Learning emotion regulation via Carrie Mathison

Quick disclaimer: I am a massive Homeland fan.  I love the show and have a website and blog dedicated to it (Carrie Mathison’s Diary), and I’m particularly fascinated by Carrie Mathison as a character.  For people who have never watched Homeland, she’s a CIA intelligence officer with bipolar affective disorder and this is an integral part of her character and how she reacts to situations both at work and in her personal life.

There are lots of different aspects of Carrie’s character which are useful and interesting to look at in the context on managing mental health issues such as her obsessive tendencies, difficulties with empathy, extreme mood swings, medication management and so many others which I might write about in later posts, but the most beneficial one for me is her emotion regulation skills, or lack of.  Carrie’s character has changed a lot from season one to season five (the most recent season) and she’s learned a lot of new and helpful coping strategies to manage her illness as well as becoming more aware of her own thoughts, feelings and behaviours, and it’s useful to look at this in the wider context of managing emotions in everyday life.

Throughout season one, Carrie is aware of her bipolar disorder but attempts to manage it through medication obtained from her psychiatrist sister and without disclosing it to the CIA because she would lose her security clearance.  Her emotions are intense and unstable which is clear from the first episode where we see her on a night out, coming home to change, wash and take her medication before arriving late at work for a briefing meeting.  She’s volatile and intense and seems to live in a state of almost constant hypomania, fixating on her ‘work’ as she sees it and obsessing about the possibility of Nicholas Brody working for Abu Nazir, who has been the subject of her intense fixation for several years.  She appears to be constantly on edge and hyped, working fast and intensely and impatient with other who do not see things her way.  This culminates in a full-blown manic episode near the end of season one where she ends up in hospital after an explosion without her medication which triggers her mania.

Carrie is unable to manage her mood and emotions effectively throughout the first few seasons of Homeland and this leads her to losing her job at the CIA, attempting suicide after being rejected by them once again and finally being reinstated after her obsessive theories are proved to be true.  It’s hard to watch as you see her trying desperately to contain her emotions, listening to jazz music and breathing deeply, taking her clandestine medication (clozapine) but it’s so hard for her to manage on her own and she ends up in hospital again which was partly a result of CIA intervention to use her as ‘bait’ but also taking advantage of her mood and emotional difficulties.  The benefit to this is that she finally starts to take regular, prescribed medication (lithium, a mood stabiliser) and this does seem to help her to manage her extreme moods more effectively.  There is a brief period when Carrie stops taking her medication to manage it herself through meditation and exercise but this does not work fully and she returns to taking the medication.

From the first few seasons, we learn with Carrie the importance of understanding your own experience and symptoms, and ways to manage them to minimise their interference with your daily life or work.  Carrie realises gradually that by taking her medication every day, sticking to as much of a sleep and healthy eating routine as she can, having a ‘higher power’ (meditation or God), and taking time to destress through listening to music or running, she can learn to stabilise her moods as much as possible and so that they don’t interfere with either her personal life or her work at the CIA.  There’s a conflict with her in that she believes that the medication ‘dulls’ her judgement and prevents her from working as effectively as she could do but she also realises that on balance, it is more beneficial for her work and for her mental health long term. Bipolar affective disorder is a lifelong condition that needs careful management, and Carrie recognises this.

Season four is an interesting season in relation to Carrie because although she’s taking her medication regularly, she’s based in a volatile environment in Pakistan as station chief which triggers the return of some of her difficulties with mood regulation.  There’s a brief time when she uses sexual inhibition as a way to persuade an asset (a young man called Aayan) to cooperate with her operation which shows again how she can have difficulties with empathy, boundaries and not fixating on the ‘mission’, and later that season her medication is tampered with resulting in full-blown mania and psychosis.  It’s a very intense and volatile time, and this has an impact on Carrie’s mental health as she swings from hypomanic fixation on her role in the mission, intense emotions as she becomes over-attached to Aayan and he is subsequently killed, her ethical conflict about completing her mission to kill Haqqani which would also kill Saul, and her emotional outbursts of anger, frustration and loss.  By the end of the season, she’s back in USA and trying to readjust to a more stable life and by the time season five begins, she’s managed to find a routine that works for her and keeps her moods stable.

In season five, we see a massive change in Carrie’s emotional state.  She’s living in Berlin, bringing up her daughter (a result of her intense relationship with Nicholas Brody in the first three seasons) and in a seemingly long-term relationship with a man called Jonas.  She’s taking her medication regularly, attending church, taking Frannie to nursery and working for a security company called the During Foundation.  She appears to have good insight into her illness and how to manage it, and her moods are more stable than we’ve ever seen them.  But, in typical Carrie style, this doesn’t last and soon she’s off her medication which results in intense mania and psychosis with extreme paranoia and hallucinations.  She learns from this quickly though and is taking her medication by the next episode although by then, she’s already involved in a complicated series of events which I’m not going to go into detail about here- see my Homeland blog if you’re interested!  Season five is hard to watch because Carrie is so painfully aware of her illness and how it can affect her, and although that’s vital in keeping her emotions under control, it’s also hard seeing her trying to have a ‘normal’ life and relationship which she’s never managed before.  There are some really positive changes- her reversion to Catholicism and repeated praying, taking her medication regularly, trying to be a good mother, doing deep breathing when she gets worked up or praying, trying not to act on impulses.  All of this is significant because it shows how her awareness of and commitment to managing her moods really does help with emotion regulation and she is a much more stable and resilient person than we’ve seen in previous seasons.

Carrie’s attempts to manage her moods mirror a lot of skills used in DBT.  One of the key emotion regulation skills in DBT is called PLEASE, which stands for treat Physical iLlness, Eat healthily, Avoid alcohol and recreational drugs, keep a regular Sleep pattern and Exercise.  In the first few seasons, we see Carrie frequently neglecting to sleep or eat properly, drinking large quantities of alcohol, self-medicating and only focussing on work but by season five, she’s sober, taking her prescribed medication every day, sleeping and eating apparently regularly (as much as her work permits), taking time to take care of herself and running as exercise.  And those skills are useful for anyone, regardless of mood disorder or not.  Carrie also appears to have a lot more awareness of her own emotions and acceptance of them which helps her to recognise and manage them more effectively instead of acting impulsively.

Another DBT skill is ‘connecting to your higher power’ as a way to ‘improve the moment’ and manage intense emotions.  Carrie has reverted to Catholicism in season five and this appears to be a major part of her life- we see her in church taking communion and praying when she’s feeling overwhelmed or desperate whereas a few seasons previously, she’d have been downing pills with a bottle of wine or making herself sexually available to men.  Carrie’s style of prayer fits with the DBT idea of radical acceptance- accepting the moment as it is without judgement and accepting distress or emotions without acting on it.  This is such a massive shift for Carrie and shows how far she’s come since season one, and the same skills are relevant for anyone to try.  Higher power doesn’t need to be God- it can be nature, spiritual, feeling connected…anything that takes you out of yourself.  For me, it’s long distance running or looking up at the stars- you’re insignificant in the best way and nothing really matters.

The other part of Carrie’s character development that really got to me was her relationship with Saul Berenson.  From the beginning, Saul was her mentor and friend which was consistent throughout the series- for Carrie, possibly the only consistent thing and it’s always Saul who Carrie would go to for help, advice or reassurance.  Saul was also self-focussed though and in season three, he began to take advantage of Carrie’s vulnerability by using her bipolar disorder as a way to gain a valuable asset.  But in season four, we see again how Carrie’s more than his protégée- as Haqqani said last season, she’s “his daughter, practically” and they’ve both been there for each other in so many crisis situations. Even though Saul has used Carrie (or allowed her to be used) in so many horrible ways- sending authority figures after her in season one, going to Beirut in season two, being admitted to a psychiatric ward in season three- he’s also supported and guided her throughout her career and it’s always been Saul she’s gone to in crisis.

In season four, it was Carrie who talked Saul through being targeted and recaptured, and Carrie who talked him down at the prisoner exchange. Carrie said several times, even after their relationship broke down, that she trusts Saul more than she’s ever trusted anyone. We still don’t know exactly why they aren’t really talking but it doesn’t really matter- the connection is still, and always will be, there. There are so many examples in Homeland of how close and mutually reliant there are- Carrie asking for Saul’s advice in season one, Saul telling Carrie she’s “the strongest person I know” in season three, Carrie urging Saul to trust her in season four, Saul visiting Carrie in hospital in season one, Saul watching over Carrie when she was depressed and unwell, Saul’s hurt when he found out that Carrie had concealed her bipolar from him… We don’t find out in Homeland what could have happened to make them split so intensely but I think from a self-protection perspective, Carrie couldn’t allow herself to become so emotionally vulnerable again which is why, when Saul tried to make up with her, she wouldn’t let him, telling him, “I’m not that person any more.”

When I first saw this, it genuinely made me cry but I really do accept why Carrie made that decision- she needs to protect herself and she’s come so far since season one.  I wrote a post yesterday about friendships (Friendships and mindfulness) and this really links to the same idea.  Sometimes it’s really hard but you need to move on and accept that sometimes even very close, long term relationships end.  People change and you can’t do anything about that.  It’s horrible, genuinely feels like you’re being punched repeatedly in the stomach and your chest is being ripped open but staying attached to the person that someone used to be isn’t helpful for either person.  Carrie made what is for her the right decision, and Saul needed to accept that. It’s not going to be easy for either of them and there is an intense part of me that really, really wanted them to make it up but I know that wouldn’t have been possible and that one of them would have had to change and compromise themselves which wouldn’t be the basis for a healthy relationship. Saul helped Carrie to grow and develop as a person and she provided him with emotional support and trust when he needed it, but they both changed and it was time for them to move on.

I think this is maybe the most important lesson I’ve learned from Carrie Mathison- that people change and move on and that’s OK, it isn’t your fault, people need different people at different stages in their lives and that’s normal because people change at different rates.  It’s OK to be upset or to miss the friendship but it’s also important to accept the change and move on from it.  Carrie was given the opportunity to reinstate the friendship but she chose not to, not because she doesn’t still love or value Saul but because she needs to protect herself from that amount of hurt again, and both she and Saul have changed and moved on.  Their relationship would never have been the same and it wouldn’t be healthy for either of them to try to recreate that.  Being mindful of your emotions and learning to regulate them is so important, and I think Carrie can teach some really valuable lessons about techniques and practical applications of emotion regulation skills.


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