I have just got back from a run. I am shocked to write those words. I think it might have been a decade since my last. But I recently discovered that I have slightly high cholesterol, and I’ve been advised to do sweaty exercise regularly.
This is the first time in my life that my motivation to exercise has been my physical health. In my youth, I ran because I wanted to be thinner. I’ve also run to cure my anxiety (and written about it – I was just running away from the anxiety, not addressing it). At other times, I ran because I wanted to get better at running. This was what it meant to me then to build a better life.
Running for a different reason now got me thinking about the ways I’ve related to my body over my lifetime and how this is changing as I transition from being a young person to being a middle-aged person. I don’t think I’ve respected my body, not deep down. I’ve valued it only for its functions and the purposes it served me: trying to attract others; avoiding feelings; running a faster (or, rather, a slightly less slow) 5km. Until today, I’ve not understood that my body is me, it is my life, rather than something that produces results.
The unconscious uses the body to express some pain or rage or whatever emotion the mind cannot tolerate
A lot has been written over the centuries about the split (or not) between body and mind – which, you will be relieved to know, I’m not going to precis here. What I’ve found most compelling is Freud’s understanding that mind and body are developmentally integrated right from the start, because physical development demands psychological development and vice versa. The infant’s bodily experiences – such as the physical sensation of hunger – propel the mind to develop the capacity to recognise hunger as a feeling that can be sated by a feed; and the emotional comfort and satisfaction repeatedly brought by feed after feed nourishes the child’s mind just as the milk nourishes them physically. So too psychological experiences – such as the desire to stand up and reach for something, and the determination to try again and again – are why and how muscles grow stronger. From our earliest moments, our body and mind are intertwined in mutual development as integrated as a double helix.
But I have noticed, in treatment with my psychoanalyst, that my mind and body can be in a different kind of relationship – one less integrated and more exploitative. My mind can use my body to store and express things that my mind deems unwanted or unacceptable. In my sessions we’ve become aware of how there are particular emotional states that I fear I cannot bear; instead of feeling these in my mind, I unconsciously push them into my body, where they get stuck as physical symptoms.
I used to get this with indigestion – which had nothing to do with what I’d eaten, but was a kind of physical reflux of the more acidic feelings I couldn’t digest in my mind. This was not a conscious choice, but when it was brought into my consciousness by my analyst, and my fear and vulnerability and anger and panic could be felt and put into words instead of transformed into physical sensation, it resolved. I rarely suffer from indigestion now.
The worst time I had this terrible acid reflux, I didn’t sleep for several nights in a row. I felt I was losing my mind. I went to the GP, who organised all sorts of scans and tests, but there was nothing physically wrong. It was another doctor who told me that the cause might be psychological. My analyst did not disagree. I was shocked, but I also knew it to be true.
When a patient is suffering a physical symptom, they can be offended at the suggestion that it may have a psychological cause. They can experience this as being disrespected, hearing that their illness isn’t real or they’re making it up. And of course that does happen – people can have their pain dismissed or misdiagnosed. But in some cases it could be that the physical symptoms are real – no question – and the cause is psychological, the unconscious using the body to express some pain or rage or whatever emotion the mind cannot tolerate. At times, we might assume our experience only has value, can only be real, when it is expressed in physical form. We continually disrespect our minds as individuals, as a society and as a culture; why else would we tolerate the appalling killing-off of psychodynamic psychotherapy on the NHS?
My experiences have taught me that a better life cannot be built when we are stuck unawares in ways of relating, within ourselves and with others, that are rooted in disrespect, exploitation and transaction. These dynamics are often easier to identify “out there” in wider society. It’s perhaps less comfortable to think about how they got out there, and to recognise these shapes within ourselves and within our closest relationships, in the economy of our minds.
But it’s worth persevering. When I put my running shoes back on after such a long decade, heading out not to get a better body, or to get rid of a feeling, or to beat a 5km time, it felt quite different. Straightforward, less pressurised, more hopeful. I felt grounded in my awareness of my age and in wanting to look after this one precious life of mine. And when I got back and felt the ache in my muscles and the sweat on my face, I thought, I’d better write a column about this before I miss my chance – because it may well be another decade before I do that again.
Moya Sarner is an NHS psychotherapist and the author of When I Grow Up – Conversations With Adults in Search of Adulthood
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