Becoming Aware


Janet was 55 when she came to see me for the first time.  She was at her wits end trying to sort out the conflicts and crises in her family.  Her two adult sons seemed to take turns getting into trouble.  Janet and her husband, Bob, then argued about whether or not to bail them out.  Some of the time, Bob rushed to the rescue and then other times he reacted with rage and cut his son off.   In either scenario, he placed the blame for the situation solidly on Janet's shoulders.  If she had done this or that differently, this never would have happened.  In each instance, Janet tried to mediate the conflict and hold the family together as she had done throughout their lives together.

The story she told of her marriage and family life was one in which Bob was the provider and she was the homemaker/parent.  Bob's career as a civil engineer required extensive travel, long hours at work, and several relocations as he moved up various corporate ladders.  Janet made a home for her family wherever they were and was the primary source of nurture and structure for her sons.  As her sons grew from babes to boys, she began to dread Bob's time at home, because, she said, 'All he did was criticize and fight with the boys.'  He blamed her for their bad behavior and she accepted this since she was the one with the responsibility for their care.

Janet had sought professional help several times in the past.  Each time, a crisis with one of the sons was the catalyst.  She spoke positively about these experiences.  She was grateful for the support she felt from these therapists and had even explored the possibility of becoming a therapist herself until a financial crisis in the family required her to go to work quickly.  She was forced her to abandon her training.

Despite these positive experiences and her own study, Janet and her family continued in their dysfunctional patterns.  The boys had problems with drugs and alcohol, with work, with finances, with relationships.  Bob and Janet fought over when and how to help.  Bob fought with the boys now men.  Janet worried and mourned and could find no peace in her life.

And now she was mad.  She said to me, 'I want them to grow up.  I don't care if it's my fault that they have these problems.  I want to have a life.'    As we worked together, she began to set limits with the men in her life and to have honest conversations with them about her feelings.  She gradually became able to let Bob have his own relationship with his sons.  None of this was easy.  Anxiety and guilt conspired to push her back into old patterns, but she found the strength to resist.

One day, we were talking about her progress and the inner conflicts that arose from the changes she was making.  Early on, as is my practice, I had asked for the story of her early life and she had told me about her absent, alcoholic father, her depressed mother, and her role as caretaker for her two younger brothers, all of this wrapped in an affluent, upper middle class lifestyle with country clubs, private schools, and household help.  She said that she had worked on this with a therapist 20 years earlier and felt resolved with it.  She only wanted to deal with the current situation and I, of course, honored that.

In the course of our conversation that day, however, I said, 'It's not surprising that you feel conflict about the changes you are making.  These patterns go back to your earliest years and your role in your first family.'  There is an unmistakable look that people have when they have stumbled onto an important insight.  With tears in her eyes, she said, 'He beat me when my brothers got into trouble.'    We were both astonished to learn that she had never connected the patterns in her current behavior to her childhood experience.  In honoring her wish to focus on the present, I had drawn on the tools of cognitive-behavioral and interpersonal therapy to help her identify and change the patterns.  She had experienced significant success in modifying her behavior as well as relief from her symptoms of depression and anxiety.

But what happened that day was on an entirely different level.  That insight led to fundamental changes in her personality so that she could now do, see, and feel things that were not available to her before.  Not long after, she began a new job and decided it was a good time to terminate her therapy.   I thought she had certainly accomplished the goals she brought to my office and we said our goodbyes.  Six months later, I was happy to see her name on my appointment calendar and hoped nothing sad had triggered her call.

She walked in, sat down in her usual chair, and said, 'I just wanted to come in and tell you what's happened since we last met. '  And she told me of new relationships with her husband and her sons and, most importantly, with herself.   She wanted to give me credit for all this, but I knew better.  Her insight had changed her, not me or my skill.  I only get credit for providing the context in which that insight could occur.

Awareness changes things.  Make no mistake:  after insight, much work is required, but insight creates possibility.  The longer I do my job, the more I become convinced that good old-fashioned dynamic psychotherapy is the only thing we professionals can offer that results in profound permanent change.  All the other more efficient modes of counseling and treatment help on a certain level and that is a good thing.  People need relief from certain symptoms, and, insight therapy is rarely the best way to achieve that quickly.  Sometimes people want and need tools to help them function more effectively in their daily lives.  That's excellent and I'm grateful there are methods for providing those tools.

But, if what you want is lasting change at the deepest level, if you want a 'cure' for what ails you, find a good therapist and settle in.  It could take a long time.  It will be worth it.

There is a footnote to this story.  Life is often the best therapist of all.  I never want to suggest that therapy is the only path to insight.  There are many paths.  What is required is desire, openness, and attention.  Foster these in yourself in whatever ways you can.  If therapy isn't an option for whatever reason, make your own context.   Find someone who is kind and honest and tell your story to him or to her.  Write it down.  Pray about it.  But pay attention and let yourself learn your truth.  Life holds all the lessons we need to learn.  Our job is to learn them as they come along.

'Fortunately psychoanalysis is not the only way to resolve inner conflicts.  Life itself still remains a very effective therapist.'  Karen Horney