« I’m fine »

Je suis récemment tombée sur un texte en anglais, publié sur la plateforme Medium, qui m’a interpellée et émue. L’autrice, Rainesford Stauffer, y décrit les effets néfastes que peut avoir cette petite phrase, répétée à longueur de journée, dans nos têtes ou en réponse à la sempiternelle question « Comment ça va ? » : « Ca va bien, merci ». Sauf que non, tout ne va pas bien, et ne pas le verbaliser ne fait qu’empirer les choses.

Voici l’article en question, que vous pouvez également retrouver sur Medium à cette adresse : https://elemental.medium.com/when-staying-composed-harms-your-health-27b9faf0dafb

“So how are you feeling?” the doctor, who I was seeing for the second time in two weeks, asked as she prepped the shot that would hopefully bolster my diminishing vitamin levels. “I’m fine; how are you?” I asked, replying with the immediate, automated bounce of an email out-of-office reply.

“I’m good,” she said, one eyebrow raised. “But it feels like you’re deflecting a bit here. Because this isn’t fine.” “This” meant the medical records that told her the chronic illness I’d been white-knuckling it through for the past five or so years was worsening. The severe vitamin deficiencies caused by the mystery condition were depleting my energy, melting my ability to climb stairs or firmly grip a coffee mug. They were also oozing into my memory, causing my normally rapid-fire thoughts to trail off into nowhere as I struggled to remember what I’d been talking about moments before.

It was the most recent of many times I’d said “I’m fine” when I wasn’t — because I didn’t know how to say otherwise.

Being “fine” is related to the virtues of composure and poise, or the “collectedness,” which I imagine is what people feel when they seamlessly put change in their wallet at the checkout without getting anxious that they’re holding up the next person in line. It’s a minuscule example of the composure I interpreted as moving through the world with the strength to be unrattled, unaffected, a definition that seemed to exist within me instead of something I learned. If anything, I watched as friends cried openly, or bemoaned the test they’d failed at school or a screwup they’d made, and wondered why I felt I didn’t have permission to push through the wall of poise and break down a little, too.

Composure is aspirational, and our society tends to cultivate it in women in particular. I learned this at an early age, when a ballet teacher struck me. I knew the routine: No matter the insult, no matter the mistake, no matter how badly you wanted to stuff your shoes and water bottle in a bag and flee, if you wanted her to want to work with you, you didn’t flinch. Being unaffected said something about you, that you were strong and steady, that you were capable. Upon seeing she hadn’t elicited tears, she smirked. “Composure is your talent,” she said.

It may be a talent, but it’s also a mask.

We experience physical pain as an interaction between body, mind, and culture, says Louise Hide, PhD, a social and cultural historian of psychiatry who studies the history of pain and trauma at Birkbeck College, University of London. “The three are inextricably entwined,” Hide notes. “Pain is always real, but how we experience it is subjective, changing over time according to the meaning we give it.” Personal experience, gender, race, and social expectations can cause lead us to refuse to acknowledge pain altogether.

When it comes to health, conversations on composure are split into two categories: There’s the praise of the stiff upper lip, encouraging you to lift your chin and be proud no one can see that, inside you, something is shattering. On the other end of the spectrum is an encouragement to let feelings squashed by composure spill out, as if the purge will save you. Rarely, it seems, does the focus shift to the fact that extreme composure can have physical, mental, and emotional ramifications.

“Maintaining extreme composure to the extent that we ignore our emotions, needs, and pain, compromises our physical and mental health,” says Hilary Jacobs Hendel, psychotherapist and author of It’s Not Always Depression. “We block and push down emotional energy by changing our breathing and using muscular contraction, for example, which is why people under stress get tense and develop back pain.”

Women in particular are at risk of feeling pressured out of expressing their pain. A 2001 study, The Girl Who Cried Pain: A Bias Against Women in the Treatment of Pain, showed that women are more likely to have pain reported to a health care provider dismissed as “emotional” or “psychogenic” and, therefore, “not real.” So they often choose composure over being labeled as hysterical.

Learning to be extremely composed, Hendel says, means we had to suppress natural, primal emotions, and blocking core emotions over time contributes to symptoms of anxiety, depression, and even addiction.

Sarah Wieten, PhD, studies stoicism, and in the study “Stoic beliefs and health,” defines it as “a belief system which informs one’s attitudes and actions with the inherent potential for internal resistance and conflict.” This includes focusing on “self-regulation” in different domains, such as stoic endurance, the belief that someone should endure physical suffering without complaint, and stoic composure, the belief that one should control their emotions or behavior under stress. The study posits that people who believe they shouldn’t show emotion, or should handle issues on their own, face internal conflict when they need help, which, in turn, could lead to delays in help-seeking “with potentially life-threatening consequences.”

Wieten (who says she herself leans toward stoicism) suspects that “people find the idea that you can and should distinguish between things in life that you can control and those you cannot control, and focus your attention on those you can control, to be a powerful way to cope in adverse conditions.”

But Dr. Margaret Rutherford, author of the forthcoming Perfectly Hidden Depression, says the development of the “I’m fine, I’m composed, I’m poised” persona becomes so entrenched that individuals fall into a vicious cycle of having to be who they’re not,” which includes keeping up appearances that nothing is wrong. “When I think of true poise or true composure, I think of someone who has a true sense of security,” says Rutherford, explaining that, often, what looks like composure or poise might be avoidance or suppression.

“When we’re wearing a mask, it’s because we feel like we need to protect ourselves,” says Jordana Jacobs, PhD. “Really letting go has to do with feeling safe. Because if you were to voice that something was wrong, or that you were in pain, emotionally or physically, that’s admitting vulnerability.” In other words, the act of not being fine is one that demands the most honesty of us.

That’s the catch: Being composed becomes second nature to the extent that no other state of being is internally acceptable. I felt it when I was doubled over and seeing blurry stars from pain in the emergency room as I puzzled how I’d let it get this bad. I felt it when bad exes tried to pick fights or when friends acted unfriendly, and my rebuttals that their behavior was unacceptable caught in my throat. I was envious of TV or film characters who threw their heads back and screamed, wild and untamed, free, at least temporarily, from the restraints of their frustrations. I wondered whether abandoning composure could make me free.

It’s been two months since the first shots that promised to give my energy back, eight weeks since I looked my steady stream of “I’m fine”s head-on. I’m not fine all the time; none of us are. But I’m trying to let honesty, vulnerability, pour through the cracks of composure: I’m honest with doctors. I work not to cheerily shrug off earnest “how are you?”s asked by friends. I notice little wins, like climbing five flights of stairs without the urge to drop to my knees. Admitting something is wrong might feel insurmountable to those who wear our composure like a shield, but it’s where the head back, screaming-until-your-vocal-chords-bruise variety of freedom finds you, too. Perhaps composure was a strength. Maybe it is my talent. But it is feeling, not fineness, that is bringing me back to life.

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