From the Shrink in the Cheap Seats:

Too often I find people in my office who are living with the emotional pain imposed by their own sense of inadequacy and failure.  There are single men and women feeling pressure to be married and raising a family “by a certain age,” or others wanting to be in a “committed relationship,” and both in a quiet panic over what they perceive as a lack of progress and of prospects.  There are married men and women, some with families, who are nevertheless feeling trapped and miserable.  There are the many who are divorced and struggling to restart their lives amid the emotional wreckage of a failed marriage.  And then there are all those who endlessly pursue relationships one after another, somehow unable or unwilling to tolerate being alone. 

Many of these people arrive in my office with other complaints, secondary issues that are often more the result of their situations than the cause of their miseries.  A lot of them have already been informed they have a mood disorder or an anxiety disorder or something more exotic.  Many are already taking antidepressant or anti-anxiety medications or both.  In general, these people expect therapy to “fix the problem” so they can simply resume the lives in which they have been so miserable.  When I suggest to them that perhaps their clinical problem might be related to something larger, they often look nonplussed.  Aren’t they living life the way they are supposed to live it?   Isn’t this just another misfortune that has befallen them?  Why should taking care of it require anything more than medicine and a few therapy visits?  When I explain further that their clinical disorder is not something they just caught, like a cold or the flu, and that it is part of their body’s reaction to the wear and tear of the ways they’ve been living, I get a variety of reactions.  Many respond with disbelief, some with anger, others with a mixture of the two.  And a few — the fortunate few — get curious.

When each of us arrives on the planet, we are aware of very little except, ideally, the warm and comforting and reassuring presence of our primary caregiver.  Ignorant of almost everything — who we are, where we are, or what anything means — we depend on this caregiver and those who gradually join in our upbringing.  During the time spent with this cadre, we start to develop a sense of who we are, what the world is like generally, and what it means to live in it as a “good” girl or boy.  Later, as we get older, our society takes over.  It is our institutions — educational, commercial, governmental, religious, and even our popular culture — that complete the picture.  They tell us who we are supposed to be and what it means to be successful as people, irrespective of our individual tendencies or preferences.  The effect of all these influences is that from birth we are defined as individuals from the outside-in.  And during every passage through life we are thus predisposed to view our experience in terms of who our family, our friends, and our institutions expect us to be and to do what they expect us to do.  This is how we are formed, and this is how we are ultimately controlled.  If we deviate from those expectations, the implied message is, “You are failing as a person!” 

Human development is a chancy process at best.  Under ideal circumstances, we receive support and encouragement to reverse this definitional process during our later formative years.  Under ideal circumstances, we are encouraged to develop our own personal sense of self, with its attendant values, and to assess our experiences through the filter of these values.  And under ideal circumstances, as we enter adulthood we have generally managed to develop a level of emotional autonomy, to become our own persons, and to reverse this process of self definition.  But as it happens, a lot of us grow up under less than ideal circumstances.

In my case, I entered adulthood during a time when young men were expected to conquer.  Despite the growing preoccupation with the unfolding tragedy in southeast Asia, this was also the time of the “aero-space boom,” a time when young men who did not opt to enter a classic profession were expected to conquer the world of business and technology.  Hollywood notwithstanding, the accepted model was much more John Wayne than Jimmy Stewart.  And so I began living the button-down, pinstriped life that young men at the time were expected to live, projecting an air of false confidence, often feeling as if I was being judged as a person based on whether I was seen as having a “successful” career.  More and more it became important, even in personal relationships, to “keep up appearances,” while part of me wanted to scream at the world, “This is not who I am!”  Yet I too succumbed to the relentless pressure to be what the world expected me to be.  I worked diligently to keep my insecurities, my sense of inadequacy, and my ongoing misery hidden from that world.  I tried to impress people with my knowledge and skills and personal presentation in order to be accepted.  And I constantly worried about making some public error and being judged as “not good enough.”  All this because I was allowing others to define me.  History eventually rescued me (see Blog #2), but not without my share of strife.  

Today, while people’s circumstances have changed, the challenge of how we are defined remains.  As a result, I see too many clients caught in the same old trap — people desperately seeking to be loved and approved of, because they believe that is the only way they can establish their own self-worth.  They cannot simply approve of themselves; they must be approved of by others.  These are often people willing to adopt any persona, perform almost any service in hopes that it will bring them “love.”  Then, having seemingly gained this mercurial sort of love, they must continue a desperate struggle day by day just to keep it.  Many respond with dismay when I point out that love is not a matter for barter and that if it is not freely given, it is not really love. 

This is the point where many people leave therapy, loath to undertake the serious work that lies ahead or not yet dissuaded from the notion of learning some secret or some simple technique that can quickly and painlessly resolve all their troubles.  And I always let them go without protest, because I know that, in the words of The Borg, “Resistance is futile!”  For the few who remain, however — those curious few — this is the point at which therapy can really start.  This is where they can finally begin to reverse the process of self definition from outside-in to inside-out.  This is where they can finally begin the quest to learn who they really are so that they can finally be who they really are.  And this is where they can truly begin to understand that if they are to be loved, it must be for who they are, not for who they are supposed to be.