Book Review: The Origins of You by Vienna Pharaon

 

My “Unified Therapy” psychotherapy model, which I’ve been writing about since the publication of my first book in 1988, is meant to treat people who engage in repetitive self-destructive and self-defeating behavior, particularly in relationship contexts. You know, like people who marry one alcoholic or narcissist after another. While looking at their past is essential – in fact I look back three generations to find out why my patients, and their parents and grandparents, act the way they do – what’s even more important is what goes on in the present.

I found that people were acting out roles in their families to stabilize their parents, not for selfish reasons, and were suppressing who they really would want to be if left to their own devices. We all have a tendency to do this due to the effects of an evolutionary process called kin selection. We can choose to do otherwise, but if we do we become subject to terror when our families invalidate us.

Family roles are something modern day therapists pay almost no attention to, so when a book comes out that addresses dysfunctional behavior that dates back to family processes in childhood, I’m keen to read it. The Origins of You by therapist Vienna Pharaon is such a book. She looks at her clients' repetitive dysfunctional behavior in their relationships  as a way for them to feel safe because of earlier interactions with parents. She looks for ways that people do things like act like doormats in relationships – or go to opposite extremes and constantly try to dominate other people.

She addresses five needs from which these behaviors arise, which she says derive from what she calls “origin wounds.” She notes that her clients who had previous therapists often had not mentioned them. The needs which lead to these origin wounds are:

1.       I want to fell worthy.

2.     I want to belong

3.     I want to be prioritized.

4.     I want to trust

5.     I want to feel safe.

After review their childhood history, she uses a lot of popular techniques which are basically supposed to lead to behavior changes after insight into these wounds is achieved, and then has her clients monitor their behaviors for those which lead to conflicts, communication problems, and lack of boundaries. Then they talk about what changes need to be made.

The author claims a fair amount of success doing this, which I don’t doubt. She talks about emotionally abusive parents and a little about physically abusive ones, and domestic violence in the family. But not very much about severe physical abuse and neglect or child sexual abuse which families have refused to acknowledge. In my experience, clients like those who follow the recommendations here would be subject to massive invalidation by their families, which I found eventually and (almost always) undid any positive changes they had made from the type of therapy described in the book.

To her credit, the author does say that these problematic patterns are learned in the family and passed down to subsequent generations. And that the parents also have their own origin wounds, with which I totally agree.

But there are two issues that I (but almost no other therapists) have with her ideas. First, aren’t these people really aware at some level of what they are doing, even when they won’t admit it - even to themselves? Second, are they really protecting themselves, or are they altruistically sacrificing themselves for their parents?

On the first issue, the author does seem to come closer to my point of view in the text and with a couple of her clients. She mentions that a dysfunctional path “is easily recognizable, but sometimes hides in plain sight.” A client named Amir could clearly describe what he was doing but claimed to have no idea why. A long time ago I came to the conclusion that people are not stupid or blind about this, but acted as it they were. To understand what’s going on in my view, check out these posts on a groupthink process called willful blindness.

On the second issue, it’s hard to believe that clients are acting this way because they are protecting themselves, when the patterns are obviously bring them much pain. (There is one selfish motive mentioned above: the phenomenon of existential groundlessness). But as I have said, they are sacrificing their own needs to help maintain family stability.

Which also means that the process going on with the parents continues well into adulthood. The author seems to know this on some level but does not talk a lot about the response of their parents to new changes in the client’s behavior, so it’s hard to judge if she thinks this happens very often. Near the end of the book she does mention only briefly the risk that her clients maybe be “judged, shamed, rejected, or even disowned.”

In general, the author describes these patterns and how to conceptualize them very well, along with techniques which may lead to significant behavioral changes in some families where massive invalidation is far less likely that in those producing offspring with severe personality disorders.