Thursday, August 2, 2007

Therapeutic Distinctions, Part Three

This is another in a series of posts highlighting conceptual distinctions that I find have therapeutic value in my psychotherapy practice as well as in my own life.

Caring vs. codependent
– For many years I hardly used the word 'codependency' at all in my practice, because it seemed to be so vaguely defined. I now use it to mean any excess reliance on the opinion of others to determine either the appropriateness of my actions or my worth as a person. While I now accept the usefulness of the term, I maintain a couple of reservations.

My first concern is that codependency best describes a process, not a person (see “nouns” vs. “verbs”, below). I can notice when my codependency issues are kicking up, but that doesn’t somehow make me something called a “codependent”. I think it’s very limiting and fundamentally inaccurate to turn a functional process into a definition of a person. My other concern about the concept of codependency is that it can pathologize caring about another person’s feelings. Sometimes denying personal desires in favor of another person can be emotionally and even spiritually rewarding. If I sacrifice my needs for yours I may be engaging in codependency, or I just might be busting out of the imprisoning limits of my “king baby” ego. As is the case for so many things, the definition is contextual.

Hurt vs. injury – Often in life, people will “feel hurt” or think that they have “hurt” someone else. I find it important to recognize the crucial difference between when something hurts and when it is truly damaging. The first is simply painful, while the second injures. If you say something that “hurts” me, it may be because what you said was particularly egregious, or it may very well reflect an exceptional degree of sensitivity on my part. Just because I feel “hurt” doesn’t mean that you did anything wrong. I’ve seen some people exert an awful lot of control in relationships by appearing very fragile and easily “hurt”.

Past vs. present tense
– I often witness people relating to themselves as the sum total of their past behavior. I agree there is a lot of truth in the adage “we are what we do”. But I have repeatedly observed how change in one area of our lives (i.e. “I’m living more honestly”) can bring changes in lots of unexpected areas (i.e. “I’m becoming more open with people”), and we limit ourselves too much when we define ourselves by our history (i.e. “I’m not good at making friends.”) Instead of saying “I can't do this", it’s better to say “in the past I haven’t been as successful at this as I’d like”. The point is that it’s important to leave room for the new possibilities that accompany personal growth. Effective therapy is going to expand your abilities and the range of what is possible in your life, and it helps a lot to make room for that in your self-view.

Noun vs. verb – Similarly, we all have a tendency to turn verbs into nouns. In other words, we take actions and "concretize" them into personal attributes. Examples include the difference between saying “I have a hard time paying attention” and “I have ADD”. It’s clear that sometimes labeling a behavior is very validating. The day I recognized that my difficulty recognizing faces had a name (“prosopagnosia”) was a very liberating experience for me. From a moral standpoint, the difference between “I’m a bad person” and “I’ve done bad things” is huge. Sometimes a person can use the the word "alcoholic" to begin utilizing all of the resources of the recovery movement. But sometimes people are so shame-filled and averse to the word it keeps them from addressing their problematic drinking issues. It’s important not to get too caught up in what we call a behavior at the expense of what we can do about it.

Loneliness vs. solitude – The Beatles sang about “all the lonely people”, and there sure are a lot of them. I recently read that the average American has only two good friends. But sometimes we can surround ourselves with company to avoid the sense of emptiness at the center of our own lives. It's important to be able to seek out and embrace solitude, the time to be with ourselves in order to discover and enjoy ourselves at a deeper level.
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