Last month I discussed the dilemma of a psychologically wounded person who feels torn between a yearning to get his deepest needs met – a need for connection, safety and love – and a terror that those needs will be rejected (subtly or otherwise), leading to a traumatic abandonment, or re-abandonment in most cases. This creates dueling goals: to be loved and to maintain connection through inevitable “bumps” on the relational road, which in the person’s life has proven impossible. Thus the faith that lasting relational intimacy can be found is slim to none, assuming it exists at all.
Those clients of mine who fit this description tend to struggle with addiction – chemical dependence and sex addiction being my two main areas of treatment. Those struggling with compulsive sexual behaviors often seem even more paralyzed and frightened by the conflict described herein.
One reason the compulsive behaviors are so hard to give up, I am beginning to suspect, is that they protect the person from the despair of loneliness (an insatiable yearning to connect), and from the terror of abandonment, a lack of faith that they will ever find a truly loving and consistent connection. The underlying pains of the past and dread of the future are “medicated” by temporary soothing via compulsive behaviors. The underlying problem remains unaddressed, until change is sought, however quiet or “small” that desire for change may be. It is a sign of hope, to be sure, however minor it appears at the time.
Many of these suffering souls have heard love described, and they long for and dream about it, but at the end of the day they don’t believe it can exist for them, since they’ve never experienced it and have in fact been denied it by negligent or traumatizing caretakers, which in turn has created a soulful apprehension of finding it while thirsting for it beyond measure. For many, early caretakers had their own terror and “baggage” that made them frightened or unwilling to hear their child’s truth; so the child learned to cover up and to be ashamed of some her innermost relational yearnings. She was “taught” by her environment that these yearnings were, in fact, “too much” for others, and that to expose them meant facing the unspeakable risk of abandonment – actual abandonment, in this case, with a terror of repetition in later life.
I therefore agree with those who say that, for some deeply wounded people, any relationship (even an unhappy one) is better than none. It’s not that such a person does not know they are in a “bad” relationship: it’s that their deepest yearnings remain out of awareness, too risky to expose. We may only be eating cheap fast food, but it’s better than starving. To quote Nietzche, “We would rather have the void for a purpose than be void of purpose.” The latter option represents a black hole too terrible to contemplate. (Such fears override logic easily.)
Many of these core and primitive feelings aren’t even conscious; their very unknown-ness creates even more anxiety and self-doubt in the person, since they feel “too dumb to figure it out” on their own. But ‘on their own’ is the only mode of existence they’ve ever known. They can’t even imagine any other way. Even within an actual relationship, the conviction remains that little to nothing can truly be expected from another. When the shoe drops (yet again), and their partner ignores, disappears (literally or emotionally) or lashes out at them, the feeling is something like “I knew this would happen; I’m basically on my own no matter what”.
As a result, many of them come to my office wondering if I can really help. I am an experienced therapist but, as I like to say, therapists are people too: part of the human muddle, no matter how capable or competent we appear. I can reassure them up and down that if they stick to therapy, it most likely will help; I can provide a road map for treatment, cite past successes, explain the psychology and brain chemistry of addiction, normalize their fears and terror, explain my own extensive background in treating addiction, how many clients really do get healthier and happier, talk ‘til I’m blue in the face and the cows come home (and other clichés).
But why should they trust me? Especially if they’ve tried their whole life, like Charlie Brown, to kick the football, only to land flat on their back time and time again, bruised and humiliated? I can swear I’m not Lucy, but how can they know for sure…? On one level I’m a professional; on another, I’m just some schmuck in slacks and a nice shirt. In many cases they have experienced disappointment and heartbreak with other therapists, leaving them even more doubtful.
One might say, “Well maybe they never took the therapist’s advice or suggestions”. Yes, but the person would acknowledge that, although recognizing this does not help and, in fact, only fuels their self-loathing, and the idea that others fail them and they fail themselves.
We humans tend not to follow suggestions if the relationship is not secure. And that’s assuming therapy is even about suggestions, a whole other debate entirely.
What is a therapist to do?
What I try to do, initially, is to encourage them to talk about where they are now, and how they feel about coming to see me, especially any doubtful, frightened feelings they may have. It often helps to get that out there, difficult as it is to say. I also encourage honesty about previous therapies, or (in the case of addiction) treatment programs – the good, bad and ugly. Most people new to therapy tend to see “blame” in black and white terms. Either they were a “bad client,” or their previous therapist or counselor missed something crucial and “screwed up.”
People with sexual compulsion issues tend mostly to blame themselves.
Those with low self-esteem struggle with self-loathing and fear of others. Beneath that fear lies the ever-present terror of abandonment. Very often a person new to therapy will say their last therapy failed because it’s their fault. Their marriage is on the rocks because they, essentially, suck. This will vary with anger towards others for failing them.
My only initial “agenda” is to get to know the person, establish safety and trust, and make it ok for them to have the problem in the first place, and explore the possibility that part of the challenge might involve the very understandable difficulty of placing their trust in me and hope in therapy. I assume that a person’s trust must be earned, not freely given. It would be cruel of me to expect otherwise.
How painful it is for an otherwise accomplished, high-functioning person – and most people with compulsive behaviors are surprisingly intelligent and successful – to come and admit to another human being that they cannot solve this vexing problem or control their behavior. So many times I hear the phrase, “I can’t imagine what you must think of me, I sound so pathetic.” Often they look like kids who have been summoned to the principal’s office.
Clearly there’s a lot for us to explore together, if the person is willing. And anyone who is willing to even begin this process gets huge “props” in my book, just for walking in the door.
Additionally, when we are talking about addiction, especially in the area of sexuality, shame is always a factor: the shame of having the problem, a sexual problem, the problem of not being able to solve the problem, or share with others about it, of not being able to connect in a satisfying way with others in general. To say nothing of the guilt they feel for failing others, and themselves.
People with sexual compulsion issues tend to see themselves as the sole cause of a failure to connect: not as a person struggling with an all-too-human dilemma, but a vermin crawling on a dungheap. To say self-esteem is low is an understatement (to put it mildly).
Strangely, accepting where we are – with an “airing” of the guilt and shame that bind us, to paraphrase John Bradshaw – makes it possible to begin inching forward, and to start where we are. And where we are is the beginning of a process in which it is hard to trust the therapist, for very understandable, human reasons. My inquiry is an empathic exploration of that very difficulty, in the hope of cultivating the possibility of trust – and the willingness to work through any disappointments or misunderstandings that may arise between us, and they will arise because each of us is, after all, human. (Though hopefully they will not arise too often!)
To quote Irvin Yalom, “It’s the relationship that heals”. (It was a relationship, after all, which wounded.)
I try to create the idea that we will rise or fall together. I am part of the equation and assume mutual responsibility for what happens in that room.
I’ll talk more next time about some of the challenges of this early process, and how I’ve found solution in collaboration with the people I’m lucky to have treated. In the meantime, happy holidays to all, and thanks so much for taking the time to read the column. Your feedback is always welcome.
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