You may have heard a story like this one:
Immigrant family moves to this country to make a better life.
It is a better life, but it isn't fabulously better because one of the parents, say the father, succumbs to a debilitating disease like, let's say, multiple sclerosis. This is before HIV research had discovered the better medications that we have now.
Mom goes to work, perhaps at the local factory and fits together widgets of some kind. Carpel tunnel is the least of her problems, the factory also has asbestos. She is the primary wage earner, and at minimum wage, she barely affords basic sustenance for the family.
At some point mom is either laid off or has to have surgery.
Luckily, like many families who come to the United States for a better life, this family has resources: cousins, aunts and uncles who are doing pretty well, so well in fact, that they own an apartment building of their own.
The aunt and uncle of our identified patient (IP), call her Joanne, allow the family to take over one of the flats in their building for a modest rent.
The family moves in and both daughters, Joanne and her sister, work very hard to keep the house clean and stay out of the way. They study very hard. Joanne even goes to college. Yet here's how Joanne describes growing up with her cousins:
"They were mean. If I worked to save money for college, they would say, 'Why do you think you can get a college degree? Shouldn't you give the tuition money to our father? Don't you think you owe him?'
"Or if I took driving lessons: 'Why are you taking driving lessons? You'll never have enough money to buy a car. And if you did, don't you think that would be wrong, considering how much money you owe our father?'
Or if I looked at a bridal magazine, 'Why do you think anyone would marry a poor girl like you? No one will marry a poor girl like you.'"
Reading this you might think that this is really only one particularly pathological, mean family. I think not. I think those messages are everywhere and they are very subtle. The mean cousin (yes, she's mean, no doubt about that) is expressing the messages that others, even the media, send unwittingly to those less privileged.
Any one of us might buy a fashion magazine and point out pictures of expensive clothing to a friend, knowing full well that we can't afford to buy what we're looking at.
'Why am I looking at this? I'll never be able to afford anything in this magazine,' we may say to ourselves.
We put ourselves down by asking why, of course. It is our right to dream, to fantasize, to strategize to have more, and to think of ourselves as upwardly mobile.
I saw a woman of color who told me that she walked into an expensive shop and a sales clerk handed her a few business cards, saying: "These shops might be more in your price range." This patient, ironically, has the resources to shop where ever she wants.
Is it true that people of means actually think less of everyone else? Unlikely. I think that sales clerk had subconsciously identified with the upper class. She thought of herself as "one of them" even though she was a simple clerk. Scary stuff.
But people like Joanne who have absorbed messages that they might not even deserve to even look at nice things, let alone fantasize about them, who feel guilt for having been on the receiving end of charity, really do have low self-esteem.
And it's deep.
Even someone like Joanne, who graduated college, who watched her cousins get addicted to drugs (and then go through dry recoveries), who now earns more than most people in the middle class (but is still hopelessly middle class, as are most of us), still suffers from low-self-esteem and anxiety.
Anxiety? Why anxiety?
Because of her self-doubt, when she has problems in a relationship she assumes that it is her fault. In every relationship she worries that she's not doing enough. After all, she wasn't ever really welcome in her uncle's home, and she did a lot over there.
When she leaves her house, even to go to the grocery store, if every hair isn't in place, she's terrified that others will think she's a slob. Why would anyone want to marry her, right?
And her house? You could eat off her floor, not because she worries about germs, but because she worries others will think less of her for her house-keeping if things are dirty or out of place.
People like Joanne can change their thinking, but takes work. Every time Joanne thinks she's "less-than" she has to remind herself of her accomplishments. Every time she blames herself, she has to remind herself that others contributed to a problem as well. Every time she helps someone, she has to remind herself that it is because she is a kind person, not because she owes the world a living.
It can really do a number on you.
Copyright 2006, TherapyDoc