How you 'attach' to people may explain a lot about your inner life
theguardian.com
theguardian.com
My multi-year long journey of what I learned and getting back to health - which most visibly manifested itself as CFS symptoms (Post exertional malaise) - can be summed up as:
Trusting the therapist and understanding they are not perfect humans themselves. Accepting they are not going to fix me, they are a companion on the journey, I must fix myself with their help.
Going on a journey through all major points in my past and re-experiencing what I'd been through. Whilst having the therapist with me to slowly help unfold the emotions and understand it from a different perspective (i.e. I did not cause the bad things that happened to me, it was not my fault).
This helped me build a foundation, a place of support that didn't rely on other people, which gave me self-confidence to listen to the negative self-talk that I had blocked off for years, because it was too overwhelming to hear. When I started listening to this self-talk, I could then start to converse with it. e.g. "You aren't good enough", "Perhaps I'm not, but let's see what happens when I apply my focus to it", which started taking away its power and effect over me.
Which led me to realising that my intellect and conscious part of my mind is probably only in control of 20%-30% of me. That I'm not a fully logically creature and that I needed to come to peace with my body's needs and messages from my less conscious mind and work together as an integrated whole, rather than trying to force my will based on pure 'rational' thought.
Life has been considerably better since and my decades of depression and low energy have begun to abate.
Whilst the points may seem simple, understanding like this rarely comes from knowing in the conscious mind. It is understanding that has to be understood at a deep level, which is why therapy can take a long time. My favourite way of describing this conscious acceptance but lack of sub-conscious understanding can be summed up as: “I know that, but try telling me that”.
- waking up when the alarm goes
- hitting snooze a few times
- getting out of bed with the right leg first
- wearing the blue shirt instead of the black one
- lifting your foot to avoid the doorstep when stepping out of the front door
- breathing, for that matter, or your heartbeat, your digestive processes, etc.
Honestly the 20%-30% number is way off. I would guesstimate something like 1-2% conscious decisions max.
But the difference in understanding that at superficial level vs being able to experience that at a deeper level, is what caused changes to my behaviour at a deeper level and is the real revelation.
As to how I experienced that, I would preface this by saying that this is going to be very unique for everyone depending on how your mind communicates with itself so I won't go into the exact process for fear of someone trying to emulate my path exactly (self-leadership is more important than being led). It is something I came up with myself rather than a specific therapy (again, self-leadership)
After many many sessions of eventually being able to see and feel the parts of myself pushing against each other. I began to see the person that I thought was me, which was the 'cleverest part', that was centered in the front part of my brain and that denied listening to the rest of my body. Was really a small piece of a whole. When I realised I could move my observation and inhabit different parts of my mind and body that is when I knew I wasn't leading the show in the way I believed I was.
I could see I didn't have control of the other voices or feelings that were inside of me. They would express what they wanted. I could either deny, accept them or attempt to change it if I thought that part was maladjusted and needed help. An example of a maladjusted response might be wanting to apologise for being abused or feeling shame for things that I had no control over.
As an aside, based on various therapies I’ve worked out my method of emotional acceptance of past events and traumas which has and is helping me to accept and integrate them, but it still feels crude. I catch any strong emotion and then observe it and allow it and accept it. Sometimes it’s tied to a seemingly trivial memory(my mind trick is that the memory is not actually trivial) which I can look at and integrate and accept as well.
> We have this principle we use when we're trying to locate someone who doesn't want to be discovered.
> You are what you can't stop doing.
> What that means is if we discover what someone is passionate about, then that person and that thing will intersect. Passion involves compulsion. And people, all people, have compulsions that draw them away from their safety and their best interests. People and what they love don't always intersect. People and their compulsions do. And John, well, he's compelled toward you. He's crazy about you.
And it's a quote I have a hard time not thinking about, ironically..
I've had a similar realization. I think we vastly underestimate how good our subconscious/automatic parts of our brain are. Every healthy person can run up a flight of stairs without looking where the steps are and analyzing the position of each step. Many sports involve the forming of reflexes that let your brain analyze where an object is and respond to it without even thinking about it. There's A LOT going on in terms of calculation and response. We call that a skill and once mastered, it seems effortless.
So now, as a rational person, I value the conscious part of the brain not as much for its ability to be logical (though I still cherish that as a developer) but as a an agent of improvement, a programmer for the subconscious part of the brain. And the more I can offload and delegate to the subconscious, the more new and fun things I can take on with my slow but rational consciousness.
Of course, there needs to be a feedback loop, to prevent the subconscious from drifting into self-delusion or a general asshole but for that, empathy and the Golden Rule have served me quite well.
This is all very new to me and I'm probably not explaining things very well. But I had the epiphany on this watching squirrels in slow motion do insane calculations when tossed into the air, locking their heads on a target and twisting their bodies to land precisely on their target.
It’s like diagnosing sick systems - I don’t think about it, at all - I just look, listen, observe, take in the landscape and the music of the machine, and then point at the problem. Software, mechanical systems, networks, any domain where I have enough knowledge to know what I’m looking at, the pattern recognition system can handle the rest. It makes people think that I have expertise in many domains, but really, I’m just a one-trick system-grokking pony.
The structure and function of the animal brain is remarkable. Only a few weeks ago, I was noting the habits of a hornet, which tended to pass by the same point at the same time each day, and marvelled that such a tiny handful of neurons could manage not only flight and navigation of 3d space, but a routine, habits, behaviour. What the many orders of magnitude more grey matter we have might be capable of beggars belief. There’s the old bullshit adage that you only use 1% of your brain, but there’s perhaps truth to the idea that most people horribly underutilise the power of their minds, because they have been trained to think, not to intuit.
I guess it depends on your definitions, but I think your 20-30% numbers are still way to high.
The part of you that is in control and makes the decisions that give you agency over yourself. I used to believe I was directing myself day to day, but I'd guess that the concious only has a 20-30% say in the matter.
This opposed to who is performing the actions in which the subconcious mind is involved in 99% of the work. e.g. walking is almost entirely a subconcious activity.
PEM is a rather obscure syndrome which no doctor i have met really understands, also i like you don't really have most of the "other CFS symptoms".
Basically it's an incredibly debilitating post "exertion effect" that means that every time you try to "better yourself", workout, get work done, etc. you end up crashing hard instead of feeling like "yeah i made it, now i can relax!" - you instead feel both mentally and physically like you are on the brink of death, often for days for no reason - it feels so incredibly "unfair". You could have just been promoted, got a raise, finished a marathon, doesn't matter, you feel like you are crashing from a drug bender.
Until now i have been thinking that it's either some cell level or genetic deficiency, OR that it's actually a form of burnout, ie. the way "out of the PEM prison" is through total relaxation, weaning of coffee, stopping hard workouts etc - but i have "often" tried this to little effect - what i haven't tried though is going to therapy for a "longer stretch" and your post just made me realise something: "Maybe i too am too hard on myself" - why this form of neurosis would lead to Post Exertional Mailaise i don't really know, but damn i am so happy to have found someone who's had experienced the same thing.
Anyways - i just wan't to say thank you so much for writing this, and if you or anyone else have any leads to books, forums or podcasts about this issue, i would be so happy.
The therapy is the last item in a very very long list of desperate things I've tried to cure PEM (metabolic typing, accupuncture, genetic testing, methylation, nutrition, crazy diets, and so much more).
What was the cause cause of my PEM? Negative emotions alone, wasn't the direct cause. But the supression of those negative emotions. In general terms: supressed, charged emotions directed at myself caused my PEM. Or in HN terms: constant low-level burnout.
Because it takes a lot of energy to hide those feelings from myself. A constant battle that I was generally unaware of that was happening at a deep level. I would deny the feelings of my body. I first had to build the support inside myself, with help of a therapist, before I could truly start to listen to the supressed emotions without being overwhelmed.
This was the beginning of the end for my PEM.
The book I would recommend would be: The Body Keeps the Score by Bessel van der Kolk M.D, which helped me a lot on the journey to recovery.
I've found forums to be generally very unhelpful. Something I wrote down a while back which I hope explains why I don't think they are a good place to resolve problems:
---
The unreasonable ineffectiveness of communities in solving a single problem.
One person has a problem, if problem persists for any length of time, the more likely others will be experiencing that problem at the same time.
If there are enough people with that problem, a community will form around solving it. If the community is ineffective in solving that problem, then the community will grow and begin to sustain itself as new members join with that problem and the existing members continue to work on solving that problem.
For the community to survive, the problem must not be solved or the solution has to be close to unobtainable. Ineffective solutions will be devised to solve the problem. The complexity or discipline involved in solving the problem will exceed the ability of the individuals to implement it. The blame of solving the problem will lay in not in the community itself, but the individual not being able to implement the solution. An example of this may be a nearly impossible diet, regime or routine.
If an effective solution is found to the problem. There are two possible outcomes: either the community will dissipate and active membership dwindles or it will protect itself from the existential threat and block the ideas. This is especially true if the identities or financials of individuals in the community rely upon the problem existing.
Therefore, no community that sustains itself will form around the right solution. It is unsustainable. The communities with the most active members are also the most popular, propogating the problem.
---
Please do let me know how you get on, I wish you the best.
I have already begun The Body Keeps The Score and is actively looking for a therapist now.
The perpetual cycle of overreach, then crash certainly deepens the negative self talk - the fact that you can't tame yourself through excessive discipline while ignoring "how you actually feel" (ie. often like complete trash because you ARE crashing) certainly doesn't help the "neurotic behaviour/emotional armour". But i somehow thought i could "plough through".
The suppression of real emotions seems like a perfectly reasonable explanation for why you become so tired/worn out. Also you get used to ignoring the negative self talk because you feel like it makes no sense from the intellects perspective and you have to "perform professionally" or whatever.
One thing that has kept me from really going in this direction has been the observation that 3-4 days in bed with only my laptop has been able to "heal" all of the pain and fatigue and tension in the body - if done before for example an important meeting i end up completely calm, extroverted, like another person or "the real me", but the "tension" and fatigue soon returns. Such a weird and labyrinthian process. I guess it has to do with the fact that the negative self talk quickly returns and i get burned out again very easily.
Anyway, i guess the way forward is not ploughing through with a tense body and an "ignored" mind. Sounds almost stupid as i write it out like this, but here we are.
However, no one gives us manuals for our body and we're all inside an incredibly complex system which we are not evolutionarily adapted for.
I remember most vividly when I took 6 weeks off work, stayed at my Grandmas house with her feeding me good food and not having to do anything, then going back to work again.
I was incredible. Level-headed, extroverted, energetic. I thought it was just rest, but then I began to understand (many years later) that all my cycles of energy started off in similar ways. For example, if I tried a new diet or regime, I would feel great for a week or two until I wouldn't.
I eventually came to understand that it wasn't what I did, but how I felt. I discovered what the placebo effect was (for me) and why it seemed I'd get a buzz from doing something new or starting afresh. It was because I felt powerful and in control.
This feeling of power was so helpful, so nourishing, because it countered what used to be the worst feeling in the world for me: a maldapted feeling of powerless. That feeling was connected to my trauma/past experiences at a deep level.
As everyone can attest, being in the real world often creates feelings of powerlessness, because you are not in control of everything.
That meant everyday life could quickly wear me down depending on how much nourishment I was getting from feeling powerful vs powerlessness.
An analogy I use to describe this: it is a car with a leaky fuel tank. The hole in the fuel tank is the negative emotion. The bigger the hole or the less the fuel going in, the quicker you run out of energy.
Eventually the requirement to counteract the maladapted feeling of powerless diminished, and thus I didn't need to feel powerful in the same way.
For you, the feeling that wears you down, may not be powerlessness like mine was, but by looking at the things that make you feel good, you'll be able to figure out what you get from laying in bed for a few days on your laptop.
Then perhaps you will come to understand the feelings that you avoid or are the inverse of what you get from sitting on your laptop. e.g. sitting on your laptop might make you feel in control, or might avoid the pressure you feel from having to do something that doesn't nourish you in some way.
But before big life changes are made, I would say it's important to find out which of your negative feelings come from maladaptions (i.e. to past emotions/trauma) and then you'll be able to make more effective decisions once you've resolved those maladaptions.
I think most importantly the new connection for me is that i simply get worn down outside or among other people incredibly fast for some reason - same with work projects.
I am still unsure of the actual physiological cause, as it seems to me that i can also get a crash even if i run alone in the woods - ie. no other people, but it's still a "performance" and "you" still judge it with your own mind.
What makes me sure that there is something this is the fact that you have experienced both this AND the feeling of powerlessness - and the paranoia around this - i hadn't really seen this before but i totally also have that - down the fact that i have also been high on new fads, diets, lifestyle changes but only for a few weeks or months before i try something new.
So in short "the crash" is related to feelings of being in control, bodytension and not letting things go properly, instead judging hard, becoming perfectionist and having feelings of "not good enough" - even though i just finished something. Being a hermit with your laptop is fleeing from all responsibility and letting the mind rest, just as the body, and you are probably right that the mind is just as important.
So to sum up mostly for myself. Letting go, being kind on yourself, and being comfortable with "other peoples eyes" around me, appreciating smaller incremental victories, and just as you also mentioned in you first comment - building self reliance is something i have to learn to do. I have probably had a pretty high level of anxiety inside of me that i have ignored like "everyone has imposter syndrome", or "everyone is afraid of getting exposed (whatever that means)", but it wears you down.
Just writing this out is untangling a few things for me so thank again!
You are on the right track. I'd speculate there are memories from your childhood that could be the root cause of it.
It will take time for things to change. To figure out what is going on and to listen to the messages from your body, but things will get better for you.
It took around 2 years for me (with reading and therapy) to make significant progress, but I had to exist in a world where some of the people who created the original issues were in my life still and were very unsupportive of my new revelations, which made the process harder than it needed to be. The process isn't over for me yet, but the hardest part is over with the PEM disappearing and depression abating.
Please drop me an email (email in profile) sometime, I'd be keen to know how you get on and what you learn.
You both mention self negative talk and for that reason I come forward with this recommendation, but things you discuss (repressed emotions, powerlessness/vulnerability, self-leadership,...) are all intertwined and addressed in the book in an insightful way.
The most important thing is to _experience_ Voice Dialogue (or IFS, which slightly differs in approach), ie. to be in the situation when someone talks to your 'voices'/'selves' and you 'enter' those 'voices'/'selves'. This experience results in a revelation which I tend to call (a deep) insight, no less.
VD precedes IFS (which is not that important) and I have a strong preference to VD over IFS (I would need to read more on IFS and clarify my points, which range from personal to very technical, to justify my preference).
Learning to incorporate all of me, my physical and emotional needs, had drastically helped me improve from being burnt out and depressed.
For so long I focussed on my rationality without any regard for my emotions. It’s like droving a car without being able to see out of the windows. I needed to listen to me, my body, learn to interpret it (still learning), learn what it needs, what I need.
This is the most useful mindset I've found with progressing through therapy, because it is about self-leadership.
"The body keeps score" is a book that may help you.
Always I knew I'm dealing with a professional. I saw other patients leave the room before my session started. We needed to look for an appointment because of vacations and stuff, it was always just a person doing his job.
And I'm fine with that. I also think it is necessary to have a person who is not too close to you helping you some times. Family members and friends want you to have as little pain as possible and doing better as fast as possible which is natural but often not the right thing.
"On this view, the good therapist becomes a temporary attachment figure, assuming the functions of a nurturing mother, repairing lost trust, restoring security, and instilling two of the key skills engendered by a normal childhood: the regulation of emotions and a healthy intimacy."
The therapist can't repair lost trust or security, only you can. A good therapist will help you do that.
I think seeing a therapist would be good for me, I have issues I'm struggle to fix myself but how does the conversation even start ?
What I mean is, I can go to a regular doctor for a regular problem and he will say "what is the issue?" and I can explain it pretty clearly even if I don't know the underlying cause. e.g. "My leg hurts here when I move it in such a way"
But I can't imagine how this conversation starts with a therapist. If they asked me what is wrong, I genuinely don't know. I don't know where to point to the pain. Then I just see myself sitting there with someone awkwardly, them thinking I'm an idiot.
Never forget, the therapist probably had hundreds of patients like you with the same problem getting started which means he probably knows a thing or two to help you get started :)
And really a large part of therapy seems to be diagnosis, with the added benefit that the clarity you get from working towards diagnosis (and the ability to confide in someone) already being helpful.
I would suggest just going to see someone and being as honest about why you are there, and what you hope to change as you can bear. The therapist will take the conversation from there. And if you ever feel resistance to being honest about something, just say that. You aren't required to be fully open about everything.
And no therapist is ever going to sit there thinking you are an idiot. They are there to help people, and they probably recognize that seeking help is hard. I think they will appreciate and respect the effort it takes for someone to seek help. They certainly won't ridicule someone for not knowing exactly what they want. Because they know how hard that stuff is when it comes to mental well-being.
You can even truly leap the conversation forward with something as simple as what you wrote in your message:
"I have issues I'm struggle to fix myself"
That is as good a place to start as any, but there is no expectation for you to come to the meeting ready to say that. And you will lose nothing by not saying it.
My advice, after long experience, is simply to go in the moment and see what becomes of it. The prize of health is worth it.
Another way to start is checking if you match these (though you could be suffering from one and not even recognise it by reading the abstract description): https://en.wikipedia.org/wiki/List_of_maladaptive_schemas -- if you match any, this is a great place to start, regardless of the therapy affiliation.
I really like Schema Therapy, though I've only seen one therapist qualified in it, and while she started great -- gave me a long questionnaire that pointed out my maladaptive schemas I already knew were present(she made me feel "wow, finally, a great professional, just like I read in the manual they should be"), she just didn't stick at all to the Schema Therapy session protocol I read in the manual and the sessions just devolved into the usual "so how have you been since our last session .... bla bla bla ... you're making great progress" that I'm all too familiar with all the therapists that I know.
So whatever therapy you choose, try to find a therapist that's also sticking to the therapy method.
You could ask yourself witch bothers you the most.
Also if there are clusters of schemas, start with the ones in the same cluster, but your therapist should also be able help with what to start.
I do know of such a prioritization for BPD where you first have to learn to answer back to your internalized "punitive/critical parent" mode, and eventually eliminate it, because it will sabotage your progress, just like a real life punitive/critical parent would.
I can imagine even starting by saying “I don’t really know what is wrong and what to say, so I’m afraid I’ll just be awkward and you’ll think I’m an idiot” and they’ll be like “Haha, that’s interesting, do you often feel like other people might think you’re an idiot?” and you’re up and running!
Sounds like something Dr. Sbaitso would say.. And he's a lot cheaper! :)
First of all, don’t stress about explaining “what’s wrong” to a therapist before you meet them, or let this become a barrier to you getting started (I fell into this trap for years myself). A simple “Hi my name is X and I’ve been been thinking about finding a therapist to work on some issues with. When would you be available for an initial call?” is perfectly sufficient.
A thing people say about therapy is that it’s like a bit like dating. Don’t be discouraged if it takes a few tries to find someone who is accepting new patients and feels like a good fit (most will offer a free consultation as well to help you evaluate this). Give them a fair shot, a few sessions at least (I was skeptical of a therapist I was randomly assigned ~10yrs ago, but he swiftly cured a very acute case of hypochondria that had bubbled up out of nowhere. However, you should move on to the next one if it really isn’t working—unlike dating, your therapist won’t be hurt (or if they are, then they have the tools to deal with it right?). This is probably the best directory for finding local therapists: https://www.psychologytoday.com/us/therapists
Most will give you a set of questionnaires to complete before or during your first appointment (e.g.: https://www.uwgb.edu/UWGBCMS/media/Continueing-Professional-...). This gives them a coarse baseline of what’s going on.
The conversation simply evolves from there. Over time, you will occasionally pull out surprising memories and insights from the depths of your mind like the proverbial Mary Poppins bag. There’s a lot in all of us to unpack, and they are there to facilitate that process.
A common attitude (again, one I’ve suffered myself) toward therapy is: “What will a therapist tell me that I don’t already know? I can solve these problems on my own if I actually tried.” Maybe, but the operative word phrase here is “actually tried”. Actively reflecting on your thoughts/emotions/actions and vocalizing them to another person for an hour is challenging, but it is therapeutic in and of itself. It’s very hard to do on your own, and sometimes take a probing question or two to dislodge a blind spot.
Also, if you want to listen to some real therapy sessions (intermixed with lecture content on the theory and research behind a common type of therapy), these lectures on Cognitive Behavioral Therapy are excellent. It follows a few different people from the very beginning (skeptical of or unsure about therapy or what their deeper issues are) through their process of improvement via weekly sessions/assignments. It can really help demystify therapy for the unfamiliar: (https://www.audible.com/pd/Cognitive-Behavioral-Therapy-Audi...)
PS—Keep asking good questions.
I don't like listing complaints, instead of a productive comment like yours. Obviously, some people make it work, but maybe you need to know people with similar personalities and similar issues, to get recommendations?
Not long after that I (spoiler alert) needed a psychiatrist. It took me 30 calls to find someone with availability. I punched a hole in my wall around call #20.
As recently as last Fall, I was still spinning my wheels, delaying the unpleasant search process for a therapist. I was so frustrated with “the system” that it short-circuited any desire to make the effort. There were at least four major barriers:
1) communication anxiety — worried about explaining myself and my problems to a prospective therapist. [addressed in my previous comment—keep any introduction email/call extremely simple.]
2) financial anxiety — as with all healthcare in the US, the amount you pay is a random variable. Maybe it will be a waste? Maybe I will go bankrupt? [if you have insurance, find someone on your plan using the Psychology Today search filters—they also often list the cost. if not, there are other free or low-cost resources available, but it’s context/location dependent. some potential options include the VA, school/college therapy, counseling programs @ your employer, therapists in-training, various community/nonprofit organizations. ask a trusted friend to help you search, it can alleviate some of the frustration. you can ask me.]
3) avoidance anxiety — embarrassment around explaining my life story. Why and how should I explain the fact that I smoke weed 10x a day (a true 10x developer over here) to cope with my issues, when I could simply roll another joint? [one role of the therapist is to be a non-judgmental sounding board and co-strategizer—they aren’t your coworker, parent, partner, etc. this is a hard mindset to learn, even for me to this day. I find myself saying things I think my therapist wants to hear. as a corollary: ER docs have seen the full Cartesian product of injuries from {objects} x {orifices}. whatever you come in with is not as unique or embarrassing as you think. they do this all day long.]
4) perfectionism — “Yeah I’m sure this therapist can help someone get over a breakup or their dead cat, but I’m a special brand of fucked up and they won’t get it. I need to find a someone that is perfectly specialized in my personality/problems, or it will be a waste. Also they need to have a PhD from a good school, female, not too young or too old, not ...”. [just a reminder that this is not a search for your soulmate. a student therapist or MSW may be more effective for you than a famous professor with books and accolades (see above). anecdata: the two therapists that I hand-selected didn’t pan out for me at all. the two that were chosen for me at random were a wonderful fit.]
Finally, I would push back on the idea that remote therapy is ineffective. Telehealth in general is proving to be pretty effective, and with therapy they don’t need to interact with any physical structures. The only thing that is slightly diminished is nonverbal cues, but that’s not insurmountable. There are a lot of advantages: significantly more options (no location constraints), easy to schedule and keep appointments, can be more comfortable to not be physically present, and no stressful driving. I recently did a therapy appointment call from the Appalachian Trail!
It was immediately clear to me that she was warm and personable - for this reason, the article linked above resonated with me a lot.
I don't feel that I have any more ability to explain the state of my mental health than I did at the start of the sessions, but I'd definitely credit her with improving it.
To reflect on what you have said: If you ask me how my mental health has improved, I genuinely don't know. I just know that it has.
I'll need some information first
Just the basic facts
Can you show me where it hurts?
…
When I was a child I had a fever
My hands felt just like two balloons
Now I've got that feeling once again
I can't explain you would not understand
This is not how I amThe idea is that when you (as a developer) run into a software bug you can't fix, you try to describe it out loud to a rubber duck. It turns out that the act of formulating these thoughts into speech is massively effective as a debugging method.
So my challenge to you is to revisit this statement:
>If they asked me what is wrong, I genuinely don't know.
Instead of shutting down because you don't know, just start speaking. Keep speaking. Deliberately turn off your filter. If that's hard, narrow the question. Instead answering "what's wrong?" answer "what's wrong today?" or "what's the strongest emotion you felt last week" or etc. And then expand around it. Describe the experience. Etc.
Journaling can also be useful in forcing you to produce words that describe what's going on, but it's also easier to slack off when there's nobody else in the room. If you worry about what you'll say in a therapy session, start writing and you'll likely come up with plenty to talk about.
I have the same thing. Every time I start thinking “big” I need to consciously stop myself and ask “what do you not know?”/“what needs to be measured?” Instead of continuing making assumptions.
You don’t need to speak to a duck to do that though. Speech has got nothing to do with your ego/laziness that makes you believe there’s nothing to be done and everything can be solved by thinking.
I've always had a good relationship with my mother but it was only though my therapist I even realized I did in fact have some attachment issues. Anecdotally when I mentioned that to my aunts they immediately starting sharing stories about mom. Family knew all along but they remained silent until I asked for detail. The point is for both the therapist and family just talking is enough to prime the process of discovery. You won't start with a giant epiphany.
I was initially much more inclined to have "here's my habits and behavior patterns, tell me what to fix there" type of sessions. Then I tried to play this game of trust, but the idea of trusting and leaning on someone who sees me once a week to do job and get paid seemed just wrong.
Did you ever consider looking for another therapist?
Therapists tend to get expensive though, when I improve my financial situation I'll definitely look for some more.
That is a psychotherapy cliche, but it has a lot of merit to it.
Significant adults in your life have imprinted/caused MOST of the ways you approach love or work. Just think of how vital those adults were to teach you language -- without them you wouldn't be speaking at all; with other adults you would be speaking a completely different language -- it is the same with your emotions, bounadries and limits, beliefs about yourself and others, how to meet your needs and so much more.
So, do not dismiss exploring your relationship with your parents -- it is the foundation for everything else in your life.
If someone is crying, you are getting emotional feedback from that person that they need help. They could cry for any number of reasons but the feedback they provide you by crying remains the same until you discuss it more. Paid feedback or not - outsiders will provide you similar feedback that will be relevant to you because they are able to empathize (that is if you are honest).
But I get you. if you think of paid feedback as fake reviews on playstore, you will get discouraged. It's hard to give a fake plausible review and it's quick to spot for human interaction though.
Most of the truths that you hear in a good therapy session will come out of your own mouth. You just didn't know they were in there until the therapist guided you to them.
Try to think of "trust" more in terms of safety. With a good therapist, you can trust that if you share your truth with them, with all it's ugly dark aspects, that they will not use that knowledge to harm you.
For you, it sounds like you think that the therapist "might just be doing it because I'm paying them", and that their emotions care towards you might not be genuine? Maybe that you want a kind of selfless care and the monetary aspect would make it feel less selfless or sincere?
It seemed wrong to me at first, too, but eventually I saw how it made sense. The aspects of the relationship that would normally be fraught with fear and uncertainty -- is this person invested in my happiness, will this person respect my confidences, will this person use what they know about me against me, will this person turn against me if they learn my shameful weaknesses -- are encoded in their professional obligations. That's not enough for it to be a great working relationship (you need some personal chemistry as well) but it's a great foundation to start from.
I've seen three personal therapists and a couples therapist. They all helped and I learned some tricks from them, clarified things, my BPD symptoms have diminished, but they tend to do so with age without any therapy.
All therapists sucked in the same regard -- they fail to follow through -- I've heard so many times "oh, for this issue I know this great exercise and this great technique, we'll practice, bla bla bla", only to forget about it by the next session.
I'm currently seeing a female therapists that runs some groups for DBT for BPD; but given that I'm (highly)functional and male(that's just me being mean), it's just 5% of the sessions(after an occasional flare up) that she acknowledges my BPD.
To whoever downvoted GP: please don’t unless you actually have experience.
Debuggers show you a step by step at a low level, but some are better at highlighting "interesting" modes of operation that are not necessarily what we expected. Just like race conditions and those tricky concurrency issues, a debugging session with our brain can help identify how we get stuck.
Sometimes, just the way we frame something gets entangled with another underlying issue and reframing a topic can free up that deadlock. Othertimes a trigger can be uncovered and we can apply a patch to temporarily avoid triggering it while we go delve deeper in the issues that are awoken by that trigger...
But like any debugger, it's only as good as how we use it: it's not a magical tool that operates on us passively. Beyond the trust factor, it can take a while to figure out how to best leverage the therapist for our needs.
The article gives a number of possible explanations for this, but not the obvious one: that the effect of psycho-therapy right now might not be more than a placebo effect. I wonder why this could not be the case.
I think CBT therapy scored better on average, so in that case it's not only the therapist but also the method.
Given the same level of trust, empathy, communication, etc, one form of therapy should give different results than other. They can't all be equal.
Unless ofc none of them do anything. I can find no other possible explaination.
I often think of my therapist like a personal trainer. If you get a personal trainer, and go regularly, you will get fit. The particular workout they use does not matter so much as just going. Maybe one trainer would improve my cardio more, another would make me better at lifting weights and burst strength. Either way I am going to be healthier for going.
More specifically, just like some clients of a personal trainer may need to lose bodyfat and some may need to gain muscle, implying that cardio may be indicated for some people and weightlifting for others; patients with different therapeutic needs may benefit from different therapies.
Similarly, I'm not arguing that there is no difference between different therapies, just that the way we measure is only able to say the equivalent of "most types of regular exercise result in increased burning of calories"
But ok, let's just focus on the single aspect that makes your argument hold a drop of water: calories. If you try to burn as much calories with weightlifting you will end up at least overtrained if not injured (thousands of calories per day eaten by PED users does not count). Running on the other hand can get you to Auschwitz physique pretty safely.
Which brings me to another massive difference: the failure scenarios of both techniques. You can get injured and harm your health in completely different ways. Weight lifting has vastly higher injure rates. What about therapy? There is something that can influence you but only in a good way? No way to over do it or do it wrongly? And all techniques are equal in this regard as well? I can tell you another thing which has these properties of "all are equal, nothing can harm you": homeopathy. Because again, it doesn't do anything.
> The emotional bond and the collaboration between client and therapist – called the alliance – have emerged as a strong predictor of improvement, even in therapies that don’t emphasise relational factors.
> Until recently, most studies of this alliance could show only that it correlates with better mental health in clients, but advances in research methods now find evidence for a causal link, suggesting that the therapy relationship might indeed be healing. Similarly, research into the traits of effective therapists has revealed that their greater experience with or a stricter adherence to a specific approach do not lead to improved outcomes whereas empathy, warmth, hopefulness and emotional expressiveness do.
Yeah, OK, I might buy that as much as I might buy any result associated with something as nebulous as psychotherapy. How do they characterize this, exactly?
Having good feelings about a therapist you got better from ... you probably have better feelings about a podiatrist associated with fixing your foot pain than the one who didn't as well. That doesn't mean your feelings are causal of your foot getting better. In fact the podiatrist (or therapist) might not have done anything real either; sometimes you just get better.
Let me add that, I do understand that people in the therapy field often make claims that are unsupported by scientific research, and so I can understand that you are suspicious in this case. But this field is different, there is lots of sound research.
> But this field is different, there is lots of sound research.
Come on man: pick one. I read the article as you did, and it seems like a big pile of moosh, just as most things in psychology that don't involve large sums of money. If you know something about it: share why I should trust this shit other than "trust me, the non expert." If not; not saying anything is an option.
They all share being heard, raw, and I believe that is key.
I spent time talking with a consoler years ago to work through some personal issues, and I genuinely feel having someone there to listen in a way where I knew judgements on their part would never threaten our relationship was the true value. Being able to just tell someone how I felt about things, clearly and honestly, without the need to self censor or sugar coat - particularly in the way I would with a friend - helped more than anything else.
Don't be put off by the title, it's a great read regardless if you're think you're gifted or not. Gifted in this context means something closer to 'sensitive'.
This, together with therapy, has significantly improved my life.
Otherwise a great article and some sections certainly did resonate.
Most of the western societies are still based on the mother educator and father provider model. On top of this, I personally agree that mothers tend to have the qualities that makes it easier to deal with children (in a wide sense), which creates a positive feedback (or negative, depending on the POV).
None of this is out of reach for fathers. My opinion is that with some effort and an equal amount of dedication, binding and influence on children are equal (although of course, different in nature). However, it's generally uphill.
Keep in mind that once you start to notice the gender role, even more than hearing little about fathers, you'll see the negative stereotypes: check out how are the separated fathers are depicted in the cinema - it's something that "can't be unseen".
Having said that, there's movement of course, primarily in/from the Scandinavian countries. Generally speaking, gender equality increases towards the north of Europe. American countries are, I suppose, a bit of a patchwork (definitely some countries are very "behind").
I'm not sure how much time, and if ever, genders will equalize, in particular in the literature/arts depiction. Ultimately, it's also a choice - fathers being providers is not implicitly negative, it's a cultural choice (in the context of a country). Laws, they definitely need to adapt, though!
"By contrast, children of unresponsive or insensitive caregivers form insecure attachment. They become anxious and easily distressed by the smallest sign of separation from their attachment figure... Finally, children with abusive caregivers become disorganised: they switch between avoidant and anxious coping, engage in odd behaviours and, like Cora, often self-harm."
So this is an implicit acknowledgement that the gender of that early caregiver matters less than that they are nurturing.
But I agree, the article is remiss in explicitly making mention that the gender of the early caregiver does not matter - especially given that the other half of the article is devoted to a male-female relationship (Cora and her therapist) which clearly contradicts the assumption that this needs to be a mother-child.
Personally, I would have loved to see mention that even those with one stable caregiver can still develop issues when the other caregiver is not stable, or worse: that the other caregiver does not care. That often results in a person forming good relationships with their friends, but having a different (worse) standard of conduct towards their romantic partner - e.g. a child who sees their same-gendered parent [physically or verbally] abused, and once an adult, enters into an abusive relationship because that is what is normal to them in regards to the "other" gender.
I've been told that I was a miserable newborn--I cried nonstop for months and months and my screams made everybody around me miserable too.
My mother was told by family that I needed to cry it out, but 6 months on there was no difference. I was taken in to the hospital and was found to have had a hernia which required surgery.
After surgery, I'm told, I was absolutely quiet and unproblematic. Through the rest of my childhood and teenage years I was the 'easy-going' kid of the family. Through therapy I have learned that my attachment style is avoidant, and I have no doubt that this early experience (among others) heavily influenced the way I process emotions and feelings.
It isn't that I was a naturally 'easy-going' kid, or that I didn't have the troubles that my siblings had. I felt things, but my experiences taught me not to express them. I formed a tendency to over-intellectualize my experience and, in retrospect, heavily suppress negative emotions and even physical pain. My nature was not to seek out help when I felt immense pain, but to persist with self-reliance, at all costs.
Like the commenter above, therapy has done wonders for me in learning to recognize my feelings and having the capability in processing them in a healthy way.
I am not a parent and so I can't speak to the difficulty of a child's temperament; I have no doubt that one child's personality might be much more difficult to handle than another. A parent is clearly going to be affected to their children's temperament, but the parent is also responsible for teaching the child how to process those emotions, and is significantly more equipped in dealing with how the child affects them than the child is at dealing with how their parent affects them.
What shapes us are our interactions with our early peers. This makes sense from a hunter-gatherer point of view too; those are the people we will spend almost all our life with.
I highly recommend reading The Nurture Assumption for more on this. The author effectively argues with evidence for why relationships with parents are nothing more than relationships with parents.
It really opened my eyes both for things that went on in my upbringing, the upbringing of people I know, and taught me what is going to be important as I raise my son.
In the article there ia a large portion about abusive relationships and other cases warranting a therapist's intervention. In these situations, sure parents behavior will leave a strong and lasting impact on children.
For more standard cases, parents will provide a supporting enough environment (even if not perfect) and will make their kid interact more with the world, be it school, activities etc., limiting the impact of their own direct behavior.
To get back to your point, parent's thinking and behavior is fundamental IMO, but usually not just in a direct, person to person way. It would be more on the environment and social position they provide to their children.
When parenting starts qualifying as abuse, there is a pretty steep increase. Otherwise, genetic temperament and environmental interactions have more influence.
No, it matters. Baby cries, caregiver shows up. Repeated over and over, that's how babies form bonds. Baby has a need, need is met. If the need is not met, that is trauma and it affects the way baby forms bonds. Forming bonds starts this early and it matters a lot.
Sure, baby will have a weak(er) bond with their primary caregivers if that happens, but it does not affect how they turn out later in life with other people. If it does, it is only after genetics and same-age peers have had their much bigger effects.
I do recommend reading The Nurture Assumption, which is about that specific assumption that the relationships with parents would be important in all other thing in life. It has not been proven in any strong studies.
Citation please, because there is a lot of peer reviewed literature that claims the exact opposite. One place to start with that literature would be Bowlby.
https://en.wikipedia.org/wiki/The_Nurture_Assumption#Recepti...
The Nurture Assumption received mixed responses. The neuroscientist Robert Sapolsky says her book is "based on solid science".[6] The psychologist Steven Pinker of Harvard predicts that the book "will come to be seen as a turning point in the history of psychology".[7] However, the psychologist Frank Farley claims that "she's taking an extreme position based on a limited set of data. Her thesis is absurd on its face, but consider what might happen if parents believe this stuff!"[6] Wendy Williams, who studies how environment affects IQ, argues that "there are many, many good studies that show parents can affect how children turn out in both cognitive abilities and behavior".[6] The psychologist Jerome Kagan argues that Harris "ignores some important facts, ones that are inconsistent with this book's conclusions".[8] Harris rejects the idea that The Nurture Assumption will encourage parents to neglect or mistreat their children.[9] She maintains that parents will continue to treat their children well "for the same reason you are nice to your friends and your partner, even though you have no hopes of molding their character. For the same reason your great-grandparents were nice to their children, even though they didn't believe in the nurture assumption".[10]
As I said, I recommend reading it. Do what you want with that information!
Nothing I said contradicts this - as long as you have a bond with your child.
If all you want to do is lay on the ground yourself and cry and you aren't meeting the child's needs, that is neglect and it is trauma and it does affect the child.
I don’t have specific citations, and I’m not arguing it’s rock solid, settled science, but suggesting parent-child relationships may have no effect at all is out on the edge of reasonable.
1) We would expect attachment problems to be a risk factor purely based on genetics and environment. Which is indeed what we find. Personality traits like that have stronger correlation with a) your biological parents than the parents you grew up with, and b) your friends' parents than the parents you grew up with.
2) Absolutely. The way a child views their relationship with their parents is a huge signal about what their relationship with their parents is like.
3) Yes, because environment effects are the next most important thing, after genetics.
Genetics and environment outside of the home is strongly correlated with parent relationship, which is why this is so hard to study and get right. It is possible to control for those factors though, and the result is surprising -- but makes sense from an evolutionary hunter-gatherer perspective.
A complete lack of social bonding during the first few years of life is very detrimental. Shitty bonding, or bonding with non-parents (even peers, such as siblings or friends) means it's still possible to learn to lead a normal life.
The problem with the orphanages you refer to was that not only were staff not allowing children to bond with them -- children were shifted around specifically in order to prevent them from bonding with peers. This incredibly cruel thing was done because they thought it would be worse for children to have their bond torn than not have it in the first place.
Turns out developing brains need some baseline level of social interaction to grow the correct structures.
I find I’m easily persuaded by good writing, and the most recent book I’ve read tends to hold an outsized slice of my thinking until I’m a book or two past it.
It’s that one by Judith Rich Harris?
For an extreme result of poorly developed attachment see https://en.m.wikipedia.org/wiki/Reactive_attachment_disorder
Several comments here are dismissive of attachment theory and the importance of proper development of attachment. I don't really know why but it might be the unfortunate existence of the pseudoscientific "attachment therapy" which has nothing to do with what the article is about:
The legacy of bad ideas makes it questionable as a useful form of guidance especially when lacking more concrete successes analagous to eugenics as a pseudoscientific corruption of genetics.
But "experiments", or rather observations, on for example Romanian orphanages show such strong evidence that, in my experience, this has become child psychology dogma
The effects of abuse and neglect are so large, and so hard to change after age 3 or so, that you really don't need a big sample size to see it.
It's entirely possible that the threshold at which nurture no longer matters is so low that most parents are far above the bar, but I guarantee you if you did an experiment where you spanked a 6 month old every time they cried, or left a 14 month old in a car with a box of cereal and a sippy cup alone for 12 hours every weekend, you would measure some long-term affects quite easily.
And by the way, are you saying that, if you were a man married to a woman and you had children, you wouldn't be bothered if she was insensitive or abusive with them, because it would have no long-term effects on their personalities?
Oh man, pop culture is rediscovering the use of psychoanalysis, finally! Transference is so important!
> I am referring to attachment.
Oh. God dammit.
Can't escape the vortex of "science", leading to the massive fragmentation of psychological frameworks, destroying the field's credibility.
What does it say about the theories of mind underlying the different schools of therapy that they all work about equally well?
Also, plenty of psychoanalysts were aware of the failures in Freud's theories, so you end up with theorists like Klein and Lacan who correct them while still maintaining an overall consistent model, which is _the_ thing that modern psychology lacks.
Part of the problem is that the needed scientific methods did not exist. But in recent decades they have been developed, and so we now have a vastly better understanding. And that in turn has enormous implications for psychotherapy.
As to neuropsychology, I am not familiar with that field, so my question is what does it have to say about infant psychology.
My go-to reference is
Attachment Disturbances in Adults: Treatment for Comprehensive Repair by Daniel P. Brown PhD & David S. Elliott PhD. [1]
[0] https://news.ycombinator.com/item?id=21739622
[1] https://www.amazon.com/Attachment-Disturbances-Adults-Treatm...
"... the deeper reason why no single psychotherapy seems to provide unique advantages over any other is that they ALL work because of shared elements. Chief among these is the therapeutic relationship, connected to positive outcomes by a wealth of evidence."
"The emotional bond and the collaboration between client and therapist – called the alliance – have emerged as a strong predictor of improvement, even in therapies that don’t emphasize relational factors..." cites co-author of the book "Attachment in Therapeutic Practice" (2018).
".. what if, attachment theory asks, therapy gives you the chance to reach back and repair your earliest emotional bonds, correcting, as you do, the noxious mechanics of your mental afflictions?"
It's fine to revisit and revise past theory work. It's just surprising that after 70 years, this theory that should explain so much, after scrutiny, just... doesn't.
Looking forward to the latest revisions to see how to apply attachment patterns to our modern world. I have popcorn in hand.
And sure, we can have an alt theory that goes against Attachment theory, and generate hypos from that, and put them to the test. Answering a different question, but same problem: can't just say "won't work", need to generate specific testable hypotheses.
I'm just pointing out that the theory is nice and should have more provable (and supported) predictions, but it keeps having limited support from research, fades from view, comes back around, history repeats.
After a while, our confidence goes very low. But it's not zero, and the fact that it keeps showing up again provides new hope. The theory is attractive so I hope we find its proper alignment through this latest iteration. But it has a tough road to hoe.
"That's not really the way science works. The theory drives testable hypotheses."
Aside from the ethical considerations of using human subjects to test hypotheses, you also won't like genomic/bioinformatics/physics, if you faithfully adhere to the Popper doctrine.
I'm not sure I get your final point: while Popper was never a fan of social sciences, psychologists have spent years running testable hypotheses and experimenting with them. Att is just a preexisting condition, and therefore should drive a repeatably different response to certain stimuli; I don't think anyone was suggesting we try raising babies in diff att styles.
But yeah, if you take Popper at his word, lots of work goes out the window (I avoided saying "pops"). I'm gonna choose a middle ground here, and see where att theory goes. I have high hopes!
In general though psychotherapy is a bunch of quack, as stated in the article the only thing that really matters is the patient and shrink working together.