14. Foundations of Self-Esteem - RonaldMah

Ronald Mah, M.A., Ph.D.
Licensed Marriage & Family Therapist,
Consultant/Trainer/Author
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Mirror Mirror… Reflections of Self-Esteem in Relationships and Therapy
Chapter 14: FOUNDATIONS OF SELF-ESTEEM
by Ronald Mah





Low self-esteem creates a sense of insecurity and of helplessness, which compromises attempts at supporting others.  As with a house, the foundation is the key to a solid structure.  The foundation for creating solid self-esteem in a child is the psychological and emotional health of the parent(s).  For an adult individual- that is, in a relationship, a powerful influence comparable to the foundation is the psychological and emotional health of the other person, partners, or family members.  "In intimate relationships, there is a transformation of partners' attitudes, values, and beliefs, causing them to converge over time (Price & Vandenberg, 1980; Stephen, 1985).  Explanation for this increased similarity between partners is provided by what Levinger (1983) refers to as a circular-causal model of relationship development.  The key element of this model is communication through which there develops a cognitive interdependence between the relationship partners.  As partners interact, there is a mutual contamination of cognitive elements including values, attitudes, and beliefs (Berger, Berger & Kellner, 1973).  Their views of the world are subtly eroded, altered, and recast as they communicate and make changes to accommodate each other's divergent views.  As a result, the similarity between partners increases and there is a mutual construction of a shared system of meanings that define the relationship" (Schafer and Keith, 1992, page 5).

Mutually shared life perspectives and reciprocal support are characteristics of healthier relationships.  Similarities between individuals tend to be predictive of well-matched dyads, partnerships, or groupings with greater relationship satisfaction.  The validation of being loved, respected, and cared for by a like-minded individual would tend to raise a person's self-esteem.  Mutual reciprocal feelings or thoughts and complementary behaviors would also tend to raise each other's self-esteem.  "Not only do cognitive factors such as beliefs, attitudes, and values converge in an intimate relationship but, according to the tentative and modest evidence in this investigation of American couples, so does the self-esteem of the partners.  The force behind this convergence may well be close personal communication, which has the effect of changing perceptions.  As Berger et al. argue, 'Contact between different cognitive systems leads to mutual contamination' (p. 165).  In an intimate relationship, the passage of time leads to progressively deeper disclosure; as a result, a person changes his or her interpretation of reality to accommodate the partner's divergent views" (Schafer and Keith, 1992, page 8).

Ongoing intimate communication between individuals changes how they saw themselves and how they saw each other.  Intimate or involved individuals reciprocally and mutually contaminate each other's perceptions to create a new shared reality.  This occurs over time as the relationship is stimulated by new challenges at evolving stages of the relationship (for example, development from being a child-less couple to family with young children).  "These life stage changes require a repeated process of (a) an alteration of subjects' views of themselves and their spouses and (b) the reconstruction of a shared reality.  These changes also suggest an even greater convergence of partners' self-esteem and of partners' evaluation of each other than that which occurred in the previous family life stage, and they would account for the pattern of increased convergence across… life stages" (Schafer and Keith, 1992, page 8).  The dynamics of relationship that create convergence of self-perceptions, processes, and self-esteem may relevant to the relationship between clients and therapist.  Individuals in relationships develop attitudes, values, and beliefs that may not only converge together over time, but may also converge with the therapist's over time in therapy.  Client views of self and the person or people in the relationship change in the construction of a new shared reality facilitated by the therapist.  The foundation of therapy is often the health and stability, including the self-esteem of the therapist.  There are seven fundamentals to the foundation of self-esteem in all of these relationships.  The following discussion will focus on an individual and how he or she provides foundational support to his or her partner in the couple: for example, Terry for Bert and Bert for Terry.  However, the therapist should consider how the principles are relevant to the therapist as he or she provides the foundation of therapy.  That is, the therapist for Terry and Bert.  The therapist's mental health, emotional stability, and self-esteem affect his or her conceptualization, perception, and style of work.  Therapist counter-transference affects interactions with individual clients, but is often more activated in working with couples or families.  The therapist needs to be constantly vigilant about how and what he or she contributes to the couple or family's reconstruction of a shared reality.  The therapist should consider how the foundations of his or her self-esteem affect clinical judgment and work- that is, the couple or family's evolving relationship.  

I) KNOW ONESELF
When someone verbalizes or expresses in individual, couple, or family therapy, he or she is not always aware of the motivations and underlying core being exposed.  Some individuals do not look or look deeply into the mirror to become self-knowledgeable.  "…the therapist who pauses for reflection may quickly become a passive bystander to the onrush of brutal forces, sadomasochistic twists, the infliction of raw pain by two people locked in malignant repetitions or a severe breakdown of intersubjectivity.  At such moments, the couple therapist may feel impelled to act, to intervene unreflectively as a conscripted player in the drama.  As we noted earlier, each couple therapist, along with each member of the couple, brings to the table the psychic residue, or the demons, from a particular relational history that consists of not only a mother and a father and the subject's relationship with them but also a relationship between a mother and a father.  In all therapies, but particularly in couple therapies, we need to keep at the top of our awareness that one internalizes not only each child–parent dyad and its many iterations of affect, but also the parental relationship and its many iterations of affect.  This holds true for patient and therapist alike.  So, what happens when our countertransference experience lands us in the center of our own families of origin, where perhaps we revisit in our psychic interior the wrangling or the stalemate of our own parents?  Sitting with a couple as they shout at each other, withdraw, dig in their heels, and seem utterly incapable of listening to one another with recognition, we therapists can suddenly feel very small indeed, or helpless, or recruited to fix the problem" (Pizer and Pizer, 2006, page 82).

The world or the terrain upon which an individual's self-esteem is built, is full of dangers: emotional abuse, alcohol and drug abuse, hatred, bigotry including sexism and racism, domestic violence, poverty, economic uncertainty, ecological crises, and so forth.  The first step to build the foundation of self-esteem is to dig down.  An individual brings the totality of life experiences into every relationship: self-esteem, personality, temper and frustrations, intelligence, cultural background, values, multiple experiences, education, hopes and dreams, fantasies and illusions, goals, successes and failures, joys and traumas, media messages, relationship models, and so forth.  An individual often acts from the frustration of his or her life, anxieties of the past, anger in his or her soul, fear and pain of traumas.  He or she loses track of the needs of his or her partner or the demands of reality.  Supposedly addressing another person's, especially a partner or family member's needs for support, guidance, and boundaries, he or she may be actually dealing with personal ghosts, emotional and psychological turmoil and vulnerabilities.  The therapist may need to be assertive to get each individual to acknowledge, challenge, and overcome his or her ghosts.  These emotional and psychological issues interfere with the individual, couple, or family's relationship… also the therapeutic relationship.  This is the work often of individual therapy, but insight for each partner and each family member may be as essential to couple or family therapy.  Each person brings his or her awareness or insight or the lack of it into the relationship.  Individual awareness and insight become the baseline to health and growth.

II) BEING A MODEL OF SELF-LOVE
Terry had been married to Bert when he was drinking and using crystal meth.  They had two children: a 1 1/2 year old girl and a 6 year-old boy. For many years, she had accepted minor humiliations and occasional abuse from her husband.  Finally, after Bert had picked up the toddler and thrown her across the room in a fit of rage, Terry decided that it was too much.  She moved out with the kids and filed for divorce.  Her life was much more tranquil for a while.  The shock of his violent behavior and the divorce lead Bert to become sober.  His behavior with the children improved dramatically, but it was too late for him and Terry.  A few months later, Terry came to the therapist in tears but not about the divorce.  Her 6 year-old boy Matt who had always been somewhat difficult had become extremely abusive to her.  He was very disrespectful, cussed at her, and hit her.  This should have not been a surprise.  Terry had not loved herself enough over the years to remove herself from Bert's alcoholic and meth influenced abuse.  She had not valued herself enough to leave him for herself.  She had loved the children enough, that when they were endangered she removed them from the abuse.  Matt had observed all of this.  Now he too believed that she did not to serve to be treated with respect.  After all, Terry had never asserted that she deserved to be treated with respect.  In addition, Matt had observed the model of his father abusing her over these many years.  Now it was his turn.

Terry learned that her attraction to an abusive partner and vulnerability to accepting abuse were the consequence of her father abusing her.  Unfortunately, a person may still blame him or herself for not been good enough for the parent to love and to treat well.  Such a person often blames him or herself for not being good enough for a partner to love and to treat well either. With low self-esteem, the individual wants it to be better for the children. Ignoring personal pain, this person pours love and attention into the children.  Despite self-sacrifice, but Terry still failed the children.  If she loved herself enough to leave a problematic partner Bert possibly many years earlier, she would have been a model of self-love for the children.  A healthier person with higher self-esteem would have never allowed a partner to continue to abuse him or her.  Being a model of self-love is critical to self-esteem in children and between self and a partner.

III) TAKE CARE OF ONESELF…FIRST!
The underlying message of self-sacrifice is that everyone else and their needs are more important than oneself and ones needs.  Terry has submerged her feelings and needs to serve her husband and the children.  The individual can become a negative model of placing oneself second to others as Terry became to her son Matt.  When another person's- for example, the partner or children's needs are constantly raised to the highest priority over ones needs, that prioritized person can become a tyrant who demands to be serviced hand and foot.  Unfortunately, a common requirement is for partners and especially, women to care for others first.  This has been distorted to mean sacrificing personal needs- sometimes in total.  Men are often more acculturated to being independent and taking care of personal needs.  Women are often more acculturated to place their needs secondary to others, especially children's needs and often the spouse's needs.  Unfortunately, sometimes this means that the wife/mother or social or work colleague puts herself at the bottom of the list.  Sometimes, functionally, she is not on the list at all!  The therapist may run into significant cross-cultural complications attempting to promote this principle.

Invariably, an individual is at his or her worse when depleted emotionally, physically, intellectually, and spiritually.  Bert in the grip of his substance abuse issues was disabled as a husband and father.  Terry was diminished dealing with ongoing abuse and stress.  He or she may become unavailable and unable to meet other people's needs due to personal challenges and disruptions.  Worse, the individual can further destabilize the relationship with his or her problematic responses.  Such an individual is fundamentally disabled and/or distorted in building the other person's self-esteem.  He or she has not taken care of self and has trouble liking or loving oneself. An individual who has had a difficult life and has low self-esteem, may seek to take care of others but not him or herself.  Lack of self-esteem is essentially inability to self-love.  Terry had been an outstanding caretaker of her children, her husband, and just about anyone in her social or work circles- anyone she loved or cared for, but not of herself.  Human services professionals can be prone to do this in their work.  The therapist might compromise personal and professional self-care: being available after hours, changing schedules despite inconvenience, stepping outside scope of competence and scope of practice, or being drawn into ethically questionable behavior to assist or care for a client.  Failure to taking care of oneself becomes a boundaries failure that harms everyone eventually.  An individual cannot truly take care of others, partners, or family members to the degree and effectiveness desired because of his or her own unresolved personal issues.  The best thing an individual can do to support another is to care for him or herself.  The first three blocks or parts to the foundation: knowing oneself, being a model of self-love, and taking care of oneself first have to do with personal self-esteem.  

IV) BE AVAILABLE
An individual needs to truly know him or herself, including hang-ups, temperament, and ghosts, and love and take care of him or herself.  Then he or she can follow through on the fourth part of the foundation of supporting self-esteem in another person.  An individual can be emotionally and physically available to important intimate others.  An individual cannot be available however if still overwhelmed about who and what one is, consumed by self-hatred, and holding a sense of being not taken care of.  Being available requires emotional, psychological, cognitive, and spiritual stability.  Intense internal processes including anxiety and insecurity distracts the individual from duly attending to another person's needs or issues.  The individual may claim and want to be available to the other person's needs and issues, but personal psychic turmoil can be more compelling.  The other person may not realize there are distracting and compelling issues for the individual, but only knows that he or she really counts and matters to the individual.  As much as Terry tried to nurture and support her children and others, she was also prone to become distracted or even disassociate because of unresolved disruptions and distress within her.  Periodically, she is there but not there.  The same was true of Bert during his substance abuse era.  They both risked remaining or becoming unavailable if their co-parenting collaboration became highly stressful.

A person gets basic psychological and emotional security from the individual being emotionally and physically available to him or her.  Proximity and validation basically form the premises of child attachment theory and adult attachment consequences.  The important variable for positive or negative outcomes in adulthood is the presence of emotionally available adults- in particular male figures in childhood.  This is not to minimize female attachment figures.  However, female figures are more commonly present given the cultural traditions of parenting the United States, thus more of a given versus male figures emotionally involved with children.  Terry readily identified with maternal roles, while Bert tended to be traditionally paternal with less emotional involvement.  In many societies, if the father is economically present, that is, a good provider, it is considered adequate fatherhood.  Emotional availability is not as required culturally for many males.  In some cases, emotional connectiveness to children by the father may even be discouraged.  Emotional detachment has had major negative consequences to the self-esteem of children and eventually to adult intimacy.  However, emotional distance or disconnection is not characteristic of all men, and can be an issues for some women as well.

CONTRACT OF AVAILABILITY
An individual might know or learn in therapy that the other person, partner, or family member does not necessarily want attention, but instead are checking on his or her availability.  The individual can do one of two things: one, give availability verbally and/or non-verbally; or two, offer and assert a reasonable contract of availability.  All the individual may need to do is to give a smile, make a quieting gesture, and perhaps touch the other person lightly as is appropriate depending on the relationship.  In doing so, availability is given through affectionate touch.  Once acknowledged, the recipient or person requesting availability may be able to tolerate waiting for a reasonable time to interact.  On the other hand, if this is not practical or does not satisfy the person, then the individual can offer a contract of availability to be exercised shortly.  Excusing oneself for a moment, the individual can say, "I need to talk on the phone for a bit.  When I'm done, I can do that for you."  Or, "Give me a minute and I'll be with you."  The therapist can teach contracts of availability that put a boundary or a time frame within the near future.  There is often not a compelling reason for the other person's needs or demands to be met immediately.  An individual should be available to another person, especially the partner or family member, but not 100% available.  A contract or offer of availability honors the other person's needs, but also asserts the individual's need to have private moments.  This also reconfirms the individual's availability without having to jump when another person asks him or her to jump.  Following through after the delay is essential.   The individual should add, "And, if I forget after I finish, be sure to remind me to do that…. OK?"  By saying this, the individual empowers the person to enforce the contract of availability because sometimes, an individual forgets.  The "OK?" at the end of the statement, seeks the affirmation that the contract has been understood and accepted.  The other person often accepts this without difficulty.  He or she has been heard, the availability has been confirmed, and he or she has been empowered.  

If on the other hand, the person making a request might still insist on demands to be met immediately.  Then the individual with clarity and confidence that he or she has been reasonable about boundaries and respectful can feel perfectly OK about asserting time and space for him or herself.  "Yes, I'm available.  Yes, you count.  No, you don't matter so much that I don't count!"  100% availability implies 100% vulnerability as well.  It implies that the other person is helpless without the individual to intervene and save him or her from problems.  100% availability disempowers the other person, partner, or family member.  It denies the essential struggle the other person needs to experience that one is not a victim to stress and circumstances.  This is a reasonable relationship contract and should be enforceable through the therapist's intervention.  It would however be somewhat to completely intolerable to a person with borderline tendencies.  Someone with borderline issues often cannot relate to the individual's need for self-care, manifesting in boundaries for availability.  "…the lowest degree of empathic accuracy occurred in the case of situationally-induced self-focused attention and in the case of abandonment of attempt to control.  Here, the other person's mental condition, his or her intentions, feeling, and emotions get 'out of focus' for the observer, and decoding becomes distorted" (Trommsdorff and John, 1992, page 52-53).  His or her vulnerability may be so profound that he or she will interpret the boundary/contract as betrayal, abandonment, or rejection.  If therapy runs into this reaction, the therapist would need to help the individual, couple, and/or family address his or her borderline issues.

V) SEPARATE- THERE'S TWO, NOT ONE
The therapist should consider encouraging the individual, each partner in the couple, and family members have independent activities.  When they were still married, Terry often defined herself as a mother to the kids, and second as Bert's wife.  As a result, most of her attention and activity revolved around doing things for them.  She did little for herself.  Now divorced, she still tended to submerge her needs to the children's.  Being separate comes from personal resiliency and security that the intimate other can be and still is available if truly needed.  Self-esteem needs to be from the individual's ability to have power and control, the ideal and real self, respect and love, and a sense of competence.  If self-esteem rises and falls with the other person's accomplishments and mood, then the individual is not successfully separate.  Of course, a major part of individual self-esteem will normally be based on being the kind of partner, family member, or colleague he or she seeks to be.  This is expressed in the kind of person the other person is as well.  When the individual is able to know, love, and take care of him or herself, and be emotionally and physically available, then he or she can transcend personal issues and learn how the last two keys to building the foundation of self-esteem.  

A significant caveat compromising or blocking an individual's ability to separate and have separate activities and interests would be certain personality disorders.  Individuals with borderline or dependent personality disorders in particular compulsively merge with partners and other intimates.  They not only may strongly resist separating from another, but also become threatened when the other person attempts to have independent experiences or a life of his or her own.  As with all interventions or strategies that are conceptually sound that should work, the recommendation to separate will work… unless, there is more to it.  This includes the first four foundations to know oneself, self-love, self-care, and being available and the foundations to be discussed.  There may be underlying issues making hard for someone to know oneself, self-love, self-care, or be available.  Being able to separate may stir up complex issues.  The individual, couple, or family that is unable to separate and have independence within relationship dependency or interdependence demonstrates to the therapist that there is more to it.  This becomes a diagnostic cue for therapeutic attention for the individual, couple, or family- that is, within the relationship.

VI) DISTINGUISH LOVE AND LIKE
Many loving individuals get caught in the dilemma of distinguishing love and like.  The individual feels that loving his or her partner or other person also means that he or she must always like the partner or other person.  And, try as hard as one can, there are times when the individual not only does not like the other person, he or she also forgets he or she loves the other as a partner, family member, or friend.  An individual might find this so disturbing that he or she tries to deny the reality to him or herself and to the other person.  However, the other person can still feel the anger.  The individual who does not acknowledge that he or she projects impatience and upset at the other person, denies that person's reality. The other person subsequently experiences the individual as being hypocritical.  Or, the double messages confuse the other person.  Instincts and experiences of not being liked are contradicted by the individual's insistence that he or she still likes the other person.  

A grandiose overly romantic ideal self asserts that the caring individual keeps love in his or her heart so purely that he or she can never lose that love even temporarily.  That he or she could not ever not like the other important, partner, or family member.  Being in love is not about being a saint or superhuman.  A partner may know that the other partner might never fall out of love with him or her, but does occasionally fall out of like with him or her.  The stress of the moment can make either partner forget the love that ironically initiated the relationship in the first place!  This is normal and human.  The individual needs to accept his or her humanity, knowing that the core love will not be tarnished or forgotten forever.  While love may or should be unconditional, "like" can be transitional and much more conditional.  It is OK not to like ones partner or another important intimate person sometimes.  Disliking behavior or naming the behavior as "bad" may bring up intense anxiety.  As a child, an individual may have been taught that his or her behavior was his or her essence.  However, a good person can make mistakes.  The individual needs to distinguish between the essence of the other person and his or her behavior.  The individual can unconditionally love the other person, partner, or family member but dislike or even hate his or her behavior at times.  The therapist emphasizes that it is permissible and even normal to get mad at another intimate person, and briefly forget love and history.  Less likely to be disabled by some disturbing phrase or behavior, the individual can take a transgression as an opportunity to learn how to be upset while asserting boundaries.  The therapist should constantly seize upon these problems as opportunities to challenge, teach, train, and change the relationship.

VII) UNDERSTAND THE OTHER
"According to the model of Gaelick, Bodenhausen, and Weyer (1985), a 'correct' decoding of a communication takes place when the sender's message corresponds to the interpretation of the recipient (cf. Gottman et al., 1976).  The authors conceptualize an interaction between two persons as a series of communicative acts.  Each communication consists of a verbal statement or a series of statements accompanied by various nonverbal cues.  One communication can simultaneously express specific emotions of the communicator and produce emotions in the recipient.  The model distinguishes between five parameters:

1) Intent, the affect or emotion that the sender intends to convey to the recipient

2) Perceived intent, the recipient's perception of the sender's intent.

3) Reaction, the recipient's affective reaction to the communication.

4) Expected reaction, the sender's expectation of how the recipient will react.

5) Perceived reaction, the sender's perception of how the recipient actually reacted" (Trommsdorff and John, 1992, page 45).

The therapist can check with the sender of the communication and with the recipient for intention, perception, and reaction.  Two individuals, even two partners (perhaps, especially two partners with difficulties) may not ordinarily check with one another.  The therapist should teach individuals in a relationship to check intentions and perceptions with each other regularly.  The lack of such consistent and timely check in behaviors had left each of them with negative assumptions that had corrupted their marriage.  Therapy had become a weekly check in time for Terry and Bert, but they needed to create more such times in their co-parenting relationship.  With the six discussed principles and regular check-in, an individual is more likely to communicate more skillfully and to interpret another person's communication more accurately.  Intent, perceived intent, affective reaction, expected reaction, and perceived reaction become congruent. Now possibly the individual can actually understand the other person and vica versa.  These issues: knowing oneself, being a model of self-love, taking care of oneself first, being emotionally and physically available, being able to separate, and distinguishing love and like need to be addressed.  From these processes, the individual gains enough clarity to accurately decode another person or his or her partner or family member's needs, moods, physical states, emotional states, and temperament in relevant environments: physical, social, emotional, familial, peer, and school or work.  Otherwise, unresolved intrapersonal and interpersonal issues will continue to obscure that understanding.  A strong foundation of self-esteem and understanding enables the individual to best understand the other person.  

In the book, "The Wizard of Oz," (L. Frank Baum, 1900) before entering the Emerald City, Dorothy and all other visitors and residents had to put on deeply tinted green glasses.  With the green lenses, everything that she and everyone saw looked green no matter what their actual colors were.  It was a trick of the Wizard's to make everyone think that the entire city was made of green emeralds.  Often there is a trick of stress or trauma that causes an individual see everything in a certain light or tone.  The filter of his or her own issues distorts the individual's comprehension.  Or, the individual will deny information contradictory to his or her prejudices.  The therapist needs to address such prejudices and promote growth in the respective individuals' cognitive and empathic accuracy.  "Ickes et al. (1990) understand 'empathic accuracy' as '(a) a skill, ability, or facility (b) to understand, apprehend, infer, interpret (c) with accuracy (d) the private, covert, subjective (e) phenomenological reality, mental experience, thoughts and feelings (f) of some other person(s)… However, besides the cognitive ability to understand the feelings of the other person correctly, the motivation to decode correctly should be taken into account" (Trommsdorff and John, 1992, page 42)

For example, Terry's prejudice anticipating that Bert would be harsh, punitive, and dismissive for her forgetting to tell him about a teacher conference would not allow her to hear it any other way.  On the other hand, Terry can learn, with the therapist's assistance to recognize how her harsh, punitive, and dismissive experiences in childhood with parents have sensitized her.  By resolving Terry's fear of being hurt again and finding reassurance of Bert's positive intent, Terry becomes more likely to emotionally and intellectually be in tune with him.  The therapist can teach various exercises for improving better understanding between individuals.  The therapist may model for the individual, couple, or family in session.  "the couple therapist must exercise reflective listening, a state of listening that sustains mentalizing space for the practice of 'having a mind of one's own and holding the other in mind.'  The couple therapist's practice of reflective listening to those emergent pressures that would prompt him or her to jump into the dynamic system as an active player helps to keep the therapist, as much as is humanly possible, situated in a mindful and more reliable sideline position from which to offer holding, inquiry, interpretation, and guidance.  This disciplined monitoring of self is the couple therapist's (as it is also the analyst's) own constructive use of the revisiting of scenes from childhood, but with the benefit now of reflective listening and reflective functioning" (Pizer and Pizer, 2006, page 83)

The therapist can direct attention of the individual to another person feelings and desires.  Focusing the attention of the individual on the other person improves decoding accuracy of intended emotions.  Not surprising, women were better at identifying other people's including others' emotions.   Situations that prompted focus or attention also improved accuracy.  An individual that has an explicit orientation to other persons enhances empathic accuracy.  "Such an orientation is related to certain personality variables like 'femininity' and 'secondary' control orientation and can be induced by certain situational conditions like focusing on the partner instead of oneself… In the case of 'feminine' and 'secondary' control orientation the goal is to behave in accordance with the environment (accommodation)" (Trommsdorff and John, 1992, page 52-53.  "Feminine" and "secondary" control oriented individuals are less focused on themselves and thus, are more attentive of others and decode them more accurately.  This clearly implies that a selfish or egocentric individual would not be as in tune to or understand others, including his or her partner.  The therapist can elicit the individual's observations and interpretations of others.  In couple therapy, this would be observation and interpretation of his or her partner, which the therapist can then challenge by having the partner give feedback.

Exercises in therapy to improve interactive communication can be augmented if the couple or family practices skills such as reflective listening at home.  The therapist might do something comparable with a client in individual therapy.  When interactions in session get out of hand, the therapist can intervene by shifting from the specific issue or emotions that have been ignited.  Refocusing on meta-issues of communication provides a space for individuals to "reassess, or recognize, the present situation away from the immediate crisis that has evoked the old habits of mind—those pockets of defensive dissociation that have long since outlived their original usefulness for the protection of psychic integrity in an earlier relational context" (Pizer and Pizer, 2006, page 83).  The therapist often permits arguing to continue for a short period in order to observe the individuals' dynamics.   However, he or she should not allow the individual, partners, or family members to simply duplicate household negativity in therapy.  The individual, couple, or family looks to the therapist to interrupt their negative process.  Analyzing each individual's dynamics and the dysfunctional process facilitates intervening in the heat of the battle and provides cognitive understandings for the individual, partners, or family members to use to interrupt later interactions.  Promoting greater understanding of one another and of the relationship dynamic is a goal of many therapies- for example any number of insight oriented therapy.  Being exposed to or having the opportunity to learn about each other may merely require the therapist to ask pertinent questions and offer some interpretations and insights.  However, the therapist may find getting individuals to the point of being able to understand another person or each other may take significant therapeutic work.

ADDRESS:
433 Estudillo Ave., #305
San Leandro, CA 94577-4915
Ronald Mah, M.A., Ph.D.
Licensed Marriage & Family Therapist, MFT32136
CONTACT INFORMATION:
(510) 614-5641 or (510) 582-5788
fax: (510) 889-6553
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