TIFT #92: On Hope

This last TIFT of the year seems like a fitting time to talk about hope, one of the most amazing capacities of the human mind. It’s uniquely human that some of our most vaunted achievements are driven by hope, even when the chances of success are far from certain. The winter holiday is, more than any other, a time of hope. Other holidays are different. In autumn we celebrate the harvest that has already taken place. In spring we celebrate what is on the way. In winter, while we enjoy our last great feast and rejoice in the plenty of the harvest, perhaps the deeper meaning is getting ready to endure the lean months ahead. Yes, we will make it. We will get to spring. We must. 

A definition of hope is anticipation of a positive outcome. But the outcome is not certain. If it were sure, hope would be irrelevant. Hope is an answer to the pain of not knowing, the perennial human problem of awareness of a future we can’t control. We can’t know, so we hope. Perhaps a better definition, then, would be “Anticipation of a desired outcome, when it isn’t certain.” 

When hope stands in the way of health 

Hope can be sustaining, but it can, and often does, stand in the way of health. Curiously, hope is one of the most common forms of resistance to success in psychotherapy. We have all seen how stubborn children can be when their minds are fixed on a desire. “I want chocolate ice cream!” “But they only have vanilla and strawberry.” “No, I want chocolate….” Imagine, how powerful this rigidity can be when the issue that hangs in the balance is a matter of emotional life or death. The full power of the inner mind’s hope can become attached to a certain outcome, seen as the one solution, the only path to survival. Then growth stops. 

A not uncommon version of this dynamic is in the playing out of early deprivation, a childhood shortfall of love and support. The inner self puts their hope into replacing what was missing and the waiting begins. Years later, the young self finds a partner, one who is just as impossible as the depriving caregiver. The hope is that there will absolutely be a way to change this person so they will give what the caregiver would or could not. Inevitably the new partner disappoints. Hope is crushed. 

But young cognition does not recognize a negative, and wouldn’t accept one anyway. Disappointment is somehow ignored, and hope lives on in secret until a new possibility reawakens it. 

Maybe the new hope is a therapist who promises help. The adult client enters therapy and understands how it is supposed to work but the inner child has other plans. This time the inner self is determined to  succeed. Succeed in what? In having what all children need. I call it “primal love,” the kind that is there 24/7 and requires no reciprocation. Whatever happens in therapy, the child self is disappointed. No therapist can give what the child self is looking for. 

Even if a therapist wanted to give this kind of love, it is not possible. Maybe the need is bottomless or maybe the goal is to see change in someone who is unwilling to change. Either way, the result is that the therapist is seen as refusing to fulfill the hope and the expectable emotions are pain and rage. 

Some therapists make the mistake of trying to make up for the unfulfilled need. They inevitably fail and we hope they don’t make the client pay. Others fail because they sense a dangerous demand and withdraw or reject the client. The right answer is to do what a good parent does when they can’t fulfill a wish. They acknowledge the disappointment, the sadness and the anger, and the fact that the best they can do will still fall short of the need. This is too easy to say, but the will to survive is huge and what actually happens can be of hurricane proportions, testing all participants to the limit. 

What is really going on? 

Hope has put the inner self on an impossible quest to avoid pain, anger, and the need to face hopelessness. By aiming towards repair of what can’t be fixed, the inner self is doing what nonconscious problem solvers always do when faced with an insoluble problem. The inner self finds a way to avoid the dreaded emotions. The effective therapist recognizes that those limbic emotions can’t be avoided, but can be contained within the relationship, acknowledged, and witnessed. When these ultimate emotions are met with empathic presence and patience, the inner child (hopefully) sees that it is better to stay than to run. That still leaves all those emotions to be processed. Crying and rage will begin, rise to a peak, and only when they have run their course, will they begin to abate. Only then will the inner child be willing to be comforted. That is how the original terrible emotions should have been dealt with. Now, decades later, they can finally and definitively be healed. 

The development of hope 

Let’s look at hope from a developmental point of view. I acknowledge here that, as a clinician, I may be on somewhat shaky ground. If I make wrong assertions, I’m open to being corrected. 

Since pre-human eras, the brain has been devoted to predicting the future, both immediate and long term. Defining mind as “the information processing function of the brain,” it’s mission, architected by evolution, is to take in data from the external and internal environments, identify opportunities and threats, and determine a responses that will increase the likelihood of future survival and procreation. 

Your dog anticipates your coming home. She peers out the window and listens for the faintest sounds associated with your arrival. Her mood is excited, just like a toddler anticipating the winter holiday. But I don’t think those reactions count as hope. What is missing is symbolization. The bittersweet flavor of hope comes from a mixture of painful uncertainty and the anticipation of pleasure. Holding those contradictory possibilities at the same time requires the ability to symbolize them. Symbolization doesn’t just mean words. It makes use of images, experiences, feelings, etc., encoded and stored as possibilities. Hope means holding pain at bay while keeping the positive outcome actively in mind and striving for it, despite whatever might stand in the way. 

Humans don’t start out with the gift of symbolization. The ability to separate symbols from sensory experience is an exciting event for one and two-year-olds as they play peek-a-boo. “Where is Justin…?”  “There he is!” The game involves holding an internal symbol of a person’s existence while sensory inputs say they are not there. By three or four, the game is no longer as exciting, but waiting and hoping are mainstays of emotional survival. 

Does hope require symbolizing failure? 

For children, admitting the possibility of failure requires the “skill” of acceptance, which comes much later. For small children, acceptance is essentially impossible, especially when the stakes are emotional life or death. They may let go of a desire, but the mechanism is more likely distraction or successful emotional processing as in a bout of tears. What children can’t do is acknowledge failure or hopelessness. Pre-schoolers will almost always respond to the fleeting thought of failure with denial or the assertion of a positive version of the story. Perhaps hope at younger ages does not involve any conceptual grasp of failure. It is simply held as a dread, something that must not happen. 

Let’s look further at how children cope when they lack the ability to symbolize failure or hopelessness. Pre-schoolers suffer from many things. Deprivation and abuse may be existential threats, but even under good conditions, consider the pain of being small and incapable of what older siblings and grown-ups can do so much with ease. One indication of the pain of smallness is pre-schoolers’ interest in big dinosaurs and big, powerful machines. Their way of coping is to identify with those powerful entities and imagine themselves being like them. These are forms of denial. In other words, they conjure up the opposite of what hurts. But that solution has one serious disadvantage. It involves falsifying reality. Imagining that one can fly is safe until the child is able to try it. Then it becomes seriously dangerous. What comes to the rescue is the dimension of time. 

Time to the rescue 

The dimension of time follows a similar trajectory to other cognitive developments, but comes later than the ability to symbolize the desired goal. Perhaps a good way to think about this developmental challenge is around the issue of object constancy. Knowing that Mom will return is an ability acquired a little at a time. At first, the child may learn from experience to tolerate short absences. Only later, is it possible for the child to appreciate the meaning of symbols representing time. Before the child grasps the dimension of time in symbolic form, reassurance probably comes more from the tone of voice of the reassuring adult. Gradually words like “an hour” or “tomorrow” take on meaning. At about 5 1/2 there is a revolution. 

"Grasping time is tantamount to freeing oneself from the present." 

These words by Piaget refer to the time when children gain the ability to conceive of the arc of a lifetime. That’s when they become fascinated with fairy tales that start with “Once upon a “time” and end with “forever after.” But what children can do with this ability is the revolution. For the first time, problems don’t have to be solved in the present by distorting reality through denial. Instead, problems can be solved someday, far into the future. “Someday I will be…” The beauty of this new skill is that there is no need to distort reality. One can hope in the future and who knows what will actually happen. Anything is possible. With the ability to see life as an arc, the Oedipal age child gains the possibility of solving the giant problems of the age by imagining and hoping in a better future. 

Under healthy circumstances, these fantasies become the beginnings of career and life choices. As long as they remain in consciousness, they can continue to evolve and become more attuned to the realities of life. 

On the other hand, when fantasies involve prohibited acts or outcomes, they can “go underground,” being removed from consciousness. Here I am suggesting an explanation of “Oedipal” pathology in high functioning people hobbled by internal guilt and inhibition. We still don’t know the precise mechanism of this “repression,” and there may be multiple mechanisms. Clinically it is quite clear that such “guilty quests” can remain active for decades until the possibility of being realized comes into view. The result can be problematic desires or even acting out, which tends to continue until, hopefully, psychotherapy brings to light the plan being executed and makes a place for a new solution to the old desire. 

Hope of justice 

Another dynamic I have seen is the hope of having parents admit their errors. Clients may hold the hope that if only her parent would admit to having failed at parenting, then anger would be unnecessary and there would be no need to forgive, which may be as dreaded as acceptance. Of course, the hope of the other’s repentance becomes the nonconscious problem solver’s aim in therapy. In other words, the transferential plan is to get the therapist to admit to being a bad therapist. Such cases can put a significant strain on the alliance. 

A happy ending: Hope fulfilled 

Perhaps one of the most important roles of hope is in supporting motivation for healing and growth in therapy and in life. Hope can be just as much a force for the positive and it has the power to overcome practically any obstacle. If we are to help our client trade a cherished, but ineffective solution to a life and death problem, we had better have something to offer. In this, we are in a position very similar to drug marketers hoping to sell a medication that has significant side effects. The situation is actually more challenging. The child client has already been disappointed and is expecting us to fail, yet hopes we will cooperate with the plan of avoiding anger and hopelessness. Meanwhile, we are proposing an unfamiliar and untested solution to the old problem. If we are dishonest or even inauthentic, we lose trust, so we can’t be tricky or “salesey,” but we do need to paint a picture of life after healthy acceptance. Fortunately, the product we are selling has only one side effect. It involves going through the painful feelings. That is how old wounds heal and humans come to acceptance. To the inner self the feelings may seem forever (the inner self isn’t recognizing time), and the well of tears seems bottomless, but healing is actually time limited and survivable. The art of helping clients find hope that they can participate in this healing is a significant part of successful treatment. It is helping our clients put their hopes in going through painful feelings with an empathically connected witness and experiencing the healing that may not seem possible but is. 

As much as we might wish to avoid the cold of winter, we do better to face it and experience its discomfort. We can do that with hope, keeping in mind that spring is not that far away. It will come, we will survive. And when it comes, life will feel better than ever and we will be prepared for future winters. 

Jeffery Smith MD