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Tuesday, December 1, 2009

Psychotherapy and Compassionate Self Acceptance

As a psychotherapist in New York City, I have found that one of the major challenges for people who begin psychotherapy is overcoming their own critical and judgmental beliefs and assumptions about themselves. When I work with clients who have developed a harsh sense of self, I often begin by talking to them about how psychotherapy can help them to become more mindful, attuned and compassionate towards themselves.


Psychotherapy and Compassionate Self Acceptance

Low Self Esteem, Lack of Self Compassion and Self Acceptance, and the Development of the "False Self":
Many clients who begin psychotherapy to overcome low self esteem want to find a way to feel better about themselves. As their psychotherapy unfolds, often, what comes to light is that they have rejected parts of themselves that they have come to hate. Hate is a strong word, but it is usually apt for the type of self loathing that these clients have come to feel for parts of themselves over time.

This lack of self acceptance and self loathing is not always obvious to see at first. Sometimes, it manifests itself in a critical and judgmental attitude towards others. Other times, it shows itself through a need to be "perfect" themselves and to have others be "perfect." Very often, this self loathing and lack of compassion for oneself can be seen when people develop a "false self" when they are interacting with others.

Donald Winnicott and the "False Self"
Donald Winnicott, a British Object Relations psychoanalyst and pediatrician, was one of the first psychotherapists who developed a theory about the "false self."

In his developmental model of the "false self," Winnicott posits that, early on, when parenting is "good enough" a baby learns to relate to his or her primary caregiver in an authentic and loving way.

"Good enough" is the operative term here, since parenting can never be perfect and parents cannot always be perfectly attuned to their children.

However, according to Winnicott, when the primary caregiver (usually the mother) is sufficiently and lovingly attuned to the baby, the baby is usually able to thrive emotionally and, over time, learns to relate well to others as well as to him or herself. However, when the primary caregiver is unable to connect emotionally with the baby, either because he or she is depressed or for some other reason, the infant feels rejected and develops a "false self" to try to elicit the caregiver's love and attention.

People who have developed a "false self" often describe themselves as feeling "empty" or "hollow" and have difficulty relating to themselves as people who are worthy of love and compassion. They also often have difficulty relating to others because their own critical judgments and self loathing gets projected onto others: What they unconsciously cannot accept in themselves becomes intolerable when they sense these qualities in others.

So, over time, in psychotherapy, it becomes apparent that low esteem, depression, anxiety and other emotional problems are often connected to a lack of compassionate self acceptance for oneself and the development of a "false self." It may seem somewhat contradictory, but until you can accept the parts of yourself that you don't like, they're difficult to change.

The following is a vignette which represents a composite of several psychotherapy cases where a client has a "false self":

Carol:
Carol began psychotherapy because she felt that her life was "meaningless." She was in her mid-30s and she had never had a romantic relationship that lasted for more than a year. She described herself as feeling that she "existed" but she was "not really living." She could only express this feeling in the vaguest of terms, but the feeling was strong in her. Her emotional world felt flat--no passion, no real highs or lows.

Psychotherapy and Compassionate Self Acceptance

She worked as an attorney for a nonprofit social service agency, and her employer valued her work because she worked very hard advocating for the clients and often won her cases. However, even though she knew that she was highly esteemed in her organization, she could not feel good about herself at work or in any other part of her life.

In describing her childhood history, she emphasized that she felt she had good parents and she denied any abuse or big traumatic events. As such, she had a hard time understanding why she felt the way she did, "If my parents beat me, I could understand why I feel this way about myself, but they didn't, so there must be something very wrong with me."

It soon became apparent in psychotherapy that underneath that flat sense of meaninglessness, Carol had a strong sense of self loathing. Most of the time, she was able to push down those feelings of self hatred by working long hours and keeping herself distracted. However, as she talked about herself in a judgmental and critical way, it became evident that she lacked a sense of acceptance and compassion for herself.

She ran roughshod over herself with a sense of perfectionism and judgement that was truly soul crushing. No matter how much external praise she received from others, she never felt that anything she did was good enough. She spent a lot of time ruminating about what she perceived as her personal flaws or how she "could have done it better." She was her own worst taskmaster with standards that were unattainable.

In discussing her family history in more depth, it turned out that her parents, who were highly-regarded Ivy League college professors, were rather critical and emotionally distant with Carol. They provided her with everything that she needed on a material level, but they gave Carol the overarching message again and again that what they truly valued in her was her accomplishments in school. There was little sense that they valued her just as she was as a person.

Carol learned as a child that if she got very good grades and tried to be as "perfect" as she could, her parents would praise her efforts. But if she fell short in any way, as all of us do at some point or another because we're human, they found this intolerable.

Carol was also very aware that her mother, who stayed home with Carol until she was five years old and started school, had a lot of resentment about this. Her mother would have preferred to be teaching her classes and continuing her research than staying home with a helpless, dependent baby.

Carol had heard her mother lament many times about how the time she spent away from her field was detrimental to her career and that she was never able to regain the stature that she had prior to staying home with Carol.

Carol's father concurred with her mother about this. One can only surmise that Carol's mother's anger about her role as a mother probably did not allow her to be as emotionally attuned to Carol as an infant. And throughout Carol's childhood, neither parent demonstrated much emotional attunement for Carol as a child who deserved love for herself, without having to perform to their impossibly high standards.

Prior to starting psychotherapy, Carol had never questioned her parents' attitude towards her. The feeling that she was somehow to blame for her mother's lost professional opportunities and that she needed to perform to gain her parent's love and attention was so deeply ingrained at such a young age that it had become a strong part of Carol.

And even though her parents had somewhat mellowed as they aged and they no longer had such a punitive attitude towards Carol, it didn't matter because Carol had internalized their critical and judgmental attitude on such a deep and unconscious level that she was now doing it to herself.

Over time, Carol was able to see how she had developed a "false self" to please her parents. And even though this "false self" might have developed due to her parents lack of emotional attunement, she realized that it was now her responsibility, as an adult, to overcome the emotional obstacles that kept her from accepting herself just as she is.

It was a real challenge for her, but Carol began to question her harsh, punitive attitude towards herself. She mourned for the inner child part of herself who didn't get the unconditional love that she deserved.

She also began to learn to love that part of herself that she had learned to hate--the part that needed to be loved for herself and not for her "accomplishments." As she did this, she began to feel more authentic.

She no longer felt that she was performing a role or just going through the motions in her life. Life became richer and more meaningful as she became more emotionally attuned to herself. She also learned to forgive her parents and she developed better relationships with them as she recognized that they were no longer the punitive, emotionally withholding parents that she grew up with.

As they aged, they went through their own emotional transformation and she learned to relate to them as they are now and not how they were when she was a child.

As Carol became more compassionate and accepting towards herself, she felt better about herself.


Psychotherapy and Compassionate Self Acceptance

Accepting that she was human, she could make mistakes, she no longer needed to be "perfect," her self worth did not have to be based on her accomplishments, and that she deserved love, enabled her to open up others in an authentic way that she had never experienced before.

Eventually, she was able to open up to a relationship with a man who loved for her for herself, and they developed a healthy, loving and stable marriage.

Getting Help in Therapy
If you are struggling with your own critical and judgmental beliefs and assumptions about yourself, you could benefit from participating in psychotherapy with a licensed mental health professional. Although it can be a challenge, you can learn to develop a more self accepting and compassionate sense of self so you can improve your relationship with yourself and others.

I am a licensed NYC psychotherapist, hypnotherapist and Somatic Experiencing therapist. I have helped many clients to develop a more self accepting and compassionate sense of self.

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

To set up a consultation, call me at (917) 742-2624 during business hours or email me.