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Sunday, May 3, 2015

Psychotherapy Blog: Overcoming the Confusion Between Compassion and Responsibility in Therapy

In Part 1 and Part 2 on the topic of confusing compassion and responsibility, I began discussing the problem that many adults, who traumatized as children, have with this issue.

Confusing Compassion With Responsibility:  This  Pattern Often Begins in Childhood

As I mentioned in the prior articles, traumatized children often take on the responsibilities of the parents in a dysfunctional family where one or both parents are impaired due to mental illness, substance abuse or some other problem.

Developmentally, the responsibilities that these children take on is way beyond what any child should ever have to do.  But they do it because they have become "parentified children" who function beyond their years in order to rescue their parent(s) and/or other siblings.

As parentified children, they develop distorted beliefs, which include confusing compassion and responsibility, and they usually continue to perpetuate this problem in their adult relationships, often with disastrous consequences.

Unfortunately, as I mentioned in my prior article, most of the time, adults who had these experiences as children never get help in therapy.  As a result, they often go from one destructive relationship to the next without even realizing that they're repeating patterns from their childhood.

Even when they come to therapy, they often have a hard time letting go of their distorted beliefs--even when they're able to see it logically.  This is usually because these beliefs have a tremendous hold on them emotionally.

To illustrate the dynamic that I've been discussing, I've presented a scenario below that is a composite of many different cases to protect confidentiality:

Ed came to therapy because he just ended another unhappy relationship, and he was beginning to despair that he might never be in a healthy relationship.

As we went over his family history, Ed described a highly dysfunctional family where his father drank excessively and hit Ed and his younger siblings, and his mother gambled most of the family's money.

Ed grew up feeling that it was his responsibility to take care of his siblings.  

When Ed's father got drunk, he would often hit Ed and his younger siblings.  As the oldest, Ed would try to shield his siblings from their father's blows, which only angered the father even more and made him more abusive.

Ed grew up feeling that if his father was physically abusive towards him, it must be because he deserved it.  

He believed that if he could be the "best son" that a parent would want to have, his father would stop drinking and his mother would stop gambling, so he tried as hard as he could do be "perfect."  

Confusing Compassion and Responsibility

But since this was a distorted belief, there's no such thing as a "perfect" person, and his behavior had no bearing on his parents' problems, his efforts never worked the way he hoped they would. 

When the father was out drinking and the mother went to the casino, Ed took care of his siblings, cooking for them, washing their clothes, helping them with their homework, and so on.

This often meant that, rather than go out and play with his friends, Ed would stay home with his brothers and sisters and take care of their needs.

During the times when his mother gambled away the family money, Ed would take on jobs before school, like delivering newspapers, to try to make up for the short fall so the family would have food.

Even though life was very difficult for Ed, there were times when his father would vow to stop drinking and the mother would say she would stop gambling, and life seemed like it was going to be normal for a short time.

During those times, Ed felt a great deal of love and compassion for each of his parents, and he knew that they were struggling emotionally.

Unfortunately, those times never lasted very long.  After a while, the father would begin drinking again and the mother would return to gambling, and the household would be chaotic again.

This cycle was repeated over and over again.

Each time that his parents attempted to have some normalcy in their lives, Ed hoped that it would last.  But each time he was disappointed.

When it came time to go to college, Ed chose a local college so he could continue to live at home and help his younger siblings.

He was so accustomed to juggling home and school that he didn't realize that he was exhausting himself.  Eventually, he got sick and was bed ridden.

During that time, his maternal aunt came to visit from out of state.  Shortly after she arrived, she realized how bad things were and she gave Ed's parents an ultimatum--either get help or she would contact Children's Services to report their neglect.

After that, things began to improve at home, which was a relief for Ed, but the emotional damage was already done.

As Ed entered into one romantic relationship after another, he continued to perpetuate the same dynamic that he grew up with as a child.  

The women that he chose initially seemed emotionally healthy but, over time, it would come to light that they either had a drinking problem, a drug problem or a gambling problem.  

Confusing Compassion and Responsibility

Ed felt compassion for each of his girlfriends, and he would feel, as the boyfriend in a committed relationship, that he had to do everything that he could to try to help each of these women.  But each time it was the same--he would exhaust himself physically, emotionally and sometimes financially, but he couldn't save any of them.

His friends would tell him that he was so focused on his girlfriend at the time that he wasn't taking care of himself.  On on intellectual level, Ed understood this, but on an emotionally level, Ed felt compelled to continue to try to take responsibility for each of these women.

After several disastrous relationships, Ed came to therapy and we were able to trace back his pattern to early childhood.  

We began working on the earlier experiences that were impacting his adult life using EMDR, Eye Movement Desensitization and Processing therapy, which is a therapy that was developed for trauma (see my article:  What is EMDR?)

Even though Ed knew that his beliefs about compassion and responsibility were distorted, these beliefs remained very strong for him on an emotional level.

As is often in the case when this happens in therapy, there was a part of a young part of him, a child self, that wouldn't allow Ed to overcome his early experiences.

So, having seen this many times in similar situations, I asked Ed to ask his younger self what he felt he needed.  

Tuning Into Ed's Younger Self

As Ed tuned into this younger part of himself, he sensed the younger self letting him know that he felt he couldn't allow Ed to let go of the trauma without feeling that his parents were taken care of.

As an adult, Ed knew that his parents had overcome their problems when he was 20.  But his younger self, who acted as the container for those earlier memories, was stuck at an earlier time when the father was still abusing alcohol and the mother was still gambling.

At first, Ed was confused because he couldn't understand why this younger part of himself was stuck in the past and had not gotten caught up with the present reality.  

So, I explained to Ed that we are all made up of many different aspects, including the adult self, the teenage self, the child self and many other selves (see my article:  Psychotherapy and "Parts" Work).

This is a normal experience.  This has nothing to do with multiple personalities or dissociative identity disorder.  

It so happened that in Ed's case, as often occurs for adults who were abused and traumatized as children, that this younger self was the repository for these earlier memories and remained stuck emotionally.

So, in order for the therapy to progress, we had to take care of this younger self's needs first.

Over time, through gentle exploration, we discovered that this younger self would be willing to allow Ed, as an adult, let go of his distorted beliefs if he felt that Ed's parents had ideal parents that would have taken care of each of them so they wouldn't have grown up to be so unhappy that they used alcohol and gambling to deal with their unhappiness.

Of course, there's no way to actually change the past, but one effective strategy is for the client to use his or her imagination to overcome this treatment impasse.

So, guided by what Ed's younger self communicated that he needed, Ed began to imagine the kind of idealized parents that his father and mother would have needed.  

I helped guide Ed so that he could use his imagination to make each of these idealized parents as vivid as possible with all of the qualities that his younger self felt was necessary.

Then, we took each of those images and Ed imagined his mother as a baby being held and loved by her idealized parents.  He imagined his mother growing up as a young child, a teenager and as an adult with these idealized parents who were loving and nurturing so that Ed's mother grew up to be a loving mother towards Ed and his siblings.

Ed did the same thing for his father--imagining him with loving, nurturing parents, so that his father also grew up to be a loving father towards Ed and his siblings.

By using his imagination, facilitated by an EMDR technique of using tappers to strengthen this experience, Ed created a new symbolic memory (see my article:  Mind-Body Psychotherapy: Healing Trauma With New Symbolic Memories).

The interesting thing about using your imagination in this way is that, even though the logical part of your brain knows that things didn't really happen this way, the emotional part of your mind experiences it as if it  happened, so that it becomes a healing experience.

There are some clients who difficulty with this because they remain so aware that reality was so different from what they imagined that they have a hard time allowing themselves to suspend disbelief.

For those clients, I usually gently ask them try suspending disbelief for the sake of the exercise so we can see what happens.  Most of the time, they're able to experience the healing that comes with this.

Ed was open to using his imagination and, afterwards, he discovered that his younger self felt taken care of to the point where he was able to allow Ed's adult self to process his traumatic experiences.

Over time, Ed mourned for the childhood that he wished that he had.  This was an important step for him.  

Many people avoid coming to therapy because they fear that they'll be overwhelmed by their grief.  But if they have a good rapport with their therapist and the therapist can provide a "holding environment," most people discover that letting go of their grief isn't nearly as upsetting as they had anticipated (see my article: Creating a Holding Environment in Psychotherapy).

Gradually, Ed learned to distinguish compassion from taking responsibility.  He discovered that he could feel compassion for someone, but he didn't have to take on their problems.

As he continued to make progress in therapy, Ed also no longer felt the need to rescue women that were in trouble.  He learned that it wasn't his responsibility to "save" them. 

Getting Help in Therapy to Stop Confusing Compassion With Responsibility:  Ed in a Healthier Relationship

Over time, he was also attracted to healthier women, so he was able to enter into a relationship that was healthy and satisfying for the first time in his life.

Getting Help in Therapy
The scenario that I presented in this article is, unfortunately, common for adults who were abused and traumatized as children.

Getting Help in Therapy

If this scenario seems familiar to you because you had similar experiences, you owe it to yourself to get help from a licensed mental health professional who has experience working with trauma.

You can overcome emotional trauma that's keeping you stuck and unhappy.  

Making the decision to get help is the first step.

About Me
I am a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist who works with individuals and adults.

Helping clients to overcome trauma is one of my specialities.

To find out more about me, visit my website:  Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (212) 726-1006 or email me

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