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Archive for the ‘relationship’ Category

By at least a ten to one margin, the most read and commented-upon post to this blog is my August 1, 2007 End times: Coming to the end of psychotherapy. I had not expected this, when I published the piece.

Originally written to help one of my clients sort out their thinking as they came to the end of their time working with me, I had posted it because I did think others might find it useful. It appears, now, that it addresses a real and persistent problem. Well, such problems are what we deal with in psychotherapy, and sometimes in our blogs as well.

So, “what’s the problem”? There appear to be two of them: psychotherapy clients, and their therapists. That’s simply what the data appear to support. Let me address each, in light of the continuing comments to the blog entry, and in relation to one in particular (which was withdrawn by its author, so you cannot find it there).

THERAPY CLIENTS AND THEIR ISSUES

Clients appear to have trouble with leaving for several reasons, among which are:

  • They cannot decide if it’s time or not. They don’t know how to arrive at  a decision they can feel comfortable with.
  • They have to leave, and don’t want to, and it’s disturbing them.
  • They’re ready to leave therapy, but don’t want to lose contact with their therapist.
  • They want to leave therapy, but their therapist is objecting, or advising against it.

I think you’ll agree that that covers a lot of ground.

THERAPISTS AND THEIR ISSUES

From the report of people writing comments to my blog entry, it appears that therapists also have trouble with therapy termination for a variety of reasons, among which are:

  • They think their client is making a poor decision, and really isn’t ready to leave.
  • They think their client is being “resistant” to therapy, and is basically “fleeing” therapy.
  • They appear committed to a long term relationship with their client, for reasons which (to me) appear suspicious, and object to a client’s attempts to break free.

I want in this post to comment about therapists and their problems, mostly, since the clients’ side of the picture has been commented upon by me extensively in my original post, and in my responses to readers’ comments.

When therapists think their client is making a poor decision, and really isn’t ready to leave. In a hospital, if the doctor treating you isn’t ready to discharge you and you leave anyway, which is certainly your right, unless you’re being held there under court order, you’re advised that it will be noted in your chart that you’re leaving “AMA” – again medical advice.

In other words, it is customary to tell you that we think (I used to work in a mental hospital) that you’re making an ill-advised decision. Partly this is to protect ourselves legally, but it’s also a last chance to ask you to think things over. Warning you about an “AMA” discharge seems good practice for both parties, and it’s usual and customary practice.

Such circumstances certainly occur in outpatient practice as well, and the same justifications for voicing and recording objections of the treating professional to the departure of the client hold weight in this context. In other words, we are almost certainly remiss if we DO NOT give this warning.

So, clients, you do well to consider the larger picture when you find that your therapist does not support your leaving. The disagreement likely has in it an element of real concern for your welfare.

Yet some clients come to therapy with the expectation (which can escalate to a demand) that their therapists “support” them, period. This is both unreasonable AND reasonable, in the following senses:

  • Reasonable: Our first obligation to you is to support the promotion of your health. It’s the oldest admonition in the healing arts. This means that we need to be able to offer you an informed opinion about your condition, AND that we actually make you that offer. But…
  • Unreasonable: There’s no guarantee that you’ll like what you hear  when we offer you this kind of support. Making you immediately happy is not the purpose of such support. Assisting you to be healthy in the long run IS.
  • Reasonable: “Support” is a favorite word women use in talking about their close social relationships, and with good reason (men seem not to talk about this). It’s a high value for most women, and by “support” they mean what I would call the offering of emotional congruence. That kind of support is appropriate in therapy as long as it supports (in the other sense!) your health. Such support can very meaningfully help a client learn to value their own feelings and viewpoints, for example. But…
  • Unreasonable: Do not expect us to support you emotionally while you make what appears to us to be a bad decision. That’s like praising you for staying on road while driving, as you drive across a washed out bridge.

So, can we do both at the same time? Can we support your “personhood” while disagreeing with your decision to leave? Of course, and I think we must.

I think that at all points in the therapy relationship we need to support our clients’ thinking for themselves. This, fundamentally, is about self respect. But, we also need to MODEL this behavior, which is what I do when I disagree with a client’s decision to leave. How can I advise you to respect your own thinking if I do not respect my own? Therapists are in many ways like parents: they cannot be, or act like, “friends” or “buddies”. We are coaches,  sources of expert opinion and intervention, and most definitely models. Any other understanding is almost always ill-informed and ill-advised.

Basically, our being both supportive and unsupportive of a client, when we find that that is our true position,  is asking a client to be an adult. We’re saying “It’s important that you make your own decision, and do what you think best. Nothing else will really work for you, howsoever scary it may be at the moment.” And then we may also say “And I do not agree with your decision to leave therapy at this time. I think it’s ill advised.” And then, finally we say (at least I say this, because I think it’s very important): “Now you have to make a lonely decision. I’ve given you my best thought, and the most important part of it is that it’s up to you to decide, just as it’s your fate to meet up with the consequences of your decision. This is the way life really is, and I’m here to help you with this little piece of it.”

Some clients have trouble with this, in large part, I think, because we therapists don’t work hard enough making clear what our purpose is: not to make life easy, but to make it better. Often, that means “no pain, no gain”. Some clients really kick and scream about this. I consider that a normal part of their life development. We’ve all done it at one time or another, believe me! And we therapists must remain adult, hold our ground, and hold out for the overall improvement of our clients. We, too, have a lonely decision to make: just as you have to do what you think best, and no one can really take over for you, so do we. It’s part of our ethical commitment to you.

(I’m laughing to myself right now…recalling how many times I know of parents who truthfully told their kids “You’ll thank me for this some day.” What a day of true joy THAT is – ha!)

When therapists think their client is being “resistant” to therapy, and is basically “fleeing” therapy. Well, some clients ARE resistant, and they do flee. The “resistance” is typically based either on a failure to understand what therapy is actually about (“What? I have to walk TOWARD my pain? Are you NUTS?”), or on fear, or both. The “fear” is more serious, more complex, and more difficult to deal with.

Just to give one example: a client I had once basically had never, as a child, had an emotionally supportive, protective relationship with an adult she could trust. I was probably the first person who’d ever invited her to trust herself (AND me) as we looked back at the painfulness of that childhood. She’d thought that therapy would be like a magic pill, and that we’d quickly and permanently anesthetize large parts of her memory.

When I advised her that that wasn’t quite accurate, she simply couldn’t trust that I knew what I was talking about. I think that she also couldn’t trust that she could survive contact with her feelings. She ran, against my advice and in spite of my best efforts to calm and reassure her. I believe her departure was due both to her mis-perceptions about how therapy works and her fear of herself and all other adults. A tough story, for both of us.

On the other hand, some therapists call any client who want to leave before the therapists deems them ready “resistant”. I strongly object to this. First, I don’t think it’s helpful in any way. Second, I think it a poor characterization of what’s actually happening.

Resistance can be a very good thing. I will resist your picking my pocket, for example. But it also can be a completely wrong word. If I resist having a perfectly good meal with you, because if I do so I’ll miss my train, “resisting” your invitation is simply rational. So is it rational if my client evaluates her situation, listens to me and anyone else she cares to listen to, then decides that what she want to do is leave? In that case, her leaving is the only sane, rational thing to do, and I would strongly support her leaving for that reason.

I have in fact most certainly told clients who I thought were leaving therapy prematurely (I do get a few!) that I thought all in all they simply had to go, that not to go would be wrong because it would be an act of self-disrespect. And I said this after telling them that I was convinced that therapy would be good for them, and  thought they needed it.

Again I say: I know this isn’t simple. But it IS true, and telling the truth is my first interest and first obligation. The challenge of understanding this truth is a completely separate issue.

WORKING TOGETHER TO MAKE THIS EASIER

From the moment I began addressing this topic, over a year ago, I knew that often it’s a difficult one for all concerned. I have, at all points, felt most concerned about the difficulties clients have with ending therapy. They are the more vulnerable, less informed, less experienced of the two individuals involved. I think we therapists need to help them with this issue just as we do with others.

Therapists get in trouble with this issue just as do their clients, sometimes for the same reasons! Sometimes their troubles are of their own making, and sometimes they are due simply to the nature of the problem. A fundamental objective of my writing on this topic is to raise awareness by both therapy clients and therapists both of the pervasive existence of this problem and of its nature.

We need to talk more with each other about this matter, preferably from an informed point of view. We certainly also need to respect each others difficulties in dealing with therapy termination. All in all, this problem isn’t going to go away, and isn’t likely to get much easier over time. It will just be there, waiting for us.

When therapy termination time comes, we need to do with this what we do with other problems in psychotherapy, turn toward it, look it in the eye, see its parts, feel our feelings, talk to each other, and, while as fully alive and functional as we can be, simply walk through the fire. It’s what we do, and it’s what we’re good at – or trying to get good at! It’s just another part of a life which isn’t always easy but which IS manageable.

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[ Psychotherapy may end, but the popularity of this topic may well not. There’s a follow-up to this post, which you may wish to read: Leaving therapy – so what’s the problem? (2009.01.15) ]

Everything ends eventually, including psychotherapy. A grace-full, well managed ending is ideal, but, in reality, ending psychotherapy – leaving a psychotherapy relationship – is a problem for some individuals. Mental health professionals would do well to acknowledge this more often, and respond with some specific suggestions for our clients, before they start wondering whether it’s time to stop, and then how to do it.

PSYCHOTHERAPY AS AN INTIMATE RELATIONSHIP

Intimacy takes many forms. Most intimacy in life is familial. Some occurs in the context of friendship. And some occurs in psychotherapy. In all cases, it is true that intimates know things about each other not generally known by other people in their life.

Intimacy is not always between peers. We may know significant details of the life of our First Family (President, etc.). It’s unlikely that they know anything of us, as individuals. Mothers know more about their children than the children know of them. Psychotherapy relationships are similarly unequal, for in them therapists know more about their clients than clients about therapists.

INTIMACY AND VULNERABILITY

Intimate knowledge creates vulnerability. Where intimate knowledge is asymmetrical, vulnerability is also. Whoever is known most about is usually the vulnerable one, for multiple reasons. In psychotherapy, this vulnerable one is the client.

The specific vulnerability I want to address here has to do with the likelihood that leaving a psychotherapy relationship will be a distressing time for a client. I want to consider the possibility of reducing this distress.

WHY LEAVING PSYCHOTHERAPY CAN BE DIFFICULT FOR YOU

There are so many reasons why this may be so. Here a some of the reasons most immediately obvious to me:

  • You may never have done it before.
  • When the issue of leaving occurs to you, you may not feel finished with therapy.
  • Your therapist may not talked with you yet about leaving, at the time you begin thinking about it.
  • You may have real conflict about leaving.
  • You may not be the one who brings the issue up.
  • You may be aware that your therapist is more engaged in working with your problems than you are, and you don’t have any idea what to do about this.
  • You don’t want to hurt your therapist’s feelings.
  • You may have no idea how to justify your leaving.
  • Other people in your life who matter to you may want you to stay in therapy.

GETTING YOUR THINKING STRAIGHT ABOUT LEAVING

I want to take up here each of challenges I listed above, and possibly a few others that come up as I work things through.

You may never have done it before. First-time therapy clients have a lot of “firsts” to work through in therapy. Leaving is certainly one of them. If this is not your first therapy relationship you’re more likely to have some knowledge of the challenge of leaving, even if you don’t yet quite know how to do it well. If this is your first time leaving therapy, you really ought to talk about it with your therapist. They, after all, are not first-timers, relative to this issue, and just might be able to help you. If you find it a difficult topic to bring up, then the difficulty you’re experiencing needs to be the first thing you talk about. That difficulty may well be a legitimate “therapy issue”.

Your therapist may not talk with you about leaving before you begin to feel like the time is close. If we therapists don’t take up this problem and make sense of it, what chance do you have if doing it at all well? We’re interested in getting you into therapy, and keeping you there until we can get some real work done. And then what? We seem to have little to say about this.

When I brought up this topic to my very capable faculty adviser during my internship in graduate school, his reaction was that this concern was not for us to address. “The client determines when therapy ends”, he said. OK – there’s a very good idea in that sentence, but the problem remains. (And I suspect that if I’d asked the question better I’d have gotten a better answer!)

We have many ideas to offer you. How to leave therapy well seems not to be among them. I’ve never heard this issue seriously discussed in a professional context. We seem not to think about it. We should, because it’s too often a source of distress for our clients. As a client, you cannot fix this problem, but you can realize that part of the problem for you is that too often you’re on your own with the problem. You shouldn’t be, I think, but you usually are. There is a remedy for this, however, and it’s under your control.

You will probably not feel finished, when the issue of leaving comes up. It is rare for a person to have addressed all their problems when they leave therapy. There really isn’t a need to have done this. It’s better to take up focused issues, make progress (any progress at all is better than staying stuck), leave, and then return later if this seems called for. It is realistic to see life as a series of ongoing challenges – and to accept that you’re not going to run out of problems. Do you really think psychotherapy is going to fix this? I wish!

You may not be the one who brings the issue up. If you have to deal with “managed care”, or have a seriously limited budget, you know that external factors and people can have a real say about when therapy ends. Or…your therapist may be moving, or retiring, or going on vacation. Your situation then is one of feeling unfinished but having to leave anyway (see the paragraph above, concerning this). This can be difficult, but it can also be talked about, and learned from. See that this is how it gets handled in your case.

You may have real conflict about leaving – feeling like you want to leave AND you want to stay. This is very common, for many reasons. The best thing to do is to take up the matter of the conflict(s) you feel with your therapist (do you notice a theme in my remarks, here?). Such conflicts arise from the fact that our mind virtually always holds multiple points of view about critical issues. These conflicts are part of being human, so talk about it. It’ll help, and it’ll often work to actually resolve the conflict.

You may be aware that your therapist is more engaged in working with your problems than you are, and you don’t have any idea what to do about this. In a sense, this shouldn’t happen, but it often does, anyway. First of all, it’s probably generally true that your therapist experiences a degree of fascination with your problems – dealing with them is his/her chosen profession, after all. You, on the other hand feel something other than fascination, and in this there is an essential imbalance.

Nevertheless, the rule is that the client leads. We may invite you to go certain places, but when you indicate disinterest, that settles it. It’s YOUR opinion that counts. I hope your therapist doesn’t forget this, but if they do, you still shouldn’t. If your therapist appears to need to engage with your problems, they have matters to take up with their therapist. This kind of problem is actually common in psychotherapy. Freud talked about it, and we’ve been talking about it since then. What you should know is that it’s OUR problem, not yours.

Therapists are people, and they do have problems, at times, but that should not be your concern. In psychotherapy, you’re expected to be self-centered, and you should maintain this focus right on through the time of your leaving. Your therapist can take care of themselves. They have access to excellent resources for doing this.

You don’t want to hurt your therapist’s feelings. I see this issue come up most often with young women, who are often deeply in contact with their maternal side. Such instincts are one of the glories of humanity, but really don’t belong in the psychotherapy relationship. Your therapist does have feelings, and you likely will be missed. Your therapist also has experience with this problem, and can take care of themselves.

It’s good for you to notice that your therapist values you. You do have value, and we all need to know this. However, children leave home, clients leave therapy, and we all leave life, at some point. It’s the Way of Things. If this is a persisting problem for you, you owe it to yourself to bring this problem to therapy. Doing so is an excellent idea.

You may have no idea how to justify your leaving. Many people in therapy have a history of being disrespected, and thus have some trouble respecting themselves. They often feel defensive or in need of justification. Try to understand that this is a developmental problem which you don’t have to have, and really should not tolerate. If you DO have this problem, take it into your therapy as a topic.

The best reason to leave therapy is a very simple one: you want to. I teach assertion, and I’ll say it plainly: Your feelings are your best justification for anything. (You do well to see that your feelings are based on correct perceptions of course.) If you find this difficult, then you’ve just identified and area in which you need some work, and definitely some practice. Assertion skills definitely have to be practiced. I look for opportunities to practice mine. You should too.

Other people in your life who matter to you may want you to stay in therapy. Who? Parents, spouses, children, friends, employers…did I leave anyone out? While sometimes therapy may be mandated by a judge, in all other cases, it’s your call. People can have any opinion they want. It’s a free country. And you need to keep your own counsel. Participation is your decision. When someone else has feelings about your leaving therapy, take it up with them. Understand that THEY are having a problem. Talk with them to see what’s at the root of the problem (it’ll usually be some fear which isn’t well enough identified). This will help your relationship with them, and may even give you some useful information.

SOME THINGS I WANT YOU TO KNOW ABOUT LEAVING THERAPY

You may not be the only one distressed by the idea of your leaving. We often come to truly like and enjoy our clients. I know that in mine I virtually always see the essential problems of all of us as human beings. I usually develop a strong sense of compassion, and come to care significantly about each individual I work with. How can I look casually upon the prospect of coming to the end of our meetings? I don’t know how to do this, and I’m not sure I want to learn. So, that your distress is likely shared is a very good reason for taking up leaving as a topic, with your therapist. You both should talk about it with each other. Very often the problem is one of dealing with loss – and that’s a problem that challenges all of us, in various ways.

Some therapists are as puzzled by the “leaving” problem as you may be. Not all therapists grasp that clients will leave with some of the problems they brought into therapy. I can recall our being confronted with the necessary “unfinished client” problem, by one of our teachers in graduate school. I was already familiar with it, but some of my fellow students had not thought of it, and found it troubling. If your therapist has not grasped this reality, and the fact that it’s not necessarily a problem, you still can. You must, in fact, because everyone leaves unfinished. We’re all a work-in-progress. You think this is a problem? Wait until you face dying, unfinished! (You’ve been warned – so now you have some time to prepare for that one…)

Loss is one of the great themes of everyone’s life – you do well not to turn away from it. Some people, when the time comes, simply run from therapy. It’s the only way they can handle it, but it’s not a good response. Losing your therapist is but one of many losses you will have in your life. USE the experience to address the issue of loss and what it means to you and how you handle it. It’s an excellent chance to add to the benefit you get from your therapy.

Your therapy is about you and what’s good for you. This may seem obvious, yet concern for others and a desire to take care of others, sometimes in inappropriate ways, is common, especially in psychotherapy clients. Your therapist, if she/he has a lick of sense, has done psychotherapy work themselves, and has taken up the issue of loss in the course of that work. He/she comes to their work prepared to handle the eventual loss of clients. You don’t need to be worried or concerned about them. Your attention belongs on you.

You can come back. Surprise! This doesn’t occur to many people. You can think of leaving as an experiment. Do it and see how it goes for you. You can return, if you find that you’re not ready. I’ve had a number of clients return, virtually always for only a short period of additional work. Some have come back 2-3 times. One came back four, and the fourth time was the one where she really got down to work. I was thrilled, and I think she was as well. You can simply take things as they come, just like you have to do with the rest of your life.

SOME GOOD WAYS TO TALK ABOUT LEAVING THERAPY

I want to offer here some little “mini-scripts” which may help you deal with leaving.

(To your therapist) – “I’ve been thinking that I’m about finished with therapy. What do you think about that?”

(To anyone at all) – “I’m feeling about ready to leave therapy. It’s been a challenge/good experience/disappointment/real puzzle to me/a life changing experience (pick one or more). I’m ready for a rest.”

(To yourself) – “I feel about ready to stop. I want to respect that. I can come back if I want to, or go elsewhere, later. I will always have many options.”

(To your spouse) – “I’m graduating soon from therapy. I hope you’ve been keeping up, because your life is about to get really interesting!”

(To your therapist) – “Thanks for the challenges, for the patience, for information, for the compassions and caring. I’m not who I was when I came here. I know I’ll keep growing after I leave, and what’s happened here will help to make that good growth. I’m grateful. I hope you think of me from time to time. I know I’ll think of you. Maybe I’ll send you a postcard.” (I always like to hear these sorts of statements. Expressing gratitude is something I very much value. I will often express a lot of it back – I do admire the courage and humanity of my clients. I always am inspired by it. Rarely, I think, do they realize how much they enrich my life. I want them to have some small sense of that. And I always respond positively to the idea of that “postcard”.)

CONCLUSION

I wrote this originally in one sitting, while thinking particularly of one client of mine (who reported finding it useful), but always had in mind a more general problem, involving many more individuals. What I have written seems incomplete, and unfinished, and I hope to revisit the topic and revise it further, but for now it’s time to go. This, too, is a work in progress.

(revised 2008.06.03)

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THE LEGACY OF A PARENT-CENTERED CHILDHOOD

Grow up with inept parents and you’re apt to become a people-pleaser.

In families with parents who meet the essential needs of their children – which at the least are physical safety, physical support (food and health care), social inclusion, and training in self-management of emotions – children are primarily focused on themselves, which is appropriate. In families where parents are in any way significant incapacitated (due to mental or physical illness of any kind, or to physical absence), children usually learn unconsciously that certain of their behaviors have a better effect on their parents than others. The result? More functional parents – but at a price: one becomes to a degree a manager of one’s own parents.

This out-of-balance relationship will most likely produce a child who is focused-on-others, rather than self-focused – as healthy children ought to be (most particularly in their early years). In many cases, this will result in an adult who gets anxious if they cannot moderate the anxiety of important people in their lives. A common way for this problem to show up in someone’s life is that they make promises to others which they cannot keep, AND they do this compulsively. That means that they try not to do it but do it anyway.

In the end, neither the promise-maker or promise-receiver will be happy with this behavior.

THE ALTERNATIVE: A MORE COMFORTABLE LIFE FOR ALL

Were you able to fix this people-pleasing behavior right away, the result would be that all concerned would be able to achieve long term comfort, something which is not possible when people-pleasing promises impact a relationship.

PEOPLE-PLEASING PROMISES LONG TERM COMFORT – BUT NOT FOR FREE

Such promises occur because of a desire to maximize immediate comfort for the other person. But this has clearly led to long term distress, as telling people only what they want to hear tends to distort the reality of the situation, and you set up expectations you simply cannot meet. Short term comfort and pleasure inevitably leads to long term distress for all concerned.

In some cases, this may be a simplification of the problem. One can fail to keep a promise in numerous ways, only one of which is making an unrealistic promise initially. For example, if you continuously play for immediate comfort, then today’s promises may come to preempt promises made previously, so that plans made yesterday get bumped from the schedule by today’s concerns. This kind of complexity is off-topic in this piece, just now. We’ll only consider, here, the simpler case of two people, and one promise or set of promises.

BECAUSE WE’RE ANXIOUS, WE DO NOT LEARN FROM POOR OUTCOMES

An important secondary aspect of the “unrealistic promises” problem has been that making this mistake, with its associated distressing outcomes, has NOT led to self-correction.

This is puzzling, at first. The brain is, after all, designed to learn from consequences. The puzzle is resolved when one realizes that such stuckness virtually always indicates some kind of OTHER, covert, value is influencing one’s behavior. Most often this has to do with unfinished business from one’s childhood, about which one is likely to be insufficiently aware. In this case, the covert value seems to be that of resolving one’s OWN excessive anxiety about the other person.

To put more plainly: people-pleasing turns out to be more about calming oneself than pleasing the other person. What a surprise, yes? But it makes sense. Children with inept (or worse) parents typically become scared – anxious. The learned people-pleasing is a way of resolving this anxiety, partially or wholly.

Dysfunctional parents are typically impulsive and emotionally volatile and/or depressed, and they usually have poor self-soothing skills. They do not function well as parents, and every kid NEEDS parents who function better than they do. Kids tend to learn that one can get immediate gains in parental function by doing anything which soothes their parents. Making unrealistic promises in the immediate moment is a way of doing this.

WHY THE DYSFUNCTIONAL BEHAVIOR CONTINUES, IN NEW SETTINGS

People-pleasing over-promising behavior learned in childhood will tend to generalize to all people who show any degree of anxiety – they will get “managed” by the same method acquired for managing parents. Such promises act to improve their immediate expectations of the future, and thus are calming. However, as with one’s parents, this doesn’t really fix any problem other than the immediate one of how the individuals involved are feeling now – and it well may not do that particularly well.

Fear is normal part of a working brain, and of a healthy childhood. So, too, is learning to manage such feelings so that they do not dominate the brain. But children who grow up focused on managing their dysfunctional parents do not typically acquire enough emotional self-management skills. In this area, they remain primitive.

The hook in all this – the force which drives this over-promising habit out into all corners of one’s life where one is apt to meet important, anxious people – is the ongoing anxiety one feels ONESELF about other people’s anxiety. As long as their anxiety triggers your own unfinished business about your parent’s anxiety, you’re hooked – driven to keep trying to manage things by the dysfunctional method of making unrealistic promises. Since you didn’t learn either good self-management of your own feelings OR appropriate responses to the anxiety of other people, when you were growing up, you are doomed to function in primitive ways as an adult. Not good.

In short, our dysfunctional behavior continue, in new settings, because something very old and (probably) familiar also continues: our anxiety and our inability to manage it better.

IS THERE A SOLUTION TO THIS PROBLEM? YES…FOR ADULTS (AND WELL-SUPPORTED CHILDREN!)

So…how are we to get out of this trap? How is NEW learning to be accomplished? This is a separate question altogether, and to understand the problem and its solutions we will need to look a bit at the mechanism of such learning. The good news that a knowledge of how the brain naturally works will lead us to solutions we would not have expected. They will be adult solutions, however, not child solutions. Understanding, patience, a degree of diligence, and a decent capacity for positive self-support will be needed. That’s not really a problem. Adults can do this thing, and the outcome will definitely be more pleasing than that of people-pleasing over-promising.

(to be continued)

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INTIMATE CONNECTIONS MAKE US

“She doesn’t understand me!”

“Nothing I say seems to get through!”

“He seems to be in his own world. He never really hears me…”

I seem to be hearing this from a number of people I work with, lately. I’ve heard it for years, actually, and I think there’s more going on with these complaints than is immediately apparent.

We all want to be understood, most particularly about matters which seriously concern us. For some people, it seems to be an especially critical issue. Why is this? The reasons usually aren’t obvious, but I think I know what’s going on in many cases.

Who we are, to ourselves – how we “see” ourselves – is intimately related to how others see us. First of all, we’re inherently social animals. Our brain finds other people just about the most intensely stimulating, meaningful, and valuable source of meaning available anywhere. This is true for many animals, but quite possible for none more than for us.

Our connection to other people goes far beyond this, however. Other people literally make us. Without our ever realizing it at the time, they tell us who we are in our earliest years of development – a time when we are intensely vulnerable, impressionable, and hungry to have a sense of ourselves that can be relied upon. From our primary caregivers, as we grow up, we learn behavior, language, how to dress, what to eat – all the details of being human. But more than this, we learn about ourselves: Are we worth listening to? Is what we want of any importance? Do our thoughts, our feelings, our actions have value to those who mean so very much to us?

These are absolutely vital, absolutely unavoidable questions. And they do get answers. Sadly, the answers too often are not good ones – not accurate, not useful, not even tolerable. Without our having any real say in the matter, we can too easily get inaccurate, damaging answers to these questions, when we are very young. This can cripple us for a very long time – perhaps forever.

Recently, in developmental psychology, there has been a growing interest in “the social construction of the sense of self”. It’s not a new idea, but recent research on what happens when a baby and its main parent don’t get along has shed new light on the matter. The topic has become particularly important in psychotherapy, for as we’ve better understood how critical is the relation between very young children and their parents we’ve also come to better understand some of the disorders we treat in adults.

THE CONSEQUENCES OF NOT BEING UNDERSTOOD

What has this to do with someone’s having a sense of urgency about being understood? Well, consider what happens when we are NOT understood when expressing something important to us. When we were small, if we said “Mommy, I’m tired. I want to go home,” or “I don’t want to eat that!”, did we discover that we were understood when expressing ourselves? Did we feel respected?

As a small child, when we don’t feel understood, we tend to feel isolated. We may also feel devalued. In a worst case, we may feel intensely threatened. It is as if we are calling for help, and no one seems to be hearing the call.

This is precisely what has happened to anyone who’s had to endure parents who are unaware, insensitive, resistant, or absent, for sustained periods of her/his childhood. What they come to know is something no child should have to learn: they can be overlooked, ignored, and inappropriately left to their own resources. This feels bad because it is bad.

Certainly it is a simple fact that every child wants to grow up, to “do it myself”, in the immortal words of every feisty two year old. Yet at the same time, much of life is beyond their ability to manage, for years, and THAT part of life is the responsibility of their caregivers. What we cannot do for ourselves must be understood by our caregivers, and responded to.

Perhaps we can express ourselves about the matter, and sometimes we won’t be able to. In both cases, a caregiver needs to “get it” and to respond adequately to the need at hand, if a child is to grow up feeling like their universe is a good place for them.

SOLITUDE CAN TRAUMATIZE

We start our lives in relationship – literally bound to our mothers. After birth, we continue to be bound, in a link of utter dependence, which slowly diminishes, over the years. If, while we are young (say, in the first 5 years of life) a mother or other primary caregiver is too depressed, or angry, or distracted, or drunk, or distant in any other way, to respond to our distress calls, what happens?

We become frightened, and even terrified. Children in such a situation have lost their moorings, and they simply cannot cope. Left too long in this condition, or allowed to experience this too often, a child is at real risk for becoming traumatized. Many of my clients have had this experience. It’s effect on them has been bad – often profoundly bad.

Now, let’s return to the need to be understood. People who’ve experienced inappropriate parenting (and this term encompasses both neglect and abuse) know just how bad it can get when one is not understood. Everyone’s life experience is to a real degree unique, but the terror of being invisible to parents who SHOULD be seeing you and responding to you, is the same: it’s awful, traumatizing, life-changing, and unforgettable. Its effects can often be healed, with competent psychotherapy, but the learned sense of urgency about being understood may well remain in some form, for a long time.

BREAKING FREE FROM THE CONSEQUENCES OF NOT BEING UNDERSTOOD

What works is for an adult to come to understand that their vulnerability, should they NOT be understood in their present adult life, is not the vulnerability they endured in childhood. Their childhood really IS over. If they’re still responding out of a sense of BEING that neglected child, they cannot achieve this understanding. If their memory of their hurtful childhood is still capable of emotionally disturbing them – which will be seen should any current event “trigger” that memory – they WILL respond as if they were still that neglected child. They will be overtly dysfunctional, and they won’t have any choice about it – not at the time it’s happening.

However, when their memories are permanently quieted down (both recallable memory and that other kind – the memories we all have which can be triggered but not willfully recalled), they are free to experience their present safety and the full range of options of their adult existence. Such a “quieting down” is the goal and outcome of good psychotherapy.

Adults who have experienced this may still have to spend a little time training themselves, however. Once a child learns not to fall down when walking, they still have to learn to run. Once an adult no longer feels at times like a wounded little child, they still have to learn how to act and feel like a competent adult, in the context of communication which is not being heard (much less understood).

WHAT ADULT COMPETENCE IN EXPRESSIVE COMMUNICATION LOOKS LIKE

Competent adults give priority to expressing their own truths accurately and plainly, and THEN to being understood in their expression. Having made a reasonable effort to do this (and what is “reasonable” often has to be learned), they stop. Their work is over. Understanding takes two people, and at this point the other person’s work begins. The “other person” needs to be left to do it. The speaker doesn’t control the listener, and doesn’t need to, in fact.

If we were not understood in childhood it is usually because of the incompetence of our parents – and this incompetence is admittedly often accidental. Parents are people, and they have very real limits in their abilities, like all of us. Not all parents “show up” ready to function as competent parents. People with active drug/alcohol abuse issues, people with active mental illness (including depression, and unresolved childhood trauma issues of their own), are quite likely not to be able to achieve parental competence. They won’t adequately understand their child because they cannot or do not want to. The only option the child has in this situation is to keep trying to be understood. THAT is where they will likely learn to be obsessed with being understood, an obsession which they can very easily carry into their adult lives..

As a competent adult in an adult world, we will sometimes not be understood. It’s unavoidable. If one has made a reasonable effort to express oneself – to speak one’s truth in accessible language, then a failure to be understood is likely to be due to inability on the part of the listener: they cannot or do not want to understand.

So, if you’re having a problem being understood, take time to understand why. It may well have nothing to do with you at all, just as it may well have had nothing to do with you in childhood, if you had this problem then. Acquiring and maintaining an appropriate sense of personal accountability and responsibility (not the same thing at all) is a good part of being a competent adult. It’s worth working on until you get it more or less right. The secret is to do what is yours to do as well as you can, and to let others do the rest. Most of the time this will work. It can be trusted. It’s good to know this.

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