Self-Loathing AngerAbout 30 years ago during analytic training, my good friend Tom Grant was describing a difficult case in seminar — a man in his mid-30s whom Tom had already been treating for quite some time. Tom’s client came from a severely dysfunctional background that had restricted his ability to feel for and depend upon other people. He lived an emotionally isolated life; he was “schizoid,” to use the psychoanalytic term for it — “having a personality type characterized by emotional aloofness and solitary habits.” After years of analysis with this client, Tom had helped him to develop a strong liking for other people; Tom believed that a profound sort of love was likely beyond this client because he had been too damaged, but he could nonetheless sustain relationships and even get married. Tom said he had no problem accepting the limitations of what their work together could accomplishment.

At that time, I had a great deal of trouble with what he said. I was convinced that with enough time and hard work, we could help our clients to transcend their past, to become just as “normal” as anyone who had come from an intact, loving and healthy family. Looking back, I can see I had a highly idealized view of psychoanalysis, largely because I wanted to believe that my own lengthy analysis had made me “normal.” It took me many years to face and accept the ongoing nature of those emotional issues that had driven me into therapy at the age of 19, years to recognize the lasting effects of early damage. In my recent psychotherapy work, I’ve been focusing on similar idealized expectations held by my clients. Sometimes those expectations are conscious; often, they show up as self-loathing.

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Lying to Our Clients

During several recent sessions, one of my clients has been struggling to make an important decision in her life that’s causing her considerable anguish — whether or not to leave her husband. I don’t normally give advice in such cases, but based on my lengthy relationship with this client, I strongly believe that she ought to stay for the time being and have told her so. Her doubts about what to do have continued to resurface and I’ve repeated my point of view whenever I thought it appropriate and helpful.

Over the weekend, I received an email from this client; she acknowledged feeling somewhat “paranoid” and wanted to touch base with me about her thought process. Her intuition told her that, in truth, I thought she ought to leave her husband but felt it would be “unprofessional” for me to tell her so. She worried that her decision to stay was foolish, that she was closing her eyes to the depth of her husband’s emotional difficulties; she feared that by staying, she was setting herself up for even greater heartbreak down the line. She felt certain that I believed the same thing but couldn’t bring myself to tell her so.

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Diary of a Shame Attack

On Saturday, I made a short new video, making use of what I’d learned in media training. I felt very good about that video because I’d confronted some underlying shame and the related wish to remain invisible — that is, relying on a blank facial expression and little modulation in my voice in order to reveal as little as possible. I uploaded it to my YouTube channel and wrote a short post about it here on After Psychotherapy. Not long after the post went up, I received a supercilious, mean-spirited critique from one of my readers. Even after 2-1/2 years writing this blog, I still find it difficult to bear when site visitors say hurtful things to me. I have not developed a thick skin. In posting the video, stating explicitly that I felt good about it, I had made myself vulnerable; receiving that comment hurt. I felt humiliated.

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Accentuating the Positive

I haven’t heard it in a number of years, but every once in a while, a client will ask why we talk only about “what’s wrong” in therapy. It’s a valid question. Australian blogger Evan Hadkins, who frequently comments here on After Psychotherapy, has chided me for over-emphasizing the painful aspects of the work I do; the occasional site visitor will accuse me of “pathologizing” everything, rather than trying to view certain behaviors in a more positive or “normal” light. I’ve been thinking about the various reasons why I (and other therapists) don’t accentuate the positive in our work more than we do. What follows are a number of explanations, each of which contains an element of truth.

1. Unhappiness Feels More Meaningful

You might recall that Tolstoy’s Anna Karenina begins with a famous quotation: “Happy families are all alike; every unhappy family is unhappy in its own way.” In other words, novelists don’t write books about happy families because after you’ve described their experience one time, everything that comes after will be repetitive. The intricacies of misery are so much more interesting than satifaction, both in books and in therapy; happiness and contentment, after a time, become boring.

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