves or anybody else. Depression in general seems to be self limiting. The depression is more central than the manic state. If you just keep them safe they will get better in almost all cases. Psychosis is a state of chronic terror and the defenses against the state of chronic terror. Human beings are not intended to be terrified for weeks, months, on end, or in some cases years. We are not built to take that."

My understanding of Bert’s comment is how essential it is to break down fear and terror, first by being in a safe space and reducing the intensity, and once feeling calm enough can begin more of a healing process.

From my experience with Open Dialogue, and in my conversations with individuals and families, I've begun to notice more clearly the dilemmas in people's lives, also referred to as a "double-bind" - meaning the difficult choice needed to be made between two, or more, undesirable alternatives. These double-binds are often related to the list of fears mentioned earlier. The difficulty of this decision process stops us in our tracks, being unable to make choices, or how to respond to a problem. It limits our ability to take risks, likely for good reasons, and this is how experiences can go unprocessed - leaving a feeling of being suffocated and doing one's best to compensate so the fear doesn't become consuming. Once a person feels safe to begin sharing these fears, dilemmas, an opening allows for an ease to the suffocation and, as a result, releasing more of the painful experiences.