Patients sometimes say things like this: “If psychotherapy is largely a process of cultivating self-love, where is it supposed to come from? I don’t feel like I love myself. I can hardly stand myself. Where do I begin?”

Well, anyone who is alive to ask this question has survived, because at some point in the critical period of their infancy they, too, were loved. And babies love their caregivers, because love works as a circuit, a between-ness, like the glue between two surfaces. The love feels good because it works: my caregiver is loving me and I’m receiving it, and when I love her back, I experience my own goodness in the delight she takes in my smiles, my sounds, my touch, my presence.

My goodness is twofold, without any distinction being drawn: I am worthy of the Mother’s love, and my love for her is good. Therefore: I am good. I love myself. Trauma interferes with the benefits of that good foundational experience—but not completely, since you are still here, even though you’re also in pain. The task at hand is to reawaken those early, primitive good feelings and make them sustainable.

First, who do you love? It need not be a human person, but it must be a person in your eyes: a dog, a cat—a bear or an elephant if you know anyone who is an actual member of those species—or your nephew, grandmother, partner, friend—anybody you love. It could be a figure from religion or the arts, so long as admiration is not the main thing, but love. And if there is nobody in your life, bring to mind your feelings on seeing a baby or an elderly person, your spontaneous compassion for children in distress, even kids you don’t know.

If you can think of someone for whom you feel love, think of your feelings for this person. Feel the feelings. Notice that they arise naturally, without structure or measurement or transaction. Notice that they are not based on achievements, or talents, or cost/benefit calculations. As the philosopher Kant taught in the 18th Century, persons are ends in themselves, not means to an end. Adults love the baby because-the-baby.

An infant is too young to have accomplished anything cultural, and it’s too early to tell whether there are any significant talents present or not—thank goodness. That way, these extrinsic grounds for esteem can’t interfere with the fundamentally non-rational flow of love between caregivers and babies that is absolutely necessary for the survival of individuals, and of the species. As we therapists never tire of mentioning, babies tend to die if they aren’t loved-over-time by at least one individual caretaker, whatever other love, food, and shelter they do receive. If you’re still here, somebody loved you. That means you have some experience of the thing you’re looking for.

Thinking of a person you love brings up feelings of care, protectiveness, belonging, warmth, similarity, compassion, and esteem. You need to get yourself onto the list of beings who deserve this good stuff from you. Then you need to get yourself up to the top of that list. The fundamental reason to love yourself is because it is your right and role, your dharma, your vocation as a living organism on this planet. But if that currently feels too foreign and far-off, be motivated by altruism. Some depressed people only hate themselves, while others hate everybody; right now, I’m addressing the first group. Love yourself because the oxygen mask on your own face will keep you capable of giving oxygen to somebody else, instead of collapsing for lack of it.

After some time spent trying to love yourself so you can help other people, your motives may ripen and expand to include genuine, intrinsic self-love. Meantime, Nietzsche wrote, “The self-despiser nevertheless esteems himself—as a self-despiser.” In other words, if the only thing you can approve of about yourself is that you have sufficiently high standards by which to condemn yourself, well, those high standards are an esteemable form of investment in the Good, so start from there, and build out. Are you using the high standards as guides to improvement, or as a blunt instrument for self-punishment? If switching from punishment to guidance is hard, there is some internal cruelty in the mix, and you may currently be addicted to that cruelty.

Well, how would you feel and act if the person you love was being treated the way you treat yourself? You would intervene protectively; you would make emotional contact, to make sure the person was ok; and you would help your beloved to defend against attacks. Do that for yourself, as a matter of ordinary responsibility, like washing your hands after you use the bathroom, or like offering a glass of water to somebody who obviously needs it. Decency. If you can’t be kind to yourself, start with being polite to yourself, and work your way up to lovingkindness.

Elsewhere on this blog I’ve written about the inner exercise you can do to get better and stronger at self-love. It is an imaginal exercise, something you do with your imagination. What’s “imaginary” is a mental representation of something physical, compared to which the representation is relatively unreal—it is “merely imaginary.” But working to heal your inner child is itself a mental (both emotional and intellectual, both affective and cognitive) job. The problem, the solution, and the work of applying it are all psychic, not material. They all share the same form of realness, namely psychic reality. Inner actions are actions indeed, just as much as taking out the garbage, changing a tire, or dressing a flesh-wound is taking an action. A better analogy would be practicing with a musical instrument, because each session of practice—with all its frustrations and small glimmers of triumph—improves the prospects for progress the next time. Like therapy.

 If this post resonates with you, consider booking an appointment with me at 917-873-0292, or email Jamey@drjameyhecht.com. Sessions are available in-office in Park Slope, Brooklyn, and remotely in NY, NJ, TX, and CA.

In F. Scott Fitzgerald’s great American novel The Great Gatsby, a self-made millionaire aspires to win the heart of a woman he once loved. Daisy is married and unavailable, but Gatsby has idealized her for years. He knows that she appreciates the outward signs of wealth, fame, and power—things that confer status—so he reinvents himself as a wealthy tycoon, hoping this will impress her enough to make her value him. He benefits from this quest because it focuses his energies, motivates him, and brings him the clothes and cars and cash that sometimes make life fun and exciting. Gatsby makes his money by bootlegging liquor during Prohibition, when it was illegal and therefore risky and lucrative. Alcohol has destroyed myriad lives, but in moderation it has been part of the good life in many cultures for millennia; one could argue that Gatsby’s path to success was not so antisocial as to be self-discrediting—he is no Al Capone, and no Macbeth. But such success itself poses a problem: if it all works out, and Daisy is won over by glitz and bling, how will he know she really loves him? Gatsby is a man, not a Rolls Royce or a bank account.

The book ends in tragedy, when Gatsby is killed by another character. But had he lived, one possible outcome would’ve been a temporary affair between him and Daisy, followed by some kind of disillusion. Either she would reject him and stay with her boorish husband (Tom), or Gatsby would tire of her upon realizing that she loves his status, his money, his power, more than she is capable of loving him. Such disillusion would be agonizing, but it would do him a world of good. Disillusion is the way out of illusion, and some illusions can be extremely hard to escape because their logic has a seamless continuity that conceals the exits. Of course I want to live in a giant mansion; of course more money is always better, ad infinitum; of course a higher status will enhance my success at anything I could possibly undertake in life, including finding a mate. It is because these assumptions seem so obvious that their fundamental error is so hard to detect.

Freud taught that the purpose of psychoanalysis (it applies to mental health treatment in general) was to help people to love and to work. The idea that more-is-always-better has serious drawbacks on both sides. In work, it threatens what we call “work/life balance” and risks work addiction, in pursuit of ever-more earnings, far beyond our ability to enjoy them. In love, more-is-better can mean either of two troublesome things. It can mean I am stuck in a compulsive accumulation of temporary partners, building my “body count” without checking its effect on my wellbeing. Or it can mean I am doing what Gatsby did, pursuing just one partner, but using means that are accumulation-based: if I have more status than these competitors, then I’ll win the competition for her. What gets neglected here is the way my toys and my success can upstage the merely human, unique individual I actually am. I also may fail to notice how much my attention is diverted from my “Daisy” onto the men with whom I’m busy competing, jockeying for position, comparing the size of our houses (paging Dr. Freud), etc.

If such a disillusioned Gatsby can survive the disillusioning experience, he may win the real prize, one more valuable than the solid gold toilet, or the victory over his male rivals, or even Daisy herself. The real prize is a mature freedom: freedom from the endless compulsion to accumulate ever more status and wealth, and with it, freedom from the need to woo the kind of person who remains focused on that kind of stuff. Whoever escapes from the prison-house of status-seeking gets to love and be loved by people who are also free of it.

There are plenty of good reasons for a couple to want lots of money, or for a single person to want wealth in an eventual marriage. Raising kids, running a small business, keeping a theater afloat, endowing a community’s nonprofit, all these require plenty of cash and become impossible if there isn’t enough, and the list goes on and on. What’s not so good, is chasing wealth as a substitute for self-love, and hoping that the display of this wealth will attract somebody else who has the same confusion between wealth and love.

People who are unconsciously afraid of love might not be able to tolerate getting the love they really need, but do not want. So they collude with similar people to form relatively loveless couples, held together not by deep affection, acceptance, and desire, but by the glue of status, purchasing power, and the conspicuous display of resources. Real love is associated with eventual death, because if I fall in love with one unique, mortal, individual person, I will one day lose them and it will matter to me. If I marry someone I really love who really loves me, I move forward on what Kierkegaard called “the stages on life’s way,” and this means leaving youth behind and getting closer to the end. Focusing on status and trophies can instead create the illusion that I am outside of the arc of the life cycle, that my world is one of endless youthful playdates and context-free experience, often of a dissociative, thrill-seeking kind. Diverse pleasures have their place, and there’s nothing inherently bad about thrills. But it’s worth checking: am I doing this as a defense against something else? Might I be partying quite this much because I am avoiding something?

If this post resonates with you, consider booking an appointment with me at 917-873-0292, or email Jamey@drjameyhecht.com. Sessions are available in-office in Park Slope, Brooklyn, and remotely in NY, NJ, TX, and CA.

We were all born innocent and beautiful. Then we had a childhood, in which the people who raised us gave us some combination of three things: love (getting the good stuff), neglect (not getting the good stuff), and abuse (getting the bad stuff). When a kid gets neglect and/or abuse from a parent, the psychological process involved is something like this. The person who is supposed to take care of him with nurturance and protection is giving him pain instead. Why? Because the parent is a bad parent. He or she may be a good person, but too damaged by their own untreated trauma to provide good parenting.  If the child realizes this, he will be forced to see that his parent will never meet his needs for consistent nurturance and protection, since they aren’t capable of it. That’s despair, and no kid can tolerate that, because the younger you are, the more your very survival is at risk if your parent is bad. Babies can actually die from lack of love, even if they get all their physical needs met (food, cleanliness, protection from heat and cold, etc.). The name for that is marasmus, or “failure to thrive.” To avoid such life-threatening despair, the child uses the only available defense, despite the terrible price it will cost him. He keeps the parent good, by taking their badness into himself: he must be the bad one, so that the parent can still—in his mind—remain good.

This defense solves the terrifying problem of being stuck with a bad parent. But it does so at the expense of the child’s self-respect, and he grows up believing that he is bad to the core. After all, only a bad child would get bad treatment from a parent who was fair and just. If the parent is good, and yet she treats him badly, it must be because he himself is bad: he must deserve the bad treatment. Believing this, he grows up with a heart full of toxic shame. Guilt is pain about something you have done, but shame is pain about what you are. Some kids misbehave—lying, stealing, hurting themselves or others, abusing drugs, failing at school, having sex too early and unsafely—in order to verify that they are indeed the bad one. If they are going to get neglect and/or abuse no matter what they do, then doing bad things will at least mean that they really do deserve the pain they get, and that feels less unjust. This story accounts for the fact that, when troubled adolescents do get asked why they behave so badly, they often have no idea.

Such a kid typically hates her parents and appears to be in a battle with them. Her destructive behavior is seen as a means of revenge against the parents, and in a way, that’s just what it is. It can also be a protest against a deeply felt though poorly understood sense of having been wronged. It can also be an effort to attract the parent’s attention so that neglect will be replaced by punishment (since, unlike neglect, punishment at least requires the parent to acknowledge the kid’s existence). And in an environment of authoritarian bullying, parental commands backed by force, and unexplained rules, a kid may become destructive in order to preserve her integrity. I may be a bad person, he thinks, but at least I’m my own person.

Now that you’re an adult, the old defense has worn out its usefulness. It costs far more than it’s worth. When you hear the question—what’s wrong with me?—the answer is nothing, because it’s the wrong question. The right question is, What happened to me?

There are several reasons why being kind to yourself might feel terrifying (at first). It requires admitting that the good parents you yearned for are never coming, because here you are, doing for yourself what they should have done. It reminds you of what you should’ve gotten from the people who were supposed to nurture and protect you. The better you treat yourself, the greater the contrast between what you got and what you now realize you deserved. And if you grew up believing that kindness was weakness, that kind men were feminine, that kind people were naïve and lucky and full of shit, then you have to admit you were wrong.

Feelings of worthlessness/self-hate are messages from a wounded child part of you. Don’t buy into what he says. You know things he does not know. Turn toward him, and in your mind’s eye (your imagination), pick him up and dry those tears and speak to that kid with soothing words of love. Tell your inner lonely little child: I love you… I got you… we’re ok… come with me. Talking to parts of yourself that way is not crazy, it is a survival skill.

When you hear intrusive negative thoughts, use your mind/your intellect/your inner observer. Say, oh, look, part of my mind is attacking me right now… isn’t that interesting. Say to that inner attacker: Oh, you again. Yes, I know what you think. But I know something you don’t know. Say to that inner attacker, Yes, I know you think you’re making some kind of contribution, but aggression is not the kind of help I need right now. When you hear intrusive negative thoughts, connect them with what you know about your history. Oh! This is an echo of other people’s shit that got thrown at me in the past. I do not have to hang onto it.

Your inner attacker is an internalized parent, a copy of the one(s) who gave you some amount of neglect and/or abuse. Your parent(s) may have grown old and harmless by now, but those aged parents aren’t inside you. What is inside you is a figure made of the young, strong, crazy people they were when you were a kid. You can’t get rid of that inner bully or kill him/her off. S/he has a place at the table. But not the head of the table. The inner bully needs a seat in the car, but not the driver’s seat. Get that person into a passenger seat so you can steer your life.

When you start to love yourself, it will soon become clear that the love that you have inside—which is yours to give, when and where you want to—is very high-quality, and it’s going to get even more valuable as you grow. It’s the good stuff. It is worth a lot. You can be a source of the good stuff, giving as well as receiving. When you’re accustomed to feeling like a vacant cave of darkness, a black hole from which not even light can escape, it’s strange to think you might turn into a star that radiates light instead. But it happens.

For Further Reading:

The Drama of the Gifted Child, Alice Miller

The Forgiving Self, Robert Karen

Healing the Shame That Binds You, John Bradshaw

Radical Acceptance, Tara Brach

Slings and Arrows: Narcissistic Injury and Its Treatment, Jerome David Levin

If this post resonates with you, consider booking an appointment with me at 917-873-0292, or email Jamey@drjameyhecht.com. Sessions are available in-office in Park Slope, Brooklyn, and remotely in NY, NJ, TX, and CA.

When a young person presents with both addiction and failure to launch, there is almost always a pressured tension between the patient and his or her family, especially those who control the pursestrings and pay for the therapy. The twenty-something’s journey (out of addiction and deferral, and into adulthood) should be distinct from his relational process with his family. In fact, it may even be psychologically necessary for him to move forward without having reached a stable accord with them. That way, he can be sure that his progress is not mere compliance. As that progress yield concrete results---especially, paying more of his own bills---he can be more confident that it isn't mere defiance, either. 

Compliance and defiance typically have been the poles between which the patient has been running back and forth for years, inside a family system which is stuck in that pattern. His compliance seems to be movement forward into adulthood, so long as most of what he complies with happens to be good advice, and reasonable rules, that come from exasperated elders who may well love him. But compliance is never really as good as it looks, because it's not autonomous, so it is not sustainable; it builds resentment that comes out sooner or later.  His defiance appears to be much worse, of course, because it's often full of hostility, self-destructive, anti-social, risky, and debilitating. 

Part of the reason this pattern is so terribly stable and hard to break up, is that the family's response to the young addict's defiance is usually a call for a return to compliance, this time a new-and-improved compliance that will last. That never works, because even if he does produce a good lengthy chunk of compliance, it's still mere compliance.  The solution is, in most such cases, to bring in a therapist whose client is not the family, but the patient himself. That way, the patient can continue doing the only two things he knows how to do, but in a whole new way which will permit him to learn new skills: he defies the family, and complies with the therapist in a genuine, collaborative search for what the patient (himself/herself/theirself) actually wants from life.

Why is that compliance somehow better? Well, between the patient and the therapist there is no personal history of being hurt, or betrayed, or robbed, or worried half to death. The professional is not burdened with guilt or regret about the past of the patient and his family. So she or he can afford to keep the patient's interests central, striving to collaborate with him on a viable path to a good-enough life (good-enough in the patient's own terms), at the heart of which must be a kind of guarded friendship between the struggling young patient and Reality. 

This is the same Reality which he has avoided for so long, languishing in addiction and the related un(der)employment. For him, Reality has been a place of failure, shame, and fear. Changing that is not easy, even with professional help. By the time such a patient arrives in the therapy office, he may have been to rehab, only once or many times. Depending on the nature of the addiction involved, recovery might be the first order of business; sometimes it has to come second or third. The choice (or the cycle) between abstinence and harm reduction should be respected, in accord with the specifics of the case and the values of both patient and therapist.

When something has been stable---even something toxic and annoyingly stable, such as a particular dynamic in a family system; a particular role for a particular person; any ongoing relational process that's been around for a while, even if it's one that truly sucks---its replacement by something better is still a big change. And all big changes, good or bad, are losses of the familiar. The good big changes are also gains, sometimes far bigger gains than the loss involved. So when a young person is coping with addiction and "failure to launch," and he or she manages to change and become successful-enough, sometimes the family gets upset---even though this good development is exactly what they've been pulling for all those years. It's new and it feels strange and people aren't sure how to respond to it.

And from the patient's side, as the therapy gains traction his capacity to manage his own affairs may be growing at a different rate than his capacity to deal with his family in ways that remain timely, kind, and effective for the pursuit of his own interest. Again: the patient's ability to cope with reality may be growing somewhat faster than his ability to deal with parents or other attachment figures in good-enough ways, enough of the time. Those older adults should try to keep these two capacities distinct in their minds, even though they are closely linked. Yes indeed, a guy who can keep a job ought to have the relational skills to manage his family elders without too much emotional noise-making. But as a therapist I can report it's extremely common for people of all ages to regress into childhood self-states when they deal with their parents---especially when purse strings are involved; or when there has been a divorce; or when there has been bereavement in the early death of a parent; and when addiction has been the main coping mechanism for a long time. If the patient acts messy with his folks, it doesn't necessarily mean he's still being messy out in the world.

In general, as far as good things go---things that might flow from the family to the patient, in recognition of his recent achievements---timing is important. It may be fine, and even lovely, for his family to use words and gifts to celebrate him for going straight after he manages to do so. But such things should never be mentioned beforehand, nor set up as an incentive. It has to be a free gift, at the right time, not too soon and without any strings attached. Of course, when therapy has just begun and addiction is still active, that's still a distant concern.

Compliance and defiance look and feel very different. Ultimately, both are forms of captivity to the cycle they form together. The way out is a genuine alliance between patient and therapist, in which it's made clear that there is a world---vital, interesting, unpredictable, sometimes friendly, and not impossible to join---beyond the one that has proven so painful and boring. Sometimes, the first hint of this lies with something outside the problem which can illuminate it: literature, or religion, or science and nature, or politics---it doesn't matter what the source is, so long as the patient gets the news (eventually, and as soon as possible) that, as Shakespeare's Coriolanus says when he leaves his mother: There is a world elsewhere.

If this post resonates with you, consider booking an appointment with me at 917-873-0292, or email Jamey@drjameyhecht.com. Sessions are available in-office in Park Slope, Brooklyn, and remotely in NY, NJ, TX, and CA.