Prisoner of the Past

As I have said many times, psychodynamic psychotherapy is based on the theory illustrated by an inverted triangle.  The base, now on top, represents the here and now.  The point at the bottom signifies infancy.  The space within contains our life’s experiences from our earliest moments. Interplay with the significant people in our early life (parents, siblings, grandparents, nannies, etc.) will determine who and what we will be as adults.  Whatever coping mechanisms we develop as little children will become the basis of our personalities. 

If we are fortunate enough to be born into families where we are accepted for who we really are, we can develop into healthy, fully integrated adults. A child growing up in such an atmosphere can experience the freedom to develop intellectually, to grow and change, to express curiosity and creativity, as well as to develop and expand its interests and passions.  

Unfortunately, such freedoms are the exception rather than the rule.  Most parents, because of their own childhood experiences, have neither the insight nor the ability to nurture this type of freedom in their children. 

These behavioral traits (which many parents feel their children are born with) are not genetic.

Generally, parents, without malice or intent, impose significant restrictions on their children.  They often communicate the message to their children that the expression of certain inborn traits is unacceptable or “bad”.  This would include experiencing and expressing anger, fear and sexual gratification.  Most parents, unfortunately, feel threatened and uncomfortable when their child expresses its anger or indicates fearfulness; few parents are able to deal openly with their child’s sexual curiosity or sexual experimentation and they communicate their discomfort and displeasure either subtly (with a frown) or directly (through criticism or punishment). 

None of us, child or adult, wishes to be in pain.  The young child experiences pain when the uncomfortable parent reacts negatively to his open display or expression of his most basic emotions.  This starts very early in the child’s life.  Not wanting to experience this pain, the child, with no conscious awareness, begins to seek ways to avoid it.  Through trial and error, it will attempt many forms of behavior in order to protect itself from the parent’s disapproval.  Those behaviors that work by neutralizing the parent’s reaction become part of the child’s repertoire or defense system.  The others will be discarded.  So the child may become the “good kid” (see The Good Kid Syndrome), the “bad kid”, or the “sad kid”, etc.  These behavioral traits (which many parents feel their children are born with) are not genetic.  They are simply the primitive coping mechanisms or defenses which the child developed early in life. 

These early defenses have major significance in our lives since they are often the basis of our personalities. Unfortunately, we often suffer for using these defenses.  The “good kid”, by definition, has to bury all behaviors that are considered “bad”.  Such a child will pay a heavy price for having to conceal its unacceptable emotions.   

The “sick kid” (the child who neutralizes the parent’s emotions and attempts to get the parent’s sympathy and attention by manifesting physical problems) is often plagued later in life by hypochondriacal symptoms.  He may go from doctor to doctor seeking an answer to what his problem is and gain pity and attention from his family who cut him a lot of slack because he isn’t well. 

The “sad kid” finds that his sadness gives him a lot of power as he distracts his parents from whatever complaint they may have about him and gets them to focus on their concern that he isn’t happy. They unintentionally program him to use his depression as a defense and this can become a lifelong problem as he becomes a depressive. 

The “bad kid”, who discovers that temper tantrums are able to overpower the parents, later becomes an overbearing bully in his adult relationships.  Other children who learn that lying produces certain gains may become pathological liars as adults.  

These are but a few examples of how early childhood defenses become the basis for our adult styles and personalities. Our parents’ reactions to our early behaviors create a script which we follow into adulthood.  Consider this. Their reactions to us followed from their own childhood.  That is the reason why so many family patterns can be traced back through the generations.  It is not so much in the genes as it is in our experiences. Thus, the child often carries the heritage of the family and truly becomes a prisoner, not only of his own earliest days, but also of the past. 

Although this may make it sound that we are destined to repeat the negative patterns that seem to form our family’s characteristic coping mechanisms (for example, to use alcohol or drugs as a way of coping with stress), there is hope that, through the use of psychodynamic psychotherapy, we can delve into the origins of an individual’s characteristic behavior and free him from the limiting affects of these defensive patterns  Making these patterns that were unconscious conscious becomes the first step toward change. 

There is an existential question, “How does one un-learn the taste of an orange?” The answer is that you can’t.  Once you have tasted an orange, you can never say that you do not know its taste.  So it is with what we discover in therapy.  Once you recognize a pattern and its causes, you are different.  You are now aware. It is no longer unconscious, automatic behavior.   

Recognizing and understanding the root cause of these patterns occurs during what I call “de-mystification”. A patient suffering from long term depression will discover that his depression is the result of a long established pattern of repressing anger.  He will discover that he was not permitted to openly express anger as a child, had to internalize it and consequently became depressed. Through therapy, he will develop insight into the ways in which his parents communicated to him that expressing anger was unacceptable.  As a child, he was powerless to deal with the consequences of displaying anger.  In treatment, he will come to see how these fears of parental disapproval generalized out into later relationships with authorities, peers, and mates.  In other words, even as an adult, he would not be able to confront anyone effectively. 

The ultimate goal in therapy is to reduce the fears that have followed patients from childhood.  The depressive will learn to confront when he is angry. He will no longer internalize his anger because of the fear of physical or verbal abuse, guilt arousal or the fear of rejection or abandonment which were used to control him early in his life. 

The process of psychodynamic psychotherapy identifies the origins and causes of the debilitating patterns that have made lives difficult and helps patients to reduce and eliminate them.  The ultimate goal is Freedom: freedom from the often crippling messages which were presented to us as children. 

Cognitive-behavioral therapy which has been in vogue for over twenty-five years approaches issues from a very different perspective. Causes are not considered. Significant childhood patterns are not addressed. The direction of this type of therapy is to attempt to simply control behaviors through training.  I have had many patients who have been exposed to cognitive behavioral therapy and have reported no insight and little change. The problem with controlling ones behavior is that the underlying causes persist and the behaviors can resurface at any time.  

This is like putting a Band-Aid over an infected area and never treating the infection. 

Those patients who truly want to be at peace emotionally find the process of psychodynamic psychotherapy the key to unlocking the bonds of their childhood so they no longer have to be Prisoners of the Past. 

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