Reflections From Inner Space
Explore the social and technological changes of contemporary culture that challenge therapists and clients.
Explore the social and technological changes of contemporary culture that challenge therapists and clients.
Negative self-talk also known as self-critical thinking afflicts millions of individuals. It can range in severity from paralyzing vicious attacks on the self to a steady, barely noticeable stream of chatter that deflates self-esteem and dampens motivation. It can lay dormant within a field of good fortune only to be triggered by the smallest of mistakes that unleashes a flood of verbal attacks against the self.
Negative self-talk is co-extensive with a self-consciousness that casts a dark shadow over one’s life. Stopping it is not simply a matter of replacing negative thoughts with positive affirmations. Self-critical thinking functions like an operating system that runs the multiple programs of the self, from self-evaluation to perception of others to decision-making. Having established dominion early and unwittingly in the sanctuary of the self, it is seamlessly woven into the fiber of one’s being. Seeing the world differently is as inconceivable as it would to be to imagine having three eyes and one ear.
The core of self-critical thinking is based on fundamental assumptions about one’s unworthiness, unloveableness, and defectiveness, assumptions that are accepted as fundamental truths. These assumptions are often internalized through the complex interactions with key individuals beginning in early childhood and extending through one’s development. Drawn from a catalogue of qualities such as intelligence, attractiveness, strength, creativity, etc. that constitute the vocabulary of self-esteem, individuals become fully armed with ammo for negative self-talk at an early age. Under the tyranny of perfectionism, life becomes a painful, unwinnable battle against a simple, but harsh and unbending standard: if I am not perfect, then I am bad.
It is more than a curiosity to wonder why there is such a powerful attachment to the negative in the human psyche. One criticism seems to have the power of a dozen compliments. This curiosity is heightened when one considers that many individuals who are plagued by negative self-talk are competent, creative and accomplished.
Self-critical thinking trumps what is worthwhile about a person and reflects a highly distorted, negative picture of the self. It expresses a personal, subjective belief that doesn’t recognize or value one’s abilities. One looks at the world from a position of inadequacy and defectiveness, characteristically feeling not as smart, not as attractive, not as creative, not as funny, not as sexy, or not as successful as others who are perceived in a much more favorable light.
Changing negative self-talk is a journey of self-transformation. There are many roads to change and psychotherapy can be an important part of this process. While there are numerous theoretical therapeutic orientations, if you were to look at what effective clinicians actually do in therapy, you would find many similarities in contradistinction to the stated differences in their theoretical orientations. In the next post I will outline a series of steps that provide guidelines to help deal with self- negative self-talk.
The bubble burst. Waking up to this reality is a process. And there is no quick fix. What burst apart was more than the banking, automobile, and housing industries. A set of cultural beliefs and values lay in the debris of the economic collapse. Reminiscent of 9/11, our “collective illusions of safety, inviolability and grandiose invincibility, illusions that had long been mainstays of the American historical identity” was shattered. Stolorow in the Huffington Post (10/15/08). These illusions girded the economic growth leading up to the recession and remain a ghostlike presence in the recovery process.
“No Fear” is a slogan that captures the mindset of this identity, a mindset intoxicated with denial. Being intoxicated with denial glorifies risk and the accompanying blinding sense of invulnerability. Risk imbued our spending, investing, and thinking in general. Being guided by risk is like riding a motorcycle drunk without a helmet. Wall Street and Main Street bet that the cycle would not crash.
When it did, there was an eruption of fear, panic, and pain. During stressful times, emotional life becomes turbulent and complex. It is the nature of being human that current stresses, especially when severe, can trigger old wounds and memories. The stress associated with financial worry can feel like a brain wreck. Real survival concerns and worries are intertwined with past experiences, stirred by feelings of shame and guilt.
Conventional wisdom often fails to grasp the complex psychological dimensions of hard times. It values hardiness and active mastery and devalues vulnerability and weakness. It preaches a code of behavior embodied by the saying, “when the going gets tough, the tough get going.” Its message exacts a quiet toll as it encourages the restoration of self to its prior position of power and invincibility at the expense of authenticity.
Ironically, when the going gets tough, the tough don’t always get going. Many get irritable, hide their fragility, drink excessively, and isolate themselves or at least their pain. Rather than aspirational, these behaviors represent a model of maladaptive coping. In contrast when the going gets tough, the weak and vulnerable become depressed. They feel conflicted, confused, doubt themselves, blame themselves, complain, possibly drink and withdraw, but are more likely to seek support and even professional help.
A commentator recently suggested that we call the recession a reset as a way of thinking more hopefully about current conditions. If we reset the economy without re-evaluating the assumptions and beliefs underlying the mindset that generated these problems, then the reset will simply create the conditions for the repetition of old patterns in new situations.
As Stolorow suggests our individual beliefs about ourselves are deeply rooted in our collective psyche. Psychoanalysis and Deconstruction provide a framework for understanding this connection. According to Derrida (1)(Sarup 1988), western thinking is rooted in a “logic of binary oppositions” that establish the hierarchical categories that we use to think. This form of thinking splits reality into polarities such as good/bad, active/passive, rational/irrational, masculine/feminine, sane/insane, strong/weak, and healthy/sick. Psychoanalysts refer to this polarization of reality as splitting. Colloquially it is referred to as black and white thinking.
In Derrida’s framework, the first term of the binary is privileged and overvalued. It depends on its meaning through the tacit exclusion and subordination of the second term. In other words when the tough get going, weakness is present through its absence. Life is never simply how it appears. Tough and weak are not mutually exclusive, but indivisibly alloyed. One quality is felt and the other split off
While Psychoanalysis views splitting as a form of primitive thinking characteristic of severe personality disorders, Derrida’s framework suggests that binary oppositions (splitting) permeate psychological discourse and structure the categories we use to understand and describe who we are and how we judge others,
Splitting as a phenomenon of everyday life is illustrated in how average individuals experience the Self. Personal identity and perceptions of others are gauged on a dichotomous rather than continuous scale. Binary terms like good/bad, strong/weak, extrovert/introvert, smart/dumb, beautiful/ugly, cool/uncool form the building blocks of identity that become fixed ideas, and endure as convictions that indelibly define the self and the Other. I am not good enough, smart enough, attractive enough speak to how individuals experience their low self-esteem and constitute the reasons many seek psychological counseling.
It is helpful to think of these psychological splits like fault lines that lie beneath the earth’s surface creating an invisible structural fragility. The dichotomization of reality exemplified by splitting creates a linguistic matrix in which self and others are judged against absolute categories. It engenders an “us versus them mentality,’ where individuals either externalize blame on others or collapse under the weight of self-blame. Somebody wins and somebody loses. Splitting reinforces the polarization of difference between sick and healthy, high and low functioning, good and bad, tough and weak that leads to an increasing sense of either personal inadequacy or grandiosity and to the alienation of the individual from the group.
The collective anxiety and uncertainty about our future is potentially transformative. The psychological reset that is needed starts with personal accountability, but not accountability driven by the logic of binary oppositions. Different conceptual tools are required to facilitate this personal/cultural transformation. We need to develop a more permeable, flexible, and compassionate way of thinking about the self while creating a greater openness to and acceptance of the influence the others. Our need for a psychological overhaul while perhaps more subtle is just as critical to the nation’s wellbeing as the economic bailout.
(1) Sarup, Madan, (1993) An Introductory Guide to Post-Structuralism and Postmodernism
Christopher Bollas (1), an English Psychoanalyst, has made the thought-provoking statement that the ”psychoanalyst’s practice is a form of countertransference.” He is not referring to the specific reactions of a therapist to a client, but to the heart felt structure of the psychoanalytic situation, the frame, the conditions of practice and the ground rules of engagement with clients. Historically the frame (2) has been conceptualized as a necessary and salutary boundary established by therapists in order to create the conditions of safety for the client. In contradistinction, Bollas states that Freud created the psychoanalytic situation out of his unmet and unanalyzed needs. “What Freud could not analyze in himself – his relation to his own mother – he represented through his creation of the psychoanalytic space and process.”
Bollas’ essay prompts therapists to examine the countertransference significance of the frame or risk acting out their countertransference in their maintenance of the frame. If the classical frame expresses the analyst’s unconscious needs along side conscious practical considerations, the frame becomes a psychological construction that blends contradictions and inconsistencies with procedures. One can look at the classical frame as one would examine a dream. The patient, the analyst, and the rules governing their interaction represent different aspects of the analyst. The patient is expected to free associate while the analyst acts in accordance with the principles of abstinence, anonymity, and neutrality. One can see how the analyst/patient amalgam embodies a paradoxically scintillating tension between the wish to be known intimately and the fear of being known.
This paradoxical tension persists in contemporary psychoanalytic and psychotherapy practices. The therapist’s wish for intimacy and the countervailing fear create cross currents layered into the psychotherapeutic frame. Clients walk into an office. They accommodate to a structure that combines personal and impersonal elements in the most tantalizing ways. They are clients or patients, not friends, but they are privileged to an intimacy that few friends enjoy. They experience an unparalleled though limited exclusivity: they are listened to, encouraged to be intimate for 45 or 50 minutes once or multiple times a week. They pay for this privilege and then leave. This is indeed a strange configuration that conjoins intimacy with the formality of a business relationship.
While there has been much focus on the co-construction of therapeutic meaning, the frame is the unilateral creation of the therapist. The length of session, flexibility over ending session, fees, personal disclosure, gift giving and receiving, and extra-therapeutic contact have been set up by convention with the needs of the therapist in mind. Historically, therapists viewed the frame as inviolable (2). Therapists have too uncritically accepted the conditions that structure clinical practice as necessary givens, without examining either its psychological significance or its impact on the client. Therapists consciously maintain these conditions, and only under duress and with great reluctance modify them. Client’s counter reactions to the frame have been interpreted as acting out.
Often the settings of the frame sift out those clients who accommodate from those who don’t within the first few sessions. It is not surprising that most clients who remain in treatment accept the frame, though some grudgingly. I have had clients politely joke about paying to have somebody listen to them. I’ve had one client; however, whose articulate protest of the frame provides a client’s perspective on the frame. She was a therapist in training who came for counseling to fulfil her graduate school requirement. She was never comfortable in her role as client. She made this clear in the first session when she told me that she didn’t like the idea of therapists telling clients what to do. I was never comfortable in my role as not therapist. There was often anxiety mysteriously floating in the office creating a background of suspense and discomfit that could not be addressed. I believed that her unarticulated anxiety associated with fears of dependency prompted her to avoid the role of patient. This triggered in me an anxious uncertainty about my role, and an insistence on acting more like the therapist. The more I acted like a therapist, the more she resisted acting like a client. We became locked in an impasse. Efforts to talk about the impasse only deepened it. We sustained a tense and uncomfortable relationship for 11 sessions, until she decided to find another therapist.
One can look at our brief therapy as a struggle over the frame. She was articulate and insightful. She felt that the frame was established and maintained for the comfort of the therapist at the expense of the client. It was a mechanism for therapists to titrate the needs of the client. She claimed that the therapist’s narcissistic insistence on maintaining the frame encouraged the client’s accommodation, and accentuated the compliance of the false self. She felt that the needs of the true self, especially the regressive needs, cried out against the rigidity of the frame, particularly the compulsive commitment to ending sessions on time. While the client is invited to open her heart, she must abruptly stop at the end of the hour. This rigid adherence to the frame posed a grave threat to the client who might need more flexibility in order to grow. My client felt this rigidity to be harsh, insensitive and potentially re-traumatizing for the client.
In thinking about this case years later, I realized that I failed to be the therapist that she needed. I was unwilling to understand and accept her wish not to be a client. She was pleasant, neither demanding nor argumentative. She would casually minimize the value therapy, frequently remind me of ways in which she obtained therapy from friends, alternative healers, while complain that she wasn’t getting anything out of the therapy. She would articulately highlight the artificial impersonal aspects of the frame. She made her co-payment at the start of each session with a certain ambiguous acknowledgement that left me feeling unmistakably paid. I viewed her statements about the inequality of the frame as defensive. While she never explicitly asked or demanded me to modify my approach, her Being insisted on what I unthinkingly felt to be a massive demand. I thought about her personality inconsistencies as evidence of underlying problems of dependence and trust. I believed that she didn’t want to be in therapy. I did not consider that she did not want to be in with me. I did not think about my need to end sessions on time and the subtle or not too subtle ways in which I began to disengage as the clock approached the end of the hour. I did not consider my focus on her defensiveness as counter defensive. In the end, she felt that I didn’t get her resistance to therapy and told me so. I was wounded, but relieved.
As I thought about the issues of this case, the following images emerged. I imagined swimming in the ocean toward a raft located not too far from shore. I recalled childhood memories of arduously swimming toward a raft and the relief I felt when I had arrived. I thought about how my feelings in a therapy session resemble the feelings I had swimming. Will the ocean become too rough? Can I make it? Am I going too far? Will I be able to get back? Not being a strong swimmer, these feelings were always present when I swam away from shore. Another image entered my mind. Years ago I participated in a one day process-oriented group therapy training. At the end of the group, after we addressed termination, the facilitator left. As he opened the door to leave, it creaked. The sound stirred the still air. In the silence I felt the creepy image of a lid shutting on a coffin.
(1) Bollas, Christopher (1987) The Shadow of the Object: Psychoanalysis of the Unthought Known New York, Columbia University Press.
(2) Robert Langs (1973 The Technique of Psychoanalytic Psychotherapy,
(1976) The Therapeutic Interaction
It is a challenging and unique aspect of our profession to have one’s professional identity so intimately linked with one’s personal self. Becoming a therapist is a state of mind, a sensibility, a never-ending process of developing an identity, a solution to a deeply personal problem, as well as learning a body of knowledge, a set of techniques, and establishing a career. The therapist’s identity is an amalgam of professional role, which grows around a personal amorphous core. The professional and the personal dimensions of self are variables in a complex equation describing the therapist’s identity,
The practice of psychotherapy isn’t for everybody. We have chosen a most interesting and difficult job where satisfaction, challenge and peril co-exist. We are privileged to a special intimacy. Day after day hour after hour we hear the most intimate details of a person’s life. What we hear from our patients triggers pain within ourselves as we suffer the same symptoms and difficulties in our lives.
What is the relationship between the difficult, symptomatic aspects of oneself and therapeutic behavior, between the professional and personal dimensions of oneself? How does the cultivation of a professional identity over the span of training and practice assimilate these unhealthy aspects of self? How do we learn to use our Self including the “unhealthy” parts when what is split off and dissociated by the individual is also devalued by the professional community?
The paradox we experience as therapists is that while we work tenaciously and compassionately to heal our patients, we tend to close ourselves off to those unhealthy wounded parts of our personalities. We have struggled with our wounds, which often was motivation for becoming therapists and have fine-tuned our ability to help others. At the same time these wounds continue to be present and provoke shame. We feel considerable pressure to present a normal, competent, professional self to our patients, colleagues, and even to ourselves.
The socialization of the self into a professional role and the ongoing expectations attending a successful practice create the conditions for splitting within the therapist’s self, where the professional holds the “preferred (idealized) version of self and the personal holds the remains, including what is messy, wounded, inadequate, and unacceptable.
What motivated you to become a therapist? What life experiences influenced this decision and shaped your development? I welcome your comments.