Some have said so, but I disagree. Gottman’s studies of couples resulted in one of the most powerful findings in psychotherapy research: when one member of a couple expresses contempt for the spouse, 94% of those couples will divorce. Contempt is one of the most destructive emotions for relationships. If it has no place in marriage, how can it have a place in therapy? If it is destructive for a patient to have contempt for the therapist, how can it be healthy for the therapist to have contempt?
I know, some of you might say, “Hey, it’s not contempt for the patient, but for his defenses.” But do we really want to model contempt? Do we want the patient to join us in a relationship of mutual contempt for his historical adaptations, known as defenses?
When we show contempt for the defenses, we invite the patient to show contempt for his defenses as well. We treat his defenses as contemptible, as not-me. But who among us has not used defenses……today? If we treat his defenses as not-me, we treat him as alien. Yet, we are all too human. We are all defense users. Contempt for his defenses shows contempt for his humanity and our own.
Sadly, the patient may show contempt for his defenses in order to form a closer relationship with us. Just as his parents showed contempt for him and asked him to join them in a contemptuous symbiosis. But this would be a pathological relationship rather than a therapeutic alliance.
There is no need for us to show any contempt for the patient’s defenses. We can block them and direct the patient’s attention to his inner life. We can point out his defenses so he can see them. We can point out the price and function of his defenses. We can point out how defenses that saved his life in the past destroy his life today. We can trust his longing for the truth rather than our contempt.
What are defenses after all? The lies we tell ourselves, the façade or false self we erect around ourselves. And this façade? It is not real. It is a false image behind which we hide. Why show contempt for this façade? Why treat it as if it is real, when we need to reach out to the real person who is hidden underneath? When we show contempt for the façade, we treat it as if it has being, we give it life as if it is real. We end up fighting an idea or image rather than relate to the real person behind it.
ISTDP is not a therapy based on self-rejection but on self-acceptance, accepting all of the feelings, ideas, and impulses that flow through us so that we no longer identify with the defenses that hide the flowing of you. We help the patient no longer show contempt for himself through using defenses or for using them. None of his inner life is excluded. Instead of helping him treat aspects of his inner life as not-me, we help him embrace everything as all-me. We feel all feelings. We use all defenses. We have all impulses. As the poet Terentius said, “Nothing human is alien to me.”
Patients come to us showing contempt for their inner life through using defenses. They show contempt for their inner potential, settling for lives crippled by self-hatred and self-doubt. They project, imagining that we will show contempt for them. By underestimating themselves, they invite us to do the same, showing contempt for them. They are already burdened by learned self-contempt. They do not need more from us.
Should there be contempt for the defenses? No. There cannot be room for contempt in any loving relationship. Why get distracted relating to the patient’s resistance, when our task is to reach out to the patient trapped underneath? Why treat the resistance as real when it is merely the imaginary that hides the real? Why form a relationship of contempt when that opposes the relationship we are trying to form?
In showing contempt for the patient’s defenses, we show contempt for our own defenses, our inner life. In judging the patient’s defenses as not-me, we alienate ourselves from our humanity. In that sense, we ask patients to live up to an ideal none of us can live up to: having no defenses.
Then therapy becomes a way to narcissistically exploit the patient. By judging patients for failing to live up to impossible ideals, we place ourselves on a pedestal as if we have achieved an impossible ideal. We ask patients to hold the flawed humanity we cannot tolerate within ourselves. Then we can judge it or “analyze” it “over there.”
By the way, there is no form of therapy that has a monopoly over this danger. Any kind of therapy can be misused to exploit the patient and artificially elevate the therapist. But when we “elevate” ourselves this way, we lower ourselves to a grandiose position. We betray our human potential by living a lie. And we ask the patient to do the same. No, I don’t think there should be contempt for the defenses. It’s a distraction. Reach through the resistance to the person underneath. Love for the person, not contempt for the defenses, is the pathway to healing.