Psychotherapy
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Blog (by JH, no AI)

Thoughts on Psychotherapy

Blog | Dr. Jamey Hecht | Beverly Hills, CA
 
The ILIAD: Letting Go of Anger, Too Late and Not Too Late

Enjoy this performance of Book One of Homer's Iliad, most of it produced in quarantine as an effort to keep the crisis creative. 

From a psychoanalytic perspective, the clinical value of this story lies in its viscerally felt linkage between rage and misery; competition and bitterness; loss, and the revelation that there are things far more important than being right, or vindication, or even victory. For this wisdom, the tragic drama of ancient Athens is among the best sources in the world (though King Lear, for example, teaches some of the same lessons about shame). 

Homer's epic poem, or "made thing," is among the deepest works of our species. It represents the collective labors of over four centuries of bards, who span the gap between the Trojan War itself (c.1185-1175 BCE), and the emergence of a vast epic tradition that has kept its human images alive. Those labors were woven together, and presumably linked by improvised poetic transitions, by the mind of an individual blind genius, touched by poetry's Divine origin. 

Iliad I (traditionally, the "books" or chapters of the Iliad are noted in capital Roman numerals; those of the Odyssey, lowercase) includes a Divinely sent opportunity to put aside anger. Though Achilles' reprieve from his own rage proves all too brief, each of us may be more free than we suspect; free, for example, to let go of old resentments, of old yearnings for retributive justice, or for a great day of reckoning. 

The non-tragic outcome is surely still possible for you and me, in part because the tragic consciousness is already is still available to us---only (or as I prefer to think, especially) if, as Nietzsche said, we still have some connection to the past and the ancient world.
I made the first portion (lines 1-92) in 2013; the rest in the Spring of 2020. It was a great experience----a real reward for playing hooky from the daily regime of anxiety about wasting time; or about being too expressive; or about failing to monetize every minute of each day, or meet other American expectations that are levied daily at the expense of each human spirit who buys into them for lack of support. The latter includes love (rather than isolation), as well as connection--not only to a partner and the community, but to the to the past and the cosmos.

Art exists to help us live our lives---as everybody says, in a chorus that includes Wittgenstein and Schopenhauer; Shelley and Nietzsche ("hey, those are my guys"). Living with the help of art does not make you Don Quixote. It can put you in touch with much more of reality, and not (usually) less.
Sure a Poet is a sage, a humanist, physician to all mankind.--John Keats. Enjoy some Homer, today.

"Failure to Launch" & Addiction: From the Compliance/Defiance Cycle to Emancipation

When a young person presents with both addiction and failure to launch, there is almost always a pressured tension between the patient and his or her family, especially those who control the pursestrings and pay for the therapy. The twenty-something’s journey (out of addiction and deferral, and into adulthood) should be distinct from his relational process with his family. In fact, it may even be psychologically necessary for him to move forward without having reached a stable accord with them. That way, he can be sure that his progress is not mere compliance. As that progress yield concrete results---especially, paying more of his own bills---he can be more confident that it isn't mere defiance, either. 

Compliance and defiance typically have been the poles between which the patient has been running back and forth for years, inside a family system which is stuck in that pattern. His compliance seems to be movement forward into adulthood, so long as most of what he complies with happens to be good advice, and reasonable rules, that come from exasperated elders who may well love him. But compliance is never really as good as it looks, because it's not autonomous, so it is not sustainable; it builds resentment that comes out sooner or later.  His defiance appears to be much worse, of course, because it's often full of hostility, self-destructive, anti-social, risky, and debilitating. 

Part of the reason this pattern is so terribly stable and hard to break up, is that the family's response to the young addict's defiance is usually a call for a return to compliance, this time a new-and-improved compliance that will last. That never works, because even if he does produce a good lengthy chunk of compliance, it's still mere compliance.  The solution is, in most such cases, to bring in a therapist whose client is not the family, but the patient himself. That way, the patient can continue doing the only two things he knows how to do, but in a whole new way which will permit him to learn new skills: he defies the family, and complies with the therapist in a genuine, collaborative search for what the patient (himself/herself/theirself) actually wants from life.

Why is that compliance somehow better? Well, between the patient and the therapist there is no personal history of being hurt, or betrayed, or robbed, or worried half to death. The professional is not burdened with guilt or regret about the past of the patient and his family. So she or he can afford to keep the patient's interests central, striving to collaborate with him on a viable path to a good-enough life (good-enough in the patient's own terms), at the heart of which must be a kind of guarded friendship between the struggling young patient and Reality. 

This is the same Reality which he has avoided for so long, languishing in addiction and the related un(der)employment. For him, Reality has been a place of failure, shame, and fear. Changing that is not easy, even with professional help. By the time such a patient arrives in the therapy office, he may have been to rehab, only once or many times. Depending on the nature of the addiction involved, recovery might be the first order of business; sometimes it has to come second or third. The choice (or the cycle) between abstinence and harm reduction should be respected, in accord with the specifics of the case and the values of both patient and therapist.

When something has been stable---even something toxic and annoyingly stable, such as a particular dynamic in a family system; a particular role for a particular person; any ongoing relational process that's been around for a while, even if it's one that truly sucks---its replacement by something better is still a big change. And all big changes, good or bad, are losses of the familiar. The good big changes are also gains, sometimes far bigger gains than the loss involved. So when a young person is coping with addiction and "failure to launch," and he or she manages to change and become successful-enough, sometimes the family gets upset---even though this good development is exactly what they've been pulling for all those years. It's new and it feels strange and people aren't sure how to respond to it.

And from the patient's side, as the therapy gains traction his capacity to manage his own affairs may be growing at a different rate than his capacity to deal with his family in ways that remain timely, kind, and effective for the pursuit of his own interest. Again: the patient's ability to cope with reality may be growing somewhat faster than his ability to deal with parents or other attachment figures in good-enough ways, enough of the time. Those older adults should try to keep these two capacities distinct in their minds, even though they are closely linked. Yes indeed, a guy who can keep a job ought to have the relational skills to manage his family elders without too much emotional noise-making. But as a therapist I can report it's extremely common for people of all ages to regress into childhood self-states when they deal with their parents---especially when purse strings are involved; or when there has been a divorce; or when there has been bereavement in the early death of a parent; and when addiction has been the main coping mechanism for a long time. If the patient acts messy with his folks, it doesn't necessarily mean he's still being messy out in the world.

In general, as far as good things go---things that might flow from the family to the patient, in recognition of his recent achievements---timing is important. It may be fine, and even lovely, for his family to use words and gifts to celebrate him for going straight after he manages to do so. But such things should never be mentioned beforehand, nor set up as an incentive. It has to be a free gift, at the right time, not too soon and without any strings attached. Of course, when therapy has just begun and addiction is still active, that's still a distant concern.

Compliance and defiance look and feel very different. Ultimately, both are forms of captivity to the cycle they form together. The way out is a genuine alliance between patient and therapist, in which it's made clear that there is a world---vital, interesting, unpredictable, sometimes friendly, and not impossible to join---beyond the one that has proven so painful and boring. Sometimes, the first hint of this lies with something outside the problem which can illuminate it: literature, or religion, or science and nature, or politics---it doesn't matter what the source is, so long as the patient gets the news (eventually, and as soon as possible) that, as Shakespeare's Coriolanus says when he leaves his mother: There is a world elsewhere.

If this post resonates with you, consider booking an appointment with me at 917-873-0292, or email Jamey@drjameyhecht.com. Sessions are available in-office in Park Slope, Brooklyn, and remotely in NY, NJ, TX, and CA.

Survival vs. Growth

Surviving is a lot easier if you have a reason to survive. But even if you have no reason at the moment, it is still your job to survive while you search for one. It is your job to become a happier man or woman, more and more capable of loving self-acceptance. You must grow, because that is what human beings are here to do. You do not have to become perfect. Even if you never accomplish anything—and you will accomplish plenty—you are worthy of love just as you are right now. Even if only a tiny part of you realizes that, you can make it. You don’t need a reason to love yourself.  You don’t need an excuse to love yourself. You don’t need permission to love yourself. You don’t need to meet criteria to love yourself. It isn't achieved by striving, because it is the necessary baseline above which all striving occurs. It's achieved by letting go: you are already a living organism on this planet; therefore, loving-self-acceptance is already within you somewhere. Shift it into the center.

Does loving yourself feel selfish? How about breathing? Does breathing feel selfish, too? A good cliché can help here. Recall the old saw about the oxygen mask on the plane: you have to put on your own mask first, so you don’t pass out while trying to get your kid’s mask onto his little face. As with breathing, so with love: you first, so you have the strength to help others next.

Daring to Grow

There is an adult part of you that wants to grow. There is a child part of you that just wants to survive. Addiction is a survival strategy. It allows the terrified child part of self to replace unbearable states of mind with new states that are euphoric near the beginning of drug use, and merely numb when the addiction has really taken hold and tolerance has increased. Because of trauma, the child part of self remains frightened, helpless, and in chronic emotional pain. It has very little experience of being consistently loved, and it is struggling to remain unaware that the parents it depended on were not good-enough parents. Maybe they were good people, but they were not good-enough parents—otherwise there would be no trauma, and therefore no addiction necessary to cope with it.

The reason why growth into genuine adulthood is so utterly scary for the child part of self, is that growing up requires admitting two things: first, the parents of your childhood were not good-enough to meet your needs, and second, your childhood is over, so the good-enough childhood is never going to happen, after all. Relentless hope for a better childhood is the reason some people won’t grow up. On the other hand, this relentless hope is mixed with despair, because they’ve been waiting so long, and striving so hard, without the good stuff ever coming along. Unhappy kids strive to excel, since that might please their parents enough to turn them into reliable, encouraging, affectionate, safe parents. Unhappy kids strive to rebel, since that might rouse their parents’ interest in them. Unhappy kids strive to be self-destructive, since that might elicit their parents’ loving care. Unhappy kids strive to be good-enough parents to their own parents, since that might teach their parents how to do it. Unhappy kids will try damn near anything they can think of as they strive to get what they need from the people who are responsible for their very existence. When little or none of it works, the result is despair. But because the despair is still mixed with unrealistic and relentless hope, they cannot avail themselves of the one good thing that despair has to offer: release from the exhausting misery of relentless hope.