Sunday, January 24, 2010

the truth about ourself

Accepting the Truth about Ourselves
By Psych Central Staff



Considering the amount of time I spend confessing my mistakes and shortcomings in therapy, I often think the doc missed his true calling. And therapy would definitely be easier if I could step into his office, confess my sins and leave the rest of the work to God until my next session. I’d leave every session cheerfully if it were that simple.

But it isn’t that simple, and the doc doesn’t let me off the hook that easily. He forgives readily, but he doesn’t let me forget that my behavior needs work, so he always seems to have plans to talk about and explore the behavior that led to my latest confession.

I don’t look forward to these conversations, but I have grown accustomed to them, because we have them regularly. Facing the pain that I inflict upon others remains a daunting task for me, primarily because of two nasty little details: I hurt others more often than I care to admit, and it isn’t always unintentional.

It’s the latter detail that often causes me to wince these days, particularly since the person I currently target most often is also the person who’s trying to help me understand and change my behavior: my therapist. And he does not subscribe to the belief that it’s enough simply to recognize when we hurt others, apologize, and try not to do it again. While that’s a good place to start, it is too easy to make promises we don’t or can’t keep, and simply trying not to do it again is a lesson in the illusion of responsibility, neither one conducive to therapy.

It’s easy to say, I won’t or I’ll try not to do it again, and when I’ve made that promise in the past I always intended to keep it. But a lifetime of not understanding my behavior and being caught off-guard by powerful feelings have left me with some serious deficits in impulse control, particularly in my close relationships. Making promises without making serious attempts to understand my actions leaves everyone around me frustrated and angry, so much of my therapy consists of figuring out why I do what I do.

My long-time favorite and usually truthful answer to that question, “I don’t know”, invites my therapist to challenge me as we begin the task of figuring it out together. But I’ve come to appreciate his expectations of hard work, responsibility, and honesty, just as I appreciate his forgiveness and understanding when I make mistakes, because I make plenty of them. That’s a hard-to-beat combination of values, and knowing I can count on him to uphold those values makes facing the truth about myself less formidable.

It is less distressing now, but it still isn’t easy. I am a trauma survivor, and we trauma survivors often blame ourselves for the pain and abuse inflicted upon us, but we generally find it extremely difficult to accept that we too are capable of hurting others. We tend to hold firmly a belief that we are incapable of hurting others due to knowing and experiencing the pain and terror of abuse. This belief is a protective measure, and its primary purpose is to protect us from the threat of identifying with those who abused us. If we can identify with them in
any way, we might be like them, and the last thing a survivor wants to be like is an abuser.

And so, upon realizing a few years ago that I had indeed hurt people, I was quite upset but not as shocked as I thought I would be. In my attempt to protect my self-image as one who would never hurt others intentionally, I reminded myself that we all hurt people inadvertently sometimes, and, pleased with my acceptance of the truth I was content to believe that my behavior, while hurtful at times, was never abusive because it wasn’t intentional. And as long as it wasn’t intentional, there was little I needed to do except try to avoid making the same mistake again. But that acceptance was short-lived, and whatever discomfort I felt at the time paled in comparison to the shock I felt upon my later discovery—that at times I had hurt people intentionally.

I clearly remember the panic I felt when I realized I could not deny, at least to myself, that I had hurt someone intentionally. I was at home at the time, thinking about the work I was doing in therapy, when an incident involving a friend, an incident that I had long since forgotten suddenly found its way back to my memory, instantly shattering my belief that I was incapable of deliberate harm. My heart raced, my hands trembled and my stomach churned. One word flashed through my mind repeatedly: ABUSER.

I wanted to run, I wanted to hide, I wanted to hurt myself—anything to escape. The one thing I did NOT want to do was admit this to my therapist. I was certain that he would hate me, fear me, and reject me. I was terrified by the thought of telling him, but I was equally terrified by the thought of being alone with this secret. After agonizing over it for some time, I finally made a decision, hoping it was the right one but fearing it would be my therapeutic downfall. I
chose to tell him what I had done.

My therapist did none of what I expected when I told him. He didn’t hate me, fear me, or reject me. His compassion was clear and genuine. He not only still cared about me, he praised me for having the courage to face an ugly truth about myself. It was a pivotal moment in my treatment, and I was grateful for his ability to respond with sensitivity and kindness.

Not all trauma survivors are fortunate enough to experience compassion in the face of their own admission of guilt when it comes to hurting someone intentionally. Not all trauma therapists are capable of responding to such admissions with sensitivity and kindness. This is unfortunate, because the truth is that we are all capable of inflicting harm, and the sooner we recognize this fact, the better our chances of understanding and preventing it.

But some therapists react with fear, and though they may try to respond therapeutically to our admissions, as trauma survivors we are quite adept at recognizing both fear and anger in people important to us. We don’t usually miss this; if anything we tend to seize upon it immediately and revise our version of events to minimize the impact on our therapists.

When therapists react with fear, it sets the stage for a therapy with little substance or honesty, sometimes resulting in an elaborate but unproductive game of self-deception for both parties involved. Sometimes therapists minimize the impact of our actions by questioning our actual intent. They sometimes become self-protective, insisting upon behavioral contracts to protect the therapy even in the absence of any threats to our treatment. Others become even more punitive, to the point of outright rejection, insisting that they cannot work with us because they do not feel safe.

Safety, of course, is essential to both client and therapist, and in the presence of behavior that truly threatens either party, it is necessary to take protective action. But it has been my experience, and the experiences of numerous other trauma survivors, that some therapists exhibit a knee-jerk reaction to any perceived threat, real or imagined. I once had a therapist tell me she was frightened of me because of a violent dream I had shared with her. Needless to say, the therapeutic value of that relationship went downhill rather quickly.

But I am far from alone in this experience. Without making a generalized statement based on assumptions, I frequently see some common factors that I believe contribute greatly to therapist fear and to the failure to help us face and understand our own hurtful behavior. Unfortunately, these contributing factors sometimes result in therapy that only touches the surface, or in termination of treatment. In either situation, the possibility of exploring and understanding the harm we inflict upon others is lost.

The first factor, which I encounter often in discussions about trauma therapy on the Internet, is a significant history of trauma and abuse in the therapist’s own life. This is a delicate issue, because of a common belief among both trauma survivors and a number of therapists that
survivor therapists are the best trauma therapists due to their own experiences. I don’t dispute the fact that survivor therapists are probably the most sympathetic therapists due to their own experiences, but sympathy alone does not make one a good therapist.

Though this is not universal, survivor therapists often appear to be more fearful in general, which is not surprising given the neuropsychological complexities of trauma related disorders, and the fact that residual effects of trauma can last for many years. This fear is usually communicated to clients in one way or another despite the therapist’s efforts to conceal it. Its effect is to preclude any real investigation of our own tendencies to lash out at others because we are more likely to hide those aspects of ourselves that we believe our therapist fears or dislikes.

We want to be cared for and liked, and we also have a tendency to be caretakers ourselves, so any indication that our therapist is anxious or upset by something we revealed is likely to be met with a reluctance to disclose such information in the future. This is a problem I encounter frequently on Internet survivors’ forums, and I believe a contributing factor is that survivors who later become therapists often do so before they complete their own therapy, which makes them even more susceptible to vicarious traumatization. This is detrimental to both client and therapist.

A fearful therapist who relies upon dissociation to avoid being triggered by the client’s material is not a better therapist because she has this ability, she is an impaired therapist, and a therapist impaired by dissociation may have crucial lapses in judgment due to a failure to integrate thoughts, feelings, and experiences. She may feel discomfort or fear while conducting therapy with a particular client and believe it is due to an implicit perception of the client’s inner rage when in reality it is due to an unresolved issue of her own. Under those circumstances, any examination of the client’s behavior toward others is likely to be clouded by the therapist’s own issues which she mistakenly attributes to the client.

An additional factor leading to the failure to examine our own hurtful behavior is the misconception that abused girls become adults who internalize their anger and hurt themselves, and abused boys become externalizing adults who hurt others. While there is some validity to this, it is by no means an absolute truth. Yet this belief is perpetuated by survivors, therapists, and society in general and is often presented as an absolute truth. This is a dangerous practice, because it results in a tendency for female survivors and therapists to believe it is not necessary for us to look at the ways in which our behavior might be hurtful to others, and a tendency also to assume that as females, we are different because we do not identify with our abusers, who are commonly males. It offers us some relief because it absolves us of the anguish and shame associated with identification, and it leads us full circle to our original belief that we are incapable of hurting others due to knowing and experiencing the pain and terror of abuse.

But it may also lead to a serious problem: becoming trapped in the cycle of abuse by adopting the role of perpetual victim. It is not at all uncommon for female survivors of childhood abuse to become revictimized as adults. As children, we were not responsible for the abuse and our
options were extremely limited. As adults, however, we often continue to place ourselves in situations and relationships that hold us hostage to those limitations because we don’t believe we play any role in being abused.

But if we look closely at our own behavior in relationships with the help of a good therapist, and we are willing to be honest with ourselves, we usually discover that we make choices which keep us from getting out of the victim role. These patterns of behavior are frequently played out in most, if not all of our important relationships. Many people, abused or not, fail to recognize that in every relationship, even abusive relationships, two people are responsible for what works and what doesn’t work. Unfortunately, when people hear such a statement, they often interpret it as blaming the victim by making her responsible for someone else’s decision to hurt her, but that’s not what it means. It means that two people make independent decisions that impact each other, and if we don’t understand how and why we came to those decisions, we’re likely to use the same approach in another relationship, thus repeating an unsuccessful and harmful pattern of behavior in relationships unconsciously.

When we combine unconscious patterns of relating in ways that cause us harm, with a firm belief that we are incapable of causing harm to others, we have a disastrous mixture, because we then tend to believe that we are as helpless as we were during our childhood. We fail to recognize or feel our anger and rage because anger feels dangerous and threatening to us, but when we don’t feel it, we can’t use it appropriately to protect us from harm.

Anger is a normal human emotion, and if we fail to accept that being the victim of the worst kind of hurt and pain has made us more, rather than less angry, we run the risk of believing that our experiences made us better people because being abused taught us to be gentle and kind. Certainly there is nothing wrong with being gentle and kind, but if we attribute those qualities to being victimized as children, and we do not recognize the depth of our anger and instead see ourselves as incapable of hurting someone else, we cannot be fully human.

In order to be fully human we have to accept that if we are capable of doing good, we are also capable of causing harm. Some people may cause more good than harm, or the other way around, but we are all born with the capacity for both, which is an evolutionary necessity because any organism that’s unable to inflict harm is destined to die out due to its inability to defend itself. We need the ability to cause harm in order to survive. It doesn’t necessarily mean we have to use that ability but we do need to possess it, and we need to recognize it exists because we won’t be able to use something we don’t know we have.

And if we believe we’re unable to inflict harm, if we believe the ability to cause harm does not exist in us, then we are also likely to believe, consciously or unconsciously, that we can’t defend ourselves against harm. If we harbor a belief that we cannot defend ourselves while continuing to place ourselves in unsafe situations and relationships, we remain trapped in the role of perpetual victim.

I believe that the conflict between an unacknowledged desire to hurt others, and the belief that our experiences taught us to be gentle and kind to others may often result in the deepest pain, because those of us who believe we do not want to hurt others often display behaviors characteristic of internalized anger. Suicide threats, self-mutilation, withdrawal and distancing are behaviors that often communicate rage, and that leave others feeling helpless, hurt, frightened and confused. When we deny any intent to harm others by these actions and insist that we are only harming ourselves, we are communicating our refusal to acknowledge and deal with our underlying rage in less destructive ways. Denial of the impact of our behavior on others is often as damaging as the behavior itself.

Therapists who collude with clients to avoid the discomfort of examining hurtful behavior are not being kind, they are being misleading and irresponsible. For our own well-being and that of our significant others, it is necessary to understand and to accept that all human beings are capable of inflicting pain, and that we all do so, whether intentionally or inadvertently. And whether we care to believe it or not, we all inflict pain intentionally at one time or another. Even the name-calling behaviors we learned as young children are intentional attempts to cause pain, because we would not engage in that behavior if we did not want to hurt someone’s feelings.

And therapists who are themselves fearful, for any reason, are of little help to those of us who are often puzzled by and frightened of our own behavior in relationships. Survivors who become trauma therapists before completing their own therapy are not serving anyone’s best interests. It is neither helpful nor altruistic; it is self-serving and potentially damaging. Trauma clients need the calm, steady presence of a therapist who is fully present, not the illusion of a steady presence exhibited by a dissociated therapist. And just as a young, frightened child becomes more fearful if she recognizes fear in her caregiver and protector, trauma clients also tend to have heightened reactions to the perception of fear in a therapist. We often find it very difficult to differentiate between the past and present during periods of intense emotions.

My therapist’s calm demeanor and unwavering presence when I am fearful of my own desires to hurt him during this confusion allow me to feel that rage in safety rather than act on it. This is extremely important to my continuing progress toward healing, because being abused did not teach me to be gentle and kind. Being abused taught me to go to extremes in order to get some needs met. It taught me to hurt others before they hurt me. It taught me to take what I need through boundary-busting behaviors when my attempts to meet needs are thwarted or denied. It taught me to hurt others by disguising anger with humor. Being abused taught me to be angry and distrustful, and it taught me to be especially wary of people who claim to care about me, and this includes my therapist.

Our work together is often difficult, painful and frustrating, and I sometimes wonder which of us suffers more when I reenact the past in our relationship, because that is when I am most likely to want to hurt him in some way. Sometimes I recognize a reenactment before I take aim and fire away, but becoming adept at recognizing reenactments before I act on those feelings takes a lot of practice, and in the meantime I am making a lot of mistakes.

But it’s through those reenactments that I am learning enough about myself to know that my use of humor isn’t always just for fun, it’s often aggressive. Behaviors I once saw as self-protective are actually disguised attempts to retaliate. Discovering personal information about my therapist and sharing it with another client was done with the intent to hurt him, not because I needed someone to talk to.

There is only one thing more difficult in therapy than admitting to intentionally hurtful behavior, and that one thing is admitting it to my therapist when he is my intended victim. There is nothing more painful than facing the one person in my life who consistently shows me kindness and compassion, even in my worst moments, and confessing to an action meant to cause him pain. But there is nothing I need more in therapy than the opportunity to be who I am, to let my therapist know me, to let him into my life during my worst moments as well as my best.

His refusal to give up, his ability to see beyond the difficulties I have in our relationship, and his continued compassion when I am at my worst help me find the courage to admit my hurtful actions to myself and to him, to face the pain I inflict upon others when I do not understand my own pain. My therapist’s expectation of honesty is not something I am expected to give to him — it is a gift he has given to me.

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