I don’t know when things began to be so misunderstood, but our cultures clearly contribute to perfectionism, shame, low self-esteem and a general dissatisfaction with the self. Children learn young that they are supposed to be the “best,” and that involves as many people as possible not doing as well as they do. We are supposed to build close relationships at the same time our “success” involves those around us not doing well. This seems to me a sick system, but we are raised in it. As a therapist who has treated numerous people who did manage to be the supposed best—even though they were intensely unhappy—as well as those who did not, I see what this does to people. I have always told my clients that it is good to know what they are “good” at and what they are not. When I started out, I remember being shocked that people had a hard time with this idea, that it was too loaded to be matter-of-fact. And yet, people pour into therapy complaining of having low self-esteem. What is self-esteem really but seeing ourselves as compared to others and coming out favorably or unfavorably? Far too often people compare the act others put on to their own real feelings. That is like comparing how you look as soon as you wake up to someone dressed for an event.
I think shame and a feeling of being bad or unacceptable come after learning we are separate. We all have to learn this, like it or not. Then, if we are accepted in our separateness, we have a chance to not be filled with shame and a longing to be better in some vague way. People who had miserable, abusive childhoods were obviously not given this and in fact are given multiple messages that they are bad. That is the essence of shame, that we are somehow bad in a core kind of way. Yet, there are non-abusive homes in which the parents do not know how to let their children know that they are okay in their being different from them. But some special parents do not need their children to be identical to them, to mirror how they wish they were. My mother was such a person. She never studied psychology but knew in her heart in a truly wise way.
Psychologists and other mental health professionals talk a lot about labels. There are reasons, of course: We all know what it means when someone is depressed, for example. We can understand it as a state of mind aside from it being a diagnostic label. We know that if someone is schizophrenic, it is a very sad situation. Labels exist so people can communicate without needing a long explanation each time. I get that, of course. In my profession, we also say that to provide the right treatment, we need the right diagnosis; while there is leeway in the treatments that may be provided, there is truth also in the belief that the right diagnosis shapes the treatment options we consider. To continue with the same example, you would not treat someone depressed in the same way you would someone with a psychosis; however, I would hope that many things would be the same—the caring, the respect, and the remembering that both are human beings with feelings. It is this last point that I have been thinking about for a long time—for years really.
One of the painful things about being a psychotherapist is sometimes seeing problems as they are developing in children, and being unable to change the circumstances that foster these problems. In the past I did many psychological evaluations of children, and would sometimes see them periodically over the course of years. There is certainly much mistreatment of children that never reaches the attention of the authorities, but evaluating these children, who were in foster care year after year, taught me a lot about our system and about the human condition. I remembered again some of these children as I wrote my book, and was thinking recently about how many of the issues I often see now in my adult clients, like obsessive-compulsive disorder, were born during childhoods not so different from those of the children I used to see. I'd like to tell you about "Elena," one of the children I evaluated, to illustrate how our experiences as children mold and shape our personalities.
Elena was four years old when I first saw her. She was physically and sexually abused by one of her mother’s boyfriends, and her mother said she did not believe her. When Elena began to act out with others, the authorities became involved. Her mother belittled her often, and did it in front of others. The current boyfriend cursed at her, called her names, and would go into alcoholic rages that were unpredictable. He had been physically abusive, but when he began to sexually abuse her Elena became even more frightened all the time. She remained at home for several years while services were provided to the mother and the boyfriend moved out, but there were other boyfriends and she was often left alone in the house, without food or support of any kind. Elena had therapy, but the result was minimal as her mother was uncooperative. When Elena would cry or tell her mother she was afraid of the dark and afraid to be in her room, her mother would laugh and make fun of her.