Therapy Abuse

In the last couple of years some of the men in my practice have complained that their partners, generally women, but they could be men, aren't as physically demonstrative as they would like them to be.  They tell me they want kisses as much as sex, although sex would be nice, too.  You know the old joke:   

How do you cure a nymphomaniac?  You marry her. 

We could talk about the joke forever, right?  But my editor tells me that I have to focus, so let's do that, focus on this problem, the disappearance of affection.  I'm thinking that if men are complaining, it means that they have finally caught up to women, feel more free to talk about their feelings in the twenty-first century.  And it's a good thing, not a gender issue so much as a windfall from the Women's Movement.

Women can ask for love and sex.  Men can ask for sex and love.  Just say something, please.

When it's brought to my attention in therapy that a partner in a committed relationship has become painfully avoidant, unaffectionate, emotionally distant and cold, I want to shout out, act like Nancy Grace of CNN fame, now the vigilante judge on the new daytime Fox TV show, Swift Justice. I want to verbally beat on the ostensibly withholding partner, glare at the poor, unsuspecting soul, and make harsh, judgmental faces while bellowing:

What were you thinking when you got married?  That you could let it go?  Do you think that just because you have a ring on your finger you don't have to show love anymore?  Do you believe that just because this person (I would point at the beleaguered spouse) signed up for life with you  that you can do your own thing, turn your mate into chopped liver?  What's wrong with you?@!@!?  Do you think people can go through life, day after day, week after week, with no kisses, no hugs?  Don't lie!  Don't lie to Swift Justice!

Men, women, doesn't matter which gender is the stingy party.  When it comes to affection, I (and Judge Nancy, we're thinking) take no prisoners.

But that's so judgmental!  So not therapeutic, ranting in this way.  It is what lawyers do, not therapists.  Most people don't see a therapist to be beaten up verbally and emotionally, what might be considered therapy abuse.  When we go to a mental health professional we're hoping for calm, relaxed, half-asleep doctors who explain the psycho-dynamics to us, the whys and wherefores.  We want to know why a partner is unwilling, unable to show affection, maybe.  Or we want to work on change, changing our partner, sure, but maybe changing ourselves.

Most of the time that's the case, and it is a slow, healing, sensitive process.  But some people are just dying for us to let loose, give them hell.  You can tell when they want someone to sober them up.  And quite honestly, when that happens with my patients, when I launch into a critical and judgmental tongue in cheek rant, for it had better be tongue in cheek, then that person is likely to love it, and will want to come back for more.

You could say, and you would be right, that this is dangerous water in which we tread at this moment.  A therapist on the Internet  probably should not be giving young, impressionable therapists the impression that it is fine to beat on patients.  Suggesting this, even whispering it, begs a lawsuit, screams professional suicide.

So don't do it without an amazing relationship with your patients, okay?  That would be unprofessional. And make sure they know you're kidding, or at least make the case so that they strongly suspect you are kidding.
If you're lecturing a patient, no matter how badly he or she deserves it, make that delivery tongue in cheek,  and act apologetic as the insults roll off your lips.

At this juncture it is best to reinforce what tongue in cheek really means.  Find a mirror, gaze at yourself in this.  Push against your cheek with your tongue.  Push that cheek way out. Go ahead. Do it right now.  We'll wait.

Could anyone possibly take you seriously if you look like this before, during, even after a rant?  Preferably during the whole show? 

Yes, it's possible, you say,? Your rendition of tongue in cheek in the bathroom mirror looks serious? Then that's bad.  Bad because the more concrete, the more literal among us take us at our word.  Best not to do this intervention with terribly concrete, literal patients.  And to be sure you are not misconceived, consider utilizing the other cheek, too, alternating the process:  Tongue in the right cheek, push.  Tongue in the left, push.

Return to the mirror and practice this, and for good measure, try raising your eyebrows up and down a few times.  If you are still worried that someone will feel abused when you rant in this fashion, be sure to tell them that you were being facetious. Confess, 

"I was just kidding.  You have good reason, seriously, to withhold affection.  Let's talk about it." 

Then go into it with the patient, find out what that good reason is. Because how should you know, otherwise?

We would call this giving somebody his day in court, presumably. Or just good therapy.

therapydoc

Think it, Don't say it

I think we left off talking about how you might consider being sensitive to make-up or the lack thereof at the holiday party. It's not about the make-up. Readers made the point that there are a million great reasons not to wear any.

But we try to look for the sad, maybe look through the make-up with some, and ask, sincerely, How goes it? Not that everyone's going to want to out themselves about feelings, but you never know.

It's nice to have permission to do that, to really be honest and be able to tell even casual friends what's going on with us. We need a certain amount of established intimacy in the relationship, I should think. But when does that start? Somebody has to get it rolling, take the risk and the fall. Might as well be you. It's that How are you feeling, REALLY, we're talking about here. You go fishing and sometimes you catch one.

One tries not to do that too often as a therapydoc, FYI. At parties, I mean.

We were looking for ways to approach these family reunions. I wanted to give you a little armor, a Jedi shield, light saber maybe. This year, you can see, we're a little stuck on the party theme. It's just one of those things. You either love 'em or you hate 'em, nobody's neutral. Obviously some people must love them or there wouldn't be so many.

Just an excuse to get together, right? Take it from me. Bring a gift to the hostess. Don't listen to the Your presence is our present thing. A little something.

Oh, I digress. Anyway, on to parties. It's a tool, right, a way of picturing people interacting socially. That movie, Goodbye Columbus comes to mind, but I can't remember-- Did that first scene, the shmorg, take place at a wedding? A Bar Mitzvah? All I remember is that the movie irrevocably stereotyped Jews and it wasn't a nice stereotyping, so I couldn't get past that scene and hated the movie. Don't see it.

For our purposes, just picture everyone at a party eating and drinking.

Could be coming right up at your house. One More Week.

We'll look at an interactional sequence that's pretty common, even though it's terrifically dysfunctional. It's dysfunctional at parties, it's dysfunctional at home, it's dysfunctional in the bedroom or at the breakfast table. It's one of those faux pas that you can't take back once you make it, but boy, you had better try.

What else could I be talking about except:

Don't you DARE say that about my mother.

Or:

How DARE you say that about my mother?

Same thing.

It works like this. I'm in some kind of mood, maybe irritated at my mother (Mom, please, this is totally made up, it's not at all about you, we're just illustrating a point at your expense. You're good with that, being part of the fun. It's one of your greatest traits.).

My mom's always been a good sport.

But let's say she were an annoying person, which she is NOT, and that I'm irritated with her. FD is in ear shot and I feel like kvetching and I say, "My MOTHER is SO domineering. She drives me crazy telling me what I should be doing with my life. And have you ever noticed how she always has to have it her way?" (She's not like this, just to reiterate. She's the opposite, if anything, a total push-over.)

But this is a vignette, so FD falls into the unwitting trap and says, "Yeah, I've always thought she's pretty domineering."

Not being a violent person, I take the 5 lb sack of potatoes on the kitchen counter and whip it over his head.

He gets up off the floor and says, "But YOU said she's domineering."

I CAN SAY WHATEVER I WANT ABOUT MY (fill in the blank, mother, father, brother, sister, son, daughter, god-child, any close relationship)_________BUT YOU BETTER THE H. . . NOT!

So clearly, at a holiday party, the same rules apply. It's hard, too, because what are we doing at a holiday party if not talking quietly over drinks and hors deurves about someone else? We're all about pseudo-intimacy.*

Still. Avoid the trap of agreeing with someone who is busy dissing a close relative. You will be sorry.

Let's say your friend, who is nibbling on an olive for example, says to you, sincerely, "My uncle is a total miser." You work with this person's uncle and you know it's true.

Still. You can't agree with him, even if it seems like he wants you to agree. You can't agree because this is your friend's uncle, not Tom Cruise. Your friend knows all about his uncle's great qualities, so he can talk about him. He can say whatever he wants. Not being a close relation, you don't know the half of it, however, even if you do work with him, and if you say something negative this will surely make him defensive. Maybe not immediately, but later on, when he's taking off his tie, thinking about the conversation. And he'll hate you.

This is pretty normal proprietary stuff. We own our relatives, share blood lines basically, and we want to be proud of our possessions, our stuff, our DNA. Insult my mother? My uncle? You're insulting me, stupid.

Doesn't have to be a blood relation, either. It can be anyone towards whom we feel an attachment. If I'm close to someone, that person's a part of me. A friend. A teacher. A doctor. MY friend. MY teacher. MY doctor. Boundaries can blur. We blur them unconsciously.

No, it's not a hard and fast rule. Many of us have abusive relatives about whom we feel we simply have to say something negative. Certainly that's what therapy is about sometimes. It's a fairly good family roast. But even in good therapy, especially in good therapy, we try very hard to look for the reasons people behave in the ways that they do. We really want to get people OFF the hook.

Not that you can't fantasize, when it works, about pulverizing someone who has it coming.

But let's let the victim make that call.

So at the cheese dip, when someone disses his mother, I'd stay on the safe side. Think about it this way.

(a) Whatever you say about someone WILL get back to that person
(b) You insult people? You look bad.

When someone disses someone else, in fact, I'd stick with, "Wow, (she) he's so NICE to everyone else. You have to admire that in a person, you know?"

And mean it.

therapydoc

*Pseudo-intimacy happens, in this case, when we talk about someone else to avoid talking about ourselves.