It took me a long time to be able to start accepting responsibility for my mistakes — not just automatically saying I was sorry for the sake of keeping the peace — but actually owning up to the errors I had made and acknowledging that I alone had dropped the ball and should have done better.

Realizing that I was afraid of rejection, anger and repercussions I often kept silent when someone discovered an error I had made choosing not to own up. Fortunately I never went so far as to blatantly blame someone else. (Except maybe my brother when I was 6 and he was 5.)

As a child I was so afraid of losing my parents' love and approval that I developed the habit of trying to be perfect; if I couldn’t live up to that self-imposed standard then when a mistake was discovered, I attempted to make myself invisible. (Recall, later in my live I developed anorexia — with the objective of shrinking my body with the impossible aspiration of disappearing.)

I regret how long it took me to discover that accepting responsibility is freeing. Because then the ordeal is over. There is no playing the situation over in your head, no constant worrying that you’re going to be found out, no obsessing that your mistake is going to come back to haunt you during the year-end recap.

Additionally, you earn the respect of your family, your friends, and your co-workers. When you are able to say, “I’m sorry. That was my mistake. What can I do to fix it?” that garners a certain amount of admiration for its straightforwardness. Of course, then you have to follow through on your promise to correct the error.

Sometimes, things aren’t so easy to physically fix, but one can still verbally accept responsibility and acknowledge the damage that has been done. Patients sometimes miss appointments and don’t call to cancel. That’s unfortunate because if I knew ahead of time that they weren’t coming, I could have scheduled someone else who needed to be seen in that time slot. When I see the patient the following week, they could (and sometimes do) acknowledge that it was irresponsible of them just not to show up without calling.

At that point, I can’t reverse time, but I can accept their apology.

How can I help a patient who insists on abdicating responsibility gain some insight into their behavior? I ask them how they would feel if someone did that to them. I ask them if they were a customer service representative working for Public Assistance and they picked up the phone and someone on the other end started screaming at them and cursing them out, how would they react? Would their inclination tend towards being kind and understanding? Or would it be towards being defensive?

Often the first response by the client is “You don’t know what they (Public Assistance) did to me.”

I reply “Put that aside for the moment. Neither does the person on the other end of the phone. He or she just answered and they hear someone screaming and cursing at them.”

I might imitate for effect. How would you react if that were you? I let that sink in.

Sometimes they get it and sometimes they don’t and the behavior continues. That’s unfortunate because conduct like that will continue to have negative consequences until something explodes or implodes. I will revisit it because there will be more incidents and I will try to help my patient see the patterns and repetitive cycles.

I attempt to set an example for my patients. If I err in the therapeutic relationship, I apologize and explore with my patient how my mistake affected them. As with other relationships, it’s better to get these things out into the open right away otherwise they linger and contaminate the quality of the relationship.

People appreciate honesty and the accepting of responsibility. We are much more likely to face antagonism when we lie or try to hide our errors. It took me almost fifty years to learn that.  I hope it doesn't take fifty more for another revelation.

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