Al Tyers Therapy
Medication or mediation: the happy accident of the typo
I wrote in this blog on anxiety about how people can attempt to self-medicate their way out of a crisis with alcohol and drugs, and how that quite often doesn’t work out very well.
Although to be more accurate, “self-medicate” is what I meant to write but… didn’t.
Due to a typo, kindly spotted by an eagle-eyed colleague, what I actually wrote was “self-mediate”, which isn’t really a phrase that you come across but ended up being quite interesting for me.
The Oxford English Dictionary defines “mediate” as: to “intervene in a dispute in order to bring about an agreement or reconciliation.”
So: do people attempt to self-mediate? This might mean conflicting parts of the self being in conflict, and a need to try and pull those together.
I’m not talking so much about a psychiatric diagnosis where someone has dissociative identity disorder (which used to be commonly called multipole personality disorder), but rather the more everyday experience of having competing desires and demands.
This might be something like worry. Unless we are extremely over-run with worry and anxiety there might be a part of us that can step back and think “hang on, is this rational or not?”
I’m not for a second saying this makes everything better or worries go away, but I am suggesting that a person might be then in something like a battle between the anxiety, which is real and serious and worthy of consideration, versus whatever cognitive functioning and reasoning they can apply to a situation.
(Incidentally, you could say that a desire for oblivion and escape via drugs and alcohol is about being unable to deal with noisy and difficult parts of the self, being unable to negotiate with them and wanting to shut them down...)
For example, you might read something in the news about skin cancer and become worried about getting skin cancer from sunburn. Clearly some level of care and consideration is required to mitigate your risk: you might not walk around in 90 degree heat (remember that?) without suncream and a hat, but equally you might not remain inside forever even if it is 45 degrees out.
A rational part of you could make an assessment of what might be reasonable precautions, but it would be competing with a sense of fear, worry, dread.
In a sense, living a functioning and fulfilling life is about mediating between conflicting forces: the pull towards catastrophising, fret, panic versus a desire to have satisfaction in the moment, or strive towards a goal, or find meaning.
To find a way to live in some sort of balance, perhaps we need to mediate between different drives in ourself, different parts of ourselves. The first step to that might be to understand what those parts are.