Saturday, January 25, 2014

Why Is It That It's Often the Healthiest Person in a Dysfunctional Family Who Goes to Therapy?

It's not unusual for the one person who comes to therapy from a dysfunctional family to get scapegoated by the family into feeling like she or he is the unhealthy one in the family.

Why Is It That It's Often the Healthiest Person in a Dysfunctional Family Who Goes to Therapy?

Often, other family members point to this person as the one who has the most problems because s/he is attending therapy.  But, in fact, the person who goes to therapy from a dysfunctional family is often the healthiest person in the family.

Why Is It That It's Often the Healthiest Person in the Family Who Goes to Therapy?
Let's understand, first, that by saying that it's often the healthiest person in a dysfunctional family that goes to therapy, it's understood that this is a generalization and it's not always true.

But, having said that, it is often the case because the person who recognizes that s/he needs help is, at least, aware that there is a problem that s/he can't overcome alone, and s/he wants help from a licensed mental health professional to make changes.

In an earlier article, I discussed The Role of the Family Scapegoat in Dysfunctional Families, which is an important concept in order to understand why family members often turn on the healthiest person in the family who seeks help in therapy.

When someone, who is part of a dysfunctional family, seeks help from a psychotherapist, the other family members often feel that this person is being disloyal by airing the family's "dirty laundry," and they often feel worry that the therapy will upset the tenuous "equilibrium" that has been established in the family and upset the status quo (see my article:  When Family Loyalty Gets in the Way of Your Psychotherapy Treatment).

I usually find that a composite vignette, helps to clarify the subjects that I discuss in my articles.   As always, this is a composite of many different cases with all identifying information changed to protect confidentiality:

Jane
When Jane was growing up, no one in the family talked about uncomfortable feelings.  They also didn't talk about Jane's older brothers, Bob and John, who were drinking, getting into trouble at school, and getting arrested for disturbing the peace.

Jane's parents blamed their sons' schoolteachers, the principal, their neighbors, and the police, and they refused to acknowledge that their sons had problems.

Despite the trouble that their sons were getting into, they refused to acknowledge that there was anything wrong at home or that they could or should do anything about the problems.

Whenever other family members, like Jane's uncles and aunts, would try to point out to her parents their sons' problems were escalating, the parents made excuses and refused to believe it.

As a result, Jane learned to keep her feelings to herself and she also tended to ignore her brothers' problems, even if one or both of them came to the dinner table drunk.

After Jane's oldest brother, Bob, died in a car accident, her parents and John focused on suing the other driver, who was not hurt, and the police for "not doing their job."

But a toxicology report revealed that Bob, who was not wearing a seat belt, had twice the legal limit of alcohol in his system and he was the one who rammed into the other driver.

Jane's parents' denial was so strong that they refused to believe the toxicology report.  They wanted "someone to pay" for the loss of their son, but they couldn't find an attorney who was willing to take the case, so they gave up in frustration.

At that point, Jane was living on her own.  When she heard about the toxicology report, she had enough physical and psychological distance from her family to begin to realize just how much her parents and brother were in denial.

She also realized that she had been in denial all of her life about the dysfunctional nature of her family.

After Bob died, Jane tried to talk to John about his drinking, but he didn't want to hear it.  He dismissed her concerns and told her he could control his drinking at any time.

Jane's parents also became upset with her when they found out that she was trying to talk to John about his drinking.  They also refused to talk about Bob's death.

This resulted in a big argument between Jane and her parents and, even though she loved them, Jane decided to take a break from her family.

Jane knew she needed this time away from her family to grieve the loss of Bob and to think about what had been going on for her all of these years while she was living at home.

After Jane's best friend recommended that Jane get help, Jane started therapy.

Working in therapy, Jane soon discovered that, even though she was more willing than her parents and brother to deal with her feelings of loss and confusion, she was also fairly shutdown emotionally.
She realized that she had been numbing herself emotionally for years and there were times when she didn't know how she felt.

Working with Jane, I helped her to develop the necessary coping skills to deal with the feelings that she had been blocking for so long.

After we worked on coping strategies, I helped Jane to connect with her dissociated emotions by helping her to pay attention to what was going on in her body.

Gradually, she was able to identify her emotions based on what she was feeling physically in her body.

When Jane decided to reconnect with her family, against her better judgment, she told them over dinner that she was in therapy.  She hoped that they might consider going to therapy too.

John left the table abruptly knocking down his chair as he walked out of the house.  Jane's parents remained silent.

But later on, while Jane was washing the dishes, her father told her that he had always felt that, out of all of his three children, she was the one who was "too sensitive," and she needed to learn to "toughen up."  He also told her that he didn't "believe" in therapy.

When Jane tried to tell him that she thought he was in denial about Bob's and John's problems, her father was outraged and said he couldn't believe she was saying this to him.

Why Is It That It's Often the Healthiest Person in a Dysfunctional Family Who Goes to Therapy?

Jane's mother remained silent for a while.  Then, she told Jane that she knew something was wrong with Jane when Jane tried to tell them that Bob and John had problems.  She told Jane she couldn't understand why Jane would say this, and it indicated to her that Jane was the one who had the most problems in the family.

As she spoke, her mother's voice escalated until she was shouting.  She told Jane that she couldn't believe that Jane was giving money to "some quack" and saying negative things about the family in therapy.

At that point, Jane was angry and humiliated.  Once again, she took a break from her family because she realized how unhealthy it was for her to be around them at this point.

Even though she was in therapy, she was just at the beginning stage of therapy and she didn't feel that she had consolidated the gains she had made so far.  She needed time to work on herself without her family's criticism and distorted views.

During Jane's next session in therapy, she was able to process her emotions about her family's reactions to her being in therapy.  Even though it was painful to feel these feelings, she was still relieved to be able to feel them instead of pushing them down.

Over time, Jane felt more confident in herself and the gains she made in therapy.  Since she still loved her family and she didn't want to remain estranged from them, she worked in therapy on how she could have them in her life while taking care of herself at the same time.

Jane realized that she couldn't change her family and it was useless to try.  All she could really do was to change herself and try to accept them as they were.

At the same time, she didn't want to feel emotionally abused when she went to visit her parents, so when she called them, she set some boundaries with them:  She wouldn't try to convince them to change how they felt, and they would agree not to tell her that she was the one who had the most problems in the family.

Jane's parents and John missed her so they agreed to keep their feelings about Jane's therapy to themselves.  Jane knew there was no perfect solution and she was resigned that this was the best that they could do.  So, when she went for visits to see her parents and her brother, everyone, including Jane, kept to the agreement.

A few years later, Jane got a call from her mother and, in a somewhat awkward tone, her mother revealed that she had recently found out from a friend that she really admired that this friend had been helped in therapy.  She talked about how shocked and dismayed she had been at first to hear that her friend was in therapy.  But, over time, her friend was persuasive in convincing her that she had been helped in therapy.  And, her mother said, she had to admit that she saw positive changes in her friend.

Jane knew that this was her mother's way of apologizing to her, and she felt relieved that her mother was starting to become more open minded.

In the meantime, Jane felt that she benefited from grieving the loss of her brother and regaining a part of herself that she had lost during all of those years that she was pushing down her emotions.

It's Often the Healthiest Person in a Dysfunctional Family Who Goes to Therapy

She realized now that by numbing the uncomfortable feelings, she was also numbing all of her feelings, including any positive feelings.

Having worked through this issue in therapy for herself, she now had access to a range of emotions that she had been denying before, and she felt more alive than she had ever felt.

Focusing on Yourself Rather Than Trying to Change Your Family
It's a common experience that when someone from a dysfunctional family gets help in therapy, s/he wishes that the rest of her family would get help too.

Even though this longing often comes with the best of intentions, it often backfires in families that aren't ready to hear this.

Maintaining the status quo in the family often becomes paramount, even if it means pathologizing the healthiest member of the family.

Their rationale is often:  "If you're going for help, there must be something wrong with you" or that the family member who is going to therapy is being duped in some way by the therapist.

Another accusation that families make is that people who seek help in therapy are "weak" (see my article:  Common Myths About Psychotherapy: You're Weak If You Go to Therapy).

Although some families come around after a while, especially if they discover that someone that they admire outside of the family is attending therapy (as in the vignette above), many family members never change their minds in terms of identifying the person who is getting help as being the emotional "weak link" in the family.

Under those circumstances, usually, the best thing that you can for yourself is to focus on your own psychological development in therapy and not try to change your family.

As an adult, you might also want to consider whether you want to reveal that you're in therapy and, if you do, if you can deal with the potential criticism and hostility that might come from your family.

Only you can decide what's best for you, but many therapy clients learn a sense of self preservation under these circumstances and, in many circumstances, they learn to have a sense of compassion for their family members.

Getting Help in Therapy
If the vignette about Jane resonates with you, you could benefit from getting help from a licensed mental health professional who has experience dealing with this issue.  Although getting help might bring certain challenges with your family, the benefits, including leading a more fulfilling life, usually outweigh the challenges.

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

I have helped many clients who come from dysfunctional families to lead happier, more fulfilling lives.

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

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