*** Now Available: Attachment to Your Therapist: A Conversation. This series of posts in expanded E-Book form, on Amazon.***
Two recent comments touched on strong emotions about the therapeutic relationship but on opposite sides of the same dilemma in psychotherapy. One person felt that she should become more attached to her therapist for her treatment to be effective, but was having trouble allowing that to happen due partly to shame. The other was horrified and ashamed to realize that she had become attached to her therapist. Other readers have expressed similar intense feelings of shame in relation to a therapist.
The key is understanding how our conscience can be pressed into service to shield us from possible pain. In recent years, perhaps since the 60s, the conscience or superego has almost disappeared from professional literature. On the other hand, I think it is one of the most important and useful concepts we have. I have devoted a whole chapter (Chapter 5) to the subject in How We Heal and Grow: The Power of Facing Your Feelings. I came to this view from working with trauma survivors and realizing that healing the intense feelings of the trauma was hard to get to, but once it happened, that work was done. In contrast, inappropriate feelings of low self-esteem and even guilt seemed to be much harder to heal and remained subject to relapse when something bad happened in my patient’s life. To me this meant we were dealing with two distinct healing mechanisms. To make a long story short, I eventually came to understand that distorted attitudes and values had been internalized into the conscience or superego and were producing negative judgments against the self at the same time that healthier values were working as they should.
Let me clarify. I have a very simple view of the conscience. It has two parts. One is a set of internalized templates of appropriate behavior. These consist of attitudes, values, ideals and prohibitions. According to Alan Schore, they start to appear around 18 months of age. The conscience begins to be functional by age three. Three year-olds really want to be “good.” What has not been well recognized is that values, positive and negative, continue to be internalized throughout life. Trauma is one time when negative values are most likely to be internalized. Most important, they are very hard to change. The obvious reason is that your conscience needs to resist the impulse of the minute in order to keep your ship steady over time.
The second part of the conscience is the “enforcement arm” It uses very specific forms of positive and negative reinforcement to influence behavior and keep us out of trouble. It rewards behavior consistent with our values with feelings of pride. It punishes our deviations with feelings of shame and guilt. These are very powerful feelings and strongly influence our behavior.
People whose early attachment experiences have caused pain and discomfort very often develop internalized values that say it is “bad” to trust or get close. When such values are in place, guess what we feel when we find ourselves getting close or trusting another person? Of course, we feel intense shame. Perhaps these values were internalized in the first place for a very good reason, to prevent repeated experiences of rejection or betrayal. On the other hand, in adult life, when we can chose those we trust and those we want to get close to, values formed long ago can prevent us from entering into healthy relationships.
There is another aspect to this problem. Imagine if one has spent a lifetime avoiding closeness or dependance. Do those needs disappear? Most likely not. To the contrary, they get very strong. The more they are suppressed, the stronger they get. Intense needs generate intense shame.
This is the situation expressed so often in comments to posts on Moments of Change. People who need to experience safe and healthy dependance and trust find themselves feeling terribly ashamed of their natural needs.
Trusting a therapist is essential for the work to go as far as it needs to. If you are guarded, then you are leaving your therapist with an incomplete picture of yourself. If your therapist is not trustworthy, then your progress may be limited and something needs to be done. Assuming the therapist is worthy of your trust, it may take time to work up to full trust, but it needs to happen. Dependency is also part of healthy relationships. We are interdependent. When you have an operation, you become completely dependent. We need to depend on others for things beyond our capacity. The complicated part is how we are dependent. Parents constantly make judgment calls about when to help and when not. There are times when tying a child’s shoe lace is the right thing to do and times when it is better to say, “You can do it.” These are truly judgment calls and cannot always be perfect.
Therapy is also a place where patient and therapist must make judgments about what emotional work the patient is ready for. It is possible for patient and therapist to collude to have the therapist cover areas where the patient should actually be doing the work for his or herself. Therapists have the same responsibility as parents not to allow this, but it is a good thing to talk about it together if there is any question. These are not always easy things to spot and working together is a good check on how you are dividing up the emotional work. For example, therapy is aimed at helping patients build their own real-life relationships. There might be a time when the therapist is the only person a patient is ready to trust or feel close to. On the other hand, a time will come when risking closeness with outsiders becomes possible and therefore necessary for growth. So the key question is, “Am I really able to do this for myself?” Of course your conscience will chime in (inappropriately) that you should be ready for anything, but that may not really be true and the challenge may truly be beyond your capacity.
If you would like to read more, click HERE to return to the main page where How We Heal and Grow is available.
See the next post in the Attachment Series: Healing Shame