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Anxiety

You Don’t Really Want to Get Better

Most people fear a basic change in their identity, be it positive or negative.

Of course, psychotherapy clients want relief from their symptoms, depression, anxiety, and other painful emotions. But at the same time, they don’t want to change the fundamental defenses that would then allow them to develop and overcome their psychological maladies. Most people fear a basic change in their identity, be it positive or negative.

From an early age, children form a powerful bond with their parents, whom they are dependent upon for their ultimate survival over a prolonged period of time. Every child needs protection, love, and affection from adults who ideally possess both the desire and ability to provide for the satisfaction of the child’s basic needs. In instances when a parent is misattuned or emotionally absent, the infant suffers heightened anxiety states that can, at times, feel life-threatening. Children make the best adaptation possible to the circumstances in which they find themselves.

To cope with their situation, children defend against their anxiety and pain by imagining that they have a permanent connection to their all-powerful parent. They form a fantasy bond with their mother or father in which they feel that they are connected, as though they share one identity. This fantasized merger offers comfort, safety, and security, and partly compensates for what is lacking in their interpersonal environment. Those children who suffer an excessive amount of rejection, hurt, and emotional pain form intense fantasy bonds in order to assuage their anguish. The fantasy bond also offers partial relief from death anxiety.

To maintain this imagined connection, children deny or minimize the reality of parental inadequacies and abuses, and in the process idealize their parents while at the same time internalizing their parents’ negative attitudes and feelings towards them. Early on, children come to see themselves as unlovable, bad, or deficient, and they carry this basic image forward into their adult lives. It becomes a fundamental aspect of their core identity.

From this point on, any break in either the parental idealization process or the negative self-conception leads to feelings of tension or discomfort. Once formed, any intrusion or break with any aspect of the fantasy bond leads to an increased state of anxiety. When this powerful defense is challenged there is a feeling of dread, an acute awareness of being helpless and alone. There is often a sense that to be without the fantasy bond would be life-threatening.

Positive movement in psychotherapy that challenges the parental idealization or helps clients see themselves in a better light can paradoxically be experienced as threatening rather than freeing. Instead of feeling better, they may feel shaky or uncomfortable and tend to negate their insights or progress. For this reason, although people may wish to change, they may fight against positive developments. Indeed, most people, in or out of therapy, are afraid, even terrified, of making powerful changes in life for the better because of the threat that these changes pose to their core defenses.

Clients undergoing therapy face an ultimate dilemma. Their natural tendency to embrace new insights and enjoy the benefits of perceiving themselves in a better light is interfered with by heightened anxiety caused by challenging aspects of the fantasy bond with their parents. Feelings of emptiness and being alone, along with an actual sense of loss, can be particularly painful and lead to a generalized resistance in therapy. The operation of the fantasy bond and the subsequent anxiety at breaking with it are both largely unconscious. This makes it difficult for clients to identify and understand their reactions when any aspect of the imagined connection is exposed or endangered.

In The Enemy Within: Separation Theory and Voice Therapy, I describe how psychotherapists find themselves in a kind of adversarial situation with a client to the extent that the client is expressing resistance. They want to help their client perceive his/her childhood and family situation realistically and move away from self-critical and self-destructive thinking, yet the client may be resistant to both processes. In general, people are reluctant to challenge their psychological defenses because these defenses were once essential and protected them when they were the most vulnerable. They were the most effective adjustment they could make to destructive environmental influences they encountered as children, and they served to reduce tension, anxiety, and emotional distress.

In conclusion, it is valuable for both therapist and client to face the fact that in an important sense, the client does not want to get better. Both people can benefit from the insight that positive events in an individual’s life can have adverse effects because they disrupt key components of the fantasy bond. For the same reason, personal development or improvement in psychotherapy can foster clients’ feelings of insecurity and a sense of aloneness, and can even stir up feelings of death anxiety. Therapists can best help clients understand and work through potential regressions by helping them to understand the full impact of their basic resistance to breaking with the negative image of themselves that they formed in their families of origin. While in a defended state, clients often imagine that their anxiety will be intolerable if they change. It is the therapist’s task to help clients realize that if they develop their tolerance and learn to cope with anxiety and painful emotions, they can move on, broaden their perspective, and lead more fulfilling lives.

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