Surf-Head

Psychiatry in waves.

Hanging with the Abyss

Less control is more, when staring into the abyss

Longo "Monster" Wave

When waves build to a little over comfortable height, whatever that may be for each surfer, that surfer gets a glimpse of the abyss. The set up is you, prone and cantilevered on your board, hanging over a steep precipice. The abyss is ostensibly just the trough or the base of the face of that tall, steep wave. But it somehow becomes a suck-hole, black-hole, incorporating adjunct terrors of wiping out, smashing on rocks, drowning. And, tangentially, psychological terrors, inadequacy, isolation, abandonment, helplessness, etc.

The abyss is something we typically try to avoid, at least not stare into. I've got a huge, gaping abyss in my leg... Well, it's getting better. After my third surgery for an infected, ruptured Achilles, the wound was left open, rightly so, to heal from the inside. Initially, it looked like the old visible man anatomical models or a Shark Week attack, pending perspective. By now, several weeks later, it's more of a beefy red flesh wound. Over the weeks, others around me, friends, family, patients, have betrayed their sense of the abyss, in my leg.

Granted, gore in and of itself can be fairly vivid and startling. Peoples parts aren't meant to be bright red and glossy. Blood and muscle should be politely tucked under the skin. And it's understandable that gore has a close affiliation with violence, considered a psychological hot button and game changer. But conventional aesthetics and the trauma card aside, I'm pretty sure that the true horror of gore is about unveiled or flayed open vulnerability.

On occasion, I've shown my series of progressive flesh wound, iPhone shots to carefully selected viewers, mostly to relate and validate my coping. When my selection radar is off, a viewer may whince or recoil. Now, I have to figure that in this age of hyped up mechanical reproduction and cyber-Sodom, no one is truly shocked by the sight of gore per se. So it must have to do with an empathic response to the fragility of the flesh and the vulnerability of the greater self.

Part of my regimen over the past few weeks, since the visiting nurses passed on the mantle, has been changing my wound dressings. Mostly, I can frame and compartmentalize this as a necessary medical macro. But two out of ten times, the wound becomes the abyss, a big, blloody, pulsing, red suck-hole. Not mere gore, but David Croneberg style gore, laced with the scarier psychological torments, weakness, helplessness, hopelessness, abandonment. Bleak.

Weirdly, though philosophically not so weirdly, there is a huge upside to staring into the abyss. Once you've allowed yourself the horror/pleasure of doing it for a while, it's neither particularly horrifying nor pleasurable, just a fairly normal state of existential contemplation. The trough of a steep black wave becomes a reminder of fears, but also a potential sweet spot or opportunity to confront fears. The hole in my leg becomes a chance to engage in rather than avoid or hide from vulnerability. Eight years ago, I had cancer, chemotherapy, and a handful of big surgeries. It was when I finally got so familiar with the abyss of nausea, pain, sadness, and helplessness, that getting through it become very relaxed, even easy.

I still forget and drift into avoidance, but I always feel better, less, and paradoxically more in control, when I take the time tong hang with the abyss. GD

 



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Greg Dillon, M.D., is a psychiatrist in private practice in New York City and an Assistant Professor of Psychiatry and Public Health at the Weill Cornell Medical College and New York Presbyterian Hospital Cornell.

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