Tough Beginnings

In my previous blog, Nobody told Me It Would Be Like This, I discussed psychotherapy patients who came from families where they felt safe.  In this blog, I’m going to talk about patients who did not feel loved by their parents, and rarely felt safe as children.  They might have suffered sexual, physical or emotional abuse from parents.

These are the people I usually see in my practice. Often they have tried other therapies, usually those with a cognitive or behavioural focus. They may have found these therapies useful.  However, the therapies have not helped them to develop the emotional security necessary for creating a good life. 

Despite their difficult beginnings, these people can be highly successful.  They may run their own businesses, or have high-powered jobs. They can be industrious,  highly intelligent, charismatic, and confident.  

At the same time, they are easily overwhelmed by their emotions.  They can suffer sudden bursts of anger where they spin out of control.  They can sink into terrible bouts of depression.  Despite seeming outwardly calm, they can be constantly anxious or angry.  Despite their success, life is experienced as a constant battle for survival where at any moment they could fall over an edge.  They have generally relied on a narrow range of skills to create their lives and can feel terribly lost when these strategies don’t work.

These patients often know they had a bad start to life. They will say their father was violent or their mother was cruel. However, they do not fully grasp how the early abuse has affected their psychological development and shaped the progress of their lives. In fact, to get where they have in life, they have had to defend themselves against the psychological impact of the abuse, believing they successfully overcome everything that happened to them.  

For the psychotherapy to be successful, these  patients will have to face the traumas of their childhood. There may be times when they think they are going to die. They can feel lost and alone.  There can be times when they feel on the edge of collapse.  They can suffer alarming psychosomatic symptoms. The difference is, this time these feelings are experienced in a safe environment.  They can be worked through, rather than defended against.

One of the most painful moments for these patients is when they discover they were set up to fail.  The reason they couldn’t get close to someone wasn’t because they hadn’t found the right person. Their relationships hadn’t worked because their early experiences of intimacy were fraught, and often involved violence.  Deep within them, closeness was associated with danger.

The reason they were addicted to drugs wasn’t because they lacked willpower.  It was the only way to quieten a mind that became hyper-alert during an abusing childhood.

They were out of touch with themselves because to be in touch was to risk feeling the pain of how much they had been abused.

It is a confronting moment when the patient realises they have spent their lives fighting against the psychological impacts of the abuse they suffered.  It was a fight they were always destined to lose. Patients will often cling to the belief that they could have done something to make everything work.  That they had some control. They will often criticise themselves for what hasn’t worked in their lives, rather than face the impossibility of the task they were given. In fact, a psychotherapy sits in the tension between the patient’s need to deny the impact of their childhood, and the reality of the psychological damage that was done to them.

Therapy can be highly disturbing for these patients.  However, going through the process gives them the chance to build a new self that is not as dominated by childhood traumas.

In the following clip, Suzanne Vega tells how Luka responds to the violence he suffers in the home.