Tuesday, February 16, 2016

Reader's Therapists Disagree With Me

"Letters, we get letters
We get lots and lots of letters"

Yet another interesting letter came to me in response to my posts that make the recommendation to adult victims of abusive families that they find a therapist who can help them confront their abusive parents about the family dynamics in ways that get the parents to stop any ongoing dysfunctional interactions. 

A therapist actually fired the reader from his practice because the patient did not want to divorce her mother!

As I have said repeatedly, I never recommend that patients continue to be abused by their families. However, I do not think that divorcing your family is the only other option, and it is certainly not the best option. This is because, unfortunately, you continue to carry your parents around with you in your head for the rest of your life. 

Fear tracts and other tracts in the brain's limbic system that determine the way we all normally respond to the interpersonal environment - and that are highly resistant to fading away through the normal processes of neural plasticity - come from, and respond more strongly to, one's parents than to anything else in the environment. 

It does not take much parental contact at all to reinforce them - even once every few years might do it. Contact from other family members in which messages about the parents are provided also works quite nicely in this regard. In fact, anyone else who behaves in any way that is even somewhat analagous to the way the parents behave will also trigger and reinforce them - and the pathways are very powerful in shaping our usual behavior.

Even if you stop interacting with parents altogether, you are very likely to pass on repetitive dysfunctional interactions to your own children despite your best efforts. Often people go to the opposite extreme from their parents in the way they interact with their children, yet end up with kids with exactly the same problems, as described here. Other children from abusive or neglectful households decide never to have children themselves for fear that they might turn out acting just like their own parents.

As mentioned, divorcing a family and continuing to be abused are not the only two options. There is a third: the one I mentioned in the first paragraph above. It is certainly not an easy thing to accomplish, or patients would have done it themselves long ago. It takes a lot of patience and persistence. And doing it badly is worse than not doing it at all. Nonetheless, with one's family of origin members, where there is a will, there is a way.

Unfortunately, the majority of therapists these days do not really understand family dynamics at all, are unaware of the above risks involved in recommending a "divorce" from parents, and do not know the techniques for helping their patients overcome multiple resistances and invalidation from family members when the patients attempt to discuss family dynamics with parents in a constructive way.

Interestingly, just after a received the letter from the reader mentioned above and went on to answer it, I got an extremely nasty missive from a psychotherapist on this very subject. Perhaps it was even the reader's prior therapist. I mean, who knows? I won't mention the therapist's name, but she even signed it. The letter read:

As a therapist I can say you are an awful therapist; truly terrible. The best thing a person who has been abused as a child can do is get away from their parents, make peace with it. Suggesting that someone that has been abused, goes back to the abuser and does the work to try and repair damage is abusive and shocking. I am shocked.

This therapist apparently thinks patients who were abused as children are just too weak and damaged to stand up to their family members. How invalidating! That's probably what the abusive parents think of their adult child as well.

Anyway, here is the letter from the reader complaining about a therapist just like her. My answer is written below in amber color.

My parents abused me, physically, sexually and emotionally. As a result I
have a traumatic brain injury. I was put in foster care when I was 13. I am
now 35. I have gotten help. I am getting help still. My last therapist fired
me after I reconnected with my mother.

My mom has apologized and she has changed! It took awhile as in years but we now have a great relationship. I have a new therapist. I am scared because over Christmas I reconnected with my father who has also apologized and changed for the better. I have closure.

I have my family. I am scared that if I tell my therapist she is going to
freak on me, shame me, guilt me and or fire me. I am seeing her for help for
my own bad choices and the resulting trauma. I know she hates my family but I
don't understand how a therapist can tell me that I can change while insisting my family who they have never met can't [right on!]. It doesn't make any sense. I am not sure how to tell her.

I can't comment on your situation specifically without personally evaluating you and your family extensively, and without knowing a lot more about your experiences with your therapist, so the following are general comments that may or may not apply to you:

As you may have guessed from my blog, I am a firm advocate of my patients reconnecting with their families, even if the family had been abusive, as long as the abusive or invalidating behavior has been stopped and has been openly discussed by the involved parties, with the result that everyone has some idea of where the dysfunctional patterns came from and what purpose they had served. Before that goal has been accomplished, I coach my patients on how to get through the family’s often formidable defenses against having such conversations, so that they can get to that point.

Of course, I make sure that my patients have a safety plan for themselves (and their children if any) if this process starts to take a wrong turn, in which case we try to figure out what went wrong and how to get things back on track. I almost never give up. However, if a patient puts their child in danger (like leaving a young one with a grandfather who had sexually abused the patient as a child), we have to work on that issue first.

Unfortunately, there are a lot of therapists who still believe that divorcing one's family is the best course. My recommendation in such a case is to find another therapist. Unfortunately, therapists familiar with dysfunctional family dynamics are getting harder to find.

Also, if someone is afraid to be honest with their therapist, that in general ties the therapist’s hands, so there is almost no point in continuing. A good therapist may certainly question a patient’s decision but should never attack them personally for having made it.

Tuesday, February 2, 2016

Themes of This Blog Seen In Newspaper Advice Columns – Part III

This is the third in an occasional series of posts showing how several of the issues I discuss in this blog show up in letters to newspaper advice columnists. In order to assure themselves a wide readership, advice columnists must bring us problems that resonate with a fairly wide demographic, and they therefore provide us with another source of information about human behavior and cultural trends.

I follow Jeanne Phillips (Dear Abby), Carolyn Hax, Amy Dickinson (Ask Amy), and Marcy Sugar & Kathy Mitchell (Annie’s Mailbox).

Of course these letters leave out a lot of what might really be going on with the writer, and I will be admittedly speculating about how the behavior described in the letters may be examples of covert issues that are not being directly discussed.

Before each letter, I will discuss the blog subject that seems to be being discussed. I will also include a link to a related post. I am not including the columnist’s responses to the letters. 


In the following letter, a father pushes his son away by constantly telling him what a disappointment he is. The son has rejected the trappings of what the father considers successful living. It is quite likely in such situations that the "disappointing" son might be acting out the father's repressed or covert rebelliousness against the very standards the father seems to embrace. 

In such situations, the father probably does things on rare occasions that indicate to the son that the father is "getting off" on what the son is doing - but then the father rejects him as a way of rejecting that part of himself that he finds unacceptable. In actuality, those parts were unacceptable to his own family of origin.  The son then obliges by keeping his distance. Thus, this could be a possible example of the role of Avenger.

12/6/15, Carolyn Hax.  Dear Carolyn: Through the years, my husband has learned to let go of the hopes and dreams he had for his son, that he would achieve financial and social success as my husband defines it: white-collar job, nice house, nice cars, wife and family, membership to country club, all the trappings that he has achieved for himself and that represent success to him. His son, on the other hand, works in the restaurant trade (not in management), lives a pretty bohemian lifestyle but has neither been in trouble with the law nor abused drugs... Husband has never made it a secret that he feels son could have done better. Son has never married at age 40 but now finds himself the father of a child (he plans to take responsibility for the child). We want to be a part of this child’s life. At this point, the only expectations my husband has of his son is that he respond to his efforts to contact him. To no avail. Son responds on his own timeline or not at all despite repeated requests. My husband wants to draw a line in the sand over this. I think we should go with total capitulation for the sake of the future grandchild. How can I be supportive of my husband (“Yes, I understand how frustrating this communication thing is for you”) but still make it clear that I will not take part in any “line in the sand” stance? This is creating tension between my husband and me. - The Step Mother


In the States, we tend to think people are basically selfish and don't care what other people think, especially family members. We think kids growing up are more influenced by their peers and the media. Of course, the questions of which media a teen looks at and with which peers he or she chooses to associate with - and there is a large variety to choose from - is ignored in these formulations. The choices people make are no accident. Also, as I've pointed out many times, kids who appear to be oppositional to their parent's wants and values only do that because that is what they think the parents expect of them.

I believe people really are willing to sacrifice their own opinions and desires in order to please their parents. Of course, how much one can challenge parental values depends on how conflicted the parents are about them. In the following letter, a woman performs summersaults trying to both be her own person and please her parents at the same time. 

12/14/15. Ask Amy. Dear Amy: I have been with my partner for five years; he rents his own place and I live with my parents. My parents are old-fashioned and believe I can only live with him when we are married (I used to share this view, but now I don't). I have finished college and have moved back home to pay off my debt and save for a house (or wedding!). My partner's home is five minutes away from my workplace and my folks' house is one hour away (in good traffic), so I do frequent "sleepovers" at his place. This is causing tension in both households. I pay rent to my parents and I help out my partner by cleaning up after myself and buying bread, milk and eggs regularly. But he says that I'm using him, and that I'm just doing the minimum. He says I should be preparing dinners for both of us when I am there, doing washing, or helping by paying rent or at least one utility bill. Now I'm broke, tired and grumpy. I'm at his house cooking and cleaning, and then when I'm at my parents, I'm doing exactly the same thing to appease them because I've slept over at my partner's house. I've gone cold turkey and have slept only at one home, but then money is wasted on gas driving back and forth. I can't afford to move out and I don't want to get married just so we can live together. HELP!!! — Betwixt


When someone is playing a dysfunctional role within their family of origin, it can be difficult and painful. When seeking a spouse or partner, such people will often pick someone who will help them to continue to play the difficult role. They, in turn, help their spouses play a difficult role within the spouse's own family of origin. This is what I refer to as mutual role function support. It can be thought of as a form of mutual enabling.  

It is important to remember that the alcoholic enables the "co-dependent" to be a co-dependent as much as the co-dependent enables the alcoholic. The whole process is bidirectional - it goes both ways simultaneously. In the following letter, the son of a controlling mother marries a spouse who is also rather controlling, as even the advice columnist recognized. In a variation on this theme, the mother and the wife start competing with one another over who will have the most control over the poor guy. If the mother's need to control men were a bigger issue for her and her family, he might never have even become engaged in the first place.

12/15/15. Ask Amy.  Dear Amy: I have a controlling, manipulative, guilt-tripping mother-in-law-to-be! I know that each time I hear from her she is just trying to trap me into saying yes to something. These traps include trying to get me to change our wedding plans, and roping me into a jewelry party hosted by her friend (repeatedly pushing on that). She just can't understand the word "no." When I did say no she whined to my fiancé, saying it felt like a slap in the face (can you say "manipulation"?). This has to stop. My fiancé tried dealing with it by telling his mom that I will say no to some things, but I felt this was really his way of calling me "pushy." My fiancé tried the kid gloves approach and it didn't work. I decided to take matters into my own hands and texted her three examples of her overstepping her boundaries and letting her know it would no longer be tolerated. She had the nerve to say it made her "sad." Now he is having a hard time because his mom is upset. He doesn't understand that we have to back each other up, especially in situations like this. His mom is so bad that she needs a copy of his shift schedule at work because she wants to keep track of him. Maybe my approach is too direct, but so what? We are in our 40s and don't need to be under her thumb. I don't let my mom get away with this kind of behavior, and I'm certainly not letting a MIL do this. What is your opinion, Amy? — Upset


One of the most read posts on my Psychology Today blog, and the one which generated some of the most heated responses from reader, posed the question of whether parents who had been cut off by their adult children were really as clueless about the reasons that happened as they portray themselves to be in public. With my patients, unlike the followers of many psychotherapy schools, I always presume that people are never too stupid to notice that their repetitive behavior leads to bad outcomes - yet they continue to engage in it anyway.

The following letter is remarkable in that, while ostensibly asking advice, the mother of an alcoholic woman, who is also what I refer to as a Minnie the Moocher, admits as clearly as imaginable that "I know I've enabled my daughter for her entire life."

12/28/15. Annies' Mailbox.  Dear Annie: Our oldest daughter is married to a nice man and they have a sweet 2-year-old daughter. My son-in-law makes good money and my daughter can afford to stay home, but they never seem to have enough to get ahead. My daughter has been known to spend foolishly. They only have one car and it doesn't run half the time. They can't afford another. We let them live in our home for a year rent-free, so they could save enough to purchase their first house. I know I've enabled my daughter for her entire life. She is very spoiled and self-centered. We argue a great deal and exchange hurtful words. Regularly, I surrender to her selfishness and give her money or run errands for her, even though I work full-time. I do these things because she is a recovering alcoholic and drug addict, and I fear she will otherwise return to that life again. She doesn't attend her meetings anymore. I don't know how to handle her. I'm either forced to defend myself or give in to her whims. She never appreciates anything I do for her and she never does anything for me. Her husband is no better. He is selfish and spoiled by his mother, and he also enables my daughter. She's a good mother, but I babysit a lot. Her husband doesn't complain when she gets together with her friends, but he works long hours and they don't have much time together. I think he feels neglected. How do I know when to do things for her and when not to? How do I tell the difference between enabling and being a good mother? When she gets into one of her horrible, blaming moods, how do I handle that? This child has become a bitter pill to swallow, but I love her so much.  — Mother of a Narcissist