Thanks so much to the readers who commented on “It’s the Love,” Post #36. How often does a therapist get to participate in a genuine dialog with clients outside of a therapeutic relationship? I hope many therapists are taking the time to read the 25 comments on that post. They are incredibly valuable and instructive for all of us.
In October, 2019, I tried to write the definitive post about resolving the intense attachments and underlying pain that survivors of trauma and neglect most dread. I got it right that grieving the shortfall was not the answer, but a commenter on the recent post said it much better: “Telling someone to grieve a lack of love seems similar to telling them they should simply grieve not having enough oxygen or water.” Beyond that, I proposed that therapist empathy was the answer. Now I can see there is much more to it. This post should be considered a further step.
Bracing against some dreaded experience
Susan commented, “The trust sometimes starts to build but it feels quite fragile and unstable like a house of cards one minor slip up or mistaken comment cause it to come tumbling down.” What is left when trust crumbles is return to a state of being braced against hurt. That means being in a constant state of preparation, aimed at fending off the thud of disappointment. This pattern of defense comes from long ago. How do children prepare themselves? Often it is in the body. It might be a bent over posture. It might be self-criticism so as to be braced against surprise. It might be bodily tension against physical assault or violation. It might be an idea. One client braced herself against loss of control of her own anger by telling herself she was the cause of her mother’s psychosis. Another did the same by holding the idea that he was a “bad person.” Bracing keeps the client safe from pain, surprise, and loss of control, but it also blocks therapeutic progress.
Why is bracing important?
Bracing is critically important because it is what stands in the way of healing. The foundational change mechanisms, Extinction and Memory Reconsolidation have the same two requirements. 1) Activation of the emotional trigger for the maladaptive response pattern, and 2) exposure to surprising new information with which to update the old pattern. The first requirement is the one blocked by bracing. Without an openness to experiencing the dreaded emotion, healing can’t take place. It’s that simple.
Clearing up some confusion
In thinking about this post, I realized that I had been put off the trail in reading about Memory Reconsolidation. The research is built on the “learned fear paradigm,” in which mammals (human and others) are trained to be afraid, then untrained by re-experiencing the feared experience in a context of safety. The subtle difference is that it is not the fear that is erased, it is the dread of an emotional experience. Fear is not what is dreaded; fear is the “signal anxiety” that tells the mind to watch out. More basic to healing is activation of the experience that is dreaded. When clients are able to let go of bracing, it is because their fear is already diminished. It is when they experience a sense of safety and openness, a sense that nothing too bad will happen.
The core, dreaded emotional experiences
If I said the thing client’s dread is “the unknown,” that would be awfully abstract, but it is not that far off. The mammalian brain evolved to prioritize figuring out whether it is better to attack or to run, and that depends on “sizing up” the opponent or the challenge. Getting it wrong means death. The situation is even worse for children. They may not be able to know whether they have the resources (i.e. support from big people) to meet a challenge. For them, especially if caregivers are not seen as reliable, the answer is unknown. The calculation comes back, “I don’t know if I will survive this.” Naturally, they prepare for the worst by bracing. It happens in an instant and is anything but abstract.
Bracing consists of maintaining an instinctive, self-protective stance. Words for the dreaded experience might be “helplessness,” “hopelessness,” or “not knowing,” but they are all equivalent to facing death. The opposite, “survival” is also an abstraction, but the brain treats it as a very concrete imperative and will do anything in its power to gain advantage. For children, that means being loved so much that the big people will look beyond their own needs and provide safety.
The opposite of bracing is trust and safety
Once again trust and safety are abstractions. The brain has a more direct way of expressing these. When humans (and other mammals) feel a full sense of safety, we see it instantly. Think of kids on vacation with their loving parents. They skip with joy and excitement. They feel no constraints. They speak freely and act with exuberance. That’s the feeling clients are seeking when they test our trustworthiness. And when they find that kind of openness, they will be on their way to the readiness and confidence they need to unbrace and be open to experiencing their dreaded emotions in the safety of a trusted relationship.
Clients who have experienced deprivation or trauma
The people who commented on the “It’s the Love” post are, like many others, people who live their lives bracing against hurt or abandonment. Their inner child attaches fiercely to their therapist in the understandable (and hopefully realistic) belief that this person may save them. In order to let go of their bracing, they need to establish a robust trust. This leads them on a quest for indicators of trustworthiness.
For each client, as for those who commented on the blog post, what is reassuring may be quite unique. For one person, it might be a willingness to use touch or give a hug. For another, it was knowing that the therapist would put aside the need for sleep and respond to a call during the night. Often these amount to “proofs” that the therapist is willing to put aside their own concerns and notice the needs of the client. We can imagine that these are often opposites of the critical failings of an inadequate or abusive parent.
When the therapist finally understands and comes through, only then, can the bracing be released. Only then, can the client let go, be vulnerable, trust, and allow the proximity of danger, knowing that they are not facing it alone. That is why clients fight so hard to get their therapists to show themselves worthy of trust.
Effects of therapist boundaries
Imagine, now, that the therapist holds back, believing that rules must never be bent or boundaries softened. The effect may be just like the parent who had more pressing things to do. “You are not important enough for me to put aside my personal concerns.” It’s even worse when the therapist has some (BS sounding) explanation for why their withholding is the right thing to do. That’s like a parent who openly justifies his or her failure. What self-respecting client would not brace even harder under those circumstances.
And what about the therapist who makes promises but does not keep them? That feels like being led on, then betrayed. It leaves the client concluding that the therapist must be using the client’s dependence for personal gratification, while disregarding the real need for trust.
Even concrete proof of trustworthiness may still leave room for doubt. “Will she care next time?” “Are my demands leading to built up resentment and an eventual rejection?” “Can it possibly last?” These doubts are real, given that, in the eyes of the inner child, the stakes are life and death. What ensues may be a prolonged give and take over proof of trustworthiness. If the dance of doubt and proof is ever going to end, there needs to be a moment when the client, in effect, says, “What the hell! I’m going to go for it and trust.”
One thing that may make that possible is the therapist showing some human limits. Imagine the therapist who does show some irritation at being tested over and over. What if the display of irritation gets discussed without defensiveness and both participants come to accept that the therapist is human and has limits. This conversation introduces the idea that the therapist does not have to be infinitely trustworthy, only enough to be willing to be there to help the client face their worst dread.
What the testing adds up to
The negotiation over trustworthiness can take many forms, but what the back and forth amounts to is a chance for the inner child to grow in maturity. One example of a more structured approach to this negotiation is the “limited reparenting” that can be part of Schema Therapy. The child has a chance to move from a young quest for absolute trustworthiness to a more adult view that even the best people have limits. This acceptance is what can make possible the letting go or unbracing that ultimately makes it possible to re-activate the archaic dread in a context of safety, thus fulfilling the required conditions for Memory Reconsolidation.
One commenter on the blog post describes exploitation by a narcissistic and unscrupulous therapist. Why did she trust him? This discussion gives the answer. When children are in a dire situation, archaic survival instincts take over. They may trust whoever is there, even a perpetrator. When there is no other choice, the need for adult support is imperative and humans will naturally trust (and bond with) the available other.
I believe this is the origin of trauma bonds. Following such an experience in childhood, untrustworthy people are no longer screened out and rejected. To the contrary, they are instinctively identified as trustworthy, up to a point. However in the unfolding of that relationship, our commenter did not fully “let go.” Against reason, she kept hoping that the therapist would prove worthy, but he didn’t, and she never fully let go of her bracing. As a result, therapy with a self-serving therapist was not of benefit.
Are there times when touch is the only way?
So far in this post, I have held to the idea that the only reason for going beyond traditional boundaries is to prove trustworthiness in the form of willingness to go above and beyond. Are there times when touch is required for therapy to work? I think the answer is that bracing exists at different levels of development. When the bracing is physical, it may be that that is the only language that can be taken in. Sometimes words can reach in and be received in a way that can release physical bracing, but I’m not sure this is universally the case. Somatic Experiencing Therapy, for example, can include non-erotic touch in such a way that communication is established on a nonverbal level. One situation where an open mind may be especially warranted is when the bracing is in the form of somatic symptoms of involuntary muscle tension, psychogenic pain, and regulation of internal organs such as the gut.
And what about the eroticized transference? As with trauma bonds, the experience of trust, a subjective feeling of safety and predictability, may first have been established in the midst of sexual abuse. In such cases, it is understandable that the inner child will seek out the same illusory kind of safety with the therapist. This is a place in therapy where touch is likely not to be safe and where therapists need to be open to recognizing their own possible vulnerability. Real discussion in a context of safety can, under the best conditions, lead to the client being able to accept boundaries and find genuine trust. On the other hand, it might, as in the case of the blog commenter, not be resolvable, except by ending that therapy.
Recognizing and exploring the many forms of bracing can be the beginning of a process in which the inner child grows and matures. Gradual acceptance transforms childlike views of what was needed to more adult ones. The endpoint of this change process is readiness to experience the dual awareness of traumatic pain in a context of adult safety, allowing Memory Reconsolidation to heal the old dread. Remarkably, in coming to the needed sense of safety and trust, what was originally missing, loving support for growth, is ultimately fulfilled.
Jeffery Smith MD