Irrational Beliefs vs. Defense Mechanisms

The current predominant school of thought in psychotherapy is called cognitive behavioral therapy (CBT), which replaced the previously dominant school of thought, psychoanalysis (PA). There are of course, other psychotherapy schools - over 200 of them as a matter of fact. Why? Well, as I described in a another post, because of three facts: 

1. The brain is so complicated. 
2. We can’t read minds. 
3. People lie not only to others but themselves. 

Psychology is still a very young science. 

It is in a phase of development that the scientific philosopher Thomas Kuhn, in his classic book The Structure ofScientific Revolutions, called the “pre-paradigmatic stage.” This means that in young sciences in which not a lot is known, a lot of theories compete with one another for dominance until the evidence accumulates to the point in which one model starts to predominate. After a while, some problems with that model arise, which then leads to the development of new models. For instance, although Newtonian physics still works for large objects, it falls apart at the subatomic level, where it has been replaced with quantum physics.

Understanding that this is the way science works has not stopped a lot of psychologists and other therapists from loudly claiming that their model is the only correct one. The psychoanalysts used to do it. When anyone dared to question the theory, they were told they needed to get into psychoanalysis to find out why they were resistant to its ideas. Three logical fallacies in a single sentence! (For those readers interested in logic: ad hominem, non-sequitur, and begging the question. If you want more detail, e-mail me back channel).

Now the CBT people are playing this same “We are right and you are wrong; we are superior to everyone else” game. Historically, the game went down this way: Psychoanalysis attributed “neurotic” behavior (showing signs of mental disturbance but is not psychotic) to conflicts in individuals between their biological urges – their id – with their values that were internalized from their upbringing – the superego or conscience. CBT people said this was all a buncy of nonsense, and went on to cherry pick certain parts of PA theory that were obviously incorrect to throw hot water on all of the PA ideas – which is another one of the tricks that indicate “groupthink” is operating instead of “facts and logic.”

Which brings us to what is postulated to be the cause of neurotic behavior which cognitive therapists champion (behaviorism – rewards and punishments - seeming to have almost disappeared from the therapy arsenal of a lot of CBT therapists). Starting with Albert Ellis and latter with Aaron Beck, they attributed it to “irrational thoughts.” Someone thinking, for example, that they simply must be this or that, or torturing themselves by imagining unlikely worst-case scenario outcomes which would then prevent them from even trying something new that they might just excel at.

So who’s right? Well, both of them. But don’t tell that to any of them on either side. I once mentioned what I am about to say to Albert Ellis at a psychotherapy conference, and he practically laughed in my face in front of a whole audience. Anyway, the key is something that authors Jonathan Haidt and Gregg Henriques have discovered: Logic in human beings did not evolve to arrive at truths. It evolved to justify group norms. 

Groups have to stick together to survive; they can’t be constantly arguing about everyone’s individual ideas about what to do when they are, say, attacked by another tribe. So group cohesion has survival value – at least it used to. It still does to a significant extent, but with the advent of technology and other modern developments, not nearly as much as it once did.

Before I understood this, I was bothered by something I called the “problem of stupidity.” Why were people torturing themselves with these thoughts which are obviously and transparently stupid or illogical.  Even seemingly highly intelligent people do this all the time. Are we all really that dull-witted? I didn’t think so, so I asked myself why these people are seemingly acting as if they are that dumb.

See if you can spot the irrational idea in a recent letter (8/14/19) to advice columnist Dear Abby:

8/14/19. DEAR ABBY: I've been with my boyfriend, "Rocko," for two years, but in the late months of last year… He would disappear for days at a time, block my phone number and ignore me. I was sure he was seeing another woman or taking drugs because he is an ex-addict. Two months ago, he was arrested. I was right -- Rocko was on drugs and had been hanging out with another woman… I hate myself, and I can't stop wondering why I wasn't enough.

See it? Her boyfriend is an addict and a cheater, yet this woman wonders why SHE wasn’t enough for him! It wasn’t his glaring and obvious faults and limitations: his problems were all due to her and her being inadequate to meet all of his needs. How nice of her to blame his irresponsible behavior on herself rather than hold him accountable!

If we assume that she is not stupid enough to think this is a logical conclusion, then we have to ask ourselves why on earth she doesn’t just dump the S.O.B. and find someone who will treat her right. I answered this by looking at the end result – what I call the net effect  - of her continuing to think this way. It’s obvious. She ends up staying with a man who cheats and uses drugs. So this would have to be her intent.

(But why on earth should she want to do that? The answer to that question in my opinion lies in her playing some sort of dysfunctional role in her family of origin which requires her to do this in order to stabilize her unstable parents. Explaining that part is beyond the scope of this post, but various roles are discussed in detail in previous ones).

So the irrational belief generates anxiety which then prevents her from acting in her own best interests. This allows her to continue to sacrifice herself for her kin group – a process known in evolutionary biology as kin selection. Guess what? The defense mechanisms of PA accomplish the very same thing. Analysts think that defense mechanisms are meant to control anxiety, but as a fellow blogger known as The Last Psychiatrist once said, if that were true, they sure do a lousy job of doing that. No; in fact, they too are meant to either create anxiety or do other things which lead people to avoid doing something that might conflict with their role in their family.

If for example your role in your family is to be a scapegoat so that your frustrated father can blame you for all of his problems and not have to feel bad about himself, his behavior is bound to make you angry. Your anger makes it hard for you to maintain the scapegoat role. You may eat (or repress) a certain amount of it, but some of it must be discharged somehow. So you come home and kick the dog (the defense mechanism of displacement).

Defense mechanisms or irrational thoughts? You say tow-may-tow, and I say tow-mah-tow. They are the same damn thing!

Personality Disorders: Researchers Continue to Make Misleading Assumptions

In this blog I have discussed several instances of researchers making unwarranted assumptions about both their study populations and in interpreting their results in a variety of ways. In this post, I’d like to focus on three recent articles about personality disorder research. The first is a possible refutation of a common presumption, while the second two assume facts not in evidence.

The difference between “cannot” and “do not:” Confusion based on lack of attention to subject motivation, and ignorance of the concept of “false self.”

Shane MS; Groat LL. “Capacity for upregulation of emotional processing in psychopathy: all you have to do is ask.” Social Cognitive & Affective Neuroscience. 13(11):1163-1176, 2018 11 08.

Could it be that a psychopath’s apparent lack of ability to be empathic stem from differences in motivation rather than ability? This article is certainly possible evidence that this is the case. Perhaps people who routinely engage in anti-social acts suppress empathic responses because that is their role in their family. That what has been observed results from subjects’ false selves? 

This study of course does not address that latter issue, but thinking about it certainly suggests something which could explain the results. (Of course, it would help in that endeavor if we could read minds, because the thing about a false self is that it is based on someone lying to themselves in order to fulfill a social function, so they are highly unlikely to tell experimenters the truth during a short interview).

In any event, in this study, high-psychopathy participants showed typical, significantly reduced neural responses in the brain on an fMRI to negatively-toned pictures under passive viewing conditions. However, this effect seemed to disappear when the subjects were instructed to try to maximize their naturally occurring emotional reactions to these same pictures!

The locations of these increased neural responses included several brain regions involved in the generation of basic emotional responses and which have often been shown to be reduced in psychopathic populations. Thus, despite baseline differences from non-psychopaths,  high-psychopathy participants appeared capable of deliberately manifesting emotional responses to the negatively toned pictures within several brain regions believed to underlie emotional processing. 

Of note was that the magnitude of these deliberately evoked emotional responses was comparable to levels exhibited by low-psychopathy participants’ during passive processing.

A high index of suspicion versus an “inability” to correctly read the mental states of others

Quek et. al., “Mentalization in Adolescents with Borderline Personality Disorder.: a Comparison with Health Controls.” Journal of Personality Disorders, 33 (2):145-165, April 2018.

Mentalization refers to an individual’s capacity to understand and interpret the meaning of one’s own and others’ behavior by considering underlying thoughts, feelings, intentions, and desire. As in other studies, this was “measured” in adolescent subjects with borderline personality disorder (BPD) and normal controls while interpreting the mental states of others shown in pictures, videos, and narrative vignettes of people in various social situations.

The authors of this paper mention almost in passing that the ability to mentalize  is thought to develop within the context of, and is dependent on, the quality of infant- parent interactions. In the experiment, the differences between the performance of the BPD subjects compared to the control group on the various tests became much greater when the material they interpreted suggested attachment-related stress or arousal. 

Additionally, the major differences between BPD subjects and controls seemed to primarily involve what the authors describe as hypermentalization (that is, making much more complex inferences than expected about social cues, signs, and mental states) by the BPD subjects, rather than through a loss of detail.

Despite all this, the authors don’t seem to consider the obvious possibility that attachment figures’ influence on their children’s ideas about the social behaviors of others continues unabated long after they are no longer infants.

So let’s do a mental experiment. How might you evaluate the motives of other people if you were to grow up in an family environment characterized by your being constantly invalidated and given highly confusing double messages about how you are supposed to think and behave, and even being verbally abused— if not physically or sexually abused—if you seem to have guessed wrong about that? Do you think you might have a higher index of suspicion about other people’s intentions than someone who did not grow up in that environment? Do you think you might have more difficulty making sense of other people's behavior? Ya think??

So, do kids with BPD grow up in that environment? Well, in addition to Linehan’s theory of an invalidating environment being part of the etiology of BPD, and my own paper from 2005 (Comprehensive Psychiatry, 46[5] pp. 340-352) which showed that adults with BPD reported about three times the number of double messages from their parents than non-BPD controls, consider the following paper.

Changing parent’s behavior towards BPD children can make those with BPD better—but their behavior apparently had nothing to do with their kids having developed the disorder in the first place

Grenyer et. al., “A Randomized Controlled Trial of Group Psychoeducation for Carers of Persons with Borderline Personality Disorder.” Journal of Personality Disorders 33 (2):214-228, April 2018.

As mentioned in a post on my blog on Psychology Today, researchers into BPD have of late developed an interest in the “burdens” on parents and other caretakers (almost always other relatives) of having a child or adult child with the disorder. Such “carers” are the subject of this particular study, and were recruited through flyers distributed to mental health services, local media, patient advocacy groups, and patient family and support networks. The recruits were put into groups and given a lot of “psychoeducation” about their charges.

The first thing that jumped out at me in this paper was the fact that, even though the carers were evaluated for being critical and over-involved with their BPD children, there was nothing mentioned about seeing if the parents had been guilty of physically or sexually abusing their charges when the fledgling BPD patients were children. This, despite the fact that every empirical study done on this subject in BPD patients finds a high level of significant abuse history. Of course, parents who respond to flyers and volunteer to be research subjects in this sort of study are highly unlikely to have been seriously abusive. So right away, the experiments are selecting for a somewhat atypical sample of parents of children with BPD.

The second thing that jumped out at me was that the psychoeducation provided for the subjects was supposedly based on Bowen family therapy theory, when the researchers mentioned and seem to know absolutely nothing about one of the major tenets of that theory. You know, those that involve intergenerational transfer of dysfunctional family patterns. The researchers mention nothing about the parents being somewhat responsible for the development of the disorder in their kids in the first place!

That they seem to make this assumption is even more awe-inspiring when you look at what was being taught to the parents and which apparently led to improvement in the BPD child’s behavior as well as in the parent-child relationship. They were taught to:

1.      Be non-judgmental, validating, attentive and appropriate.

2.      Reduce their reactivity and try to remain calm and “mindful.”

3.      Attend to their own needs through staying connected with friends and family, attending to their own physical and mental health, and taking breaks.

4.      Model appropriate assertiveness and setting appropriate boundaries and ground rules for the relationship.

5.      Get outside help when crises arise and having a crisis plan.

So, if they had to be taught these things, and if doing those things leads to improvements in their children, maybe the fact that they were doing the opposite of those things all the time previous to the experiment was what was creating their child’s problems in the first place. Exactly what you would expect considering the family dynamics of BPD.

The Dysfunctional Family Role of the "Loser"

It seems like a lot more adults in the United States are living with their parents than ever before. Some of this is completely reasonable and is in no way indicative of significant family dysfunction, as economic conditions have led many twenty-somethings to require much more time to get their financial ducks in a row so they can move out and be more independent. 

In other cases, however, this phenomenon is due to significantly dysfunctional family dynamics. If the pattern continues into the adult children's thirties, forties, or even later, the odds that dysfunctionality is the culprit skyrocket. 

In  a previous post, I discussed some typical patterns that create this pattern, and pointed out that the adult children remain enmeshed with their parents because, covertly, they are taking care of some of their parents' needs. They may be mediating disputes between bickering parents who for whatever reason will not get a divorce; they may be helping take care of sick, elderly, or just plain lonely parents; they may be providing free cooking and housekeeping services for families that for a variety of reasons are not being done by someone else.

Or in some cases, all of the above!

This is the shell game that I refer to as Who is Taking Care of Whom?

I have seen cases of such patterns that continue throughout the entire lifetime of the adult child. You can find many examples of a sixty-something year old man or woman living with an eighty-something year old mother or father. The adult child's siblings may all be independent, but the "identified screw-up" seems to be the parent's favorite child.

Usually in these instances, the parent is taking care of all of the adult child's financial needs, including for housing, food and spending money, so said adult child does not have to work outside of the home.  The reason they do not work, however, is actually because they already have a full time job: taking care of their parents.

On the surface, it seems to all the world - and even to many peripheral family members - that the adult child is using the parent, and said adult child normally receives all of the blame for the dysfunctional living arrangement. They are accused of using the parents because of less than admirable motives.  Many such folks readily accept this blame, and in fact act in many ways to confirm everyone else's worst fears. They do this to protect the image of their parents, and in the process sacrifice their own reputation.

Another variety of this pattern is when the adult child living with parents pretends to be a failure who always seems to need the help of their parents. That is the version of the shell game that is the subject of today's post. The adult child appears to be a big loser in both love and work. Said adult children will venture out into the real world from time to time, only to return in relatively short order with their tails between their legs.

So how does one go about becoming such a loser?  Let me count the ways.

They may flunk out of school for various and sundry reasons that are not actually the real reasons. Alternatively, they may get a degree in something that qualifies them for a profession that is rapidly disappearing from the current landscape, so they cannot get a permanent job.

They may make impulsive decisions that get them in trouble in way one or another, and subsequently lose any job they do manage to land. They may even develop various medical or mental illnesses, some of which are real and some of which are feigned and some of which are both, but all of which appear to be far more disabling than these particular illnesses should ever be in real life (the role of the defective). Drug or alcohol problems are common.  Some of these folks are massively obese.

They may get themselves fired from a whole series of jobs, again for reasons which may appear legitimate but are masks for the real motivation of the job loser. Or they might take a job knowing that the company they work for is actually planning layoffs.

These people may also or instead play the role of loser in their love lives.  They may look like they are really trying to meet romantic partners by going to singles events or signing up for dating websites, but somehow very little comes of it. Or they choose partners - or a series of partners - who are abusive, have drug or alcohol or commitment problems, or are in other ways dysfunctional, so their parents have to come and rescue them from dangerous or dead-end relationships. Sometimes repeatedly.

Because of these patterns, the parents - who are in reality highly dependent on Mr. or Ms. Loser - often criticize the poor judgment of their offspring unmercifully.  

The more the parents criticize, the more the adult child continues making the same mistakes over and over again. The parent then feels justified in continuing to make the criticisms. On the rare occasions when the adult child expresses anger at the parent's constant harping and verbal abuse, the parent can point to the child's irresponsible behavior as justification for it.

In a very real sense, the adult child is purposely giving the parent this ammunition to use against him or her, although they do not have to think about this consciously while doing so because their behavior is habitual and automatic. This allows the parent to avoid feeling guilty for both their criticisms and for the fact that they are contributing to their own child's impairment. The parents, of course, act in this manner because they themselves are playing their own roles within the family.

Some are stuck in bad marriages because of family/cultural/religious prohibitions regarding divorce.  Some are females who are stuck in outdated gender roles with a prohibition against women being independent.  Some need their child to act out their own repressed anger because they cannot do so themselves - often due to family rules prohibiting anyone from being "selfish" enough to put their own needs above those of other family members.

There is a very incisive and sophisticated comic strip called Momma by Mell Lazarus that absolutely nails the family dynamics described above. A son named Francis is the identified loser.  He apparently does have his own apartment, which of course Momma is paying for, but he is constantly doing everything in his power to act out the various negative characterizations of him that Momma compulsively throws his way. 

It's kind of sad that a cartoonist understands this dynamic better than many therapists.

Book Review: Ghost of My Father by Scott Berkun

Half of all profits from this edition of Mr. Berkun's book, Ghost of Our Fathers (Berkum Media, 2014) will be donated to Big Brother Big Sisters of America

Our parents, or our primary caretakers when we were growing up, have a profound effect on us for our entire lives. They have this effect whether they like or not, and whether we like it or not. Attachment research has shown that their interactions with us help shape our mental models of both the world and how relationships are supposed to operate under various environmental contingencies (schemas).

The part of the brain called the amygdala, central to our fight/flight/freeze reactions to fearful stimuli, has specific cells that respond only to the face our mothers (or primary female attachment figures) - and nothing else. It also contains cells that respond only to our fathers/male attachment figures - and nothing else.

Even those who have managed to become more self-actualized or differentiated from our families of origin - who can follow our own muse and live according to our own independently formed beliefs - still hear or feel those old tapes of our parents' admonitions whenever we do things of which our parents routinely disapproved. I know I do, and my parents have been gone for decades. We can choose to ignore these tapes, but there is often a nagging doubt that arises in our minds whenever we do.

In his new book, Scott Berkum describes a feeling of being haunted by the past as well as by the ongoing behavior of his father, and does so eloquently using the words of a poet. I'll mention some examples of his beautifully-worded descriptions of some of the phenomena discussed previously this blog shortly.

Most of what I have written about dysfunctional family interactions on this blog as well as my blog on the Psychology Today website concerns what happens when parents give us contradictory or mixed messages about what is important to them, as well as what they expect from us. But what happens when they seem to give us almost no signals at all? When the parent is a big cipher? This is what happened to the author in his relationship with his father, and I suspect, though to a much lesser extent, with his mother.

His father was gone much of the time during his childhood, spending most of it working or at the racetrack gambling. He completely abandonned the family and the patient's mother twice in order to have extended affairs - once when the patient was eight years old, and once when the patient was in his forties. And yet when he returned each time, the mother would want him back, take him in, and take care of his needs.

He seemed to have little interest in what was important to the author. Much of the time he seemed to barely acknowledge his son's presence. The only sustained interactions they had seemed to occur at the dinner table, when the author, his siblings, and his father  would debate political and social issues. Father would seem to purposely take up a provocative position on the issue, and then stick with it no matter what arguments the author came up with.  Dad would never concede a point.

The author was plagued thoughout his life with a feeling that he was unworthy of his father's attention, and that nothing he did mattered to his Dad.

The author tried on numerous times to do what I recommend to my patients in therapy: attempt to empathically confront Dad to try to find out what made him tick and what he was really thinking (metacommunication). Unfortunately, each time he tried he ran up against a brick wall that would never come down. His father seemed to be incapable of discussing feelings. If the author pressed forward anyway, the conversation would devolve into a shouting match.

The book does not describe what was said during these explosions. With my patients in therapy, I try to obtain a blow-by-blow description of exactly what was said,  in chronological order, as best the patient can remember. This often gives hidden clues about the emotional processes that are taking place in both participants during the battle, as well as to why they are reacting the way they are.  In turn, this can suggest ways to have conversations that do not go in the usual direction and do not become fighting matches.

Interestingly, Dad did apologize for his behavior on one rare occasion and even expressed his love, but both the apology and the expression seemed to ring hollow with the author, who more or less rejected them.

Of course, when the author rejected them, he may not have realized that this let his father off the hook as far as further elaborating on the problem at hand- which was likely the father's goal all along. Saying what a family member wants to hear in a seemingly insincere way and/or when it is least expected often leads to such a rejection of the expressed sentiment. The person who does this then walks away thinking, "Just as I thought - he didn't really want to hear that, but at least I tried." This is an example of the game without end.

The author does discuss some genogram information, although whatever therapists he saw may not have not called it that nor known exactly how that information might best be used to design more productive family interactions in the present. The information about his father's upbringing was rather telling, and seemed to explain one statement the father made in the middle of one of the author's attempts to metacommunicate: "Your problem is you remember too much."

The author's paternal grandfather was described as "the quietest man I ever met." The author adds that he "...was always watching professional wrestling when we visited. He'd stare into the television as if he and it were the only thing left on the planet. His social skills, even with his own grandchildren, were non existent...I don't remember him ever saying a word to me."

No doubt Dad's father had done to him pretty much what he did to his own son. 

Clearly this was Dad's unfortunate role model for being a father. Clearly there was a family rule against fathers and sons communicating meaningfully. The author also admits that he shared some traits with his father - at times more than he cared to admit even to himself - demonstrating the intergenerational transfer of dysfunctional traits. The father must have tried to handle his own feelings by trying to "forget" what had happened.

A clue as to the origin of the family rules is that the father's paternal great grandfather  fled to the US from Ukraine in 1902 to avoid being drafted into the army, leaving his brothers behind. Undoubtedly there was a lot more to that story, especially since the brothers died in the Holocaust many years later. Was there some resulting hidden guilt and shame that had to be kept out of mind and never discussed?

The book is supposed to be primarily about the author's relationship with his father, so Mr. Berkum gives limited attention to his relationship with his mother. While he described them as close, it sounds as though certain subjects were off limits with her as well - like why she remained involved with such a distant man, and why she would take him back after a second betrayal.

The only person in the family who seemed to be able to express anger was the author's sister Tracy, who of course went overboard in doing so. Interestingly, the parents seem to keep her around almost as a pet - she lived with them or next door to them even after she married and had kids - until she, like the author himself did as a rather young man, finally moved away to escape. 

No doubt the parents needed Tracy's expressiveness to release some of their own pent-up rage.

Some concepts from the blog that the author describes poetically:

Distancing: "He mastered wounding us just enough that we'd leave the conversation as quickly as we could." (p. 11).

Existential groundlessness: "...we forget when we become adults that the armor made to survive our youth no longer serves us...yet removing it is painful...it puts us at odds with our family and friends, as tribes prefer to stay with patterns of the past. Most people convince themselves that removing their armor is something they don't need to do. And their families, complicit in the same denial, reward the defense of the status quo, ensuring the...same armor, and the same ghosts, will be passed on to the next generation..." (p. 17).

The power of family ties:  "It is curious, perhaps even strange, that the choices of my father would impact me so profoundly at forty years old." (p. 22).

"I didn't realize that just because you're done with the past doesn't mean the past is done with you."

Mutual role function support: "Each person needs the other badly, in the way an alcoholic needs another drink. When one takes a drink of the other...it feels good. It covers certain holes, allowing them, in moments, to be forgotten, but does not fill them. My mother and father love each other for that feeling, and hate each other  for the same reason." (p. 114).

On the feeling of not counting for his father, after a brief encounter after he returned late from the racetrack:  "It was the bottom of the barrel of his day..." (p. 150).

I could go on. This book is a brutally honest memoir, well worth reading.

If You Deny Your True Feelings, Your Children Might Just Express Them for You

A Dialectic Perspective On Defense Mechanisms.

In my post of February 11, 2011 on dysfunctional family roles, I described the roles of the savior and the avenger.  In families in which children play these roles, a parent is suppressing and/or denying strong impulses or desires which were unacceptable within the family in which the parent grew up. The parent tries, more or less, to ignore these impulses or even to pretend that they never existed.

In the case of the savior, the child acts out the parent’s repressed ambitions. In the case of the avenger, the child acts out the parent’s repressed anger and hostility. 

The above picture is a skit from the comedy duo Key and Peele doing an impression of President Obama. The President gets to act all cool and collected while his “anger translator” goes off the deep end.  This symbolizes exactly what such kids are actually trying to accomplish.

Why and how do children end up doing this?

To start with, trying to deny or ignore one’s strong emotions or urges unfortunately does not make them go away. This just plain does not work. This fact sets up what psychoanalysts call an intrapsychic conflict. The repressed urges and feelings press for expression, while the person who has them attempts to fight them off in one way or another. 

The analysts focused mostly on the individual’s mental gyrations, called defense mechanisms, by which people with intrapsychic conflicts compulsively attempt to ward off the undesired aspects of themselves while still covertly allowing themselves some hidden expression of those very aspects.

Although the analysts were wrong about a lot of things, they were certainly on the right track with the concepts of intrapsychic conflict and defense mechanisms. Those are quite real, and are universally recognized by people in our culture in their everyday lives - even by those psychologists who claim they do not exist!  

Even cognitive behaviorists have been known to shout at someone, “Don’t take your frustration out on me!”  That means the frustrated person is relieving himself of the feeling of frustration by redirecting it to someone that the person is not afraid of. This is the defense mechanism called displacement.

What the analysts missed are some of the interpersonal effects of defense mechanisms and their ramifications. It took a whole different school of therapy, family systems, to point out that repressed and warded off feelings in a parent can directly induce their children to act out those unacknowledged feelings. 

Of course, family systems therapists had to distance themselves from the psychoanalytic therapy that was the predominant paradigm when they started out. So they repaid the analyst’s favor by not acknowledging the role of the parent’s intrapsychic conflict and its aspects within the individual.

The dialectic perspective tells us that a mental phenomenon is neither exclusively an intrapsychic phenomenon nor  an interpersonal phenomenon, but both simultaneously. In fact, in general the dialectic perspective consists of the concept of both/and as usually being preferable to either/or. To fully understand psychology, we have to look at phenomena from a variety of perspectives and try to integrate them into a unified viewpoint. In today’s fragmented field of clinical psychology, an integrated, unified viewpoint is what is often sorely lacking. 

There are some of us trying to work on that (See the Unified Psychotherapy Project for more information).

So let’s get back to our repressed parent. The denial of strong feelings or urges leads people, in response to certain aspects of their family environment, to behave in a somewhat unstable way. They may appear to other family members to be highly emotionally disturbed. This affects the other family members and often leads to highly charged, dysfunctional interpersonal reactions by the whole family group.

Since group survival depends most on the functioning of the group leaders – the parents - having unstable parents frightens children. They consequently are induced to try to find ways to behave that seem to make the family interactions at least somewhat smoother. This does not mean that the interactions will become truly smooth by any means. Just more predictable and somewhat more stable. The process by which all family members strive to keep the behavior of its members within certain bounds is called family homeostasis by family systems therapists.

If the child acts out or expresses the parents’ repressed urges, the parent often calms down.  

As I explained in the earlier post, parents frequently live vicariously through identification with their children. When their children do what they themselves are afraid to do, it allows for some expression of their repressed urges. The parents may even subtly encourage these behaviors from their children without actually asking them to do anything. A parent might, for instance, grin like a Cheshire Cat as they describe their little darling’s exploits to others in the child's presence.

Of course, they cannot actually praise the behavior of the child without admitting that they think what the child is doing is a grand idea, so they have to deny that that they are subtly pushing the child in these directions. In fact, they will turn around and criticize the child for exhibiting the very behavior they are pushing the child to perform. This is the most common and typical type of double message seen in dysfunctional families. Damned if you do, damned if you don’t.

This general pattern of acting out is not limited to repressed ambitions and repressed hostility. A whole range of repressed feelings, urges, and even beliefs can be acted out by children. Let me give one more example.

Let’s say Mom was brought up in a severely and strictly religious family that preached that women must and should be totally subservient to their husbands. On the surface, Mom may claim to really believe that this is the way things ought to be, and join in with friends and fellow church members in loudly condemning more assertive women.

Underneath this almost smug sense of being satisfied with this allegedly morally superior way of  relating to their husbands, the women may actually be seething and chomping at the bit to decide for themselves how to behave, even if their husbands disapprove. In such a situation, they are actually jealous of the assertive women they criticize. They also covertly hate these other women, because the other women serve as a constant reminder to them that they are not really happy being on a leash. If they lived in a cave and didn’t get cable, as comedian Bill Maher used to say, they would not see that there were other options, so these hidden dissatisfactions might be easier to ignore. But alas, they do not.

Children are very perceptive and try to find ways to make Mom feel better. They look for ways to allow their mothers to vicariously live through them as they behave in a somewhat assertive way with the men in their lives. On the other hand, they cannot be too successful at being assertive in this manner, because that too would remind Mom of how unhappy she is when perhaps she does not have to be.

This bizarre situation can lead a child in this position to devise ways to walk this tightrope. Actually, there are a whole host of different strategies than can be employed to accomplish this seemingly impossible feat. For example, a daughter in this situation may marry a series of domineering and possessive men, put up with them for a while, and then go all ballistic on them in a wild and ultimately self-defeating form of rebellion that may adversely affect their own children. They then leave each men and go on to another one just like him.

Their mothers and other interested parties then get to tell them how insane they are, and also get to remain smug in the knowledge that they themselves would never act in such a manner. Being a "wildwoman" may even become a label by which other people tend to refer to them.

This is of course is just one example of ways in which children may develop a false self or persona. While the intrapsychic conflicts of the parents affect every other member of the family to a greater or lesser degree, one sibling out of many may become “it” while the others escape relatively unscathed.

Older Siblings and Neglectful Parents

I have lately been coming across another interesting pattern of family dysfunction. It takes place in families characterized by having several siblings and in which the parents were severely neglectful of them when they were growing up. This pattern is particularly likely when the adult who neglected the kids was the mother.

The neglect might have stemmed from any of a number of factors: parental depression, parental alcohol or substance abuse, mothers who had been bullied by demanding and violent husbands, husband who had made sure that their wives were perpetually pregnant, parents who were overly-enmeshed with their own families-of-origin, families subject to religious strictures against birth control and/or mothers working outside the home, and probably a host of others.

In many of these families, childcare duties fell on the oldest of the siblings, who was pressed into service to take care of the younger ones. This situation is a setup for disturbed sibling relationships after everyone has grown into adulthood.  There are three reasons for sibling discord in such a situation that I would like to focus on and describe:

1. The siblings are angry at the neglectful parents, but they protect their parents from those negative feelings by displacing them onto the older, mother-substitute sibling. 

2.  The older sibling, having no real power in the family and being ill-equipped to be a parent, becomes verbally or even physically abusive to the younger siblings. 

3.  When the oldest sibling is a male and the younger ones female, and when there is no parental supervision as there often is not in such cases, the boy sexually molests the girls. (Occasionally, older sisters will also molest younger sisters).

Problems #1 and #2 frequently occur together, although not always, leading the younger siblings as adults to isolate or even completely exile the older one from the rest of the family. As the parents age, the younger siblings may get together to keep the eldest away from the parents, and to make sure that he or she is disinherited in one way or another. Vicious gossip about the eldest may make the rounds. The children of the eldest siblings are often gossiped about and/or exiled as well.

Whenever I hear about incest between siblings, I find that, at least among my patients, parental neglect is nearly ubiquitous.  Sometimes the unsupervised children are literally never taught that there is anything wrong with doing this. When the elder sibling grows up, he (or she) becomes totally ashamed of what he had done. Usually the siblings, as adults, will never even discuss what happened. They may go on and act like nothing at all untoward had ever happened. They may avoid one another, but sometimes they may even become quite close!

Patients that grew up in such families often report that everyone in the family stuffs their feelings when in one anothers’ presence, and that no one speaks up when someone else displeases them. Family members are also highly prone to giving one another the “silent treatment” when upset with one another, or cutting off contact for years at a time.

I have often heard patients who were severely neglected as children opine that they would rather that their parents had been abusive rather than neglectful if they had to choose between the two.  At least then they would seem to matter to the family. There are few feelings worse than having your whole family act like you just don’t count for anything and that your very presence is a big bother.  

Guest Post: Addictions and Development

Today's guest post is by Emma Haylett. She decribes growing up with an alcoholic father who literally tried to recruit her as his drinking buddy, and in the process put her smack dab in the middle (triangulation) of her parents' relationship. This may be a telling example of someone in the role of go-between.

A Revelation

My father bought me my first 6-pack of beer. I was only 14 at the time and drank it behind closed doors, away from him and the rest of my family. It was a late summer night and I remember my mother was already hidden away in her room, lights off, TV on such a low volume like she was whispering with ghosts. Dad sat in a broken recliner watching western violence, occasionally calling my name to come drink with him. Instead, I wrote. I started writing before I popped the first cap and continued to do so after all of them were empty and stagnant around me.

I knew the other kids at my school drank. I knew my dad drank. I watched him every day, but what I didn’t realize was the problem he held. Within the next two hours, I was dizzy and tired. The spoken words of my father were surrounded in quotation marks intermittently written down the page, phonetically spelled out: “Em-uhh,” “ehmm,” and “c’mon to the livin’ room, now.” 

As my state of clarity became more and more unclear, my dad’s stayed exactly the same. I didn’t know he was permanently inebriated until pouring over my notes the next morning. This revelation became something of an alcohol abuse study for years.

My mother never noticed the extra beer my father bought. I think she always assumed Dad was going to drink them, and it was a fair enough assumption. As he pressured me to drink them, I would sip slowly and watch him become more intolerable by the bottle. It didn’t taste good and I don’t remember it feeling good either. 

His speech slurred to the point of intelligibility and his breath was something similar to a laboratory experiment gone wrong. His actions embarrassed me – he would yell at the television if a star delivered a line poorly, and wrap his arm around my shoulder to tell me how to buy liquor underage. Whenever my mother entered the room, his face became tired and uninterested.

One evening, after Dad was snoring deeply in the chair, my mother sat me down and asked me if I drank with him. Of course I didn’t lie – I told her he would give me a few bottles and we would watch TV together. She told me Dad wasn’t healthy and that what he was drinking wasn’t, either. She told me he was always cracking cans since he was about my age, partying much too hard with his friends and family. I wasn’t old enough, she very sternly told me, “and your dad’s decisions reflect poorly upon this family.” I stopped drinking with him after that night.

Family Treatment

Dad was kinder in the early hours of the day and progressively became more incoherent and rude towards the time he usually passed out in the recliner. I come to realize, from lengthy trial-and-error experiments, that the trick to getting lunch money, permission to go out on school nights, or even a small favor was asking him in the mornings after his first coffee with a whiskey cream substitute. 

My mother took the opposite route and, when she thought I wasn’t around, suggested rehab programs later in the evenings, or else, she threatened, she would leave…again and again. But she never did. Their relationship became empty threats with the two of them screaming about whose turn it was to buy essential toiletries with the little money we had, and who was going to raise their daughter standing behind them unnoticed.

There was more hidden behind my father’s alcohol addiction than what was obvious: the empty bottles clacking together as he put another one down was always accompanied by false affection when we had father-daughter talks around the dining room table late at night about being a responsible adult, trust, and his image of love. I learned that being responsible was saving a bit of grocery money for a tall bottle of cheap alcohol. Trust was believing him when he said, “Just one more,” and love was “don’t tell your mother” followed by a bribe.  

Promises to attend my school-sponsored activities came to a screeching halt as the more dangerous drugs became the better part of him. I once found him asleep in the truck idling in the driveway with the windows down and a burnt cigarette between his still fingers. The long stem of ash flaked away as I shook him to remind him that he was supposed to take me to school.

Emotional Detox

I lied to my friends. I lied to my teachers, and I lied to myself - for years. It goes without saying that I don’t trust long or often. I had a hard time believing my ex-fiancé Jake was going for a quick run to the gas station without bringing home a brown paper sack around a bottle or plastic baggie of some substance. I am reminded of being alone when my new neighbor’s empty beer cans crash and echo against each other as she pushes her trash bins to the curb every Thursday morning. I am still angry at my mother who should have tried harder to get my father some help.

I always wished he would have even considered alcohol rehab. I firmly believe our family life could have been different, saved even, with detox and therapy. As an adult, I hesitate to show affection and honesty. I have daylight visions of my father wrecking the truck. I lose hours of sleep over the conversations I should have had with Jake about trust and what it means to be loved without stipulations.

Looking back, it’s hard to know what it is I was feeling. From adulthood, it is easy to know that my father was using me as a crutch, as a tool with which to hurt my mother. And I dutifully played the part of loyal daughter to both of them. I was a substitute, in many ways, for their relationship—an embodiment of the good in my father as my mother saw him, a (albeit young) drinker still capable of offering love - and so she ignored it. For my father, I was a female who served as his caretaker and confidant, a secret-keeper who acted without judgment, an enabler. While my father was dependent upon alcohol, I was simply (or not so simply) using it—more on that here. This was my first experience as an enabler too.

I do remember feeling trapped in between them and, because they were my parents equally, wanting to please both. If I could do it simultaneously, even in secret, it felt like a win. I didn’t like the taste or feel of alcohol, but I also didn’t like the way my father breathed my name until I came out. For me, this drinking was easier, especially since I never outright lied to my mother. Like my father, I had my justifications.

Therapy

I’ve learned that addiction is better treated as a disease. With a non 12-step program, doctors treat addicts with proper medical treatment as you would any other chronic medical illness. Working with addicts in this program has taught me that sometimes you can’t rely on having faith or attending self-help meetings. Sometimes real help (however you find useful to define it) is necessary. 

Addicts can come to an understanding of trust and commitment, as well as formulating a self-betterment plan that is supported by people like me. I provide the guidance and encouragement as well as sensitivity to the issue.

My father would always get upset if the word “addiction” was even quietly muttered.

I realize what it is like to be an addict. I watched and recorded one my entire life. To approach the issue with proper intelligence and caution is critical – to provide them with real courage and motivation rather than standing idly by will push the addict towards getting the appropriate help and the chance of staying healthy will greaten. It’s a very rewarding opportunity to be there for somebody and to see them succeed.

I help myself by helping people overcome these dangerous addictions. I help them make that sensitive reconnection to their family and children. There is always hope that they can raise their kids to live without being exposed to the fear and emotional emptiness that that I hold inside and that is so overwhelming. Getting help can change more than one life. That first step is always the hardest, but I know in my heart of hearts it can make a difference.

Author Bio: Emma Haylett finds comfort in writing. When she’s not helping coordinate non 12 step recovery programs for addicts and their families, you can find her watching terrible made-for-TV movies.