Maybe when we think of couples seeking counseling, we think of young or even middle-aged couples, but the truth is therapists see older ones, too, or older individuals seeking help because of an issue with their spouse or partner. Getting older and facing a serious illness and/or death is never easy, but what happens when both parties in the couple are the types who need to be needed, to rescue, but are afraid to need?
In the course of the years, I have met numerous couples where both needed to be needed, in a relationship in which both felt unappreciated and kept doing more and more while the other person was doing the same, and the relationship continued to worsen as each escalated this behavior. Imagine their surprise when a couple comes to see that they both want the same thing—to be needed and appreciated—and understand why their intense efforts to be indispensable are not working! In this case both people need to see what is happening and address their own issues and how they impact the relationship.
The holidays are stressful for many, if not most people. It is my busiest time, and I’m sure a lot of therapists would say the same. When people have issues of shame and perfectionism, and the other issues that go with them, they have some extra stresses that can maybe be avoided. Perfectionists have good intentions, and this can inadvertently make them exhausted and feeling very badly when dealing with holidays.
Never Give Up
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.
Diagnostic Labels: the Downside
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.
Parents and Self-Esteem
Parents are the major influence on the self-esteem of their children, and yet sometimes get so wrapped up in wanting them to do well or to be the “best” at something, they forget the effect they are having. I think it is helpful to look at what not to do. When my daughter was five and a half, we adopted her from South America. She went to preschool for a time and then Kindergarten. I speak Spanish but she learned English very quickly.
When she was in Kindergarten, she took a standardized test and scored in the 97th percentile in language skills. When I picked her up from school and we were walking to the car, I said it was amazing that she did so well, especially as she was still learning English. We got to the car, and seconds afterwards a classmate and his mother were getting to their car. The mother was screaming at this child, whom I will call Chuck. She yelled, “You just did AVERAGE! AVERAGE! How do you think that makes me feel?” and she went on to berate him as he got into the car with his head down. I didn’t say anything to her, because this kind of emotional abuse is not illegal and I feared making things worse for the little boy. My daughter said to me, “I guess Chuck’s mom isn’t so happy with him.” She asked me why the mother was so angry, and I tried my best to answer her.
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.
Aleta Edwards, Psy.D.
I am a psychotherapist in private practice, with a strong interest in shame and perfectionism. I will periodically post my thoughts about these topics and other observations relating to emotional health.