In our first session, Isabel, an agitated newcomer to therapy, declared: “I can’t stand it when Molly is upset about anything. For 16 years, it’s been my job to keep her happy and make sure nothing interferes with her always feeling good about herself. I get anxious when she’s anxious, and I work very hard to make sure her bad feelings go away. I don’t feel like a good mother unless I make sure Molly never has uncomfortable feelings.”

At first glance, it’s easy to conclude that Isabel’s comment is the expression of a parent who wants to see their child grow up to be a happy, self-confident person. Indeed, Isabel is dedicated to raising Molly to become a person with high self-regard and the ability to have successful relationships and positive feelings about life. While this is a laudable goal, Isabel’s method for helping Molly attain it is flawed.

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Isabel’s statement captures the viewpoint of many parents who believe good parenting means never letting their child have intolerable feelings. This raises questions about the consequences for children of parents such as Isabel. I am going to explore this parenting experience and look at the potential impact on the children when parents smooth over or facilitate the avoidance of anxieties and other uncomfortable emotions.

Developing Competence with Uncomfortable Feelings

From childhood through adulthood, the ability to tolerate uncomfortable and unwanted feelings is essential for negotiating every kind of relationship. If we learn early on that we have the wherewithal to get through situations that make us uneasy, anxious, unhappy, angry, etc., we are in a good position to manage our lives. This is learned through repeated encounters with these feelings, the successes and failures of dealing with them, and finally the experience of oneself as competent to manage.

By running interference for uncomfortable feelings, Isabel has been depriving Molly of developing her capacity to regulate her own emotions by feeling them and developing comfort with them. This constricts Molly’s ability to relate and leaves her without the necessary experiences that promote resilience and competence with her anxieties. Instead, she must find ways to defend against these unwanted feeling states and/or remain dependent on others to make them tolerable.

The Dance of Anxiety

Isabel has lived her life avoiding her own difficult feelings and now is devoted to protecting Molly from unwanted emotions. For Isabel, Molly’s discomfort or unhappiness is not simply a painful affect that they both must endure; rather, it is a signal that she is failing at her job of mothering. This signal creates intolerable anxieties for Isabel which, along with Molly’s uncomfortable feelings, must be eliminated. The need to protect herself and Molly from such unwanted feelings has become a central dynamic of her mothering.

The difficult issue for both Molly and Isabel is they both require the absence of anxiety. But each makes the other anxious. Molly has been a participant in this mother-daughter dynamic for most of her 16 years. The awareness that her anxiety makes her mother anxious makes her more anxious. This creates the (often unconscious) dilemma of how to both make her mother comfortable and get rid of her own anxiety. As a result, there is a dance of anxiety in which each partner attempts, but often fails, to self-regulate and simultaneously regulate the other.

In our work together, Isabel has come to understand that her anxiety over Molly’s emotional state has created problems for their relationship:

“I know I have to stop constantly taking her emotional temperature,” Isabel said. “Things between us are not so good. She’s getting older and I can see that she has a lot of anxiety about herself and her life. In the past few months, we’ve started fighting. It’s crazy-making. Either she yells at me that I’m controlling her and that I should butt out of her life or she comes to me in an agitated state and needs to be talked off a ledge about something. The thing is, I do help her and then we have a respite and I’m the good mother again and she seems happy—and I am too.”

I asked Isabel what she thought about Molly’s recent confrontational behaviors. She sighed a large sigh and responded:

When one is deprived of learning to cope with uncomfortable feelings, it is likely that compensatory strategies for dealing with discomfort with others are developed. Relationships must be constructed to elicit positive reactions and avoid creating unwanted feelings. This limits relational possibilities and requires (consciously and unconsciously) the concealing of one’s authentic thoughts and feelings.

“Well, you and I have been talking for some time now and I get that my anxiety over Molly’s feeling states hasn’t given her tools to grow up or take risks and learn that she’s capable of taking care of herself. I know in my head it’s a good thing for Molly that she can assert herself with me. She’s been so dependent on me and I don’t like to admit that I like that. But I can still get scared when she is upset. When she confronts me, I know she is having emotions that are too much for her. I feel so guilty that I become like the scared child I was with my parents and I do whatever she wants so she won’t be upset with me.”

What Isabel is describing captures two important issues that her behavior with Molly has impacted:

1. Limit setting: Because she can’t tolerate Molly’s unhappiness, Isabel has been unable to set limits for Molly when she experiences Molly’s unhappiness or displeasure with a limit. For example, when Molly gets angry at something Isabel asserts, Isabel can’t manage her own feelings and quickly gives in to make both their bad feelings disappear.

When there are no limits or when the child has too much power or control, she may become frightened (often unconsciously) with being given so much sway over a parent. Feelings of safety and being taken care of are compromised when the caretakers are not in control. Without a safe base growing up, independent actions and thoughts become risky, impeding the process of separation/individuation.

2. Dependency: Difficulties in future relationships are likely as Molly has not learned to self-regulate and has come to rely on significant others to maintain her positive emotional equilibrium, often at the cost of not knowing her own mind.

Relationships are dominated by the need to avoid intolerable feelings. In order to guarantee that others are pleased and no one has unwanted feelings, consideration and knowledge of what one wants is surrendered to others. There is a need to be agreeable, have no differing or opposing thoughts and feelings, and, in general, control the feelings of others to ensure everyone’s happy, satisfied feelings. This creates dependence on others for reassurance and approval of wishes, desires, and choices.

Anxiety About Anxiety

When one is deprived of learning to cope with uncomfortable feelings, it is likely that compensatory strategies for dealing with discomfort with others are developed. Relationships must be constructed to elicit positive reactions and avoid creating unwanted feelings. This limits relational possibilities and requires (consciously and unconsciously) the concealing of one’s authentic thoughts and feelings. In situations where the upset is so unbearable, the need to protect oneself may require hiding these feelings from one’s own conscious awareness, causing dissociation in the service of managing the feelings that emerge in interaction with others.

The dilemma of how to stay anxiety-free may lead Molly to become dependent on her mother for assurances that her life decisions are acceptable and will not create anxiety for either one. If she hands over this process to her mother, she will not develop the ability to regulate her own feelings and she will deprive herself of developing an identity separate from her mother: who she is and what she wants will be determined by the guideline of safety first—no intolerable feelings, not for Molly and not for her mother. It can become unclear who is taking care of whom. If Molly begins to feel trapped by this situation, she may also choose to deal with her discomfort and her mother’s anxiety by detaching from or rejecting her mother. For Molly, both dissociation and detachment would result in disconnection from herself.

Isabel could also deal with her anxiety by dissociating or detaching from Molly. This implies that, for the most part, her feelings about Molly would be largely on hold. While a parent could unconsciously solve the anxiety dance by unconsciously opting to anesthetize themselves, it is hard to imagine that Isabel would, under any circumstances, become so emotionally disconnected from Molly.

Isabel and I have been working on a strategy that requires conscious cooperation with herself. We have been talking about how she can reframe her “bad mother” thoughts to understand that allowing Molly to have her uncomfortable feelings is an act of good mothering that enables Molly to develop the skills to regulate her own feelings. Isabel intellectually understands that she and Molly need to be less dependent on each other for maintaining comfortable feeling states. She also recognizes she is in a symbiotic relationship with Molly that keeps Molly from being able to reflect about her own life and learn about her own wants and needs.

It is painful for Isabel to move beyond her intellectual understanding of her impact on Molly:

“I just don’t know if I can get there. I want to be able to feel like a good mother when I stand by and don’t soothe and reassure Molly. But it’s scary when I’m aware I did something that upsets her and I don’t jump in and make it okay. I’ve been trying, and she seems more anxious and she gets angry at me, which is horrible. I keep telling myself that she has to learn that she can take care of her own feelings. I tell myself she is not responsible to make me feel good. I tell myself over and over. I’m beginning to hear myself, but it’s so, so, so hard to listen to myself. But I do know I have to do this for Molly, even if it seems I’m hurting her. I hope you will stay with me while I keep trying.”

I will.

Note: To protect privacy, names in the preceding article have been changed and the dialogues described are a composite.

When I think about the people I work with in therapy who struggle with issues of separation and individuation, I notice that many who are confused or conflicted about who they are and what they want are very good at knowing what others need. They are often in relationships with significant others (e.g., partners, parents) where their role is to function as an emotional caretaker. In this role, they feel required to take on the responsibility for managing the emotional life of the other to assure that no uncomfortable and unwanted feelings are experienced. Not only does this require that they be on alert for the impact of the world on their significant other, but, most important, the caretaker must never be the cause of the other’s unwanted feelings. Critically, they must never allow their own wishes and desires to be considered as they undertake their role of regulating and soothing the other’s feelings.

What the Child Needs

From birth, the nature of the attachment between the infant and the primary caregiver impacts the development of the child’s sense of self and lays the groundwork for becoming an adult who can feel safe and secure in the world. The child needs a predictable, reliable relationship with a significant other who is able to be attuned to the infant and respond to their needs. This is essential for nourishing the development of an emotionally healthy human being who can trust and feel confident, valued, and stable. When these fundamental needs are absent, the infant is deprived of the resources and ability to reliably know who they are, what they need, and how to get their needs met.

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The child develops into an emotional caretaker when parents fail to supply the basic needs that good enough parents provide and, instead, the child is expected to provide for the parents’ needs. Some of the critical ingredients that allow children to blossom into loving, resilient, separate, self-aware grown-ups include the experiences of being:

• Thought about—i.e., know they are in their parents’ minds (mentalization)
• Mirrored
• Loved
• Helped to manage limits and have boundaries

And having:

• Interest and curiosity about them expressed

Factors Associated with the Inability to Nurture

There are many factors that make it difficult for children, at all stages of development, to receive the basic requirements for getting the needed responses from their parents and/or significant others. The following (which refers to parents, primary caregivers, and significant others) is a very incomplete list of factors associated with the child becoming an emotional caretaker. This includes parents who are:

• Behaviorally narcissistic
• Needy
• Fragile
• Passive
• Substance abusing
• Sexually abusive
• Physically abusive
• Divorced
• Suicidal
• Deceased

The Development of the Emotional Caretaker

What the parents in the list above share is an overriding interest in having the child meet their needs and a lack of awareness of and/or inability to be attuned to, care about, or consider their child’s needs as a frequent enough priority. The child learns they are expected to be responsible for regulating the parent’s emotions so the parent can be relieved of experiencing uncomfortable and intolerable feelings. If the child is successful in keeping the parent in a positive, contented state, they will be rewarded with the parent’s approval, interest, and connection. If unsuccessful, the child can feel isolated, abandoned, anxious, depressed, alone, guilty, terrified, and ungrounded. This puts the child at risk of believing the child is responsible and deserving of the parent’s neglect and disapproval.

Fran is a 56-year-old mother who feels required to caretake her significant others. She came into our session reporting a panic attack when her daughter told her she wasn’t supportive enough of the daughter’s wish to change jobs:

“I thought I was being supportive,” Fran said. “How could I be such an awful mother and make such a terrible mistake? I’m usually so careful and figure out just the right thing that makes my daughter happy. She’s 23 now, but since she was born I‘ve been on constant alert to any upset she might have and I feel like I’ve done something horrible when I can’t make her feel better.”

Fran struggles with anxiety in her relationships with her daughter and her husband. She has transferred the “powerful mother-compliant daughter” relationship she experienced in her childhood onto these familial relationships. Fran learned the necessity of emotional caretaking from infancy when she understood, if only unconsciously, that to get any of her own needs met and to not feel like a terrible person, she always had to make her mother a priority.

Learning to value oneself, and learning to feel comfortable considering oneself a priority, will evoke those old feelings. It is a formidable task to question the basis of those feelings and contemplate rejecting the definitions of self they imply.

Fran recalled that, as a child, “I was so attached to my mother. She could make me feel so good when she paid attention to me. But I always knew those feelings could disappear in a second if I missed her wish or didn’t fix some upset feeling. My father was a salesman and away a lot and he was also an emotionally distant person. I understand now that my mother had some trauma in her childhood. Her mother died when she was very young. But it’s hard to think she was, and still is, a fragile, needy person when she seems so large and powerful to me. I see that now, but it doesn’t change the power she had over me then and even now.”

I wondered: “How is she powerful now?”

Fran replied: “She’s going to be 80 and she looks so small. But maybe that makes it worse. I worry even more that I can hurt her. Every time I don’t figure out correctly what she wants or fail to give it to her, she feels hurt. I remember one time, I must have been 8 or 9, and I wanted to go on a sleepover to my friend’s house. My father must have been on the road. I was pretty good at not asking for things I figured my mother wouldn’t want me to have. I didn’t want to upset her. Maybe I remember this because it was unusual for me to even let myself know what I wanted, let alone ask. But I asked and—I’ll never forget that look. It was so full of scary feelings. I probably couldn’t identify them at the time, but I guess there was anger, contempt, disgust directed at me. I think I was terrified. Probably what made it worse—and I can’t be absolutely sure of this memory—is that her words, which she said sweetly, were something like, ‘Oh, I thought we would spend some time together.’ She may not actually have told me that I couldn’t go, but I got the message she was the sweet mom and I was the mean daughter.”

The Child’s Adaptation to the Parent’s Needs

The parent’s caretaking of the child is conditional on the child’s success in caretaking the parent. Typically, the child will begin to feel like a bad person for not fulfilling the parent’s wishes and desires. These feelings are learned early through the parent’s conscious, unconscious, direct, and indirect communications. The most powerful lessons are not conveyed through words as much as through the child’s felt experiences of (1) anxiety for not responding successfully; (2) guilt for not being good enough; and/or (3) shame for being thoughtless, hurtful, neglectful, etc. of the parent.

The child learns (mostly unconsciously) to choose approval and love which they earn if they excel at recognizing and responding to the parent’s needs. Thus, to avoid painful feelings and create hope for good feelings, the child becomes hyper-focused on what the parent needs and wants. They must be hypervigilant in their attunement to the parent and dedicate themselves to keeping the parent in an emotionally even place. However, even if they are successful, the good feelings are transient and can easily be disrupted if the parent feels the child has loosened their vigilant devotion. Thus, the vigilance must not cease.

Fran’s awareness of what her mother wanted brought quick compliance. Most likely she was unaware of her own conflicts. The child’s anxious attention to their parent’s needs necessitates the (often unconscious) blocking out of awareness of their own wishes and desires. It is reasonable to assume that as Fran reacted to that look, her unconscious functioned to erase any desire to know or consider her own needs, allowing her to avoid bad feelings and focus on possible good feelings spending time with her mother. It’s also possible that simply expressing her desire for the sleepover might have ruled out any approval for Fran’s ultimate compliance.

The emotional caretaker has little choice but to become a compliant person who is dependent on the parent to be the ultimate definer of who they are, what they need, and how they should think and feel about themselves. Self-reflection, discovering one’s own desires and feelings, learning what one wants, and feeling comfortable about getting it can be dangerous. This dynamic does not support the child’s growth and development into a unique individual who can feel confident, worthy, safe, and secure.

Becoming Free of the Emotional Caretaker Response

The process of becoming a person who can know what they need and be comfortable asking for it, instead of automatically caretaking the significant other, can be difficult and painful. Since prioritizing the other has been well developed to avoid horrific feelings, it is understandable that changing this behavior will require tolerating the many feelings from significant others that have been vigilantly avoided.

Learning to value oneself, and learning to feel comfortable considering oneself a priority, will evoke those old feelings. It is a formidable task to question the basis of those feelings and contemplate rejecting the definitions of self they imply. The early parent-child relationship needs to be explored, and it will be painful to recognize the parent’s role in creating these bad self-feelings. Additional pain can be expected as one attempts to change behaviors in relation to significant others. What is difficult, but necessary, is to develop the tolerance for the emergence of bad feelings while changing behavior from always prioritizing the significant other to giving equal consideration to oneself.

As one becomes increasingly aware of one’s own needs, it may be emotionally demanding to say no to loved ones and choose oneself. The goal is to develop the ability to find balance between attending to those we love and prioritizing ourselves. This balance is developed simultaneously with the growth of new definitions of self as a person who feels secure, valuable, confident, and loveable.

Note: To protect privacy, names in the preceding article have been changed and the dialogues described are a composite.

Some of us grow up in families where we are not emotionally free to express our desires and needs and feel compelled to be compliant in social relationships (especially with significant others). As a result, the process of becoming a person who knows what they want and how to get it is foreclosed. Instead, motivated by expectations of others, there is little room to develop an identity along with feelings of self-worth and self-acceptance.

Nancy, a married high school teacher with a 19-year-old son, came to see me when her anxiety was becoming overwhelming and her family relationships were increasingly irritating:

“I don’t know what’s going on with me,” she said. “I don’t recognize myself. I’m sniping at my husband and son all the time; I’m always in my head worried about something. Everyone annoys me. I don’t return my friends’ calls or emails; I even got irritated with my mom on the phone last week. It really upset me when I did that.”

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I asked Nancy to tell me more about what she didn’t recognize about herself and if she had any hunches about what was influencing these behavioral changes. She began to describe increasing feelings of annoyance:

“The past few months, I feel like I’ve been in a constant state of irritation with everyone. This is not me. I never get angry at people. I’ve always prided myself on having a mellow and understanding temperament. I can get along with anybody. My husband always praises me about how I’m such a good listener and that I’m so agreeable and easygoing. I’ve always thought of myself that way. Lately, I guess, especially with my son Tony and my mother, I find myself feeling disagreeable. It’s probably related to my son wanting to go away to France next year for his junior year abroad.”

Nancy continued:

“The world feels like it’s becoming such a dangerous place and I really worry about his going. My husband is ambivalent, so it feels like it’s up to me. I can’t stand the idea of him being so far away with everything that’s happening. I talked to my mom, who I was sure would understand because when I thought about taking a junior semester abroad she was really against it. She was anxious, and I didn’t go. So I thought she’d support me with Tony. But she didn’t, and I was shocked and angry. I never get angry at my mother. Now I’m this angry person and I feel so anxious. It’s scary not to recognize myself. I don’t like this new me. She’s unacceptable.”

Nancy described her new unknown self as a person who felt out of control with her feelings and at risk for getting into conflicts. She was clearly uncomfortable with her unfamiliar “not me” feelings and behaviors.

As we explored her relationship to the familiar agreeable, compliant, and understanding Nancy, we began to discover the old accommodating Nancy had also created some difficulties for her life:

“It’s hard to admit to myself that I depend so much on positive responses from my family and sometimes my friends. I always look outside of myself for reassurance that I’m doing the right thing or have the right idea. It’s the only way I can feel good about myself. It’s getting more difficult to always be so pleasing. But it’s terrifying to displease. I feel like such a bad person for not being in agreement with my mom and my son. But I have this new feeling of resentment—like I don’t want to give in. I really don’t want my son to go to France and I’m just not used to having different ideas from my family. It’s very confusing and I don’t feel like a good person.”

While Nancy was accustomed to always pleasing her family, it was frequently at the expense of allowing herself to be in contact with her own needs and wishes:

“I guess I haven’t had much experience allowing myself to know what I want or where I stand on most things. I suppose you could say I don’t have a mind of my own. Now it seems like all of a sudden I let myself have a wish for my son’s safety and then when I allowed myself to express it, I couldn’t stand that there was opposition. I felt horrible that I got angry, especially with my mother, who gets instantly hurt around anger. My son is also upset with me, and we usually manage to not be at odds with each other. He’s a good kid, so I don’t have to set a lot of rules for him. He’s like me. He doesn’t get angry and he does what his father and I say. He’s not really pushing back that much on the France thing, but it’s awful to disappoint him.”

Nancy and I have work to do. As we explore her memories from childhood through the present, she is seeing how her behavior and thinking is motivated by her desire to meet expectations of how she should be and to avoid disapproval:

“I can remember when I was a little girl, maybe as young as 4 or 5, I would get very scared when my mom seemed worried or annoyed. I somehow must have learned that I could change her feelings and make her happy. When I would see the look on her face that gave me that ‘uh oh’ feeling, I would hug her or start to sing You Are My Sunshine and she’d hug me back and then the look would go away.”

From earliest development, children develop feelings of security and connection when the mother’s responses are attuned and positive. If those responses, which ideally convey feelings of recognition, love, and positive attachment, are dependent on the child being in compliance with parental expectations, the child doesn’t feel safe and secure and can develop a fragile sense of self.

As we further explored how this dynamic played out in Nancy’s past and present, it became clear that, growing up, Nancy’s experiences of her mother and her “look” were a serious influence on Nancy’s emotional development. Moreover, Nancy’s sense of self was impacted by her mother’s need to have Nancy regulate her feelings when she became upset (angry, hurt, etc.). Nancy’s sense of self and her own feeling states became dependent on her mother’s affect remaining calm.

I asked Nancy to tell me more about how the “look” made her feel and why she thought she needed to make it go away. She told me:

“It’s probably the same now as when I was a kid. When that look spreads over her face, it seems that she disappears from me. When I think of it, even if I know it has nothing to do with me, it still feels as if I made it happen and I have to do something to make her feel better so she’ll come back to me. Even if it’s something else that upsets or hurts her, I can still feel like it’s my fault, that I’ve done something wrong to make her abandon me. I end up feeling like a worthless, horrible person.”

Nancy is not accustomed to finding herself in disagreement with her family members. This makes her confused and she questions her ideas and feelings that are different and/or in opposition to the opinions and desires of her significant others. At the same time, she increasingly understands her sense of self-worth and self-acceptance have been strongly tied to being fully in agreement with her family and that her compliance and surrender of her mind has been to avoid feelings of disapproval, guilt, shame, anxiety, anger, etc.

Now Nancy is increasingly feeling these feelings. In one session, her voice rose in anger:

“I want to have a mind of my own. I don’t want to feel at the mercy of others to determine what I think and feel. I don’t want to have to please others to avoid all those awful bad and intolerable feelings.”

From earliest development, children develop feelings of security and connection when the mother’s responses are attuned and positive. If those responses, which ideally convey feelings of recognition, love, and positive attachment, are dependent on the child being in compliance with parental expectations, the child doesn’t feel safe and secure and can develop a fragile sense of self. Without positive responses and feelings of value conveyed to the child by the parent, the development of self-acceptance and self-worth are impaired. This leaves the child in an anxious, unprotected state of not knowing what they want, who they are, and how to be in the world. It leaves the child dependent on the parent to define what they think and how they feel. When Nancy considered that she doesn’t have a mind of her own, she was expressing her awareness she has not developed an autonomous sense of who she is.

‘I’m Beginning to Have a Me’

Nancy has been working hard to overcome her resistance to tolerating those bad-person feeling states. She is better able to sit with disappointing or angering her significant others, and her guilt and shame are diminishing. As she feels and expresses more true self-feelings, she can see that while her mother and son aren’t always pleased with her and might withdraw their good feelings in the moment, they do emotionally return to the relationship able to express positive and loving feelings.

Nancy’s efforts are enabling her to develop a mind that knows what she wants. She is learning to tolerate negative responses from others and not take disapproval to mean her thoughts and feelings are unacceptable or that she has done something wrong. Smiling, Nancy told me:

“I am really beginning to know that it’s okay to want what I want no matter what anyone says. It’s getting easier to face opposition without being scared or feeling like a horrible person. I keep reminding myself: it’s just my ideas; no one can control my thoughts. I really like that they’re mine. I’m beginning to have a me.”

Note: To protect privacy, names in the preceding article have been changed and the dialogues described are a composite.

Some people have difficulty comfortably accepting qualities and capacities about themselves that are notable. They feel anxiety and shame if they even consider they might be special in any way. Fears of being criticized or seen as egotistical or arrogant and worries about being humiliated or made to feel small function to keep these people in check. Risks of competition and the dread of envy can stifle good self-feelings and inhibit relationships. It is too dangerous to come out in the world as anything other than unexceptional and unremarkable.

“I have the idea you didn’t believe me when I just said how smart you are,” I said to Jason as I responded to his skeptical look and apparent discomfort. Still looking uncomfortable, he replied, “You’re sort of right. It’s not that I think that you’re lying, but I think you’re wrong. I know I’m intelligent, but you seem to be implying that I’m especially smart and that’s just not so. I’m not the kind of smart that warrants any special mention.”

Jason and I began to look at his feelings and his need to not be seen as out of the ordinary. I asked about his associations or memories to feeling anxious when thinking he might be special. He immediately responded with a story of when he was 10 years old and came home from school excited about making the soccer team:

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“I remember being at dinner with my family and feeling excited and describing how I tried out for the team and made a goal. I was beside myself with joy. My father told me, ‘Calm down, it’s not like you’re a star athlete. Better not be so full of yourself, your teammates won’t like it.’ I tried to hold back my tears. Even now, when I remember this I think about what a fool I made of myself, thinking I was such a big deal.”

I wondered aloud to Jason: “Perhaps the message you heard was not only that you were not remarkable for not making the team, but that if you acted as if you were, peers would react badly.”

Jason responded: “Yes, I remember feeling proud and that I was special and then I got scared my friends could think I was conceited. It made me anxious. I suppose I got a lot of messages that made me feel the things I did weren’t special, that there was nothing about me that was special and I shouldn’t feel special. It was confusing because sometimes I did feel like I did special things. I won a math medal in high school and was a straight-A student in math. But neither of my parents said much about it other than something like, ‘That’s nice.’ I wish I was really smart, but if I let myself believe that for even an instant, I feel ashamed and conceited and would never want anyone to think I could have such high-and-mighty thoughts about myself. I tell myself to stop fooling myself, but I’m never clear about what’s true about me.”

Jason and I worked on his anxiety and his underdeveloped ability to reliably have a sense of himself. He learned to use the world as a mirror to see all the ways in which he is responded to: positively, negatively, and even superlatively. As we worked, it became apparent Jason was frightened to engage competitively in the world. He acknowledged:

“It’s dangerous to do too well. I picked a career in technology where I work pretty much as a loner. I don’t have to put myself out there where others can compare themselves to me. I don’t want to feel their judgments that I don’t measure up. Worse would be if they saw me as very successful and envied me or wanted to tear me down and be better than me.”

When Jason’s father implied his teammates might not like it if Jason was a star on the team, he may have been (consciously or unconsciously) communicating it was dangerous to engage competitively and to be envied. While I don’t know if this was the case, Jason seems to have internalized the idea he is not a person who is remarkable or who does outstanding things. This idea may have developed as a defense against becoming a target of destructive envy and/or of being humiliated.

Lily, like Jason, is a person who suppresses herself by swallowing good self-feelings and by silencing herself in order to avoid anxiety, humiliation, envy, and/or a wide range of bad-person feelings. Lily is in serious conflict about who she is. Not only does she feel clueless about her abilities and talents, but she is especially uncertain about her physical appearance: is she pretty, attractive, fat, sexy? Or is she unattractive, plain, and unappealing? To keep herself safe from unwanted and intolerable feelings (her own and others’), Lily needs to remain ignorant about what she looks like, who she is, and what she feels.

I have been working with Lily for three years. The first time she walked into my office, I recall thinking how perfect she looked: a pretty, 45-year-old woman, beautifully dressed, with a perfectly made-up face and a stylish haircut flawlessly in place. However, underneath this façade was an intense degree of anxiety which she attempted to manage by her powerful drive to be in control of herself and her environment. What became clear early in our work was that Lily’s anxieties were connected with her strong fears about how she is perceived in the world:

Many of us carry messages from childhood that interfere with developing clarity about our identity and with having feelings of self-worth. Fears of self-aggrandizement, competition, and envy arouse feelings of ordinariness and impede emotional growth. The more we can recognize what these messages communicate and reality test their accuracy, the more of an ability we will have to know who we are and grow our multidimensional selves.

“I just don’t know how to think about myself. I want desperately to be liked, to be seen as beautiful and smart. I’m afraid this is going to sound crazy, but I know I’m pretty and smart and I’m also totally sure I’m unattractive and stupid. I can’t trust if I’m likable. It doesn’t take much—a funny glance or an unreturned email—to make me think the worst. One minute I think I’m amazing, and the next minute I feel like a nut case for thinking I could be so great and then I feel even worse for wishing it. My worst fear is everyone will find out I’m a narcissist and an egomaniac. I’ll be humiliated and feel destroyed when I’m reminded of the truth. It has to be a secret. Who the hell am I?”

Lily and I explored what might contribute to how she became a person who is so uncertain about who she is. As I got to know her, it was clear she was not only a classically attractive woman, but she also was smart and charming and quite likable. Why hadn’t she been able to internalize an accurate and positive sense of who she was? Why was it so anxiety-producing to acknowledge her good stuff to herself and to the world? Lily’s thoughts about these questions led to her memories of her relationship with her mother:

“Whenever I think about my mother, I hear her voice saying, ‘Why don’t you put more makeup on,’ or ‘You can’t go to school dressed like that,’ or she’d tell me I should go on a diet or how I should never act as if I knew more than boys. She told me people, especially boys, don’t like conceited girls who think they’re ‘so much.’ I was pretty sure she was telling me I wasn’t ‘so much.’ I believed and listened to every word she said.”

Lily continued:

“My parents divorced when I was 2, and my mother dated a lot but never remarried. I was very close to her. She was beautiful and always interested in her looks. She could spend hours trying on clothes or jewelry. I always got the feeling I couldn’t compete with her. Mostly it was all about appearance. But she never made me feel smart. I remember she once told me I didn’t have to be smart and I needed to work on my looks. I kept working on my looks, but I never got the feeling I got her approval for my mind or my body.”

Lily took on her mother’s view of how she should be and didn’t allow herself to consider what her own thoughts, feelings, and needs were. She learned to dismiss many of her positive self-feelings and think of them as conceit or unfounded. Lily’s need for her mother’s approval had been a powerful influence on Lily’s development. Now she was trying to become aware of her own sense of self so she could form an identity separate from her mother’s definitions. One day, Lily came to her session with great excitement:

“I kept wondering what was in it for my mother to have me think about myself so negatively and believe I should never feel or express good things about myself. I have this new idea maybe she was competitive with me! I think it is true. I was looking at pictures of me. I was pretty—a pretty little girl and a pretty teenager! Unbelievable! I don’t think she wanted me to know that. As long as I thought I wasn’t a pretty or desirable young girl, I didn’t feel like one and couldn’t act like one. I think she might have envied me.”

Lily and Jason are working on noticing the positive and appreciated ways in which they are seen. Experiences such as compliments, salary increases, smiles, and invitations are registering with new meanings. The anxieties of “being full of myself” are diminishing as Lily and Jason are better able to tolerate discomfort while developing an acceptance of their more-than-ordinary selves. As they continue to grow their unique and valued selves, issues of competition and envy continue to be addressed.

Many of us carry messages from childhood that interfere with developing clarity about our identity and with having feelings of self-worth. Fears of self-aggrandizement, competition, and envy arouse feelings of ordinariness and impede emotional growth. The more we can recognize what these messages communicate and reality test their accuracy, the more of an ability we will have to know who we are and grow our multidimensional selves.

Note: To protect privacy, names in the preceding article have been changed and the dialogues described are a composite.

People pleasing is a way to reduce anxiety and eliminate stress. Some please to assure good feelings that come with positive responses like being approved of, admired, praised, or respected. Others please because of strong needs to avoid bad feelings that occur when, for example, others criticize, complain, or become angry. But there are some people who are not typical people pleasers. Instead, they live with intense anxiety that if they don’t behave in ways that elicit strong approval and avoid disapproval from others, the consequences will destroy their sense of well-being and safety. These are what I will refer to, for the purposes of this article, as terrified people pleasers.

Relationships and Terrified People Pleasers

Terrified people pleasers view the world as an impending source of danger. They tend to see relationships much like earthquakes and hurricanes: at any time, often with little warning, attachment to others can wreak great destruction in their lives. Vigilance and compliance become guidelines for safety.

Samantha walked into my office, and before I could ask, “What brings you here?” I found myself in the presence of an avalanche of feelings from someone who seemed to be a very angry, upset, frightened woman.

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“This is it. I can’t take it anymore,” she said. “All my friends are never available and selfish. I’m 63 years old, and I’m going to die alone. I’ve been seeing Marty on and off for 10 years, and he’s like everyone else: self-involved, stubborn, unloving or loving depending on his mood. I tell you, it’s enough! I’m so good to everyone, and they get what they want. I’m afraid to do things and be on my own, and I have to rely on people who always have time for each other but not for me. I’m tired of being angry and depressed and giving everyone what they want. I don’t know what’s wrong with me. I can’t seem to enjoy anything. No one likes me, and I hate everyone.”

It would take many months for me to understand the narrative of Samantha’s life. In our early sessions, Samantha described her anger and unhappiness with her friends who didn’t appreciate how she was always there for them and never reciprocated. She described taking them to dinner, helping them move into apartments, visiting when they were sick: “I did all the things a good friend does. Do you think I really wanted to be so helpful and attentive? No, I didn’t. But I felt that I had to be the perfect friend or they would all drop me. I sort of feel dropped anyway. No one ever offers to help me with anything.”

Samantha repeats this pattern of behavior with Marty: “I always work hard to figure out what he wants, and I work very hard to provide it even when I want to say ‘no.’ Then I resent him, but I’m scared he’ll leave me if I ask for anything. So for the last 10 years, our relationship has been crazy in and out. We date, we’re lovers, we’re friends, we stop seeing each other for a while, and then it starts all over again. Mostly, I freak out if either one of us gets angry. I always worry he’s going to be critical or distant, and I‘m never sure if I want him to stay or leave, but I get panic attacks if I think he wants to leave.”

When we explored this experience that felt so one-sided, it became apparent Samantha never asked friends for help or indicated any wish to be celebrated: “I don’t know, I guess it never feels okay to ask for anything. I’m afraid they’ll say no, and I’ll feel hurt and angry. I think I really have the feeling that they don’t want to please me like I don’t really want to please them. But I have no choice. I have to do it or I’ll be hurt and alone.”

Family Origins and Terrified People Pleasing

As her story unfolded, I could visualize the frightened little girl who had been designated by her father to be responsible for her mother. Although never medically diagnosed, I believe Samantha’s mother was probably bipolar. She describes a mother of unpredictable extremes: the mother who danced around the kitchen was funny, silly, all hugs, and the mother who stayed in bed, was silent or angry, and made several suicide attempts. Her father, a rarely present man who worked too much, praised Samantha for taking good care of her mother and would tell her, “You’re my good girl doing your job for us to make sure mommy is okay.”

Her father and her brother, older by three years, were emotionally detached from Samantha and her mother. Samantha recalled, “I was 12. It was the second time my mother tried to kill herself. I found her in bed with an empty bottle of pills, hardly breathing. I called 911 and my father. I don’t know where my brother was. My father told me to go in the ambulance with my mother and stay with her. He told me what a good girl I was. I don’t remember if he came to the hospital. He must have come to take me home. I just remember feeling so alone. I also felt so good that I made my father happy. There wasn’t much I could do to get that feeling.”

Much like the experience with her parents, her compliance resulted only in the transient feeling of being loved. From day to day and perhaps minute to minute, Samantha could not depend on her parents for reliable and consistent loving feelings. How could she trust anyone to love her or want to be with her?

I learned that Samantha craved the feeling of being the good girl and feeling that her mother and father loved her: “There wasn’t much I could do that would make me feel my father loved me. It looked like he loved my brother, who he did things with and joked with. He didn’t talk with me much except when he would ask about mom and how she was doing. I could get wonderful, loving feelings from my mother. I knew just what to do. I’d come home early to be with her after school. I never brought friends home. I thought she’d be mad that I wasn’t totally there for her, but I also didn’t want them to see how she was. I knew something was wrong, but I couldn’t put it into words. What was so scary for me was I’d never know which mother I would encounter on any day. She could be funny and hug and love me, or depressed and silent and absent. I’d feel so abandoned and then helpless to figure out how to make her happy and get her back so she could love me.”

One day, Samantha came to her session looking agitated. She told me: “I need to tell you about something. This is the memory I can’t get out of my head. It’s excruciating.” She burst into sobs: “I was terrified every day that she would kill herself. She did. In my senior year, I was talking about going to the local college, and I felt she was upset with me. I don’t know if that’s true, but I was afraid I was abandoning her. I thought maybe she and my father would be mad that I might not still be able to watch over her. In February of my senior year, I came home on a cold, snowy day. She wasn’t in the kitchen, and I felt that scary feeling I always got when she was in the bedroom when I got home. I went upstairs to her room and I knew as soon as I opened the door. I can’t say any more.”

Samantha learned very early that her behavior could lead to terrifying consequences: In order to feel safe, it was required that she make her parents happy. The dread of making them unhappy created panic and terror. Her detached father gave her the feelings of being valued, loved, and connected only if she played her ascribed role of caring for her mother’s emotional life and keeping her alive. Her mother’s erratic and unpredictable emotional life made it difficult for Samantha to feel she had any ability to know, predictably, how to please her mother.

Samantha had no space to develop an identity other than “the daughter who pleases her parents.” Separation and individuation were not an option, as it was too dangerous to think about her own wishes, needs, and desires.

Ambivalent Anxious Attachment

Samantha’s inability to make satisfying attachments to the people in her life mirrored her early attachments in her family. Perhaps the best categorization of Samantha’s attachment style is “ambivalent anxious attachment.” In this kind of attachment, the connection is characterized by mistrust and worry, but the need for the attachment is nevertheless intense. This pattern of attachment repeats itself in Samantha’s friendships and in her relationship with Marty. Even when wanting to say “no” to their wishes, desires, and perspectives, she always agreed. Much like the experience with her parents, her compliance resulted only in the transient feeling of being loved. From day to day and perhaps minute to minute, Samantha could not depend on her parents for reliable and consistent loving feelings. How could she trust anyone to love her or want to be with her?

Samantha has begun to understand how she repeats her early attachment style. She is learning to use thinking to override the terror and panic which emerge when she starts to feel that Marty is angry with her or a best friend doesn’t return texts or invite her to social events. This awareness is helping to diminish the degree of anxiety that occurs when she feels she’s being abandoned. She also is starting to see that her anger is evoked when she is suspicious about what people think of her and want from her.

Samantha is struggling. But she is committed to working at making changes in her patterns of attachment. As she alters her expectations and reactions to the people in her life, I expect they will respond to her in new ways. She has become increasingly able, in the moment, to consider that her assessments of her relationships based on historical responses are likely to need revision. As we continue to work, I believe she will continue to strengthen the power of her thinking so she can override acting on her feelings. Significantly, Samantha is developing a positive sense of self which can consider that she is making progress. She is.

Note: To protect privacy, names in the preceding article have been changed and the dialogues described are a composite.

Maddy: “I hate myself. I’m just like my mother. She always bossed my father around and was so controlling with me and my brother. Now I do the same things with my husband and kids. I don’t know why I can’t stop myself from always telling them the right way to do everything. I’m her all over again.”

Frank: “I feel like a terrible person, no different than my father: so rational and unempathic. Ugh! I hated that about him; how can I be just like him? I don’t like myself when I’m that way, especially with my wife. I know it’s hurtful, but I don’t seem to be able to change.”

Ellen: “I can’t believe I’m doing to my son exactly what my mother did to me. She made me crazy with her anxiety, and now I’m doing that to him. He just graduated, and I insisted he go to a close-by college. I was so worried. I know that was selfish and not best for him. My mother’s worry always limited me. Why didn’t I stop myself from doing the same to him?”

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Maddy, Frank, and Ellen are bewildered when they find themselves repeating relationships with their parents that had a negative impact on them. Consciously, these behaviors feel unwanted and dysfunctional. They don’t wish to inflict the hurt and pain they experienced in their childhoods on their significant others. They recognize the repetition and seem puzzled and unable to understand why they feel helpless to stop.

Ambivalence About Giving up Repetitive ‘Bad’ Behaviors

Each of these individuals consciously expresses self-hate when they recognize they are hurting loved ones in the same way a significant other hurt them in childhood. They identify that their own hurtful behaviors make them feel like bad people, out of control and/or hopelessly mean. Yet they also express ambivalence about changing these behaviors. When we explore and try to make sense of their resistances to change, each person, in their own way, embraces the behaviors of the parent who offended.

Maddy: “I don’t want to be this way, but honestly, it’s hard to imagine giving up control. I really believe I do many things much better than my husband and kids. In the end, I think it’s to their advantage to do it my way.”

Frank: “I know I’m an awful person because it’s so hard for me to appreciate my wife’s feelings. But she’s so irrational. Really—does it make sense that she’s so beside herself when her friend gets annoyed with her? It drives me crazy. I know I should be more caring and understanding, but I really think she needs to get more control of herself.”

Ellen: “I know it’s selfish and wrong that I’m such a worrier and my son has become a worrier. But I’m relieved he’s extra careful and cautious in his life. He said he wanted to go away to college. But I know him, and in my heart I believe he was relieved when I said he had to go to a local school. I think he feels taken care of when I worry.”

These three individuals reflect about their actions in similar ways. Rationalizing, they believe their behaviors are acceptable. At the same time, they attack themselves for repeating with people they love in the present what was hurtful to them in the past. The contradictory notions about the effect of their behaviors make change difficult to embrace.

Even though they rationalize and describe positive outcomes from repeating the behaviors of their parents, they experience bad feelings about themselves when they hurt and create conflict with loved ones. More than experiencing themselves as hurting people they love, the idea that “I’m just like my parent” is anathema. The idea of being “just like my parents” is not simply the feeling of “similar to.” Rather, it feels like “I am my parent.” This unwanted and intolerable experience of self can interfere with feelings of self-confidence and self-esteem and can play a role in the development of anxiety and depression.

With the unending pushes and pulls (between rationalizing and self-attack) to both enact and avoid repeating these old family patterns, stuck-ness in the repetitions and conflicts is solidified.

The Role of the Unconscious

These folks are not aware of any unconscious dynamics that may be keeping them anchored to their untenable positions. But if change is to occur, an understanding of the role of the unconscious in resisting change and perpetuating early parent-child relationships is essential. The aim is to uncover the unconscious meanings of holding onto the status quo and how repeating these behaviors serves each person (even when, consciously, that doesn’t make sense to them).

I will focus on my work with Frank to describe how we explored and became familiar with his unconscious and how that helped him with his conflicts and the repetitions of his early father-son relationship.

When Frank walked into my office, I sensed a man in conflict. He was assertive and self-assured but also vulnerable and defensive. He came into therapy concerned he wasn’t cut out for marriage but wanted to work on making the marriage work.

“I love my son,” he told me. “I suppose I love my wife, too, but I don’t know about me and marriage. If only for my son, I want to make it work. It’s hard to think of her needs. I get contemptuous when she doesn’t do or see things my way. I can be mean. I hate that it makes me feel just like my father. I could never do anything right—right meant doing it his way. He was a bully. I don’t do that with my son. But I bully my wife and I can be condescending with my colleagues at work. I feel horrible when I behave like my father. He made me feel like I was nothing, and now I keep doing it to others.”

If change is to occur, an understanding of the role of the unconscious in resisting change and perpetuating early parent-child relationships is essential. The aim is to uncover the unconscious meanings of holding onto the status quo and how repeating these behaviors serves each person (even when, consciously, that doesn’t make sense to them).

Frank and I spent many sessions talking about his relationship with his father. He was close to his mother, who was also bullied and couldn’t protect him from the onslaught of demeaning and destructive behaviors he encountered. Frank had some ideas about how, because of his father, he became tough and resilient:

“I probably was about 6 and I remember telling myself I would never let him get to me. I’d never cry or give him the satisfaction that he hurt me. I never asked for anything. I left home when I graduated high school and moved to another state. I stayed in touch with my mother, who would always talk about my father. I guess I stayed curious about him. I hated him, but I never stopped wishing he would be nice to me or give me the feeling he cared. On one rare visit, I told him I was doing really well and was getting a CPA, but he didn’t say much. [Sigh.] I wish I could have made an impression on him. He died right after I got my CPA. I hate to admit it, but I never stopped wanting him to be my dad. It’s too late now.”

Frank and I became aware of how conflicted his relationship with his father was. He hated him but appreciated how his behavior drove him to seek recognition by becoming strong, independent, and ambitious. Fundamentally, Frank’s strongest feelings resided in his abiding wish for his father to “be my dad.”

When I asked Frank what “being my dad” meant to him, he was thoughtful, then tearful: “I wish he was a dad like I am. My son knows I love him. I listen to him, praise him, show him affection. I play with him. He knows how important he is to me. I never had any of that.”

The more we talked about Frank and his father, the more in touch Frank became with his longing for a father—a dad. We puzzled over what made it difficult for Frank to let go of the hated father in him. Frank began to wonder: “You and I talk about my unconscious. Maybe my unconscious believes if I hold onto my hated father long enough, I’ll get the dad I so badly want. With my son, I’m not my father, I’m a dad. Now maybe I have to let go of the father in my unconscious and be the ‘dad’ with the people I care about in the world. I sort of get that I’m struggling with this, but I don’t know how to pull it off. Maybe if I could be more of a loving dad with the people in my life, I could let go of the bad dad inside me. Then I might feel better about myself and feel recognized and appreciated in the world. How do I get there?”

Frank was well on his way to getting there when he had the profound recognition of his holding onto his father as a way of trying to experience the dad he had longed for since early childhood. It is not unusual for repetitions of hurtful early parent-child relationships to be repeated in adulthood with the unconscious wish to transform a negative or hated significant other into the idealized parent that the adult continues to long for. The holding onto the destructive parent, by taking on the parental behaviors and repeating them as one’s own, feeds the unconscious wish for having the parent under one’s control, but it doesn’t provide the wished-for, idealized parent.

When one can recognize, as Frank did, that the perpetuation of the hurtful parent doesn’t and will not provide what was missed, it is easier to let go of the repetitions and embrace a more positive role model in one’s own behavior. As a result, more positive self-feelings emerge and facilitate more loving relationships.

Note: To protect privacy, names in the preceding article have been changed and the dialogues described are a composite.

“I feel like such a bad person.”

I have heard this sad statement from so many people who come to treatment struggling with terrible feelings about themselves. Typically, these “bad person” feelings are about having thoughts, wishes, or behaviors that have (or could potentially have) a negative impact on others, especially significant others. In order to fend off these feelings, people have lived their lives trying to prevent the experience that they are the cause of someone’s unwanted feelings: it is intolerable to consider that some statement they made or action they took could cause hurt, anger, disappointment, or any negative feeling. Such unacceptable reactions are “proof” that they have caused harm and are thus bad.

Expectations for behavior in families are learned early. When standards are dichotomized into either good or bad, children come to characterize not only their behaviors, but their personhood, as good or bad. For optimum development, children need positive responses from their parents. Reciprocal feelings of pleasing, loving, admiring, delighting in, kindness, etc., between parent and child are building blocks for self-esteem and self-confidence.

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In some families, “being good” is the only way to assure the receipt of positive feelings. But positive feelings are not enough for development into people who know themselves and are not fearful of relationships in the world. Children also need to learn to tolerate and manage negative feelings, both when they are directed toward the child and when the child wishes to express them to others. Children are seriously disadvantaged when parental expectations require them to have only positive feelings and ideas toward parents. If all negative expression to a parent is unacceptable or seen as harmful or destructive, the child must be vigilant: it becomes necessary to safeguard their internal world either by containing any negative feelings or by dissociating these feelings, creating unconscious certainty that they will not inadvertently be expressed. Any sense of oneself as harboring negative feelings toward a parent runs the risk of “bad person” feelings.

The Need to Excuse Parents’ Behaviors

The three people I am about to describe are struggling with the emergence of negative thoughts and feelings toward a parent. These intolerable feelings and the growing awareness that their reactions to parents (e.g., hurt or disappointment) may have some legitimacy create anxieties they are unprepared to deal with. One method for defusing the discomfort is to conceptualize the parent’s behavior in a context that makes the behavior rationally understandable and therefore acceptable. The rationales essentially excuse parents’ behaviors so that the person in therapy can disavow their own “bad person” feelings. Often, anxiety about their own negative thoughts or feelings toward a parent begins or is exacerbated when another significant other expresses negativity toward the parent.

Conrad has described how difficult his work life has been. He has little ability to take initiative at work or in his relationship with his wife. In general, he has trouble asserting himself in the world and struggles to think about what he wants and how to get it. This makes considering different work or how to better his relationships problematic. He lacks self-esteem and is vulnerable to feeling like he has done something wrong.

Conrad is remembering how his mother talked to him about his major in college: “She was always so helpful. She told me I was good at art, but I had to be practical and plan for a career which would enable me to take care of a family. I listened to her and went into finance. Ten years later, as you know, I hate my work, but I know she was only thinking of me. She lived through hard times as a kid, so my being secure financially is especially important to her. She only wanted what was best for me, and I can’t bear to feel that I cause her pain or disappoint her. I would feel so mean.”

Allowing the emergence of previously intolerable and unwanted feelings provides tools—not only for developing the self, but for the development of the self in relationship. Knowledge of feelings is a tool which can help address internal and external conflict. This means one has new and more information to decide both how and, sometimes more importantly, if to act.

Monica is depressed and anxious. She struggles with her son, who she feels rejects her and has become contemptuous of her relationship with her mother. This is intolerable for Monica, who has dedicated her life to taking care of others and making sure no one has any bad feelings because of her. Monica came to therapy because of how torn she is between trying to please her son and trying to make her mother happy. This internal and external tug-of-war is ruling Monica’s life, and there is little room for Monica to consider herself. In fact, before Monica began therapy, it never occurred to her that she should be a consideration. Monica is unable to act in any way that would make her feel she hasn’t done everything her mother expects of her.

Monica is tearing up as she tells me: “My son Rick never wants to visit my mother when I visit her. Mom is getting on in years and won’t be around much longer. I tell him he really hurts her feelings and upsets her when he doesn’t visit or call. He tells me it’s boring to visit and he hates that she always criticizes him and tells him what to do. I know that’s true, but I try to explain that she is very interested in his life and wants to make sure he does things right. Her heart is in the right place. It upsets me. I feel like I’ve done something wrong when my son behaves this way. I’m a bad mother and a bad daughter.”

Alan’s wife Nancy and his father always get into arguments. Nancy tells Alan that she doesn’t like the way his father talks about women and that his father hates women. It distresses Alan that she won’t keep her feelings to herself. Each fight between Nancy and his father throws Alan into an anxious frenzy: “Nancy is so mean to him. He loves her, but she doesn’t care. He does condescend to her, but it gets him very agitated when they fight. I worry he’ll have a heart attack. Why can’t she just keep quiet and understand he is a good dad and would never do anything to hurt us?”

Alan is a man in serious conflict. He adores and admires his father, but he frequently turns himself into a pretzel to provide for his father’s needs and wishes without feeling he is abandoning his wife. As he tries to provide what she needs and what his father needs, there is little consideration of what he desires. He has recently become aware of how it might be dangerous to know what he wants: “I think I would feel even more tortured if I had to choose between Dad, Nancy, and myself. But it’s getting harder and harder to feel I don’t exist as a person except to be there for the people I love. I know if I choose myself, it will confirm how selfish I am.”

Letting Go of Excuses and Feeling the Feelings

Conrad, Monica, and Alan could not tolerate negative feelings about their parents. All three felt at risk for feeling like awful people. They were stuck in their lives and limited in the choices they could make. In our work in therapy, it became important to recognize the pattern of excuse making and develop the awareness of anxiety that accompanied any leakage of negative thoughts and feelings about their parents. These three people began to connect how hard they worked to avoid unwanted feelings about their parents with how those feelings made them feel like bad people. They also began to recognize the connection between how their limited ability to tolerate feelings had affected their self-esteem and self-confidence as well as their ability to be autonomous in the world. They worked to let go of the excuses and make room for more authentic experiences in their relationships with themselves and, to some extent, with their parents.

The process of letting go of excuses to preserve positive feelings can produce intense anxiety as the letting go lessens the defenses and makes room for the “bad person” feelings to emerge. At the same time, the possibility for a less black-and-white palette for feelings becomes possible. As one begins to consider that there is a broad continuum between being “good” and “bad,” one can also begin to realize that having a negative feeling doesn’t automatically define one’s character. Recognition that having a wide range of feelings at our disposal makes us human becomes an important lesson in the therapeutic process. Becoming human is about separating and individuating.

For Conrad, Monica, and Alan, the separation-individuation process advanced when they could allow thoughts that previously were unacceptable. First, their heads told them that their lives were not as they wished them to be. Then, as they allowed their gut to become operational, they could use it to experience feelings that in the past were blocked and dismissed. Having these feelings facilitates the processes of self-reflection and self-engagement which promote self-knowledge. Thus, Conrad began to learn he still could nurture his artistic self and began to plan opening an art gallery. Monica has come to feel more kindly toward her son and has begun to acknowledge he can express feelings that she is only beginning to allow for herself. Alan is accepting that his attention to his own needs is not selfish, and can actually show a small smile when he tells me he chose his wishes over those of his father or his wife.

For all three, allowing feelings nurtures the growth of the self and the development of identity. They are discovering, “Who am I? Who am I in relationship to the world? What do I think, feel, want? What do I want to do?” Their need to block their feelings by making excuses is diminishing. Allowing the emergence of previously intolerable and unwanted feelings provides tools—not only for developing the self, but for the development of the self in relationship. Knowledge of feelings is a tool which can help address internal and external conflict. This means one has new and more information to decide both how and, sometimes more importantly, if to act.

Note: To protect privacy, names in the preceding article have been changed and the dialogues described are a composite.

Some people live their lives in extreme fear, approaching life with a constant sense of terror. The simplest activities of living can become fraught with dangerous possibilities. Feelings of risk and leaving safe spaces can require a person to make a careful assessment of the world before venturing out. People I’ve worked in therapy with who have this terrorized way of relating to their environment often come into treatment expressing misery and self-hate. They blame themselves for their unhappy lives and have little understanding of how they came to feel terrified all the time. They desperately want more freedom in their lives, and just as desperately, they’re afraid to be free.

The first time Joe came to into my office he looked uneasy as he sat down and stared at me vacantly. “What brings you here?” I asked.

Joe mumbled as he bent his head to the floor, “I hate my life, I hate myself. I have no life. I’m afraid of everything. If I’m alone, I can’t travel, drive, or even leave my neighborhood without fearing that something terrible will happen and no one will be there to help me.”

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This was my introduction to 47-year-old Joe, whose story helped me understand what it means to be terrorized from early childhood experiences. I wanted to help Joe understand his terror so he could relinquish his guilt and self-hate and begin to move toward more freedom in his life.

Joe, an only child, grew up in a household with an absent father who was a workaholic and a controlling mother who was depressed and also likely experienced bipolar. His father died of a heart attack on the job when Joe was 16; his mother died by suicide from drowning herself in the bathtub when Joe was 23.

Joe described his childhood: “Before I started school, I have memories of my mother singing and dancing with me and telling funny stories. Growing up, my father was always working, so Mom would sometimes take me to the yard and play catch or goof around. As early as I remember, she would get very depressed. She’d take to bed and be irritable and mean to me. I had to be very quiet and not disturb her or she would scream that I was killing her. I would sometimes hide in the closet with a book or toy, and I wouldn’t make a sound. I was very scared and I knew if I bothered her she would come at me in a rage and threaten to kill herself. I never knew which mother would be around at any time. I could leave my happy mom and go to school and come home and find her slumped on the kitchen table crying that I didn’t love her, or my father was mean, or why didn’t I stay home from school because I knew she needed me. It was so confusing and scary. By junior high, she usually had things she wanted me to do, like cook or help her with chores. She insisted I come straight home from school. She didn’t like me to bring friends home or go to a friend’s house or even participate in activities after school. It felt like she was totally in charge of me. I knew if I pushed back she would get weepy and angry and tell me she was going to kill herself and what a terrible son I was. I felt as if I’d destroy her if I wasn’t careful. But I loved her and we were close. “

When Joe’s mother died by suicide, he was living on his own just a few streets from his mother’s house. He had been trying to reach her by phone. After several hours of not answering, he told me, “I just knew she had done it. I called a neighbor and asked her to meet me at the house. We found her in the bathtub. It’s been a lifelong struggle not to blame myself for her suicide. Rationally, I know it’s not my fault, but maybe I could have done something to prevent it.”

Joe and I spent many months working on his feelings of responsibility for his mother’s death. We considered that restricting his life and his freedom could be a way to punish himself. While this guilt likely contributes to Joe’s paralysis in engaging the world, more recently our work has focused on the ways in which growing up impacted Joe’s development into a terrified person.

Becoming Terrified in Early Childhood

As Joe became more able to talk about his experience of being terrified as a child and young adult, it became clear to both of us what a visceral experience it was. We understood that Joe wasn’t an ordinary scared child experiencing fear. Rather, that child with his toy in the closet was scared to death; he was terrified. His mother terrorized him. The danger he feared of making a sound while his mother was in her bed felt life threatening. Joe did his best to fend off her rages, attacks, and shaming behavior.

He recalled, “She’d get so cold and absent, or shout ‘You’re killing me,’ or ‘You want me dead, you’re stupid, you’re weak.’ She criticized everything.”

The threat of death was very real in Joe’s house. He explained, “She would tell me, ‘You’re going to find me dead one of these days if you can’t help keep this house clean,’ or, ‘If you don’t get home from school on time,’ or, later when I was in college, ‘If you don’t call me every day.’ ”

Joe’s father played no role in mitigating his mother’s destructive behavior. Joe coped alone with the possibility of his mother’s death. Her destructive communication and unpredictable emotional presence left him feeling unsafe, unprotected, and fearful for his own survival. If Joe didn’t consciously feel that his life was threatened, unconsciously he was terrified of his own annihilation.

In treatment, Joe began to develop a more compassionate attitude toward himself as he learned to appreciate how, as a terrorized child, it was necessary to find ways to protect himself and survive the threat of losing both his mother and himself. He simply could not allow himself to visualize engaging in any activity on his own. His was a dangerous world where no one could save him in an emergency. He hadn’t been able to keep his mother safe, and now surely he was not safe.

As we explored Joe’s terror of venturing into the external world, it became clear that he hadn’t developed the ability to enter his internal world. He wasn’t free to play with ideas about his life or to wonder about new and exciting possibilities. He had to be prepared to respond to his mother’s demands. Unconsciously, he had to dissociate his own needs and desires. Clearly, he had not been able to separate and individuate from his mother.

Developing Freedom to Individuate

Joe had learned to rely on his mother to define his identity and for his positive feelings. She needed him to be dependent and used the threat of her death or his annihilation to keep him controlled and connected. He had internalized his mother’s voice, which, in his adult years, continued to govern him. Even when a parent is deceased, terror can live on in their child’s psyche. Could Joe lessen the influence of this voice that kept him in a constant state of vigilance?

I believed Joe needed to emotionally recognize that he had kept himself imprisoned in the service of keeping his essential self alive in protective custody. If he could allow himself to enter his internal world, he would be able to discover his own wishes, desires, and needs and develop an identity separate from how his mother defined him. We had to consider his unconscious resistances to growing his self and leaving his mother’s voice behind. We explored the downside of “leaving” his mother. Joe realized that he still wanted to protect his memory of her.

“She was so fragile and depressed. I still can’t hurt her or blame her. It wasn’t her fault; she did the best she could, given the deficits of her life,” Joe said.

“I know it’s time to stop protecting her. Even though I don’t believe it’s safe yet, I tell myself the risk is not so great—the pleasures and satisfactions in the world are worth the try. I’ve got to try.”Joe has struggled to overcome his resistance to separating from his mother. He is more able to acknowledge her destructive behavior and experience some anger and disappointment. This could empower him, make him less terrified, and help resolve his conflict so he could choose his self-growth rather than continue to protect his mother.

“It’s hard. I spent my life protecting my mother and myself from death. I’m still protecting my image of her as a good mother who will take care of me. Maybe I believe that if I have my mother with me—even my dead mother—it will protect both of us. I know it’s time to stop protecting her. Even though I don’t believe it’s safe yet, I tell myself the risk is not so great—the pleasures and satisfactions in the world are worth the try. I’ve got to try.”

One doesn’t have to have a parent experiencing suicidal ideation to feel terror about their own survival (consciously or unconsciously). Parents terrify their children in many ways. For example, children can feel terror about their parent’s ability to survive and keep their child alive. Terror can also occur when a child is physically or emotionally abused or result behavior that is shaming, controlling, and/or emotionally withdrawn. Anxious or unpredictable attachment can leave a child in a terrified state.

Joe has a come a long way in working on his terror and his ability to feel safer in the world. I tell his story with the hope that others who have lived their lives in terror as the result of their early family experiences don’t have to be doomed to self-blame, hopelessness, and forever be imprisoned and terrorized. When those who work on themselves in therapy understand how they became terrorized people and emotionally comprehend the visceral feelings of terror that have been endured since early childhood, they can be helped to give up the need to protect significant others who terrorized them. Often, this is the start of a transition from self-blame to freedom of self-development.

Note: To protect privacy, names in the preceding article have been changed and the dialogues described are a composite.

I work with a number of anguished parents who are surprised, hurt, and bewildered by changes in the way their adult children behave toward them. They describe relationships filled with coolness and irritation from their adult child and talk about being rebuffed when emails, texts, and phone calls go unanswered and responses to requests for dinner or birthday celebrations are ignored or refused. These parents feel pushed away and controlled by their children and clueless to understand this unexpected behavior. They come into therapy filled with a wide range of feelings, including rejection, anger, hurt, anxiety, depression, and helplessness.

Melanie came to see me because of difficulties with her oldest child, Barbara, 33, who is five years married with two young children.

“She was my first, and it was love at first sight,” Melanie said of Barbara. “We were so close. I don’t understand the change. It seems sudden, but I suppose it started after college when she became a little distant and there was some tension. Now I can’t say ‘boo’ to her without her becoming annoyed or angry. I’m always walking on tiptoe and never know when she’s going to have an outburst. She’ll yell and say awful things like I don’t understand her or I’m self-absorbed or the queen of criticism. I can’t imagine why she feels this way. I go from shock to crying to feeling outraged. I don’t know what she wants from me. Actually, it feels like she doesn’t want anything from me. It’s getting more and more difficult to get to see her or even get her to send me a picture of the grandkids or answer a text. When she ignored my birthday last month, that was the worst.”

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Melanie’s experience with Barbara is illustrative of what the distressed parents I work with describe: through adolescence they had close, loving relationships which became conflicted only after their children left home. The separation-individuation process which is expected to occur in adolescence didn’t emerge at the developmentally appropriate time. Without the benefit of individuation in adolescence, these children missed the experience of learning to navigate the power struggles and clashes with parents that are crucial for the formation of a sense of identity with feelings of autonomy and self-confidence. This experience is necessary to set the stage for feeling comfortably attached to the parent without fear of being controlled or influenced.

The Development of Saying Yes to Oneself

I have always been intrigued with the idea that 2-year-olds have to learn to say “no” before they can say “yes.” The “no” of the 2-year-old is a crucial component of the development of self. “No” is directed to the parent who engages with the child in a squabble. When there are wins for the child, their “no” is accepted, making it possible for the child to begin feeling authorship of their “yes.” “Yes” is a nod to the self, to one’s desires, needs, and drive toward autonomy.

During adolescence, this process continues. Now the parent has to shift from the position of benign authority they held with their younger child. They must find a balance between providing rules within a secure and safe framework and simultaneously allow room for the emergence of the adolescent’s “noes.” This means the child is given space to question and change the rules (although the parent will not always agree) as they move toward “yes,” i.e., developing their identity as autonomous adults.

The Adult Child’s Delayed Individuation Process

For some children, the struggle to individuate either begins or intensifies after adolescence, often during their late 20s or 30s. When this occurs, a strong need to pull away and extract oneself from the parental orbit feels necessary.

For parents who have not experienced the passionate conflicts of adolescence and may be known to happily remark “I got off easy,” their adult child’s fierce push to be separate can be heart-wrenching. When there is a delay or a reemergence of this struggle for autonomy, the parent is frequently taken by surprise and is unprepared for what may now become an intense process of individuation in which the adult child, no longer feeling required to adhere to the old rules, comes out fighting to claim a selfhood that will feel unfettered by parental influence. It can seem very sudden when a child starts to pull away, express anger, and assert themselves against the parent. Although the parent may be unaware of treating the child differently, what might have felt to both parent and child like interest or involvement in the past can now be experienced by the child as controlling or critical.

As I got to know Melanie and learned about the development of her relationship with Barbara, it became clear that Barbara was late in separating from her parents. Through late adolescence, Barbara never went through a stage where she pushed against her parents. When she went away to college, she remained close with frequent calls and emails. Between her junior and senior years, however, she and her parents fought over her decision to remain at college for the summer to take an internship. This was the first big disagreement with Barbara where Barbara’s wishes won out. Melanie wondered:

As I got to know Melanie and learned about the development of her relationship with Barbara, it became clear that Barbara was late in separating from her parents.

“I’m not sure about this, but I think things changed after that. She never lived at home after graduation. She stopped asking for advice, and I was so surprised when she decided to move to a neighboring state for grad school. Maybe I shouldn’t have said I thought she should stay local for school, save her money, and live at home. She had made up her mind, and I remember she got angry and said I shouldn’t tell her what to do with her life. I was shocked. I was only trying to help. Since then, she bristles or gets angry at any suggestion I make.”

Melanie was feeling profoundly rejected by Barbara. She felt helpless to know how to relate to her and how to change the increasing negativity she felt from her daughter. She felt controlled and without any clear sense of why this was happening:

“I can’t ask questions without her getting enraged,” Melanie said. “I asked if she took my granddaughter to the doctor when she had a fever and she told me to stop butting in! I’ve asked her such innocuous questions, like ‘Are you planning a vacation?’ Or, ‘Are you thinking about sending the kids to daycare?’ Every time I ask a question, she accuses me of criticizing her. I don’t get it. I just want to be a part of her life. She doesn’t want to let me in. Worse, sometimes I think she hates me.”

It seemed to me Barbara’s individuation process had been delayed. I assumed that since there was little conflict with her parents during adolescence, Barbara’s “noes” and “yeses” were probably mostly shared by her parents. Thus, in adolescence, Barbara would have felt no need to differentiate her wishes and needs from those of her parents. Now, as an adult, she had no developed sense of self with feelings of autonomy. So she still needed to individuate and take ownership of the “yeses” and “noes” in her life. This would give her a sense of agency and self-confidence, enabling her to feel less threatened by her mother’s opinions, wishes, and needs. Differences between them would simply be differences, not cause for concern about losing herself to her mother’s influence. She would not have to be worried about being controlled because she would feel in charge of herself.

Melanie began to understand that Barbara equated connection with influence. She recognized that Barbara’s experience of being constantly criticized became the rationale for pushing Melanie away:

“I think I get it. If I ask a question, like did she take my granddaughter to the doctor, maybe she hears it as my opinion: ‘You should take her to the doctor.’ Or maybe, she hears it as ‘I don’t trust you to know what to do’ so then she feels criticized by me. I see she is fighting being influenced by me. It’s like if she lets me in, she loses herself. If she lets herself feel close to me, it threatens her sense of self. I don’t want to be in her life to control or influence her, I just want to love her and feel loved. How is that ever going to happen?”

Facilitating Individuation for the Adult Child

Melanie’s feelings of helplessness were palpable. She was developing an intellectual understanding of what was going on with Barbara, but it is quite another thing to find a way to change the dynamic between them so their bond could be restored. I made the following suggestions to Melanie:

• Be mindful of the content of your communications. Questions can be interpreted as criticism, shoulds, or judgments.
• Find an opportunity to talk to Barbara without being defensive, and tell her you want to hear how you can be a better parent.
• Let her know you respect and admire who she is and what she does in specific ways, e.g., “I love that you’re always reading to the kids,” “It’s great that you’re learning to play golf,” “Can I have your recipe for meatballs?” or “Your home looks so lovely.” These communications contain the idea (no guarantee that it will be interpreted that way) that you have positive and admiring feelings toward your child.
• Let Barbara control the amount of contact. She is engaged with you in a necessary separation-individuation process that was not resolved in earlier years. When it becomes resolved, she will have a more positive sense of self. This will enable her to develop a strong and loving attachment with you. Once Barbara is secure in the positive feelings of who she is, there will no longer be a reason to fear being unduly controlled or influenced.

Note: To protect privacy, names in the preceding article have been changed and the dialogues described are a composite.

When I work with people who have difficulty expressing what they want and need, especially to their significant others, it is apparent feelings about hurting the other can create a fierce resistance to the authentic expression of self. As a therapist, my job is to find a way to help people navigate between consideration of the other’s feelings and honoring their own wishes and desires.

For some, realizing they have wounded someone they care about, even unintentionally, can cause painful regret and self-attack. Frequently, I find I must help people accept that they can and sometimes should choose to express themselves knowing it might hurt someone they love. My challenge is how to help someone accept that hurting and being hurt comes with the territory of love and relationships.

Identification with the Other

Mark, who has been married to Cynthia for five years, talks about how much he loves his wife and how difficult it is to make choices for himself when she disapproves of those choices: “Cynthia is such a strong person. She always seems to know what she wants and what is right for us. I wanted to take a relaxing beach vacation since work has been so crazy, but she insisted we do something more interesting. When I tried to push and said how tired I was, she started to cry and told me I should know how much she hates the beach and how it hurt her feelings that I would even suggest it. I felt really terrible and mean. She’s right: I should never have brought it up.”

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Mark and I explored his reaction to Cynthia and his feelings of guilt and cold-heartedness for not recognizing he would hurt her by expressing his wishes. Mark found it difficult to consider that he hadn’t done something unforgivable. He was consumed with self-loathing and seemed devastated as he put his head in his hands and told me: “I always feel like the world’s worst person when I hurt her so badly. It shakes me up and I hate myself.”

Mark was not aware of how he identifies with Cynthia’s feelings and experiences her pain as if it were his own: “I know just how she feels when I do that to her. I’ve felt that so many times in my life, especially when my older sisters would be mean to me. I never want to make anyone, especially the woman I love, feel so awful.”

His recounting of his experiences with his sisters led us to focus on how Mark identifies with Cynthia and assumes her hurt feels exactly like his hurts of so many years ago, inflicted with malice. I asked Mark if he could imagine not feeling so viscerally that he had hurt her and instead feel sad or sorry for his behavior. I pointed out, “You identify with Cynthia and experience her pain as if it were your own. It seems difficult to step back a little and just feel badly that your wishes hurt her and be concerned, rather than taking on and experiencing her feelings. Identifying this way makes it very difficult to allow yourself to be free to express your needs and cope with your impact. You also end up attacking yourself and feeling like a bad person when it feels like you have so seriously wounded your wife.”

Mark acknowledged he often felt paralyzed to express his wishes but found it confusing to consider he could have a choice and not identify with Cynthia. I introduced the idea of empathy to Mark as an alternative to identification. We have begun to work on what it would mean and how it would feel to be empathic (being compassionate and sensitive to feelings without having the feelings) rather than identifying. This is not yet a distinction Mark can easily understand, and we continue to work on this. We will also continue our exploration of how Mark develops his identification reaction when a significant other is hurting.

Early Family Communications About Hurt and Hurting

Some children grow up in families where parents communicate that any negative impact the child makes on the parent will not be tolerated. This means the child cannot disagree, create conflict, or express any thoughts or feelings which negatively affect the parent. Under these circumstances, the parent’s response when they feel the child has hurt them is typically a communication that the child has inflicted pain and suffering on the parent. This is frequently experienced by the child as a sign of the child’s “badness.”

When a child’s early experience is that they have the power to inflict such hurt and distress on a parent, they are likely to take on that “bad person” feeling. Thus, feelings of shame, anxiety, and worries about being destructive can become part of the child’s identity. The degree to which this is felt and internalized may depend on where on the continuum of possible responses the parent’s reaction falls. The parent’s negative responses may range from a quiet and subtle withdrawal of love or connection, to guilt- and fear-inducing accusations of “you hurt me” or “you’re mean,” to aggressive physical punishment.

This kind of negative emotional response from a parent may severely interfere with the child’s ability to develop a positive sense of self and impair the capacity to assert their wishes and desires to others. The expression of any sense of agency can create anxiety about the risk of negatively impacting the other, along with worry they are doomed to experience the feelings that have come to be part of the “bad person” identity.

Part of the work for these people in therapy is to get comfortable with being hurt and hurting as a normal component of relationships. This doesn’t mean one shouldn’t feel badly or sorry when they inflict hurt. It does mean it is necessary to address old responses of feeling devastated (identification) when a loved one is hurting, as well as the “bad person” feelings of shame and self-hate.

Jana, 29, was very angry in her session with me as she recounted a memory when she was 5 or 6: “My parents divorced, and my father left me and my younger brother with my mother. I was sad all the time and scared. My mother went to work, and we had a babysitter. I remember pulling on my mother and crying, ‘Don’t go, don’t go.’ I was beside myself. She told me to stop it, that I was making her feel bad and hurting her feelings. I’m not absolutely sure she said this to me, but I think she said something like it was mean of me to make her feel like a bad mother. I think she said that a lot. She hasn’t changed. She’s the mean one. That icy cold voice comes out of her even now when I’m upset about something or need something from her.”

I remarked, “You seem angry at her now. How did you express anger growing up?”

Jana sighed, “I am angry now. But I could never let myself get angry at her when I was growing up. I couldn’t really let myself feel angry feelings toward her until a few years ago, after I started to work with you. I was always the bad one; I felt I was always hurting her. I especially remember hurting her if I didn’t say the right thing to my grandparents. I absolutely remember her telling me I was mean to make her look like a bad daughter because of something I said or didn’t say to my grandparents. I don’t know what she wanted. It was so unpredictable. I remember this awful feeling in my stomach, like I was going to throw up. For so many years, I felt like a disgusting person.”

Jana has increasingly been able to understand her child self was not to blame for her mother’s hurt feelings and that her behaviors were not bad or mean, even if her mother experienced them that way. She is now better able to be angry with her mother and recognizes her overwhelming feelings of shame and anxieties about her impact on others are related to her early experiences.

Nevertheless, she has not been able to give up the wish for her mother to affirm her goodness. She continues to struggle to maintain a more positive sense of herself and disavow the “bad person” feelings. Contact with her mother is her biggest challenge to accepting her goodness and shedding her sense of herself as a disgusting person. Fortunately, Jana’s awareness of her situation, and her commitment to herself to grow an identity in which she can comfortably express who she is, is powerful motivation to keep growing.

For Jana and Mark, there is a strong drive to suppress their thoughts and feelings rather than risk “bad person” feelings and/or their own pain should they hurt a significant other. For any person who has to fight “bad person” feelings, it becomes necessary to loosen the hold on the idea that the other’s hurt is the consequence of their behavior and/or badness. Rather, they need to recognize that the other’s feelings of being hurt don’t always correspond to having been treated in a hurtful manner.

It may sound glib to say “hurt happens,” but it does. This doesn’t mean behavior isn’t sometimes intentional and meant to hurt and destroy. However, when I think about the people I help and their early experiences in their families, they were not helped to be comfortable with their nondestructive or non-mean behavior if the other felt impacted in hurtful ways. (I am not addressing hurtful behavior when it was intentional.) Part of the work for these people in therapy is to get comfortable with being hurt and hurting as a normal component of relationships. This doesn’t mean one shouldn’t feel badly or sorry when they inflict hurt. It does mean it is necessary to address old responses of feeling devastated (identification) when a loved one is hurting, as well as the “bad person” feelings of shame and self-hate. These old responses do not serve the individual’s needs for self-esteem, agency, and authenticity.

Note: To protect privacy, names in the preceding article have been changed and the dialogues described are a composite.