A Different Slant on CMT, Part II
Control Mastery (Broitman)A Different Slant on CMT, Part II
by Vic Comello, 11/27/98
Kathy's Symptoms
Kathy presented her therapist with a curious assortment of symptoms and an equally curious request: she wanted to be free of only some of them; the others she cherished and wanted to keep.
Kathy was in her mid-30s and worked from her home as a freelance secretary when treatment began. She was a single mom with three children aged 14, 12, and 10 from a marriage that had ended in divorce. The following description of her condition comes from her therapist's published paper:
Her depression began 3 months earlier when her oldest son left to live with his father. Kathy felt "devastated" by intense feelings of sadness and loss, along with debilitating physical symptoms of depression. She also experienced an intense "vulnerability" and her emotions felt "totally out of control." Although Kathy disliked the feelings of loss and the physical symptoms of depression, she valued highly this state of vulnerability. Curiously, the depression brought with it this state of vulnerability that allowed her to feel alive and connected to people in ways previously unavailable to her. Previously, she was closed off from feelings, hidden, cautious, and guarded with others. During the depression, however, she somehow gained access to her feelings and allowed herself to express them. Kathy made it clear that what she wanted from therapy was to be able to feel alive and open to feelings, without the accompanying debilitating depression. Currently she could only feel one of two possible states: guarded, efficient, and functional or alive, vulnerable, and unable to function. During her son’s move, she returned to "everyday functioning" and dealt with the underlying issues "by not thinking about them."
Six years previously, Kathy had experienced the first debilitating depression of her life following the second of two abortions within a period of about a year. Prior to that time she had always been "stable and emotionally balanced." The depression hit suddenly and dramatically with debilitating physical symptoms that sent her to a psychiatrist who diagnosed her as severely depressed. Anti-depressants cleared up the physical symptoms, but verbal therapy did not help much.
An interesting sequence of events led up to the first debilitating depression. Recently divorced, a single mother, and working full-time as a secretary, Kathy had felt relieved to be free of an unhappy marriage and was involved with a new man whom she enjoyed. Although she had tolerated birth control pills well during her marriage, she discontinued them after separating from her husband. She claimed that she was concerned that they "might be bad" for her health. She became pregnant in this new relationship due to a failed diaphragm, and a "battle" began inside her. She had always had strong feelings about abortions: She believed in the fetus as a living being, a "lost soul," and she also believed in every woman’s right to choose for herself. There was no way, however, Kathy could afford to have another child, either emotionally or financially. After the abortion, she ended the relationship with the man, stating that his "lenient attitudes" toward abortion made her conclude that he was not right for her.
Soon she began a 4-month long, passionate romance with a man-about-town businessman who was fabulously exciting and put her "in the limelight." He treated her as an intellectual equal and described her as the smartest partner he had ever had. She felt recognized, prized, and special. They had fabulous times together. Then one wonderfully romantic weekend she got pregnant again: the second failed diaphragm pregnancy. "If I were superstitious I would have believed I was being punished, because I got pregnant that fabulous weekend." It was "unforgivable" to get pregnant twice and to have two abortions: "The first time was bad enough; the second time was the breaking point." She ended the relationship, never telling the man about the pregnancy because she "feared he would be permissive of abortion rather than seeing it as the killing of an individual." Every Mother’s Day since that time has been a "trauma" for Kathy: "Abortion is the antithesis of mothering." Soon her debilitating depression began.
One of the most dramatic changes the depression brought was in Kathy’s feelings about mothering. Although previously she had always been intensely "fulfilled" by her children and her mothering, she suddenly felt intensely "empty" with her children. She felt resentful of what she referred to as the "surviving children." It was so hard to mother them. As in her current depression, although she disliked feeling emotionally out of control, she also cherished feeling uncharacteristically alive. She became exceptionally animated and outgoing in her social and work worlds.
I didn’t feel depressed. I felt crazy. My hands would shake; I lost weight; my emotions felt out of control; I cried all the time. But I also played, had fun, and flirted with all these people. I felt very special. Then I would return home and feel lonely and miserable with the children. And I felt so guilty: Here I had these three beautiful children I had always felt so fulfilled by and I wished I could be somewhere else.
Eventually, Kathy dealt with that depression the way she was dealing with the current depression: She became functional and efficient. An external crisis developed as her ex-husband deteriorated into substance abuse. As he became irrational and threatening toward Kathy and the children, Kathy decided she had to move herself and the children out of the state.
Overview
According to the view espoused here, Kathy's symptoms arose from a conflict between two concepts of reality:
- One that lives and operates inside her as a set of expectations about herself, her family, and the world in general--which she derived from perceptions she was led to as a child.
- A reality concept representative of her aspirations--a concept of reality she would like to live and operate inside her in place of aspects of the one that she has now. The latter is derived partially from aspirations she developed as a child, perhaps from unfulfilled aspirations of one or both of her parents, and aspirations derived from her later experiences as she found new things to be in the wider world beyond her family. The conflict arose because her installed reality concept warned her against becoming what she wished.
Of Being and Becoming
The distinction between being and becoming alluded to here is one of the relative forcefulness of past realities and unconfirmed aspirations as operating principles in a person's life. The concept of reality that is installed in Kathy's personality is forceful precisely because it has seemingly been confirmed by experience over the course of many years. Kathy's aspirations lack force as either conscious or unconscious operating principles precisely because they are unconfirmed. In Weiss's terminology, it would not be a "safe" course of action for Kathy to march off in the direction of her aspirations, because she would immediately challenge the negative expectations inherent in her installed reality concept, which would forcefully warn her of the dangers she is incurring, thus prompting her to back down.
What I am alluding to is an aspect of the developmental process, one that goes a long way toward explaining why most people don't act consistently or forcefully on their aspirations. It also helps explain why the reality concept derived in childhood remains in force to a large degree throughout adulthood. Those aspects that live on do so because they have not been challenged as representatives of a person's reality concept. They live on because a person takes them for granted and continues to see himself and the outer world in the ways those aspects define.
Unconscious Testing
Although a direct frontal assault is not possible, we humans can unconsciously move our lives in the direction of our aspirations if we are sneaky--if, that is, we strive for only small victories that can be won and still be rationalized in terms our installed reality concept would understand. We can't consciously strive to bring down the whole edifice in one fell swoop, but we can unconsciously chip away at it here and there, making a large difference over time. The small victories involve gaining the experiences we need to confirm the legitimacy of our aspirations as worthy operating principles in our lives. The more aspirations are confirmed, the more real to us our aspirations become.
It's not possible to give a complete description of how Kathy sought to confirm aspects of her wished-for self through this unconscious testing process, but I think one indication can be seen in the many awards she won. Although at least one of these was given to her without her applying for it, one generally does need to fill out an application by way of entering a contest of one sort or another. By continually entering contests that recognized achievements and winning, she did increase the reality of her wished-for self as a force in her life.
Conscious and Semi-conscious Testing
The problem with moving our lives in the direction of our aspirations does not relate to the unconscious-testing component. The problem is that at some point, challenges need to be made and victories won at the conscious level. The reason most people don't get very far in challenging their childhood training is that they are not prepared for the conflicted and decidedly uncomfortable feelings they need to bear with as they move toward a more realistic reality concept. A person tends to lose sight of his aspirations, as escaping these feelings becomes an end in itself.
There are many people who live their entire adult lives behind barriers of their own creation that have the sole purpose of shielding themselves from becoming highly motivated to face those feelings ever again as the price of realizing their aspirations. The barriers may take the form of alcohol or drugs or a preoccupation with work or hobbies or TV or sex. The list is endless because it includes anything that will allow a person to pass time while remaining walled off from recognition of the possibility of an alternative life.
These uncomfortable feelings are what a therapist would call symptoms. When these are analyzed, they are generally seen to represent ambivalence. That is certainly evident in Kathy's case. Found here are the freedom to live a new way and fears of losing control and the concern that she will be led to radically change her attitudes toward motherhood.
When seeking the cause of such symptoms, Freud would tend to look to sexuality, while CM therapists would tend to focus upon unconscious guilt derived from pathogenic beliefs. While I tend more toward the latter, I think it's important to not miss the obvious. One can learn much about symptoms by asking what they prompt the person to do.
The symptoms came twice when she was on the threshold of a new life--first, after her divorce, and secondly, when she was about to be married. And in both instances, the symptoms led Kathy to seek therapy. I think it's interesting that her first therapist apparently operated more in terms of prescription drugs than detailed analysis. It could be that at that time in her life, Kathy wasn't ready for the detailed analysis a CM therapist would require, having had no experience with therapy. Becoming dissatisfied with a therapeutic approach that only suppresses her symptoms, she evidently decided that only a thorough analysis would prepare herself for the kind of new life she wanted to lead.