“Hi Jon. Session from yesterday got me thinking about a question I want to run by you. A client has had debilitating anxiety when doing her academics. After some focus there, she’s seen that her anxiety is actually about her self-worth, which is wrapped up in her academic performance. She asked the question (paraphrased) “Am I loveable if I don’t achieve high academically?” I responded, “That’s a good question to ask yourself” and spent time focusing there. But I didn’t see much good signaling. Now it occurs to me that her question could be a subtle form of self-attack, masquerading as an important existential question. In other words, focusing on that question is the defense. Have you seen that before?” Great question!
When she asks if she is lovable, she invites you to judge her. If you judge her as lovable, you fail to help her find out why she judges herself as not lovable. She hopes your judgment can drown out hers, and that never works. So she tries to get good grades, hoping to silence her inner judge. But then she spends her entire life on the run from the judge.
Instead, we need to help her find out what feelings are underneath her defense of self-judgment.
Pt: Am I lovable if I don’t achieve high academically?
Th: Sounds like you’re not sure you are. [Block the projection of the superego and invite her to look inside.]
Pt: I’m not. [Now she can see her own self-attack.]
Th: So this belief you are not lovable, could that be a form of self-attack? [Identify the defense.]
Th: Could that be getting you depressed? [Clarify the price of the defense.]
Pt: That makes sense.
Th: I wonder what feelings might be coming up here toward me that could be making you attack yourself like that? If we look under this self-attack, what feelings are coming up here toward me? [Invite the feelings happening in this relationship that are covered up by her self-hatred.]
Self-attack is a form of resistance we call repression. When she experiences mixed feelings in a relationship, she lets her love come up, but protects you from her anger by turning it on herself. Then she becomes depressed.
So the therapist lets her know she does not have to protect him from her anger. Instead, he encourages her to feel her feelings toward him rather than devalue herself as “unlovable.” As she experiences her anger toward him, her depression will drop. Once she can experience the full extent of her anger toward him, earlier memories of anger will arise as her unconscious unlocks. Once she can face those feelings, she will be able to channel them in a healthy way rather than ward them off through her self-attack.
Remember it’s not just an intervention. We offer a different kind of relationship.
Take home point: “Am I lovable” = “I don’t think I am lovable” = self-attack. She attacks herself to protect you from her feelings which are rising toward you. Identify and block the self-attack, then ask about feelings toward you that are underneath the self-criticism. This creates a path for her feelings to go out toward others rather than be turned back upon herself. Metacommunication: You don’t have to protect me from your feelings.