My Turn: A psychiatrist’s mid-winter musings

For the Monitor
Published: 1/23/2022 8:01:22 AM
Modified: 1/23/2022 8:00:06 AM

As a result of the recent cold snap, mice are taking shelter in my garage, a squirrel gnawed a hole through the compost bin, and several squirrels are taking turns perching on the bird feeder as if it’s their private lunch buffet.

I must confess that my neighbors might occasionally hear me scream a high-pitched “Scoot! Scoot!” at the squirrels in a pointless attempt to instill fear or might have seen me in sweats and Sorels bounding angrily toward the bird feeder squirrel convention.

At this point in the winter season, my primitive mammalian brain, like the squirrel’s, craves comfort. Comfort food. Warm soup. Sleep. Chocolate. A soft quilt. A cup of tea. My cortex, in contrast, scans for ways to turn the risk of frostbite into a meaningful opportunity for personal growth. Beyond conventional winter survival advice to bundle up, stay active, keep in touch, the mental health field offers additional suggestions for dealing with this kind of adversity.

While sipping tea and wearing four layers, I find myself reflecting on teachings I learned during psychiatry training from reading the book Adaptation to Lifeby George E. Vaillant (American Psychiatric Press, 1977), a valued mentor of mine.

As I sip tea from a warm mug, I offer these sips of comfort, these adaptations to life, for cold and challenging times.

A cup of creation (“sublimation”). Make something. Build, move, improve. Create.

A cup of patience (“suppression”). Wait it out. Wait for the right time. Hold feelings steady.

A cup of hope (“anticipation”). Look toward the future. Expect better times. Make plans.

A cup of kindness (“altruism”). Put your needs aside to help someone else. Provide comfort to others.

A cup of laughter (humor). Laugh at how little we know. Laugh when you can.

Dr. Vaillant would call the terms in quotes “mature defenses.” Contemporary neuroscience would describe these terms as forms of emotion regulation, ways to manage stress, which include both explicit and implicit mechanisms.

Explicit mechanisms are conscious strategies to manage emotional experiences, such as intentionally writing a poem to express a strong emotion. Implicit mechanisms are unconscious and automatic, like white blood cells automatically going to a part of the body that is injured.

Are these the musings of a shivering psychiatrist feeling powerless against the mid-winter cold, who has given up reclaiming the bird feeder for the birds? I begin to wonder.

In medical school, I acquired reams of knowledge about body mechanisms of defense. Knowledge about infectious diseases, viruses, antiviral medications.

Wisdom, in contrast to knowledge, comes from facing challenges over and over, including the pain of subzero temperatures and minus 10 wind chills, or the challenge of a pandemic and getting through. This supports the familiar saying that ‘whatever doesn’t kill you makes you stronger.’

Based on experience, I suspect that this aphorism is true, that as we survive, we are all getting stronger.

But don’t believe me. Go ask the squirrels.

(Diane Roston, M.D. of Hanover is medical director of West Central Behavioral Health.)




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