1. Neurosis & Reality Check - RonaldMah

Ronald Mah, M.A., Ph.D.
Licensed Marriage & Family Therapist,
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1. Neurosis & Reality Check

Therapist Resources > Therapy Books > Ghost Guest Family Past
Neuroses come from very negative prior experiences.  Neuroses are anxious assumptions that previous bad outcomes are applicable to new situations.  Prior severe punishment from upset attachment figures anticipates severe punishment from an upset but non-punitive and nurturing authority figures.  Similar misinterpretations may occur as an adult when receiving the adult partner's social cues of assertion or aggression, discomfort, anger, and so forth.  An individual needs an abundance of positive reparative experiences to countermand an abundance of previous negative experiences.  The therapist needs to facilitate frequent reality checks regarding cues and behaviors of partners in a couple to counter neurotic filters.  Neurotic reactions include:

being defensive, "I didn't do nuthin'!"

projection, "You're the one who's mad!"

misinterpreting intent, "My partner always is being mean to me!"

making accusations, "He or she never lets me do anything!"  

Since personal history often includes negative experiences, therapy facilitated reality filters may initially target refuting the absolute modifiers: "always," "never," and "all the time," and contesting the assumption of unjust repetition conveyed by the word, "again."  Absolute modifiers indicate inevitable doom.  "Again" implies repetition of injustice, rather than behavior being reasonable or consequential to current circumstances.  "Again" also ignores responsibility of the complainers for current circumstances.  Accepting partial influence, power, and control mitigates negative consequences, and help counter neurotic doom.  Learning choices, in addition to recognizing false interpretations interrupt neurosis.  When the individual can recognize doom thinking,

"It must be… I will be… They must be going to… always… never… all the time…"

then, he or she can substitute,

"It might be… I might be… They might be going to… or not!  Sometimes… too often…"  

"Must" asserts neurotic interpretation as reality.  "Always," "never," and "all the time" deny other interpretations and assert unalterable past, current, and future duplication.  The couple's therapist will recognize these terms as indicative of dysfunctional relationships.  A preponderance of such terminology will often be predictive of a significantly more difficult therapy process.  Salome was using "must" literally as well as figurative asserting absolutes about Pauly when she complained to her therapist.  Her therapist picked on this semantic cue.  The therapist should attempt to substitute more hopeful and less stuck language.  The terminology change is part of a more involved process to change underlying assumptions, interpretations, and beliefs intrinsic to poor relationship dynamics.  "Might" prompts examining neurotic assumptions against reality.  "Sometimes" and "too often" asserts displeasure without doom (hope is allowed!), acknowledges positive experiences, and implies the possibility of increasing positive frequency while decreasing negative frequency.  An individual who has been habitually victimized often becomes unreceptive to being empowered if caught up in doom.  Reality may include frequent victimization, but neurotic interpretation expands helplessness across the individual's complete experience: past, present, and forever.  Helplessness is a relationship and therapy deal-killer.  Growth and change are automatically excluded as viable outcomes to therapy and the client's process.  Identifying even limited power, control, and competence versus neurotic self-definition as victims is a critical first step to empowerment and change as an individual, couple, or family.  

If a person has difficulty visualizing healthy relations, the therapist still needs to challenge the neurotic assumptions by prompting alternative interpretations even if they initially may be largely out of reach.  Positive experiences that counter-balance negative experiences enable the individual to be more in tune with reality or potential rather than neurotic interpretation.  These positive experiences can occur both in the individual, couple, and family's relationship history and often in each person's prior relationship history however rare or inconsistently.  While children develop their relationship instincts and behaviors within the family, the leadership of the family- that is, the parents bring their family-of-origin models into this system for good or ill.  The adult parents define what is, is not, and what should or should not be for everyone.  An individual, partner, or family member who has internalized non-neurotic and positive expectations will be more able to interpret reality or at least consider other than a problematic replication of prior negativity.  Personal history of stability and reasonable outcomes positively affect the sense of emotional and personal security, as well as inter-relational skills.  "…both males and females, those classified as secure expressed significantly more respect, used more negotiation, were more open, and expressed less dysfunctional negative affect that those classified as insecure" (Wampler et al., 2003, page 505).  The therapist may attempt to create such interactions in therapy as the initial avenue for positive experiences.  Positive therapy experiences- a type of intimate relationship can precede and activate positive experiences in the relationship.

3056 Castro Valley Blvd., #82
Castro Valley, CA 94546
Ronald Mah, M.A., Ph.D.
Licensed Marriage & Family Therapist, MFT32136
office: (510) 582-5788
fax: (510) 889-6553
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