Intervention tidbit #5: Insights as light, rain and shadow

People change when they feel different.  Deep loss can change a person, and deep feeling-through of that loss (The Prince of Tides – Tom Wingo weeping on Dr. Lowenstein’s shoulder) can change him back.  In depth therapy, we want blocked pain – yesterday’s or forty years buried – to finally come out, giving the person back to herself (at least to that depth of pain).

Neurotic* folk can sometimes change through reason and knowledge, but not because they have “installed”** new information, or even because it is valid and true.  For the neurotic, reasoning is co-opted by the defense structure and becomes rationalizing; knowing is undermined by deeper truths.  “Obviously my childhood was terrifying, but those days are gone and I’m in charge of my life now,” says the woman who must quit her job and find a new one because she is too anxious to drive on the Interstate.  Tell a healthy and non-defended mother that banishing a child to his room to cry alone is harmful to him, and she’s likely to say, “Yes, I can see that.  Those tears need someone there to care.”  Knowledge touches feeling, feeling changes behavior.  However, tell a congenitally tense chain-smoker that cigarettes can kill, and he might say, “Yes, I know that.  But there’s a (deeper) need.”

Today’s casual theory is that only when a piece of knowledge strikes beneath our critical defenses and touches the Self primarily, beneath the needed parent bond, can it spark emotion that changes us.

I saw this in my work with a recovering anorexic graduate student, where three insights were proposed in one session.  One touched the nerve and the heart almost instantaneously; the second toyed with being absorbed; the third struck nervous and closed eyes and was rejected.

We were looking at ways to break the identity barrier that forbade her from gaining an ounce beyond her slim victory of ninety-eight pounds.  Earlier we had discarded the drastic process of “nurturant-authoritative psychotherapy,”*** which is the reparenting – the leaning on – an anorexic needs.  The first insight:

The “mistakes” you made as a child – assumed from your parents’ words or looks – were not mistakes.  Children do not make mistakes: They have learning experiences.

I had asked my client to see this as an axiom, and one that should re-color her entire sense of herself.  “I was OK.  I just needed to see myself differently, be seen differently.  And even now, I’m just trying, and learning – not defective, not a “mistake.”  I knew such a caput Nili was possible from my work with a depressed man whose boyhood spirit was bent to his parents’ perfection-demanding glare:

. . . client’s lifelong sense . . . that his life is based on seminal ‘mistakes’ he has made through the years.  Attempting to engage in depth Focusing, he could only reach – “I’m disappointed in myself,” not a deeper underlying feeling of being a hurt child.  This led to our re-conceptualizing ‘mistake’ as ‘learning experience,’ or simply the natural behaviors of children that should not be adjudged defects, signs of low intelligence, or moral flaws.

The second insight was the hidden treasure of “trusting oneself.”  We referred to Levenkron’s observation: “If you have developed anorexia nervosa, however, you probably don’t think much of my suggestions or feel optimistic about finding people whom you will be able to depend upon emotionally.  Anorexia nervosa could well be called the ‘mistrusters’ disease.’”****  An anorexic, whose starving is the despairing-defiant identity creation of a formerly “cooperative” and “compliant” empty child, cannot trust herself: There is no seat of ego within that void from which to weather the storms of her needs and impulses.  And yet, something in her now, maybe through therapy’s help or personal successes, is reason to trust that she will not overeat to disaster, will not lose all control.  My client clearly appreciated, though in bemused optimism, this idea.  I could tell that she was like a plant wondering if it should respond to the warm rain.

The third insight was a contradiction, a saboteur: the absence of her parents’ discipline, their laissez faire negligence, which must translate to feeling unloved.  There would be no way to avoid this unconscious knowledge, and therefore no way to avoid the need for medicative nurturance: food as love.  So her self-trust would always battle the rip current of love – real calories turned empty, ten thousand zeroes that could never equal her hunger.

My client could accept the first insight, that she was a good child not a defective one, because its light shone mostly on herself and touched her birthright of self-acceptance and goodness.  But that light also cast a shadow on her parents: They had allowed her to feel, as she grew to adulthood, like a wrong person.  We left the session and I wondered: Will she be wondering – How do you blend the light and the shadow?

 

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* See blog posts http://pessimisticshrink.blogspot.com/2015/02/real-self-written-at-noisy-whole-foods.html and http://pessimisticshrink.blogspot.com/2014/09/in-house-3-youthfulness-and-personality.html for quick definitions of the term neurosis.

** EMDR terminology.  From http://www.newtherapist.com/8stages9.html, #5: “Cognitive installation of the positive self-statement – The client is instructed to pair the previously identified or an alternative positive self-statement with the original traumatic image at the same time as further bilateral stimulation takes place.  The efficacy of this phase is measured by the client’s self-reported VOC.  An attempt is made to increase the VOC to a score of 6 or 7.”

*** Steven Levenkron’s term for his reparenting psychotherapy.

**** Levenkron, Treating and Overcoming Anorexia Nervosa, Warner Books, 1982, p. xxiii.

Real self (written at a noisy Whole Foods Market café)

Some schools of psychology, systems of therapy, and clinicians deal in the “real self.” I don’t know close to the whole history, but I’ve seen the construct was a rich part of Karen Horney’s thinking one generation after Freud. My knowledge skips to Helene Deutsch with her “as-if personality,”* then leaps to Masterson’s theory of personality disorder and Janov’s primal therapy of neurosis, basically defined as the false self’s seeking symbolic satisfaction – and pain or tension discharge – of repressed unmet needs of childhood.

I see the false or unreal self as what a child becomes when his parents do not respect his feelings. A child represses and loses himself if his expressions fall into the abyss of parents’ deafness, or are contemned or prohibited, or if the inchoate Self is overwhelmed away in birth trauma or in René Spitz’s anaclitic depression.** What endures is a personality of defenses and self-soothing, and a primordial or toxic momentum.

Actually, I used to believe the Self could be slid away to oblivion and death this easily. But I may have to respect Masterson’s idea that there could be a part-genetic gift of the real self, as I know a former client whose soul should have been killed*** by his mother’s poison, yet it has emerged in a beautiful way a couple decades later.

I do not tell clients they are a false self (which would be quite evil and incompetent), but may suggest that they grew an adaptive persona in a rocky childhood terrain, and that in order to combat their depression or identity diffuseness they may need to search for their smoldering fire, their latent loves or likes. Looking at some adult’s lostness is to see a tangible and actionable thing, while to contemplate the underlying flaw – the unreal self – is to see more but touch nothing. It’s the idea of air.

Only just recently have I discovered another field of productivity in the work of the real self: the child’s and adolescent’s losing of it. A young man, sixteen, who came here because of his body image depression, said out of the blue that he becomes his friends’ or peers’ personality features when he is with them. He doesn’t have a self he is grounded in. Not in touch historically with his feelings – their push, their biological conviction – and therefore being a younger child that remains in intimidated awe of any person’s ego force, he conforms and becomes them.  And he hates it.

Thank goodness he does, because that hate is the one-dimensional watchman of his submerged real self that has stayed awake to save him. What he must do is look for the molecules deep below the cloudy surface, the molecules that say “no” or “yes,” “I want” or “I need this.” Holding on to these buried radical self-elements, he will not pretend to have an adolescent feeling his friends have, or to like a sport that they like. He will not find himself going with them where he doesn’t want to go. He will smile or frown against the current. He will be disinterring, and building, a Self.

Many of us believe we’ve seen a false self. Hillary Clinton comes off to many as a contrived personality, though Mitt Romney may have been caught more often adapting his convictions to the moment. Politicians, the lot of them, have been branded as narcissists whose altruism is a con. What matters for psychotherapy is where this problem comes from, and especially what we may do for a child slipping into the as-if world. Watch for the little boy conforming to his friends, and to you, parent. See if he is quieting in body and spirit, in a quiet and depressed home. Be aware that anxiety – a fearful home atmosphere – can drain the pool of an infant’s or child’s self-energy. Notice if he loses interest. This may, per the DSM bible, be a sign of depression. But a child’s depression is a sign of her identity flagging and folding, someday disappearing.

Nurturing and honoring the child’s real self is probably the most critical thing we can do.

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* Helene Deutsch’s “as if” personality -- http://en.wikipedia.org/wiki/Helene_Deutsch.

** René Spitz’s concept of anaclitic depression -- http://en.wikipedia.org/wiki/Hospitalism.

*** Shengold’s concept -- http://www.amazon.com/Soul-Murder-Effects-Childhood-Deprivation/dp/0449905497.