I’m afraid I’ll become my father! “I am working with a highly socially anxious man who was verbally and physically abused by his angry father when he was a child. He says he is afraid of becoming his father (i.e., abusive) and has in fact become verbally cruel to his ex-girlfriends. So he drops friends and lovers at the first sign of disappointment/conflict rather than face his anger. He is afraid that his anger will make him like his father. How can I address this fusion of him and his father?” Thanks for sharing this common problem! This kind of patient fears that if he explores his feelings he will become like his abusive father, something that is morally repugnant to him. Thus, he cannot join us in a therapeutic task that he fears would make him a worse person. Without addressing his concerns we cannot establish a therapeutic alliance. So we must help him differentiate himself from his father and differentiate the therapeutic task from an anti-therapeutic task. Differentiate him from his father: Th: Being angry doesnt make you like your father, losing control of it does. Would you like to face this anger so that you could express your strength but without his intent to hurt? Th: “Being angry with a girlfriend does not make you like your father, but discharging it through verbal abuse would. Would you like to face this anger so you could express yourself in a healthy assertive manner and let go of this verbal abuse? Wouldn’t be nice to express your concerns in ways that strengthen the relationship rather than damage it?” Reinforce his healthy concerns: Th: Obviously these girlfriends did not deserve the rage did they? Wouldnt it be nice to face this rage where it belongs (toward your father), so it wouldnt have to go out onto the wrong people? Differentiate the therapeutic task from an anti-therapeutic task: Th: “I’m so glad we are in agreement. Obviously, the last thing we want is for you to lose control and verbally abuse others. After all, that would damage your relationships and only make you feel worse about yourself. So to be clear about our task, would you like to be able to express yourself more effectively in relationships so you could handle conflict in the future? Would you like to be able to channel your anger into effective communication? Would you like to be able manage conflict in relationships so you can finally keep a loving woman in your life? Would you like me to help you learn how to deal with your anger so you could achieve those goals? Deactivating Defiance: Th: “If at any time you think our exploration might lead you to act out, would you let me know right away so that together we can help stop that? Th: “You certainly don’t have to explore your anger. After all, it’s your problem and you have the right to handle it the way you think is best. But if I don’t explore your anger with you, I’d be as useless to you as your father was. How do you suggest we proceed?” Prevent acting out in therapy: Th: You say that you leave as soon as you are disappointed. What impact would that have on our relationship? After all, if you leave as soon as you are disappointed with me, we would not be able to help build the capacity to deal with disappointment. Would you be willing to commit to working with me when you are disappointed so we can help you reach your potential? Take home points: always validate the patient’s healthy concerns so that you can make sure he sees that you have the same goal and that therapy is designed to achieve his goal. Differentiate the patient from his father and his father’s defense. Mobilize the patient’s will to a goal he wants and task to achieve it.
Posted on: Mon, 23 Jun 2014 12:29:29 +0000
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