The Inner Child

We've probably all heard someone refer to his or her "inner child."  It's another one of those psychology terms that somehow made its way into popular culture.  Carl Jung, a disciple of Freud and one of psychiatry's founding fathers, called it the "wonder child."  According to Jung, the "wonder child" is the part of the psyche with the capacity for awe and a sense of natural wonder; it is curious, creative, and loves to explore. 

The website desert-alchemy.com gives the best definition of inner child I have found so far.  It defines "inner child" as that part of the psyche that retains feelings the way they were experienced in childhood.  When it is healthy, the inner child is naturally innocent, playful, and uninhibited; it has an approach to life that is simple and straightforward.

Today, you might hear clinicians talk about the "wounded inner child."  John Bradshaw (http://www.johnbradshaw.com/) is one of the best known proponents of "inner child work."  He has authored several books on the subject and apparently appeared on several nationally televised PBS series.  Among other things, he now travels the country conducting "inner child workshops."  According to Bradshaw, an inner child becomes wounded when normal childhood dependency needs are not met during childhood.  Normal development is arrested and dysfunctional childish behavior persists into adulthood.

While some of Bradshaw's work is a little too "touchy feely" for my taste, he does get a lot of things right. 

From birth to adulthood, a child's parents are responsible for meeting all of his or her needs.  This includes physical needs like food and shelter as well as psychological needs like security, intimacy, structure, and - later on - autonomy.  Even the very best parents don't do this perfectly.  Parents are human - they make mistakes.  To further complicate things, very young children cannot speak.  This makes it hard for them to communicate their wants and needs.  Even after they start speaking they may be unable to communicate their wants and needs because children often do not know what they want or need.  So for parents, there is a lot of guesswork.  Sometimes parents guess correctly; sometimes they don't.  Fortunately, a child doesn't need perfect parents to turn out okay.  For healthy development, a child simply needs parents to be "good enough."  (I am not making this up.  If you don't believe me, see Winnicott's ideas on the "good enough mother"). 

Sadly, there are parents who are absolutely nowhere near "good enough."  There are lots of reasons for this.  Some parents fall short due to circumstances beyond their control.  Some parents are neglectful or abusive.  Whatever the reason, if a parent doesn't meet a child's needs during childhood then that child enters adulthood with significant emotional and psychological deficits. 

So in normal psychological development, other people (i.e., parents) fulfill one's psychological and emotional needs.  It is natural, then, for those whose needs have not been met by the time they reach adulthood to look for other people to fulfill them.  To this end, they enter into relationships expecting others to fill the emptiness inside them.  They are uncertain of themselves and look to others for validation and affirmation.  They do not know how to love and appreciate themselves so they rely on others to give them love and appreciatiation.  Inevitably there comes a time when they feel empty, unloved, unworthy, or unappreciated.  They blame those people they'd expected to complete them and are left feeling disappointed or even betrayed.

They may continue their search for someone to meet their emotional needs.  They will never find such a person; no such person exists.  During childhood, our emotional and psychological needs are met by other people (i.e., parents); once adulthood arrives, the time for others to meet these needs has passed.  The window of opportunity closes.  A person must learn to provide for himself whatever needs have not been met by adulthood.

It's definitely harder this way.  It is so much easier to get what we need while we're children.  As adults, it is difficult to give ourselves what we did not get from our parents.  It is difficult, but it's not impossible.  In fact, this is often the work of therapy: learning to meet your own needs, to be your own person, and to love and accept yourself. 

Shame and depression

I mentioned before that I was recently tasked to lead a therapy group focused on sexual assault, trauma, and depression.  I did some background research to prepare.  One thing that stood out to me is how frequently shame was mentioned as a factor contributing to depression.  I mentioned this during the first group session.  It seemed to resonate strongly with the group members.  As they shared their experiences I spontaneously found myself talking about the "power of shame."  I hadn't intended to go this route but it felt right.  It ended up being a very powerful discussion.

In the ensuing days my thoughts repeatedly turned to the concept of shame.  It's not something I've ever spent a lot of time talking about with patients, although it does come up in sessions.  There are, however, certain treatment approaches to which the concept of shame is integral.  John Bradshaw (http://www.johnbradshaw.com/) is probably the shame guru,   if there is such a thing.  His book, "Healing the Shame that Binds You," is a New York Times best seller.  In it, Bradshaw points to "toxic shame" as the underlying cause of compulsions, addiction, co-dependencies, and the drive to super-achieve or underachieve."

Shame and guilt are often used interchangeably, which can sometimes cause confusion.  For my purposes, I've decided to distinguish guilt and shame as follows:

*Guilt is a bad feeling caused by the fact of having committed a specific offense.

*Shame focuses on the entire self.  It is a painful feeling arising from the judgment of oneself as dishonorable, disgraceful, disgusting, etc.

Thus, guilt is concerned with something specific a person has done.  The focus of shame is on the self as a whole.

Like most human emotions, shame can be healthy in small doses.  Shame can compel us to eliminate bad behavior and motivate us to act in ways consistent with our values.  Healthy shame fuels personal growth and so helps us to become better people. 

Too much shame is emotionally and psychologically toxic.  (Bradshaw talks extensively about this in his book).  There is significant overlap between the consequences of toxic shame and the symptoms of major depression.  Here are some of the ways toxic shame manifests itself:

*Causes you to feel exposed and vulnerable, creating a sense that "everyone knows" how disgusting you are.  This leads to a desire to hide, withdrawal, or otherwise escape from public view.

*Generates negative judgments about the self, which is seens as inferior, flawed, damaged, disgusting, worthless, etc.

*Creates a tendency to blame yourself when something goes wrong.

*Leads to a sense that you have a very limited amount of power to control what happens in your life.  This eventually leads to feelings of hopelessness and helplessness.

*Can create social anxiety due to fears that others will judge you as negatively as you judge yourself.

Essentially, chronic shame leads to self-loathing; self-loathing leads to depression.   I have come to believe that chronic, pervasive shame inevitably leads to depression.  After all, how could a person hate himself and not become depressed over time?