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“What is wrong with me”? “Why do I do this to myself”? “Why do I keep making the same mistakes”?

These are common questions clients have when talking with a psychotherapist. Or a friend about an incident we are upset about. Or to our journals or the universe. It is a plea to understand. Sort of.

“Sort of”, because it isn’t really a question. It is rhetorical, meant only to judge and shame us. It isn’t meant to be answered, but to stand in judgment over us, accusing us.

The questions aren’t inherently bad ones or even cruel. Imagine them spoken is a soft and curious tone, one seeking a complex, as yet undiscovered answer, an answer buried in a multi-layered unconscious mind with a long history of self-protection, defenses, injuries, and compromise formations. Go ahead. Ask the questions kindly, with a conviction that there are knowable answers to even our most baffling behaviors.

  • If we have a goal to know and understand ourselves, we must change how we ask these questions.
  • If we have a goal of changing our most entrenched behaviors, we must develop genuine curiosity about them.
  • If we have a goal of developing healthy self-esteem, we must stop shaming ourselves about the painful reality of our drive to repeat destructive behaviors.

I understand that sometimes we feel like judging ourselves and others. I can totally enjoy sitting around with a good friend and trash talking. What that requires though, is that we take nothing into consideration: not the person’s current life stressors, not their familial history, not possible trauma and losses, or anxieties. Nothing. Just looking at their behaviors and judging them.

As a therapist, it is really easy not to judge behaviors. We are already in the conversation with a goal of understanding. When we are interested in understanding something about human behavior, we must consider as much of the whole picture as is discernable to us. We must be open to a widest range of data.

Case Example

Last week I meet with a client burdened by his repetitive selection of broken women who need him to heal them/hold them together/take care of them, with no regard for his own needs to be taken care of. He is new to the therapeutic process, so I was not surprised when he started in on his tirade against himself, about what an idiot he is, how he is clearly a glutton for punishment, and his pop psychology notion that he must like what he is doing or he wouldn’t keep doing it.

Now his pop psychology was trying to direct him in the right place, but it still had too much judgement. We do repeat things for reasons. Complex reasons though; not just to torture ourselves.

The answers to our repetitions are most commonly in our childhoods. It is there that we learned the dances of life and we will attempt to recreate the same dances/relational patterns with everyone we meet. (For more on Relational Pattern Repetitions)We could also understand our drive to repeat as a wish to repair; essentially that we are driven to recreate a similar circumstance so that we might repair the original injury.

My client’s mother died when he was in adolescence, right when he should have been launching into increased independence. His father had already been a fairly emotionally fragile man. Upon the death of his wife he was hardly able to function. My client could barely connect to his own grief at the loss of his mother, as basic survival required that he try to help his father manage debilitating grief and sadness. During this time known for fragile self-identity, he became identified with the role of caretaker. He was compelled to keep his dad standing, which meant setting aside his own needs and focusing on supporting his dad. This became tied to his self-esteem, sense of accomplishment, and feelings of well-being and security.

As adults, we can go through periods where we set aside our own needs to care for the needs of another, without losing a sense of ourselves. But that is because we have a known self to hold on to. The roles we play in our families in childhood easily become attached to self-identity. They become like the air we breathe, not even discernible as made up of distinct behaviors/thoughts/perspectives.

My client keeps choosing women who need him to take care of him for many reasons, but all are tied to this early life experience. He chooses them because before they become burdensome to him, their need for him makes him feel useful, powerful, in control, good about himself and his role as the stable one. It also allows him to avoid his own feelings of fear about the daunting nature of life, his own neediness and fragility.

For him to stop this repetitive relational choice, he must link it to his role as his father’s caretaker. And then he must do the hard work of grieving the loss of self that entailed. His must mourn his own adolescence, rage against the awful abduction of a typical adolescent pre-occupation with self, face and hate and forgive his father’s frailty. This grieving will aid him in seeing his worth and power beyond his caretaking. It will help him face his terrible fear of his own frailty, and the frailty of others, so that he won’t compulsively move in to rescue.

Grieving the experiences that negatively impacted our development and have become barriers to building the love and life that we desire is not a one shot deal. We need to grieve them deeply, over time, and then again months and years later as we bump up against newly discovered ways they are still directing our behaviors, or when we hit a new stage of life/love/self-understanding and need to catch our grieving up with our new stage of development.

So, back to the beginning. We should never stop asking ourselves why we are stuck, why we repeat. But we should ask with kindness and tenderness in our hearts, because the answers, if faced genuinely, carry a long history of pain and loss.



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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