Human beings have a tendency to re-enact their pasts that seems almost compulsory. People who are physically abused as children are more likely to abuse their own children or to later marry a physically abusive partner. Boys who are sexually abused as children are at an elevated risk for sexually abusing others as they get older. Girls who are sexually abused as children have a greater risk than others of becoming strippers or prostitutes. A girl with an alcoholic father is more likely as an adult to marry an alcoholic man. A boy with an alcoholic father has a higher risk of becoming an alcoholic himself. Women who have been sexually assaulted as teenagers or adults have an elevated risk of future sexual assaults.
This is the stuff of therapy. Unfortunately, the negative patterns people repeat or re-enact over and over again in their lives can be extremely resistant to change. This is particularly true for patterns that developed as a result of early childhood life experiences. The foundations of personality are laid down and solidified during childhood. Any sort of traumatic experience (even something like being repeatedly criticized by a parent or having a parent who never shows affection) that occurs during this time becomes woven into the very fabric of an individual's personality. It becomes part of who they are.
This can be exceedingly frustrating for therapists. It is very difficult to work with a patient who continues to repeat the same problematic behaviors despite recognizing the negative impact they have on their lives (and on the lives of those they love). It's easy to conclude that the person doesn't want help or doesn't want to change. I've had a few patients like this over the years. I eventually concluded that they needed a more experienced or more competent therapist. I just reached a point where I'd tried everything I could think of and I didn't know what else to do.
I can also recall several instances in my own life when I knew I shouldn't take a particular course of action -- knew I would regret it later -- but did it anyway. It's almost as if, for those moments, logic and reason simply didn't matter to me. I can't say that reason abandoned me -- I can clearly recall thinking to myself that whatever I was about to do was a bad idea and that I shouldn't do it. But there was something else -- some sort of pull -- that was stronger than reason. It was that pull that led me to decide, "I know it's bad for me but I'm going to do it anyway."
I think that is what is must be like for those of us who repeat the same negative patterns of behavior over and over again. There is some sort of pull that compels us to do these things, despite knowing that there will be undesirable consequences.
My issue was that in the course of looking for a committed romantic relationship, I repeatedly became involved with men who had "commitment issues." It was never done intentionally; remember, I was looking for a committed relationship. When I became interested in someone it was not usually readily apparent that this person had problems with commitment. It was only after we became involved that the commitment issues became apparent. Even so, I would remain in the relationship, always against my better judgment and always to my personal detriment.
Despite all the personal growth and self healing I was able to achieve, I never really "resolved" this issue. When I met my husband he initially indicated that he was looking for a committed relationship. About a month after we started dating he changed his mind; he needed to focus on getting his life together first. Despite knowing this, I continued to see him maybe twice a week for several months. Eventually, he worked through some of the problems he was having and told me he was ready to be serious. So I never really stopped getting involved with "unavailable" men; I just happened to get lucky.
The point is, if I couldn't stop my own self-destructive behavior patterns, how can I help someone else stop theirs? Whenever I have a patient who presents with repeated self-destructive behaviors I end up feeling powerless to help them and completely defeated. I keep working with them and trying to help but I never really feel like I'm accomplishing anything.
In theory, however, just being there to listen without being judgmental, to validate the patient's feelings, and to accept that person exactly as he is -- is, in fact, helpful. ("It feels like what I do with my friends," I always say to myself. "How can it be therapy?").
Author David Wallin (www.davidjwallin.com/PDF/DavidWallin/AttachmentInPsychotherapy.pdf) explains why this kind of mindful presence is therapeutic. "If our early involvements [with our parents or primary childhood caregivers] have been problematic, then subsequent relationships can offer second chances, perhaps affording us the potential to love, feel, and reflect with the freedom that flows from secure attachment. Psychotherapy, at its best, provides just such a healing relationship."
When I think about it, maybe that's what all of us who repeatedly engage in the same problematic behaviors need - a second chance relationship. Maybe my husband is that second chance relationship for me. And maybe for my patients I can provide that second chance...