When I hear a patient say, “Part of me wants [such-and-such]; but part of me wants [this-and-that ]”; or “Part of me feels (something-or-other), but part of me feels (something else) — I know that we've got some basic work to do.. 

My wisest mentor, the legendary Professor of Psychiatry, Dr. Elvin Semrad, used to say:  “Everything has a cost.”;  “What are you willing to pay for what you get?”; and “You have to buy peace between your head, your heart, and your body.”  And he reminded us that, on the bottom line:  “We have three choices in life: to kill ourselves, go crazy, or learn to live with what we have in life.” 

When a person says, “Part of me wants ….”, he/she is formulating a structure that from the get-go emphasizes division and conflict, and frames the resolution of the matter at hand as requiring the inevitable subjugation of “part of the self.”  It is apparent to me that this false construct is actually a form of resistance to the inevitable sadness to be felt by the whole person taking on the task of making peace with what he/she has in life.  Choosing means giving up other options, with whatever sadness and grief may follow.  Semrad emphasized, simply, “It is sad and painful not to have what you want.” 

In the course of this work, I find myself commonly saying, “All things considered — ALL THINGS — what are the issues at hand,  the options, and the costs?”  The patient who holds on to the “part of me” structure quite regularly persists in presenting the positive features of one set of options, and then flips to presenting the positive features of the conflicting set of options, thus down-playing the consequences (and costs) of either.    

One of my patients frequently gets hung up obsessing about what might be “the right decision” about whatever.  This pattern is another resistance to taking the responsibility for choosing, for going “all in”.  Finally, no matter how much we may know about the consequences (and costs) of a particular choice, some element of uncertainty is inevitable. Each choice we make requires the courage to step with all of our parts, with our whole being, into the creative uncertainty of life.

References

Rako, S, & Mazer, H. (2003). Semrad: The Heart of a Therapist. iUniverse.

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