The Honeymoon is Over

While the last few weeks have been challenging, the visible among us rise to the challenge of isolation. We're using social media (I restarted my FaceBook account!). We want to check in on friends and family, really want to, as opposed to feeling that we must. Some of us are soothing our lonely souls with stabs at painting, reading, praying, and playing-- either solitaire, video or board games. What puzzle are you doing? Let me show you mine! All done. 

And yet, the honeymoon is definitely over. The most patient among us is feeling either claustrophobic or crowded, out of sorts, at least once or twice a day. even more than we do working outside the home. 

Your therapist will tell you that your mood ebbs and flows as the day wears on without isolation. Nobody isn't cranky sometimes. 

That over-crowded feeling is leading to arguments. I'm hearing about really explosions. The kids are scared. Tensions are boiling over. Consider yourself lucky if your quarantine relationships are in better shape. But people lose it. If they're healthy they apologize, work it out. 

But hey, that's my clinical population. The truly dysfunctional relationships aren't rising to the occasion. And we're hearing that domestic violence is skyrocketing, and marital sexual assaults are on the rise. No place to go to escape.

We'll look at one type of social dysfunction in this post: The Over-adequate Under-adequate Relationship

In this model someone is sick, either has a physical, mental, or behavioral disorder that sucks the air out of the room for the other(s). To be fair, attention is inevitably on a person who is sick-- it has to be. Nobody wants to ignore the needs of a helpless individual. When there's love and understanding, patience, and especially experience in care-giving or health care, the stress is less of a problem.* It is only dysfunctional when there are systemic issues going on. I.e., the one in the sick role

 (1) the 'helpless' partner, is liking it and isn't doing much to be less so.  Or

(2)  the helpers won't let the sick person do more, when he could. That could be for a variety of reasons, such as the fear that the condition will worsen. But also,

(3) it feels good to be a helper. It raises self esteem knowing we're helping someone who needs the help. Yet you can see how that need for an ego boost isn't helpful for a person who wants to flex a few of her under-employed muscles. 

Then there's another creepy reason, which is that

(4) having a sick person stay sick legitimizes avoiding avoidance. We can't . . . you know. 

No, not a thorough discussion but add your own thoughts by all means, in the comments. They are undoubtedly correct. 

And guess what? We're all in the inadequate role now! We're all being told to stay home, get help with the groceries if you can. If at all possible, for crying out loud Stay home! Don't go here, don't go there, don't do this, don't do that. 

Some of us rise can't take it and are going out anyway. Our self, the independent individual that we have become, needs air. And we wonder, how crazy are we, taking the chance of infecting someone else or being infected. Who me? 

Having our arms tied, legs shackled, we're rising to a new level of empathy, the feeling of what it's like to truly be sick, too weak to go out, that feeling we have when we're stuck in a hospital, for whatever reason, for having a baby on a sunny day.  

Back to the OA-UA

In this classic dysfunctional relationship someone is well and someone else is not. The well person can do more and usually does. The sick person does less-- she is under-adequate. Her partner (or child) does more, compensates, relates as over-adequate relationship. 

The therapy is always to get the over-adequate to do less, the under-adequate to do more. It's more complicated, but that helps.

Now we're all theoretically under-adequate, ordering fruits and vegetables to be delivered, doing as little as possible outside our four walls. This upsets the entire homeostasis we've been talking about.

TWO EXAMPLES

(A) Say it is the young adult in the family who always makes the beer run to the fridge for the adult alcoholic. The child is already over-adequate, a parental child we say. But she has enabled since the dawning realization that this behavior, getting daddy a beer from the fridge while he watches TV is rewarding. There's secondary gain, his love and admiration. 

How does that work when she can't get him a beer, when there is no more beer? He may not be as nice. She may be confused and have to re-examine the relationship. That could be good for her, or alternatively, the relationship might become even more dysfunctional. She may spend an inordinate amount of time trying to make her father happy, land in an even more co-dependent role.  

Or 

(B) What happens when the one in the sick role wants to raise the level of corona awareness with the one who is usually healthy, but incurably carefree? The sick partner pounds the healthy partner with instructions on mask-making, how many feet he must stay away from others, and wiping down his shopping cart with alcohol swabs. Will the "healthy" one not lose his cool? Will it become a horrible argument? Of course it will. This won't go over well, the sick telling the healthy what to do. It just feels wrong.

Suffice it to say that in a clinical population upsets like these aren't unusual. Now, more than ever before, they are what no one needs or wants. There is nowhere to go to cool down. Domestic violence is rising in these troubled times, as is marital sexual violence.  

 So much depends upon the relationship, right? In the above dysfunctional OA-UA relationship model  the therapy is about inching toward the center. The OA, the over-adequate partner, gives over some of the work to the UA, the under-adequate partner, who is to do more. They listen to the complaints of one-another and delve into the origins of learned dependency. Support, trust, and validation rule. This is not the time for criticism. 

Success depends upon tone, the process of expressing wants and needs, validation. 

We could say, as we did at the start of this post, that truly dysfunction families will still be dysfunctional in a crisis; the more things change, the more they stay the same. Or we use this as an opportunity to change them.

Yes, let's do that. 

therapydoc

*Watch Zoey's Extraordinary Playlist to see how that's done. You'll need insulin, but it's okay.