Pocket principles: Self-esteem

 

Self-esteem can be defined simplistically as “feeling ok about oneself without having to prove anything to oneself or to anyone else.” Or more vaguely and reconditely as Alice Miller did: being comfortable with, accepting of all of one’s feelings. It can’t be defined as Nathaniel Branden, “the father of the self-esteem movement,” defined it: a sense of personal efficacy – feeling competent in the world. That can’t work, because feeling competent assumes being competent (otherwise the person is delusional), and competency suggests activity extrinsic to the self. Children who are loved, valued, accepted for who they are by their parents will have self-esteem. They will feel ok in their own skin, “in their bones,” will in a way feel complete, “arrived.” They’ll be comfortable in social settings, won’t be intimidated by – or feel less than – bullies or powerful adults. They may experience fear in dangerous situations, but they won’t have anxiety: Anxiety comes when a child can’t unload his fear and confusion to a caring parent and becomes a repository of pent-up apprehension, like breathing in and not being allowed to breathe out.

The bad – or deterministic – news is that if the child isn’t given, or can’t receive, the gifts of love and respect and full acceptance in her early formative years, she won’t develop self-esteem and will never have it. This is her fate because the suppression and repression of feelings is the loss of self. With no self, there can be no self-esteem. She then must grow, as time passes, a non-self that is an adaptive persona. The only way to prevent this de-evolution would be to immediately, seconds or minutes or maybe a day after the emotional shutting in and shutting down, open up to someone and let the pain flow out. Once time passes, and the persona becomes the person, the real feeling self must remain buried. In his teens he will say: “I don’t know what I want to do after high school; and thirty years later, “I don’t know who I am.”

My sixty-three-year-old client feels “melancholy” because after her retirement she no longer identifies herself as a productive, contributing member of society. It is not enough, she feels, to be just herself, a person who enjoys her life. Good things – her garden, her grandchildren, an old friend – will be pleasurable for a few moments, but they cannot overcome the empty feeling of a self lost sixty years earlier. I want her to feel it’s all right to live, to be a "human being not a human doing," but that would require having compassion for herself, and that would require knowing what she’s feeling compassion for: the hurt, buried child. Few people would want to regress to that depth, return to the beginning of their life and grieve the worst grief possible.

Of course, human beings want to feel good about themselves and unconsciously run away from this critical loss. So they define self-esteem in shallow and magical ways. I can positive- and rational-think my way to feeling good. I can “follow my bliss.” I can accomplish good works. I can love myself and help others. None of these manipulations will touch the core wound.

I suspect that real self-esteem may be so rare that humanity will always need second-tier definitions of it. It's not a real self that has conjured them.

Make my day

There is a very unpleasant but solidly, comprehensively reasoned op-ed in today's New York Times that advises dropping all prosecution against Donald Trump and "allowing the political process to run its course." This could enable, we know, the greater chance that Trump will be president again. Here is the piece:  https://www.nytimes.com/2022/08/21/opinion/trump-fbi-republicans.html. I believe that only those of us whose extremely strong feelings (which we call principles and moral outrage) willfully blind us to reality will dismiss the sorry validity of Linker's argument. I am one of those willfully blind individuals who would prefer crash-and-burn and civil war to letting that sociopath run free again.

But is there any other way that wouldn't lead to war or prove that evil holds all the cards – and the asylum keys – and will hold them forevermore?

This question, not easy to answer, leads to some free association. (Freud's seminal technique requires all verbal diapers off.) The problem comes down to our sick Republican population that admires a sociopath because of its sickness. These millions control their party's politicians, people who seek power in low places. See what we are up against. Normally, the "man in the street," if asked, would say there is something slimy, probably evil, about a person who loves Hitler, Bonnie and Clyde, Bernie Madoff. And yet that same man, and his family, and his community, and his state, will smile upon Trump, the diagnosable sociopath (Antisocial Personality Disorder) and narcissist. These individuals are therapy patients without a couch, and they will never lie down because they have the most soothing and masturbatory defense mechanism in creation: rage sanctioned by their fellow partisans and leaders. They will never want or need to look beneath their rage to the hurt and pain that fuel it. It's their child, their childhood that has always been hurting, and they will never want to collapse to its tears.

The irony is that failing to go to the child leaves it in the seat of power.

Can we reach them? I've seen many men in anger resolution therapy (what "anger management" counseling should be). It's valid to say that since they have come to my office voluntarily, they are not those self-justifying narcissists and psychopaths whom therapy will probably not help. My clients know they have a problem with anger, that the cause is not essentially their wife, their boss, their genes, the universe, or the Democratic Party. They are willing to feel. I have yet to treat a man for anger who did not cry about the brutality of his father or about the barrenness of a life "grown up too fast."

Can we get these millions to understand themselves? No. There is no couch wide enough, no microphone loud enough to turn their attention – inward. If there's to be hope, it will be that the internal weather changes in them. Their scar tissue feels too hard. Their boiling subsides. And their heart wants to come out after a long storm.

Until then, I will hope that Merrick Garland drives a mountain-sized steamroller over their sorry asses.

Debunkeries #1: You are not protecting them

There have always been, there will always be, adult clients who prohibit themselves from indicting their parents, from naming the abuses done to them in their childhood. After "fear," the main reason given is that this would devastate their parents. It would crush them, they would be mortally injured, their heart would collapse and die.

I want to disabuse these clients of their excuse, their delusion. Your parents could not care about your feelings then, and they cannot care about or be wounded by them now. Their response to your truth will be anger, self-pity, contempt and mockery, minimization, projection or denial. None of these reactions will kill or even hurt them. But they might kill you. Your real reason for refusing to name your pain and injustice is that somewhere inside you, you maintain hope for the love that never came, the being seen by them that never happened, and you fear that being yourself, being real, will destroy that possibility. But to continue to hope is to still be the child. To be an adult, you must become hopeless that they will know and love you, even with the possibility that they may someday find an epiphany of healing, of transfiguration.

I know that being the child in that sweet and melancholy dream feels better than leaving your internal home forever. But you have always been homeless.

Borderline part 3: Justice vs. truth

 

“Betsy,” mid-30’s, with diagnosed and acknowledged borderline personality disorder, named a “principle” of justice that she adheres to. She was in angry contention with her boyfriend, “Frank”: He did not accept the principle. By use of that term, Betsy wasn’t meaning the colloquial “it’s the principle of the thing,” the quietly indignant expression of a personal feeling casually assumed to be a consensus standard of morality or behavior. She was certain that she was citing a law of human nature. The test case, here, concerned the parking space that was assigned to her apartment. An elderly neighbor had been parking his car in that space. In his disability, it was a real convenience for him. The interesting matter was that neither Betsy nor Frank owned a vehicle and did not anticipate acquiring one into the near or even distant future. Nor did they have guests who might avail themselves of the space. Betsy’s position was as adamant as intelligence and fury fused could make it: It was her parking space. She demanded that Frank confront the neighbor and order him to remove his vehicle and keep it the hell out of their rightful slot. Frank couldn’t see the point in doing that. As with any number of similar situations where Betsy found injustice in mundane places, she made this threat: Do it in your own way or I will do it with guns blazing. I believe he complied.

Over several months of weekly sessions, I had listened to Betsy’s accounts of people’s incompetence and bad character. And I will admit, the logic she conjured and the evidence she cited were consistently cogent to me. Nurses who couldn’t find a vein. Botched surgeries. Doctors’ failure to successfully petition insurance companies for alternative treatments. A landlord who screwed her over. Friends who betrayed her. Though she had been fired from several medical offices in recent years, the reason always seemed to be that she had discerned real malpractice and had gone doggedly (if not rabidly) after it.

One session, by chance or ripening insight, the scales fell from my eyes and a right idea occurred to me: “Betsy, it is not a ‘principle’ that the parking space is yours. It’s your personal ‘principle’ that has no objective correspondence in reality. It is your feeling of injustice, a feeling deeply embedded in your life, in your extremely unfair childhood. You see the world through the lens of this pain. Other people have not had your life or your bent.” She agreed, at least for a moment, and in that window I suggested that she take this fact to her couple’s therapy, where it would help her see her boyfriend as a separate person with his own valid perspective on life. Without this insight in hand, she and he would continue to fight viciously. She would never respect his personhood. She would never have a borderline personality weathered by reality.

Nincompoops, Borderline, Part 2

I once explained to a 43-year-old client that he is still a little boy, has never ascended to the adult plateau. One might think this would be insulting to him. But my explanation was so discreet and strategically euphemistic, hovering, like an angel, above bullshit by a hair's breadth, that he accepted it with equanimity. (Mildly confused equanimity.) My client was the embodiment of what I would call Radical Borderline Personality: the rudiment of all personality disorder, the person whose Inner Child has remained so prepotent over time that the adult costume is powerless to contain it, to teach it adult falsehoods.

He panicked to go to work and be around the other workers. So he took several months' leave, abandoning his wife to carry two jobs plus management of the household. This barely fazed him. Much more important – he told her – were his needs for understanding, support, hugs and love.

When the therapist meets someone this pure, he discovers that the person genuinely can't understand his error, can't grasp the validity of maturity until the therapist attacks with assiduous directness, depth psychology, and inescapable logic. That is what I did, though as said, this was clothed in gracious language.

I don't know how many clients remain too much the child. It's possible that all of them do, even the high-altitude sophisticates. I mean this. Therapy speaks, then, to a fundamental sabotage: The adult's defensive persona must be strong enough to return to childhood pain and failure without drowning in it, without becoming it. But that means that the false self must ultimately predominate.

And yet there is this diametrical contradiction to futility: It is necessary to express our losses, to grieve. It is good to cry. It is helpful to rage, as long as the rage crashes through to its founding grief. It is human nature to need to give our pain to someone and to be held.

So which is it? Is psychological healing deceptive and illusory or real? Is therapy curative, palliative, or a fantasy? Can we, should we, approach the speed of light, but never reach it?

The nincompoops want to eliminate Borderline?

It seems that the existence of the Borderline Personality is being questioned.* Let me clear it up for all the PhDs out there. Borderline is dissimilar to the other personality disorders where there is a primary identifying quality and its ego-syntonic attitude. A Narcissist has perfection. A Dependent won't make decisions, requires the symbiotic feeling. Antisocial personalities have no conscience. A Histrionic person is shallow and dramatic and must be the center of a crowd. A Schizoid is detached. Each of these disorders can be revealed to have an attitude that is in harmony with the identifying feature. A Dependent is fine to be that way and may not even understand independence, may feel torturously uncomfortable with thoughts of separation, initiative and autonomy. A Narcissist finds the notion that he may be imperfect ridiculous, angering, unthinkable. A Schizoid is overwhelmingly complacent in his detachment. All these personalities have an endorsed tangible dysfunction.

Borderlines are thought to embody the stigmas of bitchiness, manipulation, of being emotional projectile bleeders. But many are not this way. They may not have a conspicuous brand. They may be assiduous (my first wife, Borderline, was a high school science teacher for many years) or infantile (unable to keep any job for more than a few days or weeks). They may brandish their primitiveness like a sword or badge of honor, or they may be sophisticated and cerebral. They may be suicidal and self-injurious or safe. They may be desperate for a relationship, or not. What makes these divergent presentations all Borderline? What is their underlying unity? A separation-individuation-stage developmental immaturity and its resultant out-of-sync-ness with the world of its time. It's the abort of psychological growth beyond infancy. This is a lost child in an adolescent's or adult's body. To be an adolescent or adult having to manage the world from an infant's inchoateness, confusion, emotionality is to be sane while insane, disintegrative but perforce held-together, a helium balloon of "thought" pulled under by an ocean of sharks.

Borderline Personality is not in the same trait category as the other personality disorders because it is the fundamental flaw at the base of all of them. The other personalities start from Borderline's failure to pass the starting gate in infancy. They all will reveal, in therapy, an essential immaturity, a "man-baby," a radical dependency on someone. The psychopath is completely dependent on victims, the narcissist on human ego supplies, the histrionic on an audience. "The creative work of these apparently detached individuals" – Schizoids – "may perhaps provide a round-about way of finding some form of social attachment."** Borderline is the skeletal structure of wrongness – the first mother-child breach – that will in time require global defenses, the pervasive, inflexible take on self and world, to maintain continuity in its second-by-second, day-to-day existence. As the other disorders will show this primordial "failure to launch," so Borderline will contain features of narcissism, alienation, dependency, sociopathy, eccentricity.

Sometimes I have diagnosed Borderline but have not recorded it in the client's chart. She might not meet official criteria, but there will be a fundamental incongruity, the prepotent impotent child competing with the adult, an immaturity that she is blind to. She will be smaller than her children, alienated from and rageful at them. She will speak and be triggered by her own words to tears because she is primarily pain. The therapist will have a feeling that says: She is not really here. She is in the past.

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* https://www.psychologytoday.com/us/blog/fulfillment-any-age/202207/is-it-finally-time-eliminate-the-borderline-diagnosis

** https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5840255/

A question to Republicans: Why so damned anal?

"In promoting depth therapy to clients, I explain how our ideas, beliefs, convictions may be guided by analytical thinking, but that analytical thinking is bent by the gravity of feelings planted deep in their history. I have them imagine two men age 50, both the epitome of physical health, both from the East Coast, both 200 IQ polymaths with doctorates in arts and sciences, having lived among the rich and the poor, oppressed and elite, both worldly in travel, reading, experience. One is a Democrat and the other a Republican. Is it rigorous thinking that has made them different? No: They are both eminently capable. It's the psyche, the way that early, formative emotional pain has been caused and treated by their caregivers that determines what ideology eventually forms in their brains. Pain is expressed and mitigated, or it is internalized to become the lens through which the person sees self, others, the world. These Republicans are the cornered rat; they are the lion with a thorn in its paw that no one ever caringly pulled out. Their passions are failure-based. One would sooner heal them by the arcanum of Freud or 'primal scream' therapy than see them change on their own." (Comment to a NYTimes op-ed – https://nyti.ms/3BdmzKY#permid=119465067)

This was a "for popular consumption" comment, lacking in some essential detail. * For childhood pain and injury to be "mitigated," it must be expressed holistically (words, feelings and gestures in sync) and held by someone else at the same time. This is historical pain that still lives in the child who still lives in the adult, and children need a savior, a believer, a parent. * When pain is "internalized," it becomes a lens not immediately but through time, the time of caregivers' neglect when scar tissue grows over it to protect the child. The scar tissue is the double-sided lens that warps feeling and perception.

David Calof, in his published interview, "Multiple Personality and Dissociation," noted that the so-called "inner child" is not the cute tyke described by John Bradshaw and other writers of the time. It may be full of rage. A worthy question is: What makes one lion with an impaled paw rageful, destructive and delusional, a different one hurt, wise and amenable to help? Why have so many Republicans, forcibly adult owing to their age, opted for anger after their childhood injury? Why do they clench their body, their throat, their fists as a form of self-protective power rather than exhale, release the tension, collapse in the truth of their hurt? Almost anyone (barring birth psychopathology) would be capable of this. I know it's not necessary to become hardened. In my late teens, I was that angry Libertarian with contempt for many, fear of the rest, alienated, ego-syntonically insular (the "self-made man"). I could find my buried, burning self. I could cry. I could read good psychology. Why can't they?

Why, even with the gift of therapy, even with a loving spouse, can they not finally lean on someone, relent to the deeper person within them?

The terse and the pithy: Cheating and careers

How is cheating on one's spouse similar to career dissatisfaction? While either affliction may have a number of causes, there is often a single phenomenon underlying both. It's the principle that explains, for many people, the problems of love and meaning.

We may love our husband or wife and still feel some inexplicable (-seeming) discontent. The men will look at every attractive woman who walks by, hoping their wives won't notice and think ill of them. One could say they are innocent because they don't mean to be this way: It is an urge the denial of which would feel like lifelong incarceration, like soul death. Similarly, we may be proud of our work – lawyer, architect, salesman, whatever – while feeling "this is not me. This feels like an act, a giving-up, a missing of something that is the real me."

Love is a feeling and meaning in life is a feeling. But our feelings are rooted in our childhood, where the chemistry of starved needs may infect them in their root structure. If early on we are starved of nutrients, we will grow up compromised: Our brain, our vitality will never be what they should have been. It is no different to be raised with conditional love or no love. We will always be needing something. We will always lack those chemicals of mother-love, unconditional love. And we will not know who we are, what our "meaning" is, because pain has blocked our natural self from participating in the world.

It's simple. We have been stunted in our formation. We remain the "inner child." The fact that this is unpleasant and "deterministic" doesn't make it less true. So much of psychology and psychotherapy is based on the wish (or delusion) that our mind, the master, floats free, above our history. It is the immovable mover and the god of ourselves. This is the magical thinking of the child within us.

The end of therapy

Books and articles on psychotherapy make a big deal of termination of therapy. The clinician should make a big deal of it. Clients need time to wrap their mind around ending this deep relationship, need time to review their gains, need time to gradually be set free to handle their life without the safety net of this drastic and intimate bond. Client and therapist talk about this process as it is happening over weeks and months, gradually weaning away to a poignant farewell.

Not in my world. I can say with certainty that most of my clients change in thought, insight and feeling, and therefore movement, as a result of our work. The great majority of them express appreciation. But there are very few terminations. Most of them fade away, stop coming in, no notice given, even those whose therapy casualized to friend and confidante over the course of a year or two. Just disappear. There is no reason for me to suspect that I am wrong about their benefits gained or their appreciation. But I know my work doesn't lead to happy positivity: more like sober or grave or blunt positivity. Clients may come to see they need to be hopeless about having loving parents. They may come to see that meaning in life happens in childhood – it is a healthy child's natural stimulation in the world – and that they will have to settle for different kinds of meaning. Evaporating their anger at their wives may come from finding and grieving their child-self and deploring or abhorring their father who shamed them. They may teeter on the edge – scissors trembling in their hand – of cutting the umbilical cord to a solipsistic miserable parent. That would leave them feeling, partly, homeless and selfless: a difficult state to consider "success" in therapy.

I can imagine that at a certain point, clients feel alone and go off on their own. That would be a paradox, as I'd tend to feel closer to them as time went on. They didn't have the positive-feeling bond with me because I helped them be their solo selves in a darker psychological world, not hoist themselves onto a platform of false feel-good, holding my hand, my glad-handed encouragements. That would leave them precarious, especially with a Cognitive therapy that produced a speciously warm relationship of thinker to thinker, not goad to feeling.

I'm sure, though, that some of them will be discomfited, those who want to live in their head while I've pointed them to the body, to the muck of their history. They will fade out, too.