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An element of a good psychotherapy, the one which requires the most skill and psychological strength from the therapist, is our work at uncovering early childhood dynamics (archeology) impacting our daily patterns (dances).

Whatever brings folks to therapy, eventually, patterns from childhood become a centrally relevant part of the therapy. While we often wish our childhoods and original family relations were not so influential in adult functioning, we are commonly plagued by relationship dynamics we recognize as a direct response to our family of origin.

Why we repeat patterns from our families of origin

By interacting with us in very specific ways, and engaging with each other in very specific ways, over and over and over, our parents/care-takers and other family members teach us a handful of “dances”. These dances are so deeply ingrained in our psyches we don’t even notice what moves we are making, or that we are even engaged in a dance, much less that there are tons of other dances we could do instead if we wanted.

As we enter adulthood, we do our dance, ingrained in childhood, unnoticed like the air we breathe. As we do our dance, we notice, and get noticed by others who do a similar genre of dance as ours. This isn’t because it is our favorite type of dance, but rather because it is the dance we recognize, the dance that complements our moves. We find people whose moves complement ours so well, we become partners. Then we dance with those partners, get into fights about the slight differences in our dances, insisting they respond in a concordant or complementary way. We slowly teach each other to dance as we do. One day we realize we have each successfully created a version of whatever dance we had hoped we would never do again once we grew up.

This is referred to in analytic circles as repetition compulsion. Repetition compulsion is an unconscious process. There is debate about the psychic purpose, but in clinical work, it offers us an up close view of the client’s internal world, and the dynamics of our client’s early relationships. And for couples, once identified and unpacked, it provides access to incredible change.

Those of us who have had an intimate partner have lived the experience of feeling like our partner was perfectly matched to trigger our most primitive issues. Sometimes we think it is ironic, or absurd, or “destiny”. It is actually more mundane and common than that. It is this same phenomenon that results in us frequently finding ourselves in a repeating pattern with friends, bosses, and peers. It is not just that we attract and are attracted to a particular type of relational dynamic; we actually build the dynamic.

How psychotherapy can help us change patterns

When we work over a period of time in psychotherapy, a good therapist can feel the push of our dance moves on their psyche. This is the same push we unconsciously use to mold our partner’s behaviors, and to invite others to react/respond to us in particular ways. A trained therapist however, rather than simply react with a complementary or concordant move, is trained to “try on” the complementary dance moves “inside” themselves. The therapist can reflect upon the pressure they are feeling to respond a certain way, without actually responding.

Armed with this information they learned through these experiences in sessions, they can help us think about why we are seeking that particular response. Therapists can stay aware of the pressure to do our dance, and help us consider other possible dance moves. Over time we can open to consider other choices, other dances, other rhythms, beats and genres. We can start to make decisions about what moves we want to make, what moves we want to respond to and how, based on choice as opposed to habit or unconscious pull. We start to understand that we may choose what kind of dance we want to do.

Our built in responses are hard to chance. They are so ingrained, so instinctual. We will have to grapple with each new move, resisting the urge to fall into old patterns. But this is how we make real change; change that allows us to find more fulfillment in our relationships.

We often come to therapy for concrete issues related to relationships, life transitions, stressful work situations, or other external crises. What psychotherapy has to offer however is much greater. Its ultimate goals are fundamental shifts in how we see/experience/think about ourselves, our relationships and existence itself.



Smith is an analytically oriented psychotherapist with 25 years in practice. She is additionally the Founder/Director of Full Living: A Psychotherapy Practice, which specializes in matching clients with seasoned clinicians in the Greater Philadelphia Area.

If you are interested in therapy and live in Philadelphia or the Greater Philadelphia Area, please let Full Living: A Psychotherapy Practice match you with a skilled, experienced psychotherapist based on your needs and issues as well as your and own therapists’ personalities and styles. All of our therapists are available for telehealth conferencing by phone or video in response to our current need for social distancing.

Author Karen L. Smith MSS LCSW Karen is the founder and director of Full Living: A Psychotherapy Practice, which provides thoughtful matches for clients seeking therapists in the Philadelphia Area. She provides analytically oriented psychotherapy, and offers education for other therapists seeking to deepen and enriching their work with object relation concepts.

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