This post is about the ways that therapeutic gains can surprise us and our clients when they lead to painful negative experiences. The bottom line is that being ready to help clients prepare for these events can turn bad experiences into positive ones.
That’s the term I use when clients experience intense shame following a significant move forward. A dramatic example of backlash happened when a client applied the best and most effective remedy for the kind of chronic submissiveness that results from parents attacking their own child. It’s what I call “civil disobedience,” meaning the adoption of the very behavior the client’s inner mind regards as dangerous. After becoming intellectually clear that her submissiveness was inappropriate and that it was caused by internalization of the attitudes of her abusers, the choice to adopt a radical change in behavior was far more powerful than any self-talk for improving low self-esteem and changing inappropriate submissiveness. For a graphic demonstration of the power of behavior change, consider the TV show, “What Not to Wear.” Simply changing their wardrobe to make it more stylish caused participants to experience intense emotional discomfort. The explanation is the same; their behavior had deviated from internalized attitudes towards the self.
In my client’s case, recognizing the inappropriateness of being submissive in her professional and personal life, we discussed how she had begun to bring civil disobedience into her relationships and could do the same through her body. In fact, bodily expression might prove to be an even more powerful antidote than “standing up for herself,” which she had already begun to practice. By the next session, she surprised me by having signed up for boxing lessons! It made perfect sense. She was showing her inner self that owning and exercising her power was perfectly healthy and normal, an example of the kind of "surprising new information" I have been talking about as part of the healing moment. A few days later, I got a request for an emergency session. She was in tears, feeling intensely ashamed and even having suicidal thoughts.
What had happened?
As I discussed in TIFT #9, shame in cases of neglect and abuse is not simply “learned” as is often assumed. A more accurate term is “internalized.” It is at the center of a mechanism that is universal among humans of any age. Being alone and disempowered triggers a response of internalizing the attitudes of whoever is nearest and most powerful. I believe it is driven by our inborn need to maintain some form of human connection. The Stockholm syndrome is an example in adult life and the movie “Good Will Hunting” depicts the same response in early life. The reason for calling the phenomenon “internalization” is that these mental contents appear to be structural and permanent. The evidence for permanence is the ease with which shame returns after apparently successful treatment when the client is subjected to one or more negative triggering experiences. Despite the possibility of relapse, the mechanism of recovery appears to be that healthier attitudes are adopted along side the old negative ones, but in a way that overrides the pathological internalizations.
The shame that these attitudes generate is a product of the conscience. That is the internal reward and punishment system, evolved to use pride, shame, and guilt as reinforcements. It does a powerful job of keeping our behavior within safe bounds to insure acceptance within in our family or tribe.
Thus, from the point of view of this automatic, self-protective system, by taking up boxing, my client’s inner mind felt she had put herself at severe risk of being evicted from human connection. Not only had she actually experienced parental punishment for assertiveness, but, from the point of view of our ancient system of self-protection, disobedience to power equates to death and demands the most severe righting response in the form of shame. More importantly, this same drive can lead one beyond shame to destructive behaviors in the form of retreat from health or, worse, self-inflicted harm.
Blame the victim
A particularly interesting and common twist on this self-punishment is blaming the victim. Just as perpetrators often do, in her emergency session, my client had turned to blaming herself for her submissiveness. Together, we had already explored and substantially targeted her inappropriate shame about showing strength. Now, in her new crisis, she had found an additional way to criticize herself. She had turned against herself for a lifetime of “giving away her power in the interests of safety.” As if it had in any way been voluntary, she blamed herself for being a “coward” and giving in to her abusers. Her self-hate was intense. This is not unusual. How often do survivors of early neglect and abuse hold themselves responsible and vilify themselves for the very dysfunctions their inner mind has automatically adopted for survival. “I’m so weak and such a people pleaser, I hate myself.”
In the face of such unfair self-criticism, we need first to listen empathically and then, as the storm begins to die down, talk about the fact that this wave of self-abuse is yet another manifestation of the Stockholm syndrome, unwarranted self-criticism, in the service of survival.
Yet another way therapeutic gain can cause negative feelings
Another very common phenomenon may not be quite as intense, but is nevertheless to be expected. When clients begin to experience newfound success and pleasure in life, they can be overwhelmed by anxiety. They become afraid that something bad will inevitably happen and their success will come crashing down. This is different from internalization of negative attitudes. It appears to be something more like learned fear. Coming from a past where childhood happiness and pride were discouraged or even punished, it is common for the inner "mammalian" mind to expect failure and predict more punishment. This response appears to represent a learned fear, generalized to the present. Perhaps this is combined with the vulnerability that comes with having something so shiny and new. Isn’t it natural to be more worried about denting a new car than one we have owned for a while? In any case, this is not shame, but anxiety. It can be quite intense and can also lead to impulses to retreat from a new benchmark of progress.
One more twist
My advice to clients in both these cases is to persist. For those troubled by shame this means marching on in spite of the discomfort, and for those with anxiety, it means embracing the fear as a product of a young inner protector and going ahead anyway. As Joyce Meyer says, “Do it afraid.”
It’s okay to go slowly or even to reduce the scope of new, healthy behavior, as long as progress is being made. I picture walking uphill against a stiff wind. Progress might be slow, but persistence pays and results will come. However, inner protectors can do even more to block what they perceive as dangerous.
The more problematic response is to build in some form of self-sabotage. What is most troublesome about this response is that it is typically invisible to the client. That’s why clients who are working at adopting healthier behaviors should always talk about the specifics with someone they trust. The other person is much more likely to spot the element of self-sabotage. Not only does self-sabotage reduce positive results; it can result in total failure. Then the client will say, “See, I knew this was a bad idea!”
The temptation to undo progress comes from our natural instinct, conscious or unconscious, to avoid uncomfortable feelings. Beware! Just as it is not safe to negotiate with terrorists, the inner self isn’t really interested in peace. Rather, our protectors see compromise as a concession that will lead to more concessions and eventually to complete elimination of the “danger.”
Sabotage can take the form of subtle signs of unsureness that signal a lack of commitment. Another common compromise is to take on too much, so as to guarantee failure. Yet another is to embed an implied question, “Is this ok?” The other person will usually back away, sensing and being uncomfortable with the implication of responsibility for an answer. The client then mistakes reluctance for rejection. There are many other tactics. Our non-conscious protectors have access to the same intelligence as we do. To repeat, supportive but disinterested people such as healthy friends and therapists are in the best position to notice self-defeating elements and point them out.
Moral of the story
What we therapists particularly need to understand about these patterns is that discussing them in advance is an enormous help to our clients in navigating the shark-infested waters of success.
Jeffery Smith, MD
Photo credit Vidi Drone, Unsplash
Looking for supervision or mentoring?
Howtherapyworks' Psychotherapy Coaching Community might be the answer for you. Click the link above to find out.
For new readers:
Free Gift Infographic
The Common Infrastructure of Psychotherapy
How lucid clinical understanding of change processes will free you from the limitations of "branded" therapies and transform your practice.
Join our mailing list to receive the biweekly TIFTs as well as news and updates. Unsubscribe at any time
We hate SPAM. We will never sell your information, for any reason.