When we are sad and tired, such as when we are disappointed in love or when we are fired from a job, making the least effort can make a world of us. We may not feel like doing anything and even the only thing we do in the first moments is to lie in bed, whether we sleep or not, thinking or just letting time pass.
Usually this is an occasional occurrence, but sometimes this type of attitude is much more frequent than usual and even becomes a trend. This tendency, typical of situations of high emotional distress and even medical or psychiatric disorders such as depression has a specific name: we are talking about clinophilia .
Clinophilia: what is it?
Clinophilia is understood as the excessive tendency of a subject to remain in bed or lying down , often without the desire or strength to perform another activity beyond remaining in that position. Such permanence is not justified by the presence of an organic cause: that is, the subject is not lying down because he cannot biologically get up from it. Thus, behind it there is usually some kind of psychological alteration or discomfort, often associated with suffering.
Clinophilia is not a disorder in itself, but rather a behavioral manifestation that could be indicating the presence of one: that is, we are facing the symptom of the existence of a problem . It is generally associated with emotional discomfort that we do not know how to avoid.
In this sense and to a great extent, we can consider that clinophilia is associated with the feeling of learned helplessness: the continuous exposure to a situation to which we have not found a way out makes us consider that our resources are not enough to face the aversive situation, inhibiting our action and acquiring a position of passivity in this respect.
Lying down prevents us from finding the cause of our pain and allows us to be in a controlled and relatively safe place, so that exposure to the direct cause of the discomfort is prevented . But on the other hand, it prevents us from dealing with it, which in the long run often leads to even greater discomfort.
Although clinophilia itself is only this tendency to remain practically immobile and passive in bed, it is usually accompanied by apathy, sadness, mental or physical fatigue, irritability and difficulty in finding beauty and pleasure in daily life.
Depending on the case, crying may occur , as well as a lack of sensitivity and emotion, such as emotional anaesthesia. It is not uncommon for hypersomnia to appear due to lack of activity, and/or to be accompanied by nocturnal insomnia with lack of restful sleep.
At the level of consequences, in addition to strengthening the above, it is frequent that a certain feeling of guilt is generated in those who manifest a lack of action and a decrease in self-esteem.
At a social level, labour problems may occur (for example, tardiness or absenteeism), and at a social level, it may also generate conflicts with the environment (such as the partner or people who cohabit with the subject) and even isolation (both due to the absence of desire on the part of the subject to relate and a possible rejection of such an attitude).
Causes and problems in which it usually appears
Clinophilia is a passive attitude that usually occurs as a reaction to a stressful, traumatic or painful situation for the subject. This behaviour does not necessarily derive from suffering from a psychiatric disorder , but can appear from the experience of phenomena such as those written in the introduction, the death of a loved one (it can appear in a process of mourning), relationship problems or even from the mere lack of vital objectives and self-realization.
In either case, what is usually at the base is a high level of suffering and emotional distress that takes away the subject’s energies.
In terms of their appearance in mental disorders, the disorders most linked to clinophilia are major depression and other depressive disorders, anxiety problems, bipolar disorder (in depressive phases) and psychosocial stress continued over time.
It is also possible for it to appear after experiencing trauma or in post-traumatic stress disorder (although in this case there is also hypervigilance and restlessness, so that the stay in bed is restless and tense), and in personality disorders such as depression or borderline.
Another possible cause is abulia and alogia in patients with cognitive impairment, such as psychotic patients with negative symptoms.
However, it should be borne in mind that clinophilia can be both a symptom of a disorder and a response to the diagnosis, course, prognosis or difficulties generated by it (i.e. it is not the disorder that generates it but a reaction to some aspect of it). It may also be a reaction to the diagnosis of medical conditions such as cancer, HIV-AIDS, diabetes or heart disease.
Treatment of this behavioral symptom
Treating clinophilia can be much more complicated than it seems. Although the treatments may seem relatively simple, we must take into account the great suffering and discomfort that the patient is in this state , understand it and respond to it. Likewise, it must be taken into account that in order to come to the clinic, the patient (or his/her environment) has had to overcome his/her resistance to the action, something that must be valued and reinforced.
The first step would be to discover the reason why the person with clinophilia maintains this behavior, what they consider to be its cause, their emotions and thoughts regarding their lack of action and the interpretation they make of it (as well as the functionality they can find in it). Likewise, it has to be assessed whether there are disorders such as major depression or bipolarity in order to make an adequate treatment (let’s remember that clinophilia is a symptom of something, whether it is a mental disorder or not, and not a disorder itself).
Once this is done, the fundamental step is to favour the activation of the subject. Establishing psychoeducational guidelines is useful , as well as programming pleasant activities or small steps (more or less graduated according to the problem, if a dramatic change is required the patient will probably not accept it) that the subject will be forced to do. For example, take out the garbage or walk around the block. By promoting an activation contrary to the emotional discomfort, the subject will gradually show some behavioural improvement, but this should not be the only thing that is done.
It is also necessary to work on the causes of their discomfort. An example of this can be found in Beck’s cognitive therapy or in the cognitive restructuring of the beliefs and biases that the patient has . Work on self-esteem and self-concept is also necessary.
An important step is to promote the progressive empowerment of the person. To do this, they can try to remember similar moments that the subject has successfully overcome, explore their attitudes, acts and the consequences that these had and analyze their applicability to the current case. Also to favour the presence of activities in which the subject presents certain domain and expertise , in such a way that he sees himself as valid and capable.
Stress management training can help to raise awareness of different ways of coping with difficulties, just as expressive therapies can help to provide an outlet for the sufferer’s internalized discomfort. In cases where there are sleep problems, appropriate treatment will also be required, as well as sleep hygiene.