Self-Defeating Behavior and the Path to Loneliness

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What price would you be willing to pay to feel that you are special? I will tell you a story of one young woman who has paid that price and then some. She is an example of how we sometimes defend our self-image at the cost of our happiness.

The patient of another psychologist, I knew this woman for about 20 years, filling-in for her therapist when he was on vacation. Gloria (not her real name) had a tragic early life. She was victimized by her parents’ verbal and physical abuse and neglect, and became an easy target for schoolmates. Gloria was unlucky, too, in that she was born with slightly less than average intelligence. Making things even worse, her body was naturally graceless and her facial features were less than attractive. But, Gloria could be sweet and socially engaging, willing and able to approach strangers and make conversation despite a long history of rejection.

Even with all her disadvantages and misfortunes, Gloria, now a middle-aged woman, might still be able to have a good and pleasing social life except for one thing: she believes that she is the world’s unluckiest person, the record-setter for having received the greatest misfortune in the history of the planet. Moreover, she feels compelled to report her tale of woe to those people she begins to get to know, very early in her relationship to them. This has the predictable result — they shy away from her, leaving her feeling rejected once more, and adding to her claim that she has been the most ill-treated human in recorded history.

I am not being facetious here; I once asked her to compare herself to various victims of misfortune including those who had been tortured, suffered in natural disasters, lived in concentration camps, or been plagued with disfiguring and painful illnesses. She assured me that her lot in life was far worse than any of them; and, that it was only fair and reasonable to expect people to be sympathetic to her and give her some of the understanding, sympathy, and support she had always been lacking.

Thus, Gloria pursues with a vengeance the comfort and affection that she believes she has coming to her. Her sense of entitlement to this, her insistence that her fellow-man should and must provide this, drives people away from her in her striving for the love she has never had. Of course, her therapist points out to her the self-defeating nature of this strategy, the need first to establish relationships based on something other than the other person’s willingness to listen to her sadness and anger. Gloria doesn’t accept this, unfortunately. The world and the rest of the human race owe her this hearing (so it seems to her), the sooner the better, and it is only fair and just to expect them to deliver what she wants.

Gloria is smart enough to understand that people she hardly knows might not have much patience or interest in accepting her premature self-disclosure. And so, you might well ask, why does she continue to do the same thing over and over with the same bad result? Why doesn’t she try something different?

After much consideration of that question, here is the best answer I can provide. First, Gloria is so desperate and needy, so starved for affection, that it is difficult for her to restrain herself from lunging at the thing she desires whenever she first sights it. But, more importantly, I think the one thing that Gloria values above everything in her life is her self-appointed status as The Most Unfortunate Person in World History.

Now, you might say that you wouldn’t want to hold that particular title. But, think about it. I suspect that this designation gives Gloria the only form of distinction she could every expect to achieve in life. Without it, she is simply a sad, angry, lonely, unattractive, unaccomplished, anonymous person; but with it, she is something special, someone who stands out from the crowd, a noteworthy individual, one in six billion, the leader in her class. And the self-nourishment she receives from licking the wounds attendant to this awful position in life almost certainly provides her with some amount of solace.

I’m sure Gloria would deny the psychological explanation I’ve just provided for her self-defeating behavior and I cannot promise you that it is accurate. But I would ask you this. Do you know people who persist in self-defeating behavior despite all the advice, therapy, or wise counsel offered by friends, relatives, and therapists? Have you sometimes wondered why they do so?

Often the answer isn’t “logical” in that it doesn’t “make sense” intellectually. But, it just might make sense emotionally, as I believe it does for Gloria. If, somewhere deep inside, she doesn’t really believe that she can achieve the life she wants, her behavior suggests that she has found a method, however self-defeating it is, to give herself some of the sense of status and recognition that life hasn’t and probably won’t provide to her.

Gloria was dealt a bad hand in life. Her response to that deal of the cards is instructive. She seems to have chosen a sort of fantasy, a story about herself that compensates her for her misfortune, just as it simultaneously fuels her continued loneliness. But be careful should you wish to dismiss her behavior as “crazy” too quickly. We all do self-defeating things in life.

Before you condemn her, check yourself out in the mirror.

The drawing above is called Africa Lonely Kids by Myfacebook. It is sourced from Wikimedia Commons.

Therapy, Responsibility, and the Nuremberg Defense

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Therapy, like life, requires taking responsibility for what becomes of you. But, as the comedy team Cheech & Chong famously noted, “Taking responsibility is a lot of responsibility.” What does that have to do with “the Nuremberg Defense?” Read on.

If you are old enough (or a good student of history) the word Nuremberg has a certain resonance for you. It is a German town that was a center of the Holy Roman Empire and the Renaissance; later becoming the host of Nazi Party rallies between 1927 and 1938, the site of the passage of the Nuremberg Laws stripping German Jews of their citizenship, and equally well-known for the war crimes trials that were held after WWII, in an attempt to hold Nazi villains to account. Such Nazi higher-ups as Hans Frank, Rudolph Hess, Joachim von Ribbentrop, Alfred Rosenberg, Albert Speer, and Julius Streicher were brought to justice there (see above photo); Hermann Goering escaped hanging only by committing suicide.

A common refrain during the testimony of the accused was the statement “I was only following orders.” This line of explanation was used so often that it became known as “the Nuremberg Defense.” It was found insufficient by the judges, who reasoned that the accused had the moral responsibility to refuse orders to commit “crimes against humanity,” even assuming that it could be demonstrated that such orders were given.

Since I don’t treat war criminals, you might be asking yourself how the failure of some of these long-dead Nazis to take responsibility applies to treating people with less dramatic problems of depression or anxiety or relationship disappointment? In the course of talking with my patients, I often discover that they have suffered from some sort of misfortune; be it inadequate, negligent, or abusive parents; accident or injury; or unfair treatment at school, at work, or in love. Sometimes the stories are heartbreaking. It is perfectly proper for patients to blame at least part of their unhappiness on these events and these people. Moreover, it is often essential that they grieve those losses, give voice to their anger and sadness, and rail against the unfairness of life. And it is important for a therapist to help them as they process their grief.

But therapy cannot end there.

The patient, if he is to improve his life, cannot simply assign responsibility to some other person as a release from the need to take charge of what becomes of himself in the future, any more than a Nuremberg defendant might hope that assignment of responsibility to the commanding officer would take him off the hook for the unspeakable acts he committed.

Put more simply, neither the war crimes defendant nor the common therapy patient can point to someone else, say “He is the one who caused this,” and leave things at that. Just as the SS criminals were asked, “And then what did you do?” so must we all, regardless of what misfortune has happened to us, ask ourselves, “Now what? Do I simply accept the injustice, forever blame others, and stay defeated and aggrieved in-perpetuity, or do I grieve my loss, take responsibility for my life, and try to get beyond the injuries I’ve suffered?”

We all know people who, however small or large the disappointment that they have experienced, never get beyond criticizing, blaming, whining, and feeling sorry for themselves. While some of this is often necessary to get past the hurt, a lifetime of it is simply a waste, a personal failure to take control and to admit and accept that if life is to have meaning and value, we all have to do something positive with that life, regardless of bad breaks. Even if fairness demands that others compensate us for our losses, if such compensation cannot be obtained, life still calls us to repair ourselves. As a therapist colleague of mine, at the risk of sacrilege, used to tell those patients who seemed to forever bemoan their fate, “Get off the cross, we need the wood.”

Shakespeare commented on responsibility-taking in Julius Caesar when he gave Cassius the words:

“Men at some time are masters of their fates:

The fault, dear Brutus, is not in our stars,

But in ourselves, that we are underlings.”

This is not always literally true. But there is no better way to live than to try to make our circumstances the best we can, however unlucky our lot. A good therapist will help you get there.

What to Expect in Your First Therapy Session

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Going to therapy for the first time takes some courage. You are about to talk about some very personal things to someone who is a complete stranger. What can you expect?

1. First of all, expect to be at least a little bit nervous at the beginning. But even before you get inside the therapist’s office, you will have to fill out some paper work. You will also receive a written description of the therapist’s practice, including such details as whether the therapist accepts your medical insurance and how he handles that. Additionally, he will give you information about how your medical records are safe-guarded and the extent to which those records are confidential.

2. The therapist should greet you, bring you into his consulting room, and sit face-to-face with you. Therapists generally want to convey “openness.” It is therefore rare for a therapist sit behind a desk, with you on the other side.

3. After a few “ice breaking” words, the counselor will ask you why you have sought treatment. If you already told him some of this on the telephone, he will want you to fill in the details.

4. Don’t feel that there is a particular “correct” order in which to tell your story. Simply tell it. Initial sessions should generally allow enough time for you not to be rushed. The therapist has probably scheduled at least 75 to 90 minutes to spend with you.

5. If it makes you feel better, it is entirely appropriate to bring an outline of the topics about which you wish to talk, and to consult this outline or read directly from it whenever you need to.

6. The counselor is likely to have some questions for you. He should want to know about your background, not only about the concerns that exist in your life at the moment. Unless he knows about that background, he won’t be able to fully understand how you came to have the current difficulties and whether they represent a repetitive pattern in your life.

7. Among the topics you might be asked about are such things as a description of your parents and their approach to rearing you, relationships with siblings, the educational and social history of your school years, whether you changed residences with any frequency as a child, past and current health concerns for you and your family, the presence of any traumatic events in your life, your dating experience, the place of friends in your life, work background, alcohol or drug use, current medications, present family relationships (spouse/children), financial concerns, and past or current depression or anxiety issues.

Additionally, expect to be questioned regarding any evidence of mood fluctuations, sleep, digestive problems, headaches, caffeine use, suicidal or homicidal thoughts or actions, attentional problems, hyperactivity, hallucinations, delusions, hobbies, religion, how you feel about yourself, whether you are able to be assertive in your life (say “no” or ask for things), diet and eating/weight problems, obsessive thoughts, compulsive actions, and what you hope to get out of therapy.

Of course, there may not be time to touch on all these areas in the first session.

8. You should not feel that you must talk about topics that are too uncomfortable for you. A sensitive therapist will give you permission to cover only the ground you wish to, and a sense of control over the progress of the session, so that you don’t become overwhelmed.

9. The therapist might well ask you what challenges you’ve had in life and how you have managed to overcome them. This kind of question helps the therapist and you to know what strengths you have and to help you remember that you have surmounted past difficulties and therefore can rely on those strengths to help you surmount the current problems.

10. By the end of the session, the therapist should provide you with some feedback about what you have said. In part, this is to help you and the therapist know if he has heard and understood what you have been saying, and whether his initial impression of you seems appropriate.

11. The counselor, to the extent that he offers interpretations of the material you have presented, ought to let you know that this is a first impression and therefore not necessarily perfectly accurate. Any good therapist needs to hear your concerns about him personally, his ideas, the therapy approach he is recommending, and his effect on you. Such a person will not be offended by your concerns and actually wants to hear from you what feels right and what doesn’t feel right about the therapy process.

12. The counselor will normally allow a good deal of time to answer any questions that you have of him and his approach. It is not essential that you make another appointment at that time, although most people usually do. If you already believe that this therapist is not the right one for you, it is perfectly appropriate to say so and to ask him for a referral to another professional.

13. By the end of the session you ought to have a sense of direction and at least an initial treatment plan as articulated by the counselor. The therapist is likely to remind you of the importance of regular attendance and that your dedication to your own healing is essential to obtaining the results you want. Therapy, unlike medical intervention such as brain surgery, requires effort and activity on your part. It is also essential that you have the courage to look at yourself honestly, recognizing that in order for your life to be better you will have to be willing to change some things about yourself.

14. At the end of the first session you might feel exhausted, in part because talking about big emotions is hard work! You are likely to be less anxious than you were when you came into the session. You may feel some amount of relief at having talked about things that you have rarely if ever discussed before. If the therapist has done his job, you should have a sense of hope.

15. In the days following the first psychotherapy encounter, you might well find yourself still processing the material you discussed. This can be unsettling, but it is quite normal. Additionally, a person new to therapy can feel that he has said too much and made himself too vulnerable to the therapist, especially if he (the patient) is a private person. Some people will therefore not return to therapy after the first session. If you have this hesitation, however, remember that it is in your interest to persist despite your discomfort if you sincerely wish to change your life. Good luck!

The above image is the entry to Sigmund Freud’s office at Berggasse 19 in Vienna, Austria. It originally was posted to Flickr by James Grimmelmann and was sourced through Wikimedia Commons.

Anger Anyone?

Some of the very logical or morally upright folks out there believe that you should never get angry. Never ever.

I’m not one of those folks. First of all, we are all human, and to be human means to have emotions. Second, it is hard to imagine a humanity capable of defending itself, the spouse, and the kids, who can’t get in touch with some needed anger when we or our loved one’s are imperiled.

When danger appears, we are built to fight or flee. The sympathetic nervous system readies you for action. Adrenaline starts to pump, the big muscles of our body receive more blood as the heart rate increases, breathing becomes more rapid, the pupils widen (the better to see danger, my dear!), and sweat gland activity heightens to keep you cool in the event of a major exertion of energy (as well as to make you slippery, so that an aggressor can’t get a firm grip on you).

All of this has been “selected for” in the Darwinian sense: if our ancestors hadn’t successfully fled the tiger or defeated the enemy with the help of these physiological changes, we’d not be here and their genetic line would have stopped.

The same logic suggests that the female of the species historically tended to choose males who were capable of defending her and the kiddies, especially when pregnancy and child-rearing made them particularly vulnerable. But, since the female couldn’t always depend upon the male when he was out hunting and gathering, she needed some anger too.

So, if you get angry, as you almost certainly do, you have come by at least some of it honestly and through no particular effort of your own.

That said, how do you know when your anger goes over the top? Some people will tell you when that happens, of course, and sometimes the authorities will in the form of police. If you are no longer a child and get into fist fights or find yourself yelling a lot, you’ve almost certainly got a problem, either as an aggressor or as a victim. Alcohol might add to your combustibility since it tends to disinhibit people, making big emotions more likely. For some otherwise mild mannered men and women, drinking turns them to the dark side. As the old Chinese saying goes, “first the man takes the drink, then the drink takes the man.” Substitute the word “anger” for the word “drink” and you have an equally valid way of looking at anger. Do you have the anger, or does the anger have you?

On the subject of old sayings, there is an Italian saying that also applies to this issue: “If you want revenge, you should dig two graves.” This means, of course, that revenge is likely to consume you (and perhaps even lead to your demise) just as much as it is likely to succeed in hurting the other party. Lives have been eaten-up and made perpetually miserable by the preoccupation with righting wrongs. Think of the centuries long enmity that exists in the Balkans or the long standing animosity between the Greeks and the Turks. Numerous other examples could be cited. One act of revenge causes the victim to look for his own revenge and back again in a circle without end.

Anger is often the result of a real injury, but the danger is in becoming the thing that you learn to hate because of that injury. The data on the likelihood of child abuse being perpetrated by parents who were themselves abused  is fairly well known. Such a parent is much more likely to abuse his children than a parent who was not himself abused as a child. When I tell people this they often find it puzzling. Surely, they say, the abused child would learn what not to do from the parent’s bad example. But think of cigarette smoking or drug/alcohol abuse. Again, the child raised by an addicted mom or dad is at greater risk of duplicating the parent’s behavior than one raised by parents who are abstinent. Not only does the child have the model of the parent as a bad example in these homes, but, in the case of abuse, the youngster has to deal with the anger and hurt inside of him, which comes from being targeted. As children these kids can rarely succeed in retaliating against their parents, but they can take their feelings out against other smaller children (including their siblings) or against their own helpless children when they have become adults. Indeed, unless the abused child is able to obtain relief from the feelings of anger and sadness that come with abuse (and this usually takes therapeutic intervention), he is likely to carry some of these emotions and their behavioral consequences into adulthood. A good book on the subject is For Your Own Good by Alice Miller. A first class movie that depicts exactly what I’ve described is Good Will Hunting.

Back to the question of how you might know whether you have an anger problem, there are a few additional indicators. Do you (or do people tell you) that you react out of proportion to events that are not seen by others as being that big? Do you find yourself feeling angry or irritable much of the time, or awakened by resentments in the middle of the night? Do you have road rage? Have you every punched a wall or thrown an object due to this sort of upset? If you are an athlete in a contact sport, do you enjoy inflicting pain on the opposition?

Even if none of the above apply, there might be other ways that you express your resentment. Do you intentionally delay or put off tasks that others (a spouse or a boss) want you to do, but you don’t believe are that important? Are you sarcastic to others, rather than direct? Do you grumble in discontent or talk behind the back of others at what they’ve done (or not done) or complain about their personal qualities, but put a friendly face on in front of them? If you’ve answered “yes” to some of these questions, you might just be “passive aggressive,” expressing your ire indirectly.

Again, I’m not saying that all anger is inappropriate. And, certainly, one shouldn’t always turn the other cheek, lest one regularly get taken advantage of. But anger can be a problem for you and for those around you. Like a big dog, it should be kept on a short leash. If you can’t manage that, think about counseling.

A recent review article in The Behavior Therapist by Kulesza and Copeland concludes that cognitive behavior therapy is the current treatment of choice for anger problems. The authors emphasize the need for both training in behavioral skills and the use of cognitive restructuring to insure the best results. Therapy for anger issues is therefore likely to include direct instruction about antagonism and its management; self-monitoring of angry feelings, thoughts, and behaviors; relaxation training; assistance in new ways of thinking about the events that trigger rage episodes; social skills/assertiveness training; direction as to how to think about and undercut anger when it does occur; and practice in being exposed to triggering events so that new skills can be employed and the patient can learn to tolerate or diffuse the emotional intensity and stop short of vehement outbursts.

Among self-help books, one of the best is Stop the Anger Now: A Workbook for the Prevention, Containment, and Resolution of Anger by Ronald Potter-Efron.

Last Words: Be Careful What You Say

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We tend to think of last words in terms of famous quotations. On her death-bed, Gertrude Stein (no relation to me) was asked, “What is the answer (to the meaning of life)?” Her matter of fact response was “What is the question?”

John Adams, our second President, alternately rival and friend of Thomas Jefferson, found some relief and gratitude in the belief that “Thomas Jefferson still survives” as he (Adams) lay dying. What he did not know in the pre-electronic year of 1826, was that Jefferson had in fact predeceased him by a few hours. Nor did either of them appear to reflect on the irony that these founding fathers both expired on July 4th.

On a less ironic note, students of American history will recall the story of Nathan Hale, captured and convicted of spying on the British during the Revolutionary War. “I only regret that I have but one life to give my country,” uttered Hale before his execution. More locally, those of us in Chicago might have heard of Giuseppe Zangara, an anarchist, who took aim at President Elect Franklin D. Roosevelt as he and the Mayor of Chicago shook hands in Miami’s Bayfront Park on February 15, 1933. The bullet hit Mayor Anton Cermak, who reportedly said to FDR, “I’m glad it was me instead of you.” Cermak died soon after and is memorialized to this day with a Chicago street that bears his name.

There are other kinds of last words, of course. The father of legendary musician and conductor Carlo Maria Giulini gathered his family around his death-bed to remind them that the word love, “amore,” should guide their thought and conduct throughout their lives. And one can only imagine how many times the word “love,” the words “I love you,” have been on the lips of both the dying and their survivors at the every end of earthly things. The religiously faithful have been heard to add, “See you on the other side.”

Last words of our parents tend to linger in the memory. We are often cautioned to part from loved ones on a high note, not a dissonant one, lest someone be left with the recollection and pain of a final disagreement, or the regret of injuring a loved one in what proves to be their last possible moment.

Two unfortunate examples from my clinical practice come to mind in this regard. One woman, whose mother had died many years before, had difficulty in shaking her mother’s last minute assertion, “You’re an ass, Jenny (not her real name).” It is not the only such example I can recall hearing from one or another of my patients. But the all-time cake-taker, the grand prize winner in an imaginary Hall of Shame of ill-timed and venomously expressed invective, are the words of a rebellious teenager to his severely taxed father.

A long history of mutual destructiveness typified their relationship. It seems that the pater familias was inept and self-interested in raising his son, and the son repaid his parent’s cruelty and clumsiness with as much drug use and petty crime as he could muster. Nor did it help that the family was under financial pressure and that the two adults of the home were a badly matched pair.

The father had only recently sustained a heart attack when the school reported to him and his wife that the son had once again been suspended. The “mother-of-all” shouting matches ensued between the middle-aged man and his first-born disappointment. And then, the last words: “You’re going to kill me.” And the reply, “You deserve to die.”

Not 24 hours later the words were realized. Deserved or not, the father was dead. And despite the fact that one could easily make a convincing rational argument that his death was not produced by his son’s words (or, at least, that the killing heart attack was waiting for whatever the next stressor was and would have happened very soon even without the argument as a trigger), it is easy to imagine that the sense of guilt would be lasting.

That said, I’m not opposed to standing up to people who have injured you, including parents. To say, “I know what you did (even if you deny it or justify it); and I won’t let you do it any more” is sometimes perfectly appropriate. That act of self-assertion can be therapeutic, even though it is usually not essential.

You can recover from childhood mistreatment without confronting the offender. Witness those individuals who do so when their abusive parents are already dead and therefore unavailable for any real-life discussion. What is essential, however, is to make certain that the mistreatment stops. This usually means that you, the now adult child, have to stop it: walk away, say “no,” or hang up the phone — whatever is required.

If, instead, you aim to change the offender, be prepared to be disappointed. Most won’t change or even admit that they did anything wrong. But if you wish to overcome your fear and master the situation, that mastery, at least, is possible.

Better, though, so much better to live as Giulini’s family lived, with love at the center of their being. I’m told that the old Italian expression for this is, “volersi bene” or “voler bene:” an untranslatable sentiment indicating that you cannot be happy without the happiness of the other. Yes, much better this way.

Perhaps its no mistake that in English and German the words for life and love are so close. Change the word “live” by one letter and you have “love.” In German, change the word “leben” (to live) by adding one letter and you have “lieben” (to love). Not just last words or Giulini’s father’s last words, but words to live (and love) by.

The 1935 photo of Gertrude Stein is the work of Carl Van Vechten, from the Library of Congress, Prints and Photographs Division; sourced from Wikimedia Commons.