Category Archives: Worthlessness

What’s Wrong with Me?

This question, and the accompanying statement, “there must be something wrong with me,” are those that I hear most frequently in the course of a working day.

In some ways, perhaps this isn’t surprising. People generally don’t come to therapy when they are thriving and full of joy.   And yet… are unhappiness, depression, feeling alone, etc. best conceptualized as something “wrong” with you?

I would say not, and that this way of thinking about things, and oneself, is pernicious and destructive, and more importantly, a kind of violence to the truth.

Let me try to explain.

Let’s say you hate being in groups of over three people. You feel anxious, bored, foolish, or very alone. Thinking of this in terms like “what’s wrong with me?” may come easily to you – it seems to come awfully easily to most of us.

[Do take a moment now to substitute your own version of this – the kind of situation where you think: “something is wrong with me.”]

It may seem to you that thinking “something is wrong with me” adds something new to the original observation. But what exactly? What do you know now that you didn’t know when you noticed you were bored or anxious?

Nothing, I would say. You don’t know any more, but you have the illusion you do. You “know” that this bored/anxious person is defective – morally/ genetically/spiritually/psychologically, take your pick.

Why does this feel like knowledge? Why do we go to this place so easily?

I tend to locate the answers to these questions in our earliest thinking/feeling. I think the idea “there is something wrong with me” is a transform of one of the earliest proto-thoughts/feelings we have – “I’m not loved.”   In any normal, let alone abnormal, childhood there are literally thousands of moments where we might come to think this: when we’re terrified and crying during the night but no one comes, when we’re starving and there’s no mum/breast/bottle in sight, when we are overwhelmed by any feeling – love/hate/anger/aloneness/fear and there is no one there to hold us and help us digest the feeling. And of course these are just the earliest such moments where we might come to think “No one loves me.”  Later, there’s the arrival of a new sibling, the priority given to another over us at family gatherings and school, the lack of recognition of what we can offer to the world, etc.

I believe that thinking/feeling “I’m not loved” is just too painful, especially to our earliest consciousness. So we replace it with another, slightly less painful thought – “there is something wrong with me.” Initially, I imagine, this is also a hopeful thought – in that if there is something wrong with me I can discover and correct it. And then I Will Be Loved!

But as time goes on, the thought becomes more solid, and the hope fades. The link with its painful origin is forgotten. And, in the fullness of time, it becomes a part of our identity. There Is Something Wrong With Me.

At this point, the thought comes very easily, and gives a kind of comfort – that of “knowing” ourselves.   I believe that for my patients, and indeed all of us, thinking, “there is something wrong with me” stops the pain of feeling anxious/bored/alone and substitutes Bitter But True Self Knowledge. We have come to conceive of ourselves as a malfunctioning machine, rather than a human being in pain.

But of course, there is no self-knowledge here, no truth.   As I’ve shown above, there is nothing added by this strangely reassuring thought to the original perception that we are anxious/bored/alone in a crowd.

Quite the contrary: it helps us avoid the truth. It stops us in our tracks and prevents us from enquiring into what is going on that makes us anxious/bored/alone. It prevents us from seeking our reasons for feeling what we do. In other words, it takes away our power to look at ourselves as rational creatures responding to something in an environment in a way that makes a particular sense to us.

It has become so obvious to me that thinking “there is something wrong with me” is a defence that I’ve become increasingly puzzled about why my clients are so attached to it, to this negative proclamation/conclusion about themselves.

It can take months, years even, to get past this repeated assertion, to get clients to focus on the phenomenology (a fancy word for “what is happening”) of a particular situation that makes them anxious, or bored, whatever.  It’s as if they cling on to this idea “there is something wrong with me” for dear life.

Of course, any identification, even a negative one, is hard to give up. Giving it up means facing the pain that was avoided by it. When people stop telling themselves there is something wrong with themselves they have to face something – a loneliness or self-effacement, for example, that echoes painfully through their lives into their pasts. We are pain-avoiding creatures.

But we are also fed in a powerful way by recognizing the truth. And getting past the empty identification “there is something wrong with me” can put us solidly, if temporarily painfully, on the earth, in our bodies and in our lives. It can give us the future this empty self-knowledge has deprived us of.

A price worth paying?

Why We Don’t Carry Through Our Resolutions

At this time of year, the newspapers and web are full of advice about how to carry through your New Year’s resolutions.  There are also endless articles about how they don’t work. But there is little written about why we make these resolutions and why they fail.

New Year’s resolutions fall into two broad categories : trying to make yourself into something that you think you ought to be (or want others to think you are)  and trying to behave more lovingly to oneself. Examples of the first are: resolutions to lose weight, to exercise more, to read more, to not drink or eat so much.   Examples of the second : to not push oneself so much, to enjoy yourself more, to give yourself pleasures you usually deny yourself.  Resolutions to learn a new skill or language can fall into either category.

While it’s wrong to underestimate the power of our desire to look and act like we think we should/ought/must (or at least appear to do so), and our desire/belief that we can start anew,  these impulses rarely last the course: witness the sharp fall in new gym attendance between January and June.

Why is this the case?  Simply because the impulse to be what we take others want us to be is not a deep one, however much we wish it were.  I know this because a great deal of work with my clients is about distinguishing what they think they ought to be/do/have from what makes deeper sense to them.  And during the course of this exploration, clients also become aware of the resentment/anger/shame that they’re not what others want just as they are. Because often, these “others” we want to please are basically stand-ins for our parents, who couldn’t help but subject us to their values and judgement.

When we make a resolution to change our shape, appearance or image, however much we are convinced that this is what we want, an unconscious kickback starts almost immediately:  why do I have to do this?  why aren’t I loveable or good enough as I am?  And it is this kickback (more often than not based on our experience with our parents) and the feelings which go with it that undermine our resolutions, not, as we will tell ourselves later,  a lack of willpower.

Okay, so this sort of resolution doesn’t work.  But what about those resolutions based on the impulse to treat ourselves more lovingly?  To take better care of ourselves, to prioritize our own needs.

Often, such resolutions come from a reaction to insight  into how hatefully we behave towards ourselves. The ways we casually treat ourselves worse than someone we loathe: calling ourselves names (you idiot/moron, you pig, you slut), denying ourselves even inexpensive pleasures (the few extra pence we can well afford for a better quality or slightly more substantial treat or even necessity),  or even time off from the grind of daily life.

Sadly, these cruel ways of treating ourselves are not shifted simply by an insight into how hateful they are.  Because often, we unconsciously feel/know this hatefulness is justified and right.  And as long as this is the case, we will return to the hateful behaviours, however much we will ourselves not to.

It is only when we undo this “knowledge,” by understanding its origins and having an experience of what being loved for ourselves truly means that our resolutions to treat ourselves better can be carried through.

Of course, gaining this understanding is hard work.  But shouldn’t it be top of our resolution list?

Seasons Greetings

I’m reblogging a post here from Neal Spira, and his blog

By nspira, Saturday at 12:49 pm
Season's Greetings

In 1943 a man named Philip Van Doren Stern sent out an unusual Christmas card. It included a short story about a man named George who suffers one defeat too many and plans to end it all by jumping off a bridge.
At the last minute he’s interrupted by a mysterious stranger who shows him what his community would have been like if he hadn’t been around to be a part of it. If this sounds familiar, it’s because three years later it was made into a movie titled “It’s a Wonderful Life.” Every time I see James Stewart run through the streets of Bedford Falls in a state of life-intoxication shouting “Merry Christmas,” I get a little life-intoxicated, too.

The world can be a cold place, a mess. The odds are against us, and it’s a miracle we get by-like a Chicago winter. But we do, and often it’s because of the angels without wings who show up from time to time in our lives, like Clarence did for George Bailey. You never know when you’re going to meet one. I’ve run into a few in my time, and maybe you have, too. I met one when I was 10 years old. He was 11, and a quite unlikely angel at that. His angelic qualities were not so obvious, juxtaposed as they were among much rougher features that could be pretty intimidating. As our lives unfolded he helped me through all kinds of hard situations, from then to almost now.
I say almost now because my friend had his now George Bailey moment last spring, and it didn’t end with him running through Bedford Falls shouting “Merry Christmas.” The saddest part of it is that there were plenty of angels around to help him out if he’d only been able to recognize them. Then again, I wonder, did I ever let him know how much he meant to me?

I didn’t know where I was going when I started this note, and I certainly don’t want to bum you out. I had this urge to give you all a gift, in the spirit of the season, just like Philip Van Doren Stern. But my conscious intentions to be uplifting seem to have turned into a long overdue communication between me and myself about my grief over my friend’s suicide, which I’d packed under all kinds of other more mundane stuff of daily living. That’s the amazing thing about writing- the truth seeps into it, if you let it, and the truth is that the loss of my friend is one of the most important things that’s happened to me this year. In that sense I guess it takes emotional priority over a holiday update about the escapades of my nuclear family. I needed to mourn my friend, and I needed to write this blog in order to do it.

To let go with one hand we need to hold on with the other. Another truth is that “It’s a Wonderful Life” wouldn’t be so wonderful without it’s darkest moments. The losses and disappointments that punctuate our lives make George Baileys of us all, and Clarences, too. The trick is to recognize your angels when you meet them, and to recognize when you can be the angel, too. Thanks for letting me get this out there, and Merry Christmas.

The Nightmare Client Who Taught Me To Be A Therapist

When I first started working as a therapist, I had the very good fortune to have a client who was a complete nightmare to work with.   I’ll call her Ellen.

How was Ellen a nightmare?

  • She would reply to my best interpretations by asking “which book did that come from?”
  • She discovered my home phone number and would ring me for hours late at night when she was unhappy with a session or with me.  She couldn’t sleep so she didn’t see why I should.
  • Often, she’d absolutely refuse to leave the room at the end of a session.  I’d have to physically drag her to the door, and out of it.  She’d wail and grab onto anything that would slow her/my progress.

I shared a suite with a number of experienced therapists from my training group. Having a patient leave sessions screaming and protesting as I physically removed her from the room, was completely humiliating for a new therapist. Which, of course, was at least part of the point.

Ellen was humiliated by my lack of understanding.  She was just returning the favour.

When Ellen was unhappy with how I’d responded (or not responded), she would dash from the couch to my desk, jump on on it, open the window and then sit with her legs dangling out.  My room is on the 2nd floor – it was a long way down.  Then she’d threaten to jump if I didn’t give her the answer she wanted.

Sometimes, I’d try to block her on the way to the window.  She’d dodge.  Sometimes I stopped her, sometimes not.

I kept thinking, “this isn’t what doing therapy is supposed to be like.  I’m not meant to be physically stopping a patient from going out of a window! And I’m certainly not supposed to be physically dragging her out of the room!”  (For more on what “should be” the case,

I did try to say this to Ellen, in many different ways.  I tried to explain that she was “acting out,” that she should talk about her feelings instead.  To no avail.

I was like a parent telling a child to behave.  Not to help them, but to help me — to stop me feeling useless, humiliated, ashamed, etc.

You’re probably asking yourself:  Why didn’t he just tell Ellen this couldn’t go on and he’d have to “terminate” therapy?

It certainly wasn’t that I didn’t think of this.  I thought of it almost every day.  Many times a day.  Especially during the periods when she was refusing to leave at the end of the session — I’d absolutely dread going to work.

What stopped me?

  • I knew Ellen was putting everything she had into her therapy.  It mattered more to her than anything in her life.  Which was, I recognized even then in my frustration and despair, a tremendous vote of confidence in me or the process.
  • Also, I strongly suspected if her therapy didn’t work, or if I ended it prematurely, she’d commit suicide.
  • And finally, and most importantly, somewhere in me,  I knew she had a point:  I was getting something profoundly wrong.

I sought out different supervisors to give me advice/perspective.  One sympathized with me.   Another told me I should start working towards the end of the session from the very beginning.  Another told me this patient did not feel I was “holding her in my mind.”

Most of this supervisory hand holding mainly served the function of enabling me to keep on keeping on.

I’m not sure now whether I should be embarrassed by, or proud of, how long this went on.  Literally years.

How did it all change?  One day, in frustration and despair at my “not getting it,” she stormed out of a session and sat on the stairs to my office weeping loudly.  I was painfully aware my (incredibly tolerant) colleagues were able to hear this.  And that their next clients, and mine, would be arriving in fifteen minutes.

I went out and sat next to her on the stairs. I was at my wit’s end.  I’d tried everything. Read books on difficult clients.  Sought help and followed it.  And here I was still useless to this client who I knew was in enormous pain and who had put such trust in me.   We sat in silence for a few minutes.  Tears started running down my face.

Ellen looked at me, surprised.  Then she stood up and went back to the consulting room.  I followed her. As the session continued, she seemed unusually open to talking and listening. When our time was up, she got up and left.  Under her own steam.

In the weeks and years that followed, her “acting out” ended. Ellen did the work she needed to do, confronted her demons, formed her first healthy relationship, started to study, and married.

I’m very aware this isn’t your usual case history.  These nightmare stories don’t often make it into print.  For obvious reasons.

All this happened many years ago.  I’ve had plenty of time to reflect on the shift in Ellen’s behaviour, and mine.   (On reflection, this shift had been underway in small ways for some time, as I’d begun to absorb the lessons she was trying to teach me.  The idea of the “one decisive moment” – in therapy or in life, is something I’d want to question.)

Ellen had been adopted and had struggled to get a real response from her dutiful good parents.  Mainly by being a holy terror.  She repeated this struggle with me.  The more I responded to her provocation by interpreting and being a “good” therapist, the farther away the real response she’d needed had seemed.  And the worse she behaved.

She needed my honest and truthful self.  Me.  Not my book-ish attempts to be “good.”  When I reflect on her therapy, I am aware of how acutely attuned she was to the difference.  And how little I was.

It’s not that the interpretations I made were “wrong” or incorrect.  (In fact, after our moment on the stairs, many of them proved very useful indeed.)  The problem was that I was using them defensively, to keep her at a distance, to try to control her.  I was simply not in a “place” to interpret.  And she knew this.

Ellen taught me that interpretation has to be offered freely, with no agenda.   It has to come from a “thinking for” the client.  While I was fighting Ellen, I wasn’t able to do this.  I was too caught up in my concerns/anxieties, in wanting her to be different.

Not all therapists are lucky enough to have a client who teaches them this early in their career.  It takes them years to learn this lesson.  Some never do.

Occasionally, I supervise trainees who have a “nightmare” client.  I always tell them to count their blessings.   That, if they survive (at times, I doubted I would) this person will teach them more than their rest of their training.

It is a therapeutic cliché to say that your clients teach you everything.  In my experience, not all clients need to teach you something.  Some simply need good-enough therapy.  But others really have to make an impression.  Needless to say, I’m enormously grateful to Ellen.  Everyone I’ve seen in the last twenty odd years has benefited from her persistence.

On Feeling Worthless

Some people know, deep down, they are worthless or “bad.”  This “knowledge” underlies everything they think and do, and everything they think about themselves.

It may not be obvious to others. Because what others will often see is a normally productive, generous, and caring person.  A good friend and a good colleague.

But those who are intimate with them will almost certainly know about this underlying feeling, even if it is never spoken about.  That’s because the knowledge that “I am worthless” is a slow acting poison in a relationship.

Because every appreciative feeling from the other will ultimately be discredited.  And every negative comment remembered and rehashed.

Many people who know “I am worthless” make do and try to manage this feeling by ignoring it or proving it wrong.  Others are driven by a feeling of worthlessness or badness to act it out, or prove it right.  They take drugs, are sexually promiscuous, commit crimes, fail badly, etc.

I’ve always been struck by the enduring power of this “knowledge.”  One reason it is so hard to shift is because everything that happens is interpreted in its light.  If someone tells the “worthless” person they are loved, beautiful, generous, intelligent, whatever – they won’t rejoice.  They won’t regard this as evidence which contradicts and even disproves their “knowledge.”  Rather they will interpret the comment as evidence the person making it is lying, has an agenda, or simply has no taste or judgement.

This is a vicious circle which easily produces despair.  No accomplishment, evidence of value or “goodness” seems to make a dent on the underlying feeling/knowledge.

In therapy, we’d regard this deep down knowledge as a fantasy or defensive structure.  A fantasy because it seems hyper real, more real and certain than any evidence to the contrary.  A defensive structure because we’d regard this understanding – “I am worthless” — as an unconsciously arrived at defence against some greater, earlier painful recognition or feeling.

The action of adopting this understanding made sense at the time – it’s less painful to think “I’m worthless” than say, that my parents have knowingly allowed me to be abused for example.

But like all defences, its costs increase over time.  And as a foundational identification – one which defines one’s very being– it’s difficult to shift – because people will fight when their basic reality, however painful, is threatened.

The first step in the process is for someone to recognize that the knowledge/feeling — “I’m worthless” – is a construction.  A conclusion arrived at in a context in which it made sense – at the time.

This understanding begins to undermine the absoluteness of the knowledge’s hegemony.  If the “worthless” person then starts to put their energy into being curious about how such an idea came about, rather than confirming its truth,  its days may be numbered.