It’s Not An Insult: Why Being In Therapy Can Be Compared To Being A Baby

People who come to therapy are often responding to anxiety, sadness, stress, or worry about what is happening in their lives. When uncomfortable feelings like these are persistent and debilitating, there is an excellent chance that they are rooted in some sort of trauma from early childhood.

For example, many of us get through childhood only by working our way through a confusing combination of difficult life circumstances and poor parenting. Growing up in poverty is bad enough, but if you toss an alcoholic parent into the picture, the result can be trauma. It is challenging enough to be from an immigrant family adjusting to American culture, but if on top of that the parents have a violent relationship or rely on violence for disciplining children, the outcome is often profoundly bad. It is difficult if one parent’s job keeps them away from home too often, but if the other parent suffers from depression, the result is a double whammy for the children’s psychological development.

If things go well in childhood, the mother is able to do an amazing thing: She is able to use the moments of her baby’s deepest distress as the times when she unconsciously delivers these profoundly important messages: I see you. It pains me to see you scared or hurting, so I will help you. I am thinking about what you must be thinking. And you are not damaging me by letting me feel your distress. We will both be ok again soon.

The normal mother does not consciously think those thoughts – she is thinking about changing a diaper or getting ready to nurse the baby. But while those activities are happening, this other unconscious work is hopefully also being done simultaneously. When that is the case, the child will grow up with his or her own capacity to roll with the punches, recover from difficulty, and generally deal with life without overreacting or becoming depressed.

Without such unconscious but essential parenting, a person lacks the ability to think for him or herself, to deal with unfamiliar experiences without undue anxiety, and to deal with the frustrations we all need to deal with. They are more inclined to lose their tempers, resort to violence, turn to substances, and try to be in control of everything. They can drive other people nuts.

When somebody comes to see me for therapy, I pay attention to these two realms: What life circumstances are generating pressures right now? And what is the patient’s capacity to regulate affect, tolerate intimacy, tolerate frustration, and express emotions – which will have their roots in what happened in the person’s infancy.

Therapy, especially a psychoanalytic treatment, can increase that capacity so that the person can lead a more normal life. The analyst is trained to create an environment in each session that will have many of the qualities of the relationship between a mother and baby. One person is the caregiver and the other the receiver. One person’s job is to open up to whatever is unknown or disturbing, and the other person’s job is to help make sense of it and transform it into something that can be thought about together. In that way the patient can have experiences with the analyst that can get the patient’s development right back on track at the point where things got derailed in early life. Then the person’s emotional development can grow and continue, leading to more and more satisfaction in life, rather than an endless cycle of anxiety and depression.

The therapist’s job, then, in analytic therapy, is to provide the unconscious function that was missing long ago. Just as a mother under normal, good enough circumstances is able to provide what the baby needs, so it is with the therapist and patient in therapy. This process takes considerable time, because it involves the growth of new pathways in the brain. When all goes well, the patient can one day leave therapy with a greatly enhanced capacity for tolerating frustration, responding with an appropriate degree of emotion, and being able to think clearly about emotions, rather than just impulsively reacting.

Treatment programs and therapies which do not understand these principles are not likely to meet with much success. Ordering someone to think before they act, for example, which may sound intuitively like a good idea, is useless if the person’s brain lacks the capacity to do so. There are implications here for families, schools, juvenile justice systems, prisons, and all sorts of social institutions. Far more attention needs to be paid to the wisdom of psychoanalytic thinking. And we all need to understand that there is nothing insulting about working in therapy to repair what went wrong for the baby long before. Nothing could be more important for healing what is wrong in someone’s emotional life.


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