Filling the Void - the Importance of Appropriate Framing and Visualisation

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Introduction

As a medical student I used to find psychology both fascinating and perplexing.

That also extended to psychiatry (the medical field that studies and treats psychological disorders).

This is at least partly due to fear of the unknown and the generally bad press that psychiatry has had (for good reasons in some cases) in popular media.

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Dr X

Sometimes a particular teacher or tutor has a long lasting influence on you that extends into your life in a manner which is disproportionate to the time you spent with them.

One of these kind of people for me was a particularly charismatic doctor who had an interest in theology and philosophy.

He also had a love of history, Sherlock Holmes and perhaps rather surprisingly - eastern meditation practices.

To protect his privacy I will call him Dr X.

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The problem that Dr X taught me about

Psychological theories can often be quite difficult to follow and understand.

Often this is because they are couched in the language of science and medicalised jargon.

They don't really speak to the individual and their personal experience.

That is not how they are constructed and it is not their real intent as they are often designed for purposes of research and categorisation.

For example we may talk of drug addiction in various terms such as drive reduction theory, homeostatic mechanisms or classical conditioning.

This doesn't really speak to the patient.

Indeed it doesn't even speak to me when I am a patient.

Sometimes to truly understand something you need to visualise it in a particular way.

In a more human way.

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Dr X's simple explanation

One time I was sitting in with a discussion that Dr X was having with a patient and he introduced me to a novel way of presenting psychological theories.

This is not scientific as such although it does contain aspects of a variety of psychological theories relating to motivation.

The patient suffered from recurrent major depression and alcoholism with intermittent abuse of more "illicit" substances - basically anything he could get his hands on.

No matter what he did he only really ended up feeling worse and more depressed afterwards.

That said his normal attempts at coping involved some kind of drug related means.

When summarising his situation to the patient Dr X told him about the concept of the "void":

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The "void" within us all

He explained to the patient that "we all have a void within us".

This "void" is experienced as a discomfort or feeling of emptiness with an inherent drive to fill it.

Some people think of it like a black hole. Other people think of it like a an empty room that needs to be filled.

Different people "fill the void" i.e. negate the sense of emptiness in different ways:

• Some people fill it with food, sex, drink, drugs, gambling.
• Some fill it with work or other productive activities.

The way we fill it can ultimately result in positive or negative consequences which can come to define our success or failure in life as well as our ultimate happiness.

Filling this void using a single activity is almost always detrimental and likely to cause problems even if that activity is normally considered to be positive.

This goes back to the ancient advice of exercising moderation in all things.

Too much of anything (no matter what it is) is likely to lead to negative consequences.

Too much work can lead to burnout. Too much exercise can lead to injury. Too much alcohol can lead to addiction and serious physical/mental damage.

It is generally better to fill the void with a balance of multiple different activities to have a healthy body and mind.

Further Dr X really believed in mindfulness based meditation techniques.

In his opinion mindfulness based meditation allowed people to take conscious control of the internal void in a manner that allowed conscious change and the development of positive behaviours.

In essence one could actually shrink the size of this void and gain better control of our lives by it.

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Not scientific

As I stated earlier this is not really what I would call a scientific way of looking at things, it is more a tool of visualisation.

I think experientially there is something universal in that feeling of emptiness or a "void" as he called it.

For this reason the explanation really seemed to work for the patient in helping to understand what he was doing and providing a framework for him to start working on his own recovery.

Dr X taught him some basic breathing exercises with some simple mindfulness to help cope with when he had the feelings of emptiness.

He also taught him some basic self-hypnosis and visualisation techniques where he would actively imagine the void being filled with a variety of positive activities whilst he slowed down his breathing.

I'm not going to pretend that it somehow transformed his life and cured him of his alcoholism - I don't think life is ever that simple.

It did give him a way of visualising and framing his behaviours.

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Conclusion

Sometimes the first step of acknowledging a problem or an issue is actually visualising it, - almost to give it a kind of physicality or existence in your own reality.

This needs to be done in a manner that is appropriate to the individual and their experience of reality and that is not the same as the conventional manner that we are often trained in.

As I have discussed before I have suffered my own problems with depression and misuse of alcohol to try to cope.

This method of framing the problem still speaks to me, not as a doctor or health professional but as a human being.

When you are ill or suffering personal problems you are a human being first and a profession or job second (if it figures at all).

I have also found that one of the things that has helped me most of all is mindfulness.

If people are interested in the subject of mindfulness I could do some posts on it (let me know in the comments).

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Thank you for reading.

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