Tag Archives: Psychotherapy

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?

Confused? You Won’t Be!

Most of us locate confusion in our heads.  But that’s not what language, and our experience, when we look at them closely, tell us.

The word “confuse” comes from the Latin confound.  “Confusus,” a past participle, meant “to pour together, mix, mingle, to join together.” So confused literally means to be fused or joined together with someone else.

The dictionary meaning that comes closest to this is “to fail to distinguish between”” as in “he always confuses the twins.”

Confusion is therefore not something that exists “in your head” but is a result of you being uncertainly located between your head and another’s.

Don’t take my word for it.  Notice the next time you’re confused.  I bet you’ll discover that you’re trying to please/avoid annoying someone else, in a situation in which, if you know your own mind, there will be conflict.  So rather than know your own mind, you become con-fused.  Which, while unpleasant, does have the benefit of letting you avoid speaking and thus incurring the other’s displeasure.

Of course, the habit (or should we call it a strategy?) of being confused starts early.  The first person with whom we’re “fused” in our mother.  For a period, we cannot tell where we begin and they end.  Then gradually (if things go well) and abruptly (if they don’t), we begin to realize we are not self-sufficient, but rather scarily dependent on this person (who we later learn to call “mum”) to keep us alive.

And this is the origin of our later problems with confusion.  Because this kind of dependence, in which we need the other to keep us alive, becomes an unconscious template.  Which is evoked in later confusions.  Thirty/forty/fifty years later, it may be called into being when we’re with someone we “need” in some way — a partner, friend, colleague, boss, etc.

For example, you may become “confused” when your boss tells you that you don’t need a raise, because you’re already well paid.  In the moment of confusion, you’re conflating your boss with your mother, in that you feel you need his/her approval and incurring his displeasure is life-threateningly dangerous.  It doesn’t matter that your mother is dead or thousands of miles away — you’re still responding to an important “other” as if you’re a child and they are the adult crucial to your survival.

Rather than recognize an understandable conflict of interest — your boss may want one thing and you another — you get confused and think he/she knows best. You’re mixing and mingling yourself with him/her so that you don’t know where he/she ends and you begin.  Because if you do recognize that you and he/she are standing in different shoes, there is going to be conflict.  And you imagine, using your unconscious model, that this trouble will be life-threatening, that conflict/trouble will mean we will lose them forever/die/face an unknown but cataclysmic disaster.

Psychically separating from one’s mother is one of the most important elements in becoming your own person.  And naturally,  it’s one of the most complex and difficult to achieve.

Because amongst other things, it means coming to terms with all those feelings/thoughts that were unexpressed (and maybe even unthought) in relation to one’s mother as one grew up — wishing she was dead, hating/loving her with a scary passion, seeing her as the devil/god incarnate alternatively,  envying and being jealous of her, despising her, wanting to gobble her up and keep her forever in your tummy etc. etc.  We unconsciously fear that these thoughts make us bad and unworthy of anyone’s love, that if we allow ourselves to be separate, and voice our thoughts, this terrible truth will come out. And we will forfeit her life-giving love.

Patients often fear even speaking such thoughts in the consulting room — as if their mothers will know, or be stricken down, at a distance.

But avoiding the truth of us being separate beings doesn’t make life easier.  It produces a plague of other ills — anxiety, indecisiveness, confusion, hopelessness, despair.

When we are truly separate, we recognize there are inevitably differences between people, and that these will have consequences.  But we are not tempted to fuse with the other to avoid them.

This makes life simpler.  There’s what you want, your ability to say it, and the consequences you face for speaking your truth.  You don’t get caught up in the anxiety that agreement, or persuading the other that you’re right, is a life or death issue. Which means there is space which can result in understanding, compromise, or simply agreeing to disagree.

(For those of you who vaguely recognize the reference in my title, it’s from Soap, the American tv sitcom in the late 70’s.)


Why Do We Keep Going Round in Circles?

Why do we repeating the same old patterns of thinking, of emotional roller coasters, of relationships?  Especially when we recognize these patterns to be stupid or destructive?

Sometimes, of course, we don’t even recognize that there is a pattern.  It’s our friends (or therapists) who say, isn’t it a bit strange that this is the fourth time you’ve found yourself dating a man who is married, a woman who forms an intense relationship with you almost immediately but drops you within a month, a man who is unavailable, and the more unavailable, the more attractive he is to you?

Is it just bad luck when this happens?  Or perhaps something else?

Freud called this pattern “repetition”  and he spoke of a “repetition compulsion.”  It doesn’t just happen with our choice of partners – though it’s often most pronounced in these intimate relationships.

Other examples: when we repeatedly get embroiled in power struggles with our superiors at work, power struggles which leave us exhausted and anxious.  Or have intense friendships which end up with us feeling betrayed.

When you’re sick of all this repetition,

Won’t you come see me, Queen Jane…

Bob Dylan

Repetition is one of the most important concepts in psychoanalysis.  Freud wrote about it in the (very accessible) paper called “Remembering, Repeating, and Working Through,” about which, I taught a seminar recently.    (If you want to have a look at the paper, it’s available here: http://therapycommunity.wordpress.com/2010/01/07/freuds-original-paper-on-the-repetition-compulsion).

The key to Freud’s thinking is in the title of the essay.  The aim of psychoanalysis is to remember, and reconstruct, one’s past so that we make sense of the choices we have made, but, have not,  perhaps, been aware of making.  This enables us to choose differently in the future. Repetition, for Freud, is best treated as a form of remembering.  In other words, repeating an action, relationship, or pattern of behaviour is a failed attempt at remembering.

To understand this, you need to have in mind that Freud’s concept of human being was that we are all meaning-making-entities, struggling to make meaning/sense of our pasts, presents and futures.  To make this meaning/sense, we have to be conscious, in his terms remember.

When we repeat a form of relationship – falling for unavailable men/women, for example – we are repeating a pattern from the past, rather than remembering it.  In therapy, we would first notice a pattern, then begin to locate associations to, or early examples of, this pattern.

We might realize that we have always been deeply involved with an unavailable mother or father.  That is to say we are still very alive to this past relationship (even if the parent is no longer around).

But this is just a start to making sense of the pattern.  Because we would have to remember what distress and other feelings are associated with this parent’s unavailability, how, perhaps, we might have felt painfully rejected, unloved.  How, perhaps we fought, were good or delinquent, to try to prevent the parent from disappearing, with no success.  (Even though this fighting, goodness or delinquency failed in its original aim, we might still be stuck with repeating these strategies too…)

Finally, we might arrive at the insight that we thought the unavailability of our parent was to do with us, was a judgement on us, was our fault.

Our repetitions of this relationship are a substitute for this remembering.  Rather than painfully remembering we are attempting to produce a different result from the same circumstances.  An attempt which, sadly, almost always fails.

(Warning to readers:   The above description is only one path this exploration might follow – it certainly doesn’t apply to everyone!)

All repetitions in our lives, all the circles we find ourselves going in, can be understood in this way.  It’s a powerful understanding because it shifts our focus from action to meaning, from attempting to will a different result each time we find the pattern repeating to engaging differently with the situation.

When you take this to heart, you aren’t just drawn powerfully to unavailable partners, impelled by an unexamined past, but rather see the past in the present, and can make a conscious choice to proceed differently.

Your thoughts might go from the wake up call:  this guy/girl is never there when I need them!  To the new ideas which are possible because of your awareness of the past:  Do I really want to get involved in protesting/complaining about their behaviour, or begging/pleasing/abnegating myself in the hopes that they will behave differently?

When you are not unconsciously driven to repeat, you can genuinely produce a different answer to these questions:  No!

And that’s what makes your life stop going around in circles.

Out of Lock Step: Saving your Marriage From the Past

In my last blog, (http://wp.me/p3ryZ0-1F) I spoke about how couples can find themselves glued together in a shared and anguished mutual misery, both partners repeating (and attempting to resolve) earlier experiences with founding others.

A large part of this experience is of desperate incomprehension, incomprehension that one can be treated this way. Especially by someone you love.  This incomprehension (like most incomprehension) is a defence against taking on the reality that something is being acted out between the two partners, which has very little to do with their actual relationship, and much more to do with their past models of love.

It’s not that couples in this state don’t have glimpses of this truth.  They’ll often say to one another “I’m not your mother!”  or “you’re acting just like a child/my father!”

But these moments of insight don’t deepen and widen. Rather, they seem to end up encapsulated in this limited accusation, not leading to a larger awareness which could make a difference.  I’ve always been interested in the mechanism that keeps these moments of insight contained.

Because if it wasn’t there, couples would experience an increasing consciousness of the larger state of affairs, and a beginning of a possibility of different action.

A big part of the problem is a demand that partners in a couple can easily get caught up in — the demand that the other person change.  This is what often brings people to couples therapy.  There will be lip service given to the idea that it takes two to tango and that both parties might be making some contribution to the difficulty between them — but there will be a stated or unstated demand from both partners that you agree that the other is to blame and therefore needs to change.

If your desired outcome is that the other take all responsibility and change — not act like your mother/father/sibling etc. — then an awareness that you might be contributing to them acting out this role is surplus to requirements.  It goes against one’s primal desire to have the founding other recognize their harmful actions and make restitution for them.  (This primal desire for the restoration of no less than Justice is powerful portrayed in Greek tragedies like Euripides’ Orestes.) And so moments of insight — “I feel just like when I was a child with my wife…” — get shredded and disposed of.

It’s important to see the power behind the process of getting rid of the evidence of one’s own culpability, because it is this same power that makes it difficult to really take on the responsibility for one’s action of projecting one’s past onto one’s partner and the ways one “brings out” the worse in one’s partner.  It’s what makes couples therapy difficult — otherwise you could just point out to a couple the obvious patterns they’re replaying and the matter would be done with.  (Or both partners could simply read this blog — much cheaper and less painful!)

In couples therapy, as indeed in all therapy, it isn’t just knowledge of what is going on that is required.  There has to be a recognition that being caught up in the demand that the other change disempowers you, making you a child and a plaything of your unconscious wishes.  It makes you stupid, unempathetic, unloving.

The more you see this, the more you want to take back the power you’ve given away, so that you can become again the loving, sympathetic partner you were at the start of the relationship.

After that, it’s just hard work, and hard-won and small revelations and victories. These take the form of an accumulation of ordinary moments where you are able to make different choices — choices that are not determined by the past but by the future you want to create. The gradual self-empowering that enables you to win the ability to make these different choices allows you to rediscover the partner with whom you originally wanted to spend time, and a sense of proportion and humour.

This is what therapists call “working through,” and it’s the bulk of a couples therapy.

Lock and Key: What Makes a Nightmare Client and a Nightmare Marriage

(This post will make a lot more sense of you’ve read my previous posting, https://thetalkingtherapist.wordpress.com/2013/09/18/the-nightmare-client-who-taught-me-to-be-a-therapist/.  It may also help to know that for years I have been working with couples, together with a female colleague.)

What is it that makes a client behave in the no-prisoners-taken way Ellen found herself behaving?

It’s the same driving force that makes couples behave abominably to one another.


But not the lovely, Cinderella-and-the-prince romantic love we like to read about and see in movies.

Freud called it transference love.

What love means to us is inevitably shaped by our earliest experiences of it, both positive and negative. We don’t stop loving our parents if they are cruel, abusive, unsympathetic, or cold. Transference love is Cinderella love lived through the distorting lens of our earliest experiences.

These templates of love are inevitably evoked when we find ourselves in an intimate relationship, one which evokes our deepest vulnerabilities.  We repeat (often unwillingly and unconsciously) earlier patterns of relationship, patterns which were set in place in founding relationships.

Often these patterns are destructive, but individuals and couples do not tend to see them as such, at least not initially.  They regard them as understandable reactions to extreme situations.  And there is a truth to this, though the extreme situation in which this reaction would be understandable is not located in the present, but in the past.

What I’m saying is that insofar as she could make sense of her actions (and there is no doubt she knew they were extreme), Ellen felt they were justified by the pain I caused her, her desperate need, and my felt imperviousness to it.

Even before she started therapy, Ellen knew that if she started to love me, we’d both be in trouble.  She knew that “love” would open in a fissure in her, a fissure to the past that would make her — and our relationship — a nightmare.  She told me she’d tried to avoid all this.  “I chose you on purpose because I thought I’d never be attracted to you.  That way, I’d never fall in love with you.”


We all know this situation.  You’re attracted to someone, fall in love, and then, as your relationship develops and your mutual dependency deepens, you start to treat your partner differently.  Irrationally.  Worse.

From my work with couples, I would guess that apart from my general unattractiveness, there was another reason Ellen chose me:  she knew I was new to the job and sensed I wasn’t really at home with myself and was too invested in being “good.” In other words, I was like her parents.  My way of being gave her a chance to repeat something that she had tried with her parents unsuccessfully, in the hopes of getting a better outcome.

Why do I say I’ve learned this from my couples work?  Because what we discover again and again in our couples work is that the reason people stay together in nightmarish marriages is that their partners have been chosen unconsciously to “solve” a problem from an earlier founding relationship.  A woman whose father is unforgiving will (unconsciously) choose a judgemental unforgiving partner, in the hope that through the alchemy of their relationship, her partner will be changed and she will get from him what she never got from her father.  And he will have chosen a woman who needs forgiveness so that he can confront his own inability to forgive herself for being vulnerable and human.

Of course, this kind of attempt at resolving a problem from a founding relationship in a couple is much more problematic than attempting it in therapy, because in therapy, there is both distance and sign up.

By distance I mean, the therapist (at least in theory) doesn’t need his client in the same way as a husband needs a wife.  He isn’t having to deal with his own needs in the same way as when he’s a husband/lover.   As the old joke goes, marriage is therapy without the anaesthesia.

By sign up I mean any therapist worth their salt knows that the most they can hope for is to be treated as badly as anyone in a client’s life.  By agreeing to take someone on as a client,, they’ve signed up for the journey.  This cannot be said in couples.  Couples have signed up to be there for one another in sickness and in health, in good times and bad…  But not to sorting out the partner’s primary problems with love.

So though I was deeply affected by Ellen, I didn’t need or depend on her in the way I depend on a partner.  This, in the fullness of time, gave me ability to reflect, get distance, modify my thinking/feeling/behaviour , and change.

If there wasn’t this lock-and-key, fish-and-hook, relationship in a couple (or in a therapy?), it would be much easier to cut the knot.  You’d just be able to say, “This doesn’t work for me. I’m out of here.”

It’s having this choice that makes it possible to make a relationship work.  It’s not something that’s always there.  It has to be won.   In my next post, I’ll talk about how.

Mind Control Techniques — Part 1

The other day a client told me he’d watched a TED video in which a French Buddhist taught a technique for making your anger into a bird, which would fly away, leaving no trace.  This lead to a discussion between him and his wife in which they wondered why psychoanalytic therapists don’t teach techniques like this…

Let me start by being clear that it’s not that I think this, or other techniques like this, don’t work.  They do.  At least sometimes.

The problem is that people don’t use them.   They don’t apply their “letting go of anger technique” in the middle of an argument with their partner, colleague, friend, sibling or parent.  They don’t use their “what me worry” tactics when they are consumed by anxiety about what they’ll do if they lose their job, or their partner falls in love with someone else, or if they develop cancer.   And they don’t remember their “be nice to themselves” procedures when they’re beating themselves to a pulp because they feel they’ve made a fool of themselves/done something stupid/or been less fluent than they’d like.

All these techniques presuppose the ability to choose to use them.  And this, in the heat of the moment, when someone is driven, is precisely what is lacking.

To put it simply, psychoanalytic therapists believe that people do what they do – even those things which to others are obviously completely self-destructive – because they think it’s a good idea and/or because it gives them pleasure.   If, in your mind, your worrying is invaluable for demonstrating your fealty to a loved parent, or for keeping away tigers, there is no need for your “what me worry” technique.  (You know the Sufi story: Nasrudin was throwing handfuls of crumbs around his house. “What are you doing?” someone asked him. “Keeping the tigers away.” “But there are no tigers in these parts.” “You see, it works!”)

This is most obvious in couples work.  (I see couples with a female colleague, two on two.  More about this in a later post.)   In couples work, you see couples engage in relationship-destructive behaviours — attacking each other remorselessly, demanding the impossible, being a victim/making the other the oppressor. You help them see what they are doing, and how this gets in the way of their stated goal, which is to have a loving, supportive relationship.  They recognize this.  And then they start again.  Either immediately, just after the session, or at the next session.

Because when this behaviour restarts they no longer see how destructive it is.

The couples (and individuals) we see are not stupid people.  They understand that these behaviours destroy the possibility of what they most want — when they’re not in the grips of their drives/defences/repetitions,.    But even though they’ve agreed to call a halt during their sessions, they don’t, not in the middle of a row.  They’re getting too much pleasure fighting an ancient enemy, showing the world how unloved they are and what a monster the other is, or demonstrating their loyalty to a dysfunctional parent.

It’s only when they see what is unconsciously driving them, see the early scenarios they are replaying in which their actions make sense, that the beginning of a possibility of a different choice emerges.           

In other words, the possibility of choosing differently is usually hard won.  It involves freeing yourself from your drives (for revenge, to win, to humiliate), your needs (to be loved), and your demands.  This is what therapy is all about – creating the space, or freedom, in which different choices begin to be possible.

It’s at this point techniques might become useful.  Because you have the possibility of choosing to use them.

But I have to say, in my experience, by the time you get to this point, techniques seem superfluous.  You just stop worrying, being angry.   Because you now have the ability to choose that the technique presupposed.

Failing in Therapy

Ever tried.  Ever failed.  No matter.  Try again.  Fail better.  Samuel Beckett

There are three impossible professions:  governing nations, raising children, and psychoanalysis.   Sigmund Freud 

The list of things we expect of ourselves as therapists is long:

  1. To be “present” and emotionally available throughout every hour that we’re seeing clients,
  2. To be “neutral,” that is, not to take sides in the client’s story – either with respect to the roles that partners, parents, and co-workers play in their lives, or in relation to favouring one outcome or possible future over others,
  3.  To remember everything we’ve ever been told and have it easily available to make connections,
  4.  To treat resistance and even attacks on the therapy/therapist in a “positive” way, that is, to be concerned with the interpretation of what such attacks mean, rather than defending oneself or smarting with (and reacting out of) hurt, (In this light, I remember a cartoon in the New Yorker. A therapist is returning home at the end of the day, his clothes torn and his face gashed.  He’s smiling grimly and saying, “My patients are really getting into their negative transference.”)
  5. To not act in any way that is driven by one’s narcissism, defensiveness, or needs for confirmation and satisfaction (emotional or physical),  and
  6. To be open-minded, open-hearted, gentle, understanding, flexible and spontaneous.


I could go on, but I think this is good enough for starters.  It makes clear why psychoanalysis is an impossible profession.  And why every therapist’s experience of working is one of failure.  Because these expectations, like those our patients have of themselves, are irreconcilable with being human.

Of course, it’s very human to have impossible expectations of oneself (and/or others), and it’s at the heart of our experience of life how we deal both with these expectations and with our failing to meet them.

As a therapist, I believe it’s the unconscious expectations of oneself (that often have their origin in the unstated/stated expectations of significant others) that produce the most conflict, pain, and despair.  These are the expectations one tries to fulfil without any great confidence they will be met, or even if they are met, that this will make any difference.

Being able to articulate such expectations, however disloyal, difficult, painful, and halting this may feel, is the key to managing them, and our inevitable failure to meet them.   This is because failing when one has consciously chosen a course in full recognition of the possibility/inevitability of failure, feels quite different from a desperate attempt to satisfy an imaginary Other.

So, for example, while I am perfectly aware I don’t/can’t live up to my analytic ideal in moments (and sometimes more than moments), the fact that I chose to practice in spite of my recognition of the impossibility of the task makes my failure more bearable. Years of personal therapy also made failing more tolerable, by attenuating radically the harsh inner judgement on my human erring.  Through this process, I have come to appreciate Pope’s wonderful succinct definition of our humanity: to err is human.

I now recognize that my way of failing, which is unique to myself and different from the way other therapists fail, is actually what I have to offer to my current and potential clients.  In other words, I’m not a machine for producing perfect understandings/interpretations. Rather, I’m a very particular window on the world, someone who has erred and learned from their erring in their own unique way.

Like the swordsman in Seven Samurai, my goal is to hone my attention and skill — to fail better.

I thus resonated with the writers who wrote so revealing on their experience of failure in the Guardian article which inspired this blog: (http://www.guardian.co.uk/books/2013/jun/22/falling-short-writers-reflect-failure)

I have many favourite quotes from this article but I’ll end with one from Anne Enright:

In the long run we are all dead, and none of us is Proust. You must recognise that failure is 90% emotion, 10% self-fulfilling reality, and the fact that we are haunted by it is neither here nor there. The zen of it is that success and failure are both an illusion, that these illusions will keep you from the desk, they will spoil your talent; they will eat away at your life and your sleep and the way you speak to the people you love.