Essential Secrets of Psychotherapy: What's Love Got to Do With It? Part One
How psychotherapy helps with "intimacy inhibition" and "love phobia."
Posted Sep 30, 2011
For psychoanalyst Erich Fromm, this task of becoming or being the right person is absolutely central to the psychotherapy process in general and, moreover, underlies most if not all of the patient's psychosocial problems: "Whatever complaints the neurotic patient may have," says Fromm, "whatever symptoms he may present are rooted in his inability to love, if we mean by love a capacity for the experience of concern, responsibility, respect, and understanding of another person and the intense desire for that other person's growth. . . . Analytic therapy is essentially an attempt to help the patient gain or regain his capacity for love" (Psychoanalysis and Religion). How does psychotherapy help patients in their search for love? What are the optimal conditions for finding true love? What does it take to cultivate and sustain loving relationships over time? And how prominent a part in the psychotherapy process does love really play?
As children, we are all born deserving of love, and desperately need it for our very survival. But, sadly, sometimes tragically, we don't all get the kind of real love we deserve. Indeed, few of us do. Not because we don't deserve it. Rather, because our parents or caretakers--for reasons that vary from death or divorce to substance abuse to neurosis to personality disorders to traumatic circumstance--are unable or unwilling to consistently provide it. At least, not enough of it. Such parents fall short--frequently far short--of being what D. W. Winnicott called "good enough" mothers or fathers as regards the ability to express and provide real love to their children. By "real love," here I mean three essential things: Unconditional acceptance: not of every behavior, but of who we basically, temperamentally and uniquely are. Appropriate limit-setting, boundaries and discipline, all of which are indispensable expressions of such "real love" on the part of parents and caretakers. And, thirdly, this "real love" consists also of a deep capacity for concern, constancy, stability, respect, empathy, warmth, compassion and the maturity to place, when appropriate, one's own personal needs and desires secondary to those of one's children and what is in their best interest. Without receiving such real love regularly from at least one parent, developing into a fully-functioning, loving adult is much more difficult. But certainly not impossible. Indeed, this is one of the most ubiquitous issues psychotherapists see: what we might term intimacy inhibition.
Intimacy inhibition has to do mainly with the marked fear and avoidance of emotional intimacy. Specifically, the vulnerability, insecurity, anxiety, passionate emotions, loss of control, dread of being engulfed, devoured, penetrated, castrated, suffocated, overpowered or abandoned, as well as vast potential for rejection true intimacy inevitably entails. Fear--especially fear of "the feminine" or fear of "the masculine"--frequently informs intimacy inhibition. (See my prior post.) As can the primal fear of the unconscious in general. Interpersonal trauma of some type is almost always historically present. Paradoxically, true intimacy requires a strong sense of self, good personal boundaries, and healthy self-esteem. When these qualities are not present, typically as a result of having never received sufficient real love during childhood, true intimacy is just too threatening to accept or allow. Consciously, we may seek it. But unconsciously, sometimes very subtly, we sabotage it or run at real intimacy's first appearance. This is why so many psychotherapy patients (and non-patients) have such difficulty dealing with dating and romantic relationships. They are afraid to love and often don't feel worthy of being loved.
This "love phobia" or intimacy inhibition is frequently what brings people into treatment, whether explicitly or implicitly. For example, if one doesn't believe deep down in his or her own inherent lovability, how can real love ever be accepted from another when freely offered? Even from one's own offspring? And how can we reasonably expect something from someone we are incapable of giving either to them or ourselves? As Fromm put it, "People believe that to love is simple but that to be loved is most difficult. . . . They do not know that the real problem is not the difficulty of being loved but the difficulty of loving; that one is loved only if one can love. . . ." So this is a different type of love-ability, having to do with one's receptivity and openness to another and the ability to lovingly accept someone for whom he or she truly is. Without this capacity, a loving relationship cannot fully be entered into or cultivated, since demanding love and acceptance from a partner without being able to reciprocate in kind is doomed to disaster.
This issue of psychological readiness for real love and relationship is central to both the Grimm's story of Briar Rose (Sleeping Beauty) and the difficulties underlying forming and sustaining intimate romantic relationships, particularly with the opposite (or sometimes same) sex. (See my prior post.) We all still unconsciously carry around the hurt, humiliation and anger of our old childhood wounds, bringing this highly charged emotional baggage with us into our adult relationships. To the extent we stay oblivious of such baggage, we continue this compulsive defensiveness against closeness despite consciously longing for it so. We unconsciously seek the love we never received during childhood from significant others rather than taking responsibility for learning to provide that love to ourselves in the present. Much as in the fairy tale of Briar Rose, we grow prickly or thorny when it comes to intimacy, insofar as we remain unconscious (asleep) of our anger, rage, resentment and bitterness about prior rejections, disappointments, abandonments and other narcissistic injuries. This neurotic state of unconsciousness causes us to act out defensively, avoiding, undermining and prematurely scuttling the very relationships we consciously seek. In such a state of mind, any real relatedness or true emotional intimacy is impossible, or at least, limited. Sex, of course, may be another matter entirely.
Paradoxically, sex can be used to avoid psychological intimacy and exert power and control over potential partners to bind or escape the anxiety of authentic relationship. Yet, as with any phobia, it is precisely this anxiety that must be confronted, understood and tolerated (as opposed to defensively acted out) during the treatment of love phobia. As with overcoming any deep-seated fear, true intimacy or real love calls for great courage. It requires courage to create and maintain intimate relationships, since we all have our fair share of protective prickliness to penetrate and get past. (We definitely need courage, but also, good timing or luck to successfully connect deeply with another, since both participants must be more or less simultaneously ready to relinquish their hostile, narcissistic defenses if real love is to flower rather than be nipped in the bud.) Fromm's emphasis on the ability to love is certainly to the point here. Almost anyone can start a relationship. But making it intimate and maintaining it over time demands the capacity for real (rather than merely romantic) love. (See my prior post on Jung's notions of anima and animus. )
Still, how accurate is Fromm's bold and sweeping assertion that psychotherapy is all about being able to love? I would say only partially. Sometimes yes. But not always. Not for everybody. If it were the case, those individuals with close, supportive, loving relationships in their lives would theoretically not need or seek psychotherapy. But, clearly, they do. For example, there may be patients perfectly capable of interpersonal love, but chronically blocked in their creative capacity. Or those suffering from some traumatic experience or persistently painful physical condition. Unemployment. Loss. Grief. Discouragement. Despair. Anxiety. Anger. Rage. Resentment. Paranoia. Mania. Psychosis. What happens in psychotherapy cannot necessarily be reduced to "helping the patient gain or regain his capacity for love." That is, at least, not in the strictly romantic or interpersonal sense suggested by Fromm.
In the deepest sense, psychotherapy (and life) is not, as Freud, Fromm, Reik and most modern psychotherapists assume, mainly about intimate relationships. Nor the capacity for work per se. For, in most cases, these are but secondary benefits. Consequences rather than causes. Neurosis can, and commonly does, run rampant in both the work and love life. Having work and relationships cannot protect us fully from the existential facts of life. Nor does it inoculate us against suffering. Moreover, such exclusive emphasis on the outer rather than inner life--what we do out in the world and with whom we do it--stems in part from a more extraverted rather than introverted perspective, and may not be fitting for all patients. (See my prior post on extraversion and introversion.) For instance, in some cases, relationships or work serve the compulsive purpose of escaping from one's self, one's existential aloneness and anxiety, and the fact of one's mortality. So, existentially speaking, these cannot be considered the sine qua non of mental health, nor of therapeutic treatment.
And what exactly is the mysterious, potent, transformative power that serves to awaken this newfound or renewed capacity to love in the psychotherapy patient? Freud, Jung and others since observed that the alchemical catalyst occurs in the dynamic and uniquely intimate relationship between patient and therapist, and very much resembles--yes, you guessed it--love. As psychotherapists, we try to provide some of what was missed out on during childhood, in the form of an accepting, supportive, attuned, nurturing, caring, consistent relationship upon which the patient can temporarily depend and draw sustenance, self-esteem and strength from. But even that falls short of substituting for what was withheld or unavailable during infancy, childhood and adolescence by one's parents or primary caretakers. Psychotherapy can't erase the painful reality of past deprivations. But it can provide the encouragement, compassion and, yes, love needed by the patient to accept the past without destructive embitterment. And to learn or re-learn to give real love to one's self and others now. But a broader discussion of this clinical utilization--and inexcusable occasional misuse--of the healing power of love in psychotherapy is best saved for Part Two of this post.