Notice my pain when I show that “I’m fine”

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pardon my use of memes

Humans are incredibly social beings. We use facial expressions and body posture, in addition to what we directly say, to communicate how we are feeling. We also rely on these clues to discern how someone else is feeling. 

But what happens when there is a mismatch between what’s on the outside and what’s on the inside?

In Dialectical Beahavioral Therapy (DBT), this is called Apparent Competence. It’s when outwardly you seem highly capable and emotionally regulated. You seem just fine, or even more than fine, and not really in need of help. Yet, internally you may be on fire. Another blogger defined it as “incongruous communications.” They continued, “The person may state a problem or talk about a subject that evokes high levels of emotion, but without the ‘matching’ level of non-verbal communication.” Apparent Competence is part of one of the Dialectical Dilemmas; it’s counterpart is Active Passivity (which I may talk about in a future blog post).

When I first learned about Apparent Competence while in DBT, I was floored. It describes my experiences to a T. Often when I am experiencing high levels of distress, then when I go to communicate this to someone, it’s like a switch flips. I put on my “fine face.” I perk up and often don’t verbalize 90% of what I was feeling or thinking. Moreover, even if I am verbally saying that I’m distressed, I do so in a way that minimizes my own pain. I laugh or chuckle, and I talk cheerfully. Though I desperately want someone’s care and validation, I can’t seem to be able to effectively express myself. 

This conflict came up a lot when I was in residential treatment for OCD. Though at the end of the day I would often rate my stress level as quite high, outwardly I looked as calm as a cucumber. Meanwhile, others reported lower numbers, but we’re sweating and pacing and biting their lips. So, often staff didn’t realize just how much I was struggling. There was a mismatch between my outside and inside, and this led to frustration on both sides. I was frustrated that the staff didn’t notice my pain, and the staff was frustrated that I couldn’t express what I needed.

Apparent competence was also relevant all of the times I went to the Psychiatric ER while in college. At home, I would be feeling immense pain and having chronic suicidal thoughts. Yet, when I got to the ER, though the pain was still there, it was almost like I was putting on a performance. There were no tears. I said little of the severity of what was really going on, or I would say it frankly and with little to no emotion. “I’m having suicidal thoughts, and I have a plan,” can be said in a lot of different tones. That tone makes a big difference in how you are perceived. Again, I told jokes and smiled to ease the tension of the situation. And again, this led to staff misunderstanding. Sometimes, nurses would get frustrated with me because if I was “fine,” why was I wasting their time? 

Not all staff was like this. Every once in a while, a nurse or social worker or doctor would pick up on the nervousness behind my laughs. They would realize I was hiding pain behind a smile. They figured out that I was just unskilled at outwardly expressing myself. And these individuals made a world of difference. I don’t blame the others for not seeing what I didn’t express clearly. I just wish they had been more patient with me or more willing to question when I seemed “fine.”

I should also note that I don’t put on these “performances” intentionally. It’s something I can’t seem to turn off. I think a lot, and I say a little. This is true in all contexts. I have dozens of thoughts about my experiences, but when I go to say them they just won’t come out.

The exception to this seems to be writing. When I am talking to a screen or a piece of paper, all of the filters magically disappear. I’m able to say in depth what I’m thinking and feeling. I go far beyond what most people would even say aloud. There is so much that I want to say built up like a dam that it all comes pouring out when I write.

Because of this, writing has become incredibly important for expressing myself to others. I even use it as a communication tool with providers. Frequently, I would write letters to my therapist or other providers expressing what I felt and how intensely I felt. Then, all I had to do was simply hand them the letter. The blogger I quoted earlier wrote, “[writing] affords the luxury of the recipient only being able to ‘hear’ what I intend them to, without being confused by non-verbal communication that doesn’t support the statements being made.” If I smiled or laughed or acted “fine,” they at least had in writing what I truly meant. Apparent Competence becomes less of an issue.

Moving forward, Apparent Competence is something I want to continue to work on. I don’t expect it to change quickly, as this is something I have struggled with my entire life. Still, I figure, if I can go from expressing 10% to 11% of what I intended to express, that’s still 1% more.

And maybe one day, I’ll be able to speak with the same comfort that I feel while writing.

Morgan

For further reading of the blogger I quoted: Apparent Competence is Going to Kill Me

this is fine2
credit unknown but yay for moar memes

2 comments

  1. Even before I read this I could feel your pain recently. I tried to let you know I was here. If you need me to come to Normal I will leave tomorrow.

    I feel angry (not at you) but that’s just wasted energy. I’d rather focus on you. You are very loved and I do see and feel your pain. ❤️Mom

    Sent from my iPhone

    >

    Like

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