Coping Mechanisms Quotes

Give me lust, baby. Flash. Give me malice. Flash. Give me detached existentialist ennui. Flash. Give me rampant intellectualism as a coping mechanism. Flash.

Give me rampant intellectualism as a coping mechanism.

Me with nothing left to lose, plotting my big revenge in the spotlight. Give me violent revenge fantasies as a coping mechanism.

Denial is a critical part of the human coping mechanism. Without it, we would all wake up terrified every morning about all the ways we could die. Instead, our minds block out our existential fears by focusing on stresses we can handle—like getting to work on time or paying our taxes.

Most people can motivate themselves to do things simply by knowing that those things need to be done. But not me. For me, motivation is this horrible, scary game where I try to make myself do something while I actively avoid doing it. If I win, I have to do something I don't want to do. And if I lose, I'm one step closer to ruining my entire life. And I never know whether I'm going to win or lose until the last second.

You might imagine that a person would resort to self-mutilation only under extremes of duress, but once I'd crossed that line the first time, taken that fateful step off the precipice, then almost any reason was a good enough reason, almost any provocation was provocation enough. Cutting was my all-purpose solution.

And that's the most frustrating thing about depression. It isn't always something you can fight back against with hope. It isn't even something - it's nothing. And you can't combat nothing.

I've always wanted not to give a fuck. While crying helplessly into my pillow for no good reason, I would often fantasize that maybe someday I could be one of those stoic badasses whose emotions are mostly comprised of rock music and not being afraid of things.

On a fundamental level, I am someone who would throw sand at children.

Much of what we call personality is not a fixed set of traits, only coping mechanisms a person acquired in childhood.

If your world is out there and you are in here then the only things that will gather within these walls are time and bitterness. Eventually, that bitterness will eat away at you and leave nothing behind but resentment and hate.

Although I contemplated suicide many times, and developed concrete plans once or twice, I never gave up. Rather than take the emergency exit, I searched relentlessly for remedies and coping mechanisms. Although often feeling worn down and deeply discouraged, I persisted in hoping better times might come.

Procrastination has become its own solution - a tool I can use to push myself so close to disaster that I become terrified and flee toward success. A more troubling matter is the day-to-day activities that don't have massive consequences when I neglect to do them.

Denial, perhaps, is a necessary human mechanism to cope with the heartaches of life.

Тo me, the future doesn’t seem real. It’s just this magical place where I can put my responsibilities so that I don’t have to be scared while hurtling toward failure at eight hundred miles per hour.

Nobody can guarantee that it's going to be okay, but - and I don't know if this will be comforting to anyone else - the possibility exists that there's a piece of corn on a floor somewhere that will make you just as confused about why you were laughing as you have ever been about why you are depressed.

Self-harm is not a grab for attention. It doesn’t mean you are suicidal. It means you are struggling to get out of a very dangerous mess in your mind and heart and this is your coping mechanism. It means that you occupy a small space in the very real and very large canyon of people who suffer from depression or mental illness.

You survived by seizing every tiny drop of love you could find anywhere, and milking it, relishing it, for all it was worth. And as you grew up, you sought love, anywhere you could find it, whether it was a teacher or a coach or a friend or a friend's parents. You sought those tiny droplets of love, basking in them when you found them. They sustained you. For all these years, you've lived under the illusion that somehow, you made it because you were tough enough to overpower the abuse, the hatred, the hard knocks of life. But really you made it because love is so powerful that tiny little doses of it are enough to overcome the pain of the worst things life can dish out. Toughness was a faulty coping mechanism you devised to get by. But, in reality, it has been your ability to never give up, to keep seeking love, and your resourcefulness to make that love last long enough to sustain you. That is what has gotten you by.

How am I supposed to like myself if all these shitty things keep happening because I do them???

When you have a persistent sense of heartbreak and gutwrench, the physical sensations become intolerable and we will do anything to make those feelings disappear. And that is really the origin of what happens in human pathology. People take drugs to make it disappear, and they cut themselves to make it disappear, and they starve themselves to make it disappear, and they have sex with anyone who comes along to make it disappear and once you have these horrible sensations in your body, you’ll do anything to make it go away.

I cope with it the best way I know - by being completely unreasonable and trying to force everything else in the world to obey me and do all the nonsensical things I want.

And finally - FINALLY - after a lifetime of feelings and anxiety and more feelings, I didn't have any feelings left. I had spent my last feeling being disappointed that I couldn't rent Jumanji.

I had tasted cake and there was no going back. My tiny body had morphed into a writhing mass of pure tenacity encased in a layer of desperation. I would eat all of the cake or I would evaporate from the sheer power of my desire to eat it.

...repeated trauma in childhood forms and deforms the personality. The child trapped in an abusive environment is faced with formidable tasks of adaptation. She must find a way to preserve a sense of trust in people who are untrustworthy, safety in a situation that is unsafe, control in a situation that is terrifyingly unpredictable, power in a situation of helplessness. Unable to care for or protect herself, she must compensate for the failures of adult care and protection with the only means at her disposal, an immature system of psychological defenses.

Females with ASDs often develop ‘coping mechanisms’ that can cover up the intrinsic difficulties they experience. They may mimic their peers, watch from the sidelines, use their intellect to figure out the best ways to remain undetected, and they will study, practice, and learn appropriate approaches to social situations. Sounds easy enough, but in fact these strategies take a lot of work and can more often than not lead to exhaustion, withdrawal, anxiety, selective mutism, and depression. -Dr. Shana Nichols

One of life's best coping mechanisms is to know the difference between an inconvenience and a problem. If you break your neck, if you have nothing to eat, if your house is on fire – then you’ve got a problem. Everything else is an inconvenience. Life is inconvenient. Life is lumpy. A lump in the oatmeal, a lump in the throat and a lump in the breast are not the same kind of lump. One needs to learn the difference.

Fear and shame are the backbone of my self-control. They are my source of inspiration, my insurance against becoming entirely unacceptable. They help me do the right thing. And I am terrified of what I would be without them. Because I suspect that, left to my own devices, I would completely lose control of my life. I'm still hoping that perhaps someday I'll learn how to use willpower like a real person, but until that very unlikely day, I will confidently battle toward adequacy, wielding my crude skill set of fear and shame.

At first, I’d try to explain that it’s not really negativity or sadness anymore, it’s more just this detached, meaningless fog where you can’t feel anything about anything—even the things you love, even fun things—and you’re horribly bored and lonely, but since you’ve lost your ability to connect with any of the things that would normally make you feel less bored and lonely, you’re stuck in the boring, lonely, meaningless void without anything to distract you from how boring, lonely, and meaningless it is.

The way you are self-sabotaging: Mindlessly scrolling through social media as a way to pass the time. What your subconscious mind might want you to know: This is one of the easiest ways to numb yourself, because it is so accessible and addictive. There is a world-altering difference between using social media in a healthy way versus as a coping mechanism. Mostly, it has to do with how you feel after you’re finished. If you don’t put the phone down feeling inspired or relaxed, you’re probably trying to avoid some kind of discomfort within yourself—the very discomfort that just might be telling you that you need to change.

However, I could no longer rely on genuine emotion to generate facial expressions, and when you have to spend every social interaction consciously manipulating your face into shapes that are only approximately the right ones, alienating people is inevitable.

Every human being is a wet, gassy katamari of triumphs, traumas, scars, coping mechanisms, parental baggage, weird stuff you saw on the Internet too young, pressure from your grandma to take over the bodega when what you really want to do is dance, and all the other fertilizer that makes a smear of DNA grow into a fully formed toxic avenger.

For the first time in months, I felt together. Sharp. In hurting myself, I had at last found a way to release the pressure. But it was more than that. I was now different. I felt different. I’d discovered a way to control my feelings. Just because self-mutilation wasn’t deemed an acceptable coping mechanism didn’t mean I was going to stop doing it

For all these years, you’ve lived under the illusion that, somehow, you made it because you were tough enough to overpower the abuse, the hatred, the hard knocks of life. But really you made it because love is so powerful that tiny little doses of it are enough to overcome the pain of the worst things life can dish out. Toughness was a faulty coping mechanism you devised to get by. But, in reality, it has been your ability to never give up, to keep seeking love, and your resourcefulness to make that love last long enough to sustain you. That’s what has gotten you by

There I was, casually wishing that I could stop existing in the same way you'd want to leave an empty room or mute an unbearably repetitive noise.

And tomorrow we'll do the same again. And again. Until one day you get up and find out that whatever it was didn't kill you after all.

She and I, we were girls who never said anything. Never wanted to assume anything. It was a coping mechanism, saving our faces for when guys like Quin came along and acted all nice towards us.

Self-mutilation is a very different issue to suicide. It is a controlled pain personal to you, allowing you to live/exist to some degree.

Some people’s coping mechanisms were all about festering and secrecy and ruminating until you grew yourself a nice little tumor in your heart with a side of panic attack. Different strokes.

Procrastination is not a form of laziness at all. It’s a coping mechanism for stress.

You lazy, floor banana motherf*****

You don't have to be a good person to feel like a good person, though. There's a loophole I found where I don't do good, helpful things, but I keep myself in a perpetual state of thinking I might.

Denial is a critical part of the human coping mechanism. Without it, we would all wake up terrified every morning about all the ways we could die. Instead, our minds block out our existential fears by focusing on stresses we can handle—like getting to work on time or paying our taxes. If we have wider, existential fears, we jettison them very quickly, refocusing on simple tasks and daily trivialities.

I have a subconscious list of rules for how reality should work. I did not develop these rules on purpose, and most of them don’t make sense – which is disturbing when you consider that they are an attempt to govern the behavior of reality – but they exist, and they play a large role in determining how I react to the things that happen to me. Large enough that a majority of the feelings I feel are simply a reaction to reality not complying with my arbitrary set of rules. Reality doesn’t give a shit about my rules, and this upsets me.

I don't just want to do the right thing. I want to WANT to do the right thing.

What doesn’t kill you-’” “Gives you a lot of unhealthy coping mechanisms?

People hide truths about themselves from themselves. Such self-deception is a coping mechanism, and to one extent or another, most people begin deceiving themselves when they're children.

The most common emotional defense is avoidance (an ineffective coping skill for any stressor) as expressed through denial (e.g., "That wasn't really bad, I barely remember it").

I don't like when I can't control what reality is doing. Which is unfortunate because reality works independently of the things I want, and I have only a limited number of ways to influence it, none of which are guaranteed to work. I still want to keep tabs on reality, though. Just in case it tries to do anything sneaky. It makes me feel like I'm contributing. The illusion of control makes the helplessness seem more palatable. And when that illusion is taken away, I panic.

Denial can be a most useful, temporary shield. Unfortunately, such flimsy armor will not last a lifetime. It is best to face your past, and do so quickly, before your past returns to face you.” — André Chevalier

.... but when a person is upset, old patterns of behavior emerge. It's true for me too, except my coping mechanisms are different

it’s only a red flag when it starts to create conflict in your life, but otherwise it’s a truly healthy coping mechanism for you to organize your sock drawer.

But my experiences slowly flattened and blended together until it became obvious that there's a huge difference between not giving a fuck and not being able to give a fuck. Cognitively, you might know that different things are happening to you, but they don't feel different.

Positive thinking, after all, is an all-American coping mechanism, practically a national pastime. Author James Rorty noted this during the Great Depression, when he traveled America talking with people forced to seek work on the road. In his 1936 book, Where Life Is Better, he was dismayed that so many of his interview subjects seemed so unshakably cheerful. “I encountered nothing in 15,000 miles of travel that disgusted and appalled me so much as this American addiction to make-believe,” he wrote.

They feel guilty for having survived so they pretend the bad things never happened Exodus (1960) screenplay

What I am is constantly thrust into my face while I'm trying to be better than I am. Even if I'm actively doing all the right things, I can't escape the fact that my internal reactions are those of a fundamentally horrible person.

She wished she had cancer instead. She'd trade Alzheimer's for cancer in a heartbeat. She felt ashamed for wishing this, and it was certainly a pointless bargaining, but she permitted herself the fantasy anyway. With cancer, she'd have something to fight. There was surgery, radiation, and chemotherapy. There was the chance that she could win. Her family and the community at Harvard would rally behind her battle and consider it noble. And even if it defeated her in the end, she'd be able to look them knowingly in the eye and say good-bye before she left.

Procrastination has become a it's own solution - a tool I can use to push myself so close to disaster that I become terrified and flee towards success.

Heroin was a coping mechanism that I had used to deal with my underlying fears. They were the real problems; heroin wasn't the culprit, my fears were.

My coping mechanism is denial. We'll be fine.

We don’t use the word crazy around here. We prefer coping mechanism.

That night, before bed, he goes first to Willem's side of the closet, which he has still not emptied. Here are Willem's shirts on their hangers, and his sweaters on their shelves, and his shoes lined up beneath. He takes down the shirt he needs, a burgundy plaid woven through with threads of yellow, which Willem used to wear around the house in the springtime, and shrugs it on over his head. But instead of putting his arms through its sleeves, he ties the sleeves in front of him, which makes the shirt look like a straitjacket, but which he can pretend—if he concentrates—are Willem's arms in an embrace around him. He climbs into bed. This ritual embarrasses and shames him, but he only does it when he really needs it, and tonight he really needs it.

Most survivors are cope-aholics, people who cope with whatever is thrown at them without reliance on others. They do not seek sympathy for their pain and feel undeserving if it is offered. They are especially adverse to sympathy from others.

I’m still depressed, but how depressed I am varies, which is good. Much of the time, it’s a comfortable numbness that just makes things feel muted. Other times, I’m standing in the shower or something and I can feel the nothingness hurtling toward me at eight thousand miles per hour and there’s nothing I can really do aside from let it happen and wait until it goes away again.

The moments of silence are gone. We run from them into the rush of unimportant things, so filled is the quiet with the painful whispers of all that goes unspoken. Busy-ness is our drug of choice, numbing our minds just enough to keep us from dwelling on all that we fear we can’t change. A compilation of coping mechanisms, we have become our fatigue. Unwilling or unable to cut ourselves free of this modern machine we have built, we’re dragged in its wake all too quickly toward our end. The virtue of a society’s culture is reflected in the physical, mental, and emotional health of its people. The time has come to part ways with all that is toxic, and preserve our quality of life.

Come on! Laugh at it all! Or at least laugh at something! All the shit will still be there to deal with when you're done, but you'll be in better shape to deal with it!

Complaining about nothing doesn't seem like coping to you, but okay.

I coped, in the grand tradition of children everywhere, by retreating into my imagination.

I couldn't even muster the enthusiasm to hate myself anymore.

The thing about being an unstoppable force is that you can really only enjoy the experience of being one when you have something to bash yourself against. You need to have things trying to stop you so that you can get a better sense of how fast you are going as you smash through them. And whenever I was inside the dinosaur costume, that is the only thing I wanted to do.

Waiting exposes our idols and throws a wrench into our coping mechanisms. It brings us to the end of what we can control and forces us to cry out to God. God doesn't waste our waiting. He uses it to conform us to the image of his Son.

Girls are genius at getting through sexual abuse. Often the only way to get through is not to feel. And that is exactly what these fantasy worlds allow: They give girls a place to go so they don't have to be present in their violated bodies. Brilliant.

Packing all of your belongings into a U-Haul and then transporting them across several states is nearly as stressful and futile as trying to run away from lava in swim fins.

. . . she is our dog. And because she is our dog, we can pick out the tiny, almost imperceptible good qualities from the ocean of terrible qualities, and we can cling to them. Because we want to love our dog.

Because, deep down, I know how pointless and helpless I am, and it scares me. I am an animal trapped in a horrifying, lawless environment, and I have no idea what it's going to do to me. It just DOES it to me.

The beginning of my depression had been nothing but feelings, so the emotional deadening that followed was a welcome relief. I had always viewed feelings as a weakness-annoying obstacles on my quest for total power over myself. And I finally didn't have to feel them anymore.

I think now that this obsession with identifying racism, which I saw so often among Somalis too, was really a comfort mechanism, to keep people from feeling personally inadequate and to externalize the causes of their unhappiness.

I lock all my scaredness down in my stomach until the fear hardens into something I hardly notice. I myself harden into a person that I hardly notice.

I fix myself, even when it causes great pain to do so, because I know that I cannot fix the way the world sees me.

Sometimes, it is easier for people to believe lies then deal with the uncomfortableness of their own fear of action. These type of people feel uncomfortable unless everyone is the same or God presents them with what is easy and obvious. It is a life long coping mechanism for the greatest fear of all--regret.

If our basic needs were neglected: our need for safety, economic security, loving connection, autonomy, self-realization and meaningful work, our need to feel equal and respected, then poor emotional well-being will be an inevitable result. Materialism was therefore an unhelpful response to various deprivations. A culturally endorsed coping mechanism that ultimately backfired.

Planning can't save you from everything. Change is inevitable and uncertainty is a given. And if you plan so much that you can't function without one, life's no fun. All the calendars, journals, and lists in the world won't save you when the sky falls. And maybe, just maybe, I've been using planning less as a coping mechanism and more as an excuse to avoid anything I couldn't control. But that doesn't mean preparation is altogether bad. Planning can be useful when you've come out on the wrong side of a cave and need to figure out a new way to get back on route. When all you can do is put one foot in front of the other and push forward.

I try to explain how people react when overwhelmed by confusion and negative emotions. Some drink too much. Others overeat or beat their wives or kick the cat. And a surprising number hold their hands against a hot plate or slice open their skin with a razor blade. It's an extreme coping mechanism. They talk about their inner pain being turned outward. By giving it a physical manifestation they find it easier to deal with. (35)

I was seized by doubt. Should I have come here? But going back was impossible. I had fled a known terror, and perhaps I could cope with this unknown terror that lay ahead.

But when you're concerned that the miserable, boring wasteland in front of you might stretch all the way into forever, not knowing feels strangely hope-like.

Slowly, my feelings started to shrivel up. The few that managed to survive the constant beatings staggered around like wounded baby deer, just biding their time until they could die and join all the other carcasses strewn across the wasteland of my soul.

Many of us learned that keeping busy…kept us at a distance from our feelings...Some of us took the ways we busied ourselves—becoming overachievers & workaholics—as self esteem…But whenever our inner feeling did not match our outer surface, we were doing ourselves a disservice…If stopping to rest meant being barraged with this discrepancy, no wonder we were reluctant to cease our obsessive activity.

know a lot of people who hide out in fantasy because reality is too hard to cope with [...] Fantasy isn't about escape; it's a survival mechanism. It's a way to deal with things that are so much bigger than you are. So I think fantasy is special, something to be cherished and protected because it's a very fragile thing and without it, we're so defenseless, we're paralyzed

There are abusive individuals whose worst little demons are greed, sloth,envy, gluttony, pride and wrath enslaved by their god which is money. They usually set their false assumptions, wrong judgments, gossips and lies forceful than the ones who hold the truth but what they missed out is that the victims of their aggressions, the targets of their wrong accusations and the recipients of their repetitive harassments carry what is truly essential and what lives longer, that is: truth and goodness, both of which shall always prevail against their vicious, evil manners.

We now know that love is, in actuality, the pinnacle of evolution, the most compelling survival mechanism of the human species. Not because it induces us to mate and reproduce. We do manage to mate without love! But because love drives us to bond emotionally with a precious few others who offer us safe haven from the storms of life. Love is our bulwark, designed to provide emotional protection so we can cope with the ups and downs of existence. This drive to emotionally attach — to find someone to whom we can turn and say “Hold me tight” — is wired into our genes and our bodies. It is as basic to life, health, and happiness as the drives for food, shelter, or sex. We need emotional attachments with a few irreplaceable others to be physically and mentally healthy — to survive.

It’s hard to explain how much that feeling of the bottom potentially falling out at any moment takes its toll. It makes you anxious, of course, and constant anxiety is impossible for the body to handle. So you develop a coping mechanism, and for us that meant shutting down. Everything we liked or wanted or felt joy in had to be hidden or suppressed. I’m sad to say that this method works. If you don’t give as much credence or value to whatever it is that you love, it hurts less when it is inevitably taken from you. I had to pretend I had no joy. It will come as a shock to people who know me now, but being able to express joy was something it took me a long time to be confident enough to do.

Over the years I have developed and employed a variety of such coping mechanisms, mostly focusing around a philosophy I call, “Live Because.” “Live Because” is in contrast to what I’ve termed “Live Despite,” which is the idea that people can live rich, full lives in spite of their physical or emotional barriers. “Live Because” takes this a step further by suggesting that in many cases, patients can live a more fulfilling life with their illness than they could ever have done without it. Ehlers-Danlos syndrome has transformed me from a frequently petty and self-absorbed person into the person I am today (still somewhat self-absorbed, but a lot less petty, and with a clearly defined purpose of alleviating whatever suffering I can). I am better because of my illness, and not just in spite of it. But this process was, and still is, a journey. Chronic illness is nearly always accompanied by depression, and the need to constantly remain one step ahead of my illness has left me fearful and exhausted. I could never go through this alone... A part of me will always be angry; such is the process of mourning the pieces of oneself that are lost to chronic disease. I have learned to accept the duality of being bitter and at peace; ignorant and enlightened... while still laying a foundation of hope for the possibility that I can still realize my personal dreams and ambitions, even if not in the exact ways I had expected.

The word “coherence” literally means holding or sticking together, but it is usually used to refer to a system, an idea, or a worldview whose parts fit together in a consistent and efficient way. Coherent things work well: A coherent worldview can explain almost anything, while an incoherent worldview is hobbled by internal contradictions. … Whenever a system can be analyzed at multiple levels, a special kind of coherence occurs when the levels mesh and mutually interlock. We saw this cross-level coherence in the analysis of personality: If your lower-level traits match up with your coping mechanisms, which in turn are consistent with your life story, your personality is well integrated and you can get on with the business of living. When these levels do not cohere, you are likely to be torn by internal contradictions and neurotic conflicts. You might need adversity to knock yourself into alignment. And if you do achieve coherence, the moment when things come together may be one of the most profound of your life. … Finding coherence across levels feels like enlightenment, and it is crucial for answering the question of purpose within life. People are multilevel systems in another way: We are physical objects (bodies and brains) from which minds somehow emerge; and from our minds, somehow societies and cultures form. To understand ourselves fully we must study all three levels—physical, psychological, and sociocultural. There has long been a division of academic labor: Biologists studied the brain as a physical object, psychologists studied the mind, and sociologists and anthropologists studied the socially constructed environments within which minds develop and function. But a division of labor is productive only when the tasks are coherent—when all lines of work eventually combine to make something greater than the sum of its parts. For much of the twentieth century that didn’t happen — each field ignored the others and focused on its own questions. But nowadays cross-disciplinary work is flourishing, spreading out from the middle level (psychology) along bridges (or perhaps ladders) down to the physical level (for example, the field of cognitive neuroscience) and up to the sociocultural level (for example, cultural psychology). The sciences are linking up, generating cross-level coherence, and, like magic, big new ideas are beginning to emerge. Here is one of the most profound ideas to come from the ongoing synthesis: People gain a sense of meaning when their lives cohere across the three levels of their existence.

We are afraid of what we will do to others, afraid of the rage that lies in wait somewhere deep in our souls. How many human beings go through the world frozen with rage against life! This deeply hidden inner anger may be the product of hurt pride or of real frustration in office, factory, clinic, or home. Whatever may be the cause of our frozen rage (which is the inevitable mother of depression), the great word of hope today is that this rage can be conquered and drained off into creative channels … …What should we do? We should all learn that a certain amount of aggressive energy is normal and certainly manageable in maturity. Most of us can drain off the excess of our angry feelings and destructive impulses in exercise, in competitive games, or in the vigorous battles against the evils of nature and society. We also must realize that no one will punish us for the legitimate expression of self-assertiveness and creative pugnacity as our parents once punished us for our undisciplined temper tantrums. Furthermore, let us remember that we need not totally repress the angry part of our nature. We can always give it an outlet in the safe realm of fantasy. A classic example of such fantasy is given by Max Beerborn, who made a practice of concocting imaginary letters to people he hated. Sometimes he went so far as to actually write the letters and in the very process of releasing his anger it evaporated. As mature men and women we should regard our minds as a true democracy where all kinds of ideas and emotions should be given freedom of speech. If in political life we are willing to grant civil liberties to all sorts of parties and programs, should we not be equally willing to grant civil liberties to our innermost thoughts and drives, confident that the more dangerous of them will be outvoted by the majority within our minds? Do I mean that we should hit out at our enemy whenever the mood strikes us? No, I repeat that I am suggesting quite the reverse—self-control in action based upon (positive coping mechanisms such as) self expression in fantasy.

There are two basic coping mechanisms. One consists of dreading the chaos, fighting it and abusing oneself after losing, building a structured life of work/marriage/gym/reunions/children/depression/affair/divorce/alcoholism/recovery/heart attack, in which every decision is a reaction against the fear of the worst (make children to avoid being forgotten, fuck someone at the reunion in case the opportunity never comes again, and the Holy Grail of paradoxes: marry to combat loneliness, then plunge into that constant marital desire to be alone). This is the life that cannot be won, but it does offer the comforts of battle—the human heart is content when distracted by war. “The second mechanism is an across-the-board acceptance of the absurd all around us. Everything that exists, from consciousness to the digestive workings of the human body to sound waves and bladeless fans, is magnificently unlikely. It seems so much likelier that things would not exist at all and yet the world shows up to class every morning as the cosmos takes attendance. Why combat the unlikeliness? This is the way to survive in this world, to wake up in the morning and receive a cancer diagnosis, discover that a man has murdered forty children, discover that the milk has gone sour, and exclaim, 'How unlikely! Yet here we are,' and have a laugh, and swim in the chaos, swim without fear, swim without expectation but always with an appreciation of every whim, the beauty of screwball twists and jerks that pump blood through our emaciated veins.

This is the critical point of this book: if you are that zebra running for your life, or that lion sprinting for your meal, your body’s physiological response mechanisms are superbly adapted for dealing with such short-term physical emergencies. For the vast majority of beasts on this planet, stress is about a short-term crisis, after which it’s either over with or you’re over with. When we sit around and worry about stressful things, we turn on the same physiological responses—but they are potentially a disaster when provoked chronically. A large body of evidence suggests that stress-related disease emerges, predominantly, out of the fact that we so often activate a physiological system that has evolved for responding to acute physical emergencies, but we turn it on for months on end, worrying about mortgages, relationships, and promotions.

Because women tend to turn their anger inward and blame themselves, they tend to become depressed and their self-esteem is lowered. This, in turn, causes them to become more dependent and less willing to risk rejection or abandonment if they were to stand up for themselves by asserting their will, their opinions, or their needs. Men often defend themselves against hurt by putting up a wall of nonchalant indifference. This appearance of independence often adds to a woman's fear of rejection, causing her to want to reach out to achieve comfort and reconciliation. Giving in, taking the blame, and losing herself more in the relationship seem to be a small price to pay for the acceptance and love of her partner. As you can see, both extremes anger in and anger out-create potential problems. While neither sex is wrong in the way they deal with their anger, each could benefit from observing how the other sex copes with their anger. Most men, especially abusive ones, could benefit from learning to contain their anger more instead of automatically striking back, and could use the rather female ability to empathise with others and seek diplomatic resolutions to problems. Many women, on the other hand, could benefit from acknowledging their anger and giving themselves permission to act it out in constructive ways instead of automatically talking themselves out of it, blaming themselves, or allowing a man to blame them. Instead of giving in to keep the peace, it would be far healthier for most women to stand up for their needs, their opinions, and their beliefs.

Dissociative identity disorder is conceptualized as a childhood onset, posttraumatic developmental disorder in which the child is unable to consolidate a unified sense of self. Detachment from emotional and physical pain during trauma can result in alterations in memory encoding and storage. In turn, this leads to fragmentation and compartmentalization of memory and impairments in retrieving memory.2,4,19 Exposure to early, usually repeated trauma results in the creation of discrete behavioral states that can persist and, over later development, become elaborated, ultimately developing into the alternate identities of dissociative identity disorder.

Physiological stress, then, is the link between personality traits and disease. Certain traits — otherwise known as coping styles — magnify the risk for illness by increasing the likelihood of chronic stress. Common to them all is a diminished capacity for emotional communication. Emotional experiences are translated into potentially damaging biological events when human beings are prevented from learning how to express their feelings effectively. That learning occurs — or fails to occur — during childhood. The way people grow up shapes their relationship with their own bodies and psyches. The emotional contexts of childhood interact with inborn temperament to give rise to personality traits. Much of what we call personality is not a fixed set of traits, only coping mechanisms a person acquired in childhood. There is an important distinction between an inherent characteristic, rooted in an individual without regard to his environment, and a response to the environment, a pattern of behaviours developed to ensure survival. What we see as indelible traits may be no more than habitual defensive techniques, unconsciously adopted. People often identify with these habituated patterns, believing them to be an indispensable part of the self. They may even harbour self-loathing for certain traits — for example, when a person describes herself as “a control freak.” In reality, there is no innate human inclination to be controlling. What there is in a “controlling” personality is deep anxiety. The infant and child who perceives that his needs are unmet may develop an obsessive coping style, anxious about each detail. When such a person fears that he is unable to control events, he experiences great stress. Unconsciously he believes that only by controlling every aspect of his life and environment will he be able to ensure the satisfaction of his needs. As he grows older, others will resent him and he will come to dislike himself for what was originally a desperate response to emotional deprivation. The drive to control is not an innate trait but a coping style. Emotional repression is also a coping style rather than a personality trait set in stone. Not one of the many adults interviewed for this book could answer in the affirmative when asked the following: When, as a child, you felt sad, upset or angry, was there anyone you could talk to — even when he or she was the one who had triggered your negative emotions? In a quarter century of clinical practice, including a decade of palliative work, I have never heard anyone with cancer or with any chronic illness or condition say yes to that question. Many children are conditioned in this manner not because of any intended harm or abuse, but because the parents themselves are too threatened by the anxiety, anger or sadness they sense in their child — or are simply too busy or too harassed themselves to pay attention. “My mother or father needed me to be happy” is the simple formula that trained many a child — later a stressed and depressed or physically ill adult — into lifelong patterns of repression.

In 2008, the national Coping with Cancer project published a study showing that terminally ill cancer patients who were put on a mechanical ventilator, given electrical defibrillation or chest compressions, or admitted, near death, to intensive care had a substantially worse quality of life in their last week than those who received no such interventions. And, six months after their death, their caregivers were three times as likely to suffer major depression. Spending one’s final days in an I.C.U. because of terminal illness is for most people a kind of failure. You lie on a ventilator, your every organ shutting down, your mind teetering on delirium and permanently beyond realizing that you will never leave this borrowed, fluorescent place. The end comes with no chance for you to have said goodbye or “It’s O.K.” or “I’m sorry” or “I love you.” People have concerns besides simply prolonging their lives. Surveys of patients with terminal illness find that their top priorities include, in addition to avoiding suffering, being with family, having the touch of others, being mentally aware, and not becoming a burden to others. Our system of technological medical care has utterly failed to meet these needs, and the cost of this failure is measured in far more than dollars. The hard question we face, then, is not how we can afford this system’s expense. It is how we can build a health-care system that will actually help dying patients achieve what’s most important to them at the end of their lives.

The person is both a self and a body, and from the beginning there is the confusion about where "he" really "is"-in the symbolic inner self or in the physical body. Each phenomenological realm is different. The inner self represents the freedom of thought, imagination, and the infinite reach of symbolism. the body represents determinism and boundness. The child gradually learns that his freedom as a unique being is dragged back by the body and its appendages which dictate "what" he is. For this reason sexuality is as much a problem for the adult as for the child: the physical solution to the problem of who we are and why we have emerged on this planet is no help-in fact, it is a terrible threat. It doesn't tell the person what he is deep down inside, what kind of distinctive gift he is to work upon the world. This is why it is so difficult to have sex without guilt: guilt is there because the body casts a shadow on the person's inner freedom, his "real self" that-through the act of sex-is being forced into a standardized, mechanical, biological role. Even worse, the inner self is not even being called into consideration at all; the body takes over completely for the total person, and this kind of guilt makes the inner self shrink and threaten to disappear. This is why a woman asks for assurance that the man wants "me" and "not only my body"; she is painfully conscious that her own distinctive inner personality can be dispensed with in the sexual act. If it is dispensed with, it doesn't count. The fact is that the man usually does want only the body, and the woman's total personality is reduced to a mere animal role. The existential paradox vanishes, and one has no distinctive humanity to protest. One creative way of coping with this is, of course, to allow it to happen and to go with it: what the psychoanalysts call "regression in the service of the ego." The person becomes, for a time, merely his physical self and so absolves the painfulness of the existential paradox and the guilt that goes with sex. Love is one great key to this kind of sexuality because it allows the collapse of the individual into the animal dimension without fear and guilt, but instead with trust and assurance that his distinctive inner freedom will not be negated by an animal surrender.