Off the Couch

Thoughts about the therapeutic process, and the dynamics of client-therapist interactions.

Trust yourself. What makes it hard and how you can get better at it.

Don't always trust yourself? Some ways you can change!

Some years ago I was working with a client who was expecting her second child. She was excited but worried, and her fears centered on the pain of childbirth. As was true of many of her past experiences, she could not remember much about the birth of her first child a number of years earlier, but she had a vague sense that it had been pretty awful. She was frightened of getting stuck in pain and not being able to do anything about it.

At the time I was also pregnant and a little worried myself. My obstetrician believed that too much pain was not good for mother or child and carefully explained how he liked to manage the discomfort. Still nervous, I spoke with a friend with several children who said, "You can trust your body. It will know how to do this."

It was a fascinating concept. While I knew that women had, indeed, been giving birth for thousands of years, I also knew these words would not help my client. My work with women with eating disorders had taught me how hard it is for many people to trust their bodies. The idea of eating when hungry and stopping when full was completely unattainable for these women.

Several years after this discussion I came across a useful book called "Intuitive Eating" ("Intuitive Eating: A Recovery Book For The Chronic Dieter; Rediscover The Pleasures Of Eating And Rebuild Your Body Image") by Evelyn Tribole and Elyse Resch which has some helpful exercises for getting in touch with your body's healthy messages about food. The book helped open up a dialogue between body and mind for some of my clients, but it underscored for me how difficult it is for many people to intuitively know when to eat, sleep or exercise -- even without an eating disorder.

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Freud introduced us to the idea that what we think we know about ourselves may have nothing to do with what is actually going on in our psyches. In fact, some of our behavior is directed by unconscious wishes or beliefs that are the exact opposite of what we think we want or believe to be true.

Recent neuroscience research has added to this sense that we can't always trust our thoughts and/or feelings to tell us what is going on inside of us. In fact, I sometimes think that brain research has just confirmed that sometimes the right hand literally doesn't know what the left is doing. Certainly the recently discovered information that the right part of our brain doesn't always communicate clearly or well to the left part (and vice versa) explains some of the confusion.

Of course difficulty knowing what we think or feel can be related to childhood experiences - painful memories we have pushed away; problematic tools for coping with feelings handed down from parents to their children (like using food to make ourselves feel better); inadequate, unempathic or hurtful responses to our developing self over the years. But it can also be simply a fact of human development. Sometimes even the best adjusted of us, having had good parenting and essentially good lives, may encounter a moment or an experience in which we doubt ourselves - in which we don't trust our bodies or our thoughts or our feelings or our competence to get through a particular situation.

What do we do then? Here are four ideas that have helped many of my clients over the years. Hopefully they will be useful to you:

1)Find people you trust: Surround yourself with them. The more you feel connected to and safe with the people in your life, the more comfortable you will feel with yourself. (I realize this is sometimes more easily said than done, but like everything else, it is a goal that takes time to reach. Check out #3.)

2)Put things into words: Talk, talk, and talk some more. Neuroscientists have shown that talking about what you are thinking and feeling to someone else, someone who is listening and who responds to what you say - not just reflecting back what you have said, but adding their own ideas and thoughts to the mix - can actually change the neurological makeup of your brain. It can help your right brain speak more clearly to your left brain, and your left to your right. It can help your unconscious become conscious, unrecognized beliefs to be recognized, and everything to get clearer. (Writing helps this process as well, but it might be even more helpful if you can share your writing with someone.) Of course, this goes back to the issue of finding people you can trust with these feelings.

Heinz Kohut, who developed the theory of psychodynamics called "Self Psychology," wrote that even finding someone we can trust takes work; and that trust doesn't appear instantaneously. We actually have to teach them what we need and how to give it to us!

3)Practice makes perfect: Like the old joke about how to get to Carnegie Hall, the key to all of this is "practice, practice, practice." None of us learns to trust ourselves magically or instantaneously - nor, in fact, should we! A perfect example is driving a car. We don't get into a car to drive for the first time with all of the right instincts ready to go. We take driver's ed, then we get learner's permits, and we practice - a lot. We get a lot of verbal instruction as well - "pull up closer to the stop sign, start braking farther back, don't brake on wet pavement, etc." And over time we put together the verbal information with the physical experience of actually driving, of watching out for other drivers, of learning what we can expect and how we can deal with the unexpected...and gradually (hopefully) we become mature, safe and trustworthy drivers.

4)Be trustworthy: If you want to trust yourself, be trustworthy with others. Try to give what you would like to receive, whether it is understanding, empathy, counsel, or simply a quiet presence. Try to recognize what your friends and family need from you and try to honestly give what you can, when you can - without sacrificing yourself. Setting boundaries is part of any caring relationship; and negotiating needs (yours, theirs, someone else's) helps you know and trust yourself, and helps others know and trust you as well.

So, whether you're trying to eat more consciously or start making presentations without panicking, you need to know that you won't get it right the first time (or the fifth or the tenth). When it comes to having a baby (and some other activities) of course, practice isn't exactly an option; so then the first two suggestions become more important. Surround yourself with people you trust - not just the professionals, and not just your loved one(s), but a combination. And talk, talk, and talk some more.

To go back to my pregnant client - as she talked with me, and with her mother and her friends and her partner, she realized that she did not completely trust her midwife. She couldn't quite put her finger on why, but she began interviewing other professionals and found someone she felt much more comfortable with. And while her anxiety did not disappear, it diminished to much more manageable levels.

And me? My child came early, before my husband and I had completed our birthing classes; but even though I didn't "know" what I was supposed to do, with the help of the professionals, a dear friend, and my husband, we did just fine.

What about you? I've found your responses to other questions so thoughtful and useful, I'd love to hear what you have to say about trusting yourself. What sorts of things have helped you develop it? What sorts of things have made it hard for you? Looking forward to reading your thoughts about this topic!

 

F. Diane Barth, L.C.S.W., is a psychotherapist, teacher, and author in private practice in New York City.

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