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Abuse, Neglect, Coming Out, Helping Clients — Self-Reflections and Psychotherapy
By Louis J. Moran, LCSW, ACSW

My husband, who a year ago helped me edit my life memoir, asked the other day, “Why did you always do what your brother wanted?” My brother had abused me emotionally, physically, and sexually from the time I was a toddler until I was about 12 years old, at which point he was mostly out of the house. I really had never thought much in any deep, meaningful way about why I acquiesced to my brother or others in my life.

As I considered this question, I noticed that my memoir published last year, American Foursquare, Behind the Façade, was written in an unusual form. Even though it covered my 70 years of life, it was written as a series of discreet scenes and vignettes from my life with no chapters and no page numbering.

I did not plan this form of written narrative as a preconceived literary conceit at all; it just seemed natural. As a child trying to survive, living life moment to moment and being on guard was natural. Even after the abuse is long gone, the tendency to protect the self, to passively acquiesce and to accommodate, to be a people pleaser, to not rock the boat often lingers as a significant part of how we treat others and ourselves as we walk through life.

The Overarching Principle
Psychotherapy has been the practice of personal historical exploration in search of the roots of problems people experience in their everyday lives and their sense of themselves. Once discovered, these insights are usually posited as the agents of change. After years of practice, what became clear to me is that, while useful in our understanding of ourselves, insight does not necessarily provide a path for change.

More behaviorally-oriented therapists usually skip the search for insight and instead focus on behavioral goals and the steps to achieve them. For certain fears or phobias, this approach has utility. However, psychotherapy can sometimes stop short of providing an identifiable path to moving beyond dysfunctional or dissatisfying patterns of interacting with the self or others, while behavioral therapy can intentionally ignore the powerful underlying motivations for behavior.

In my clinical work, I began to ask the question of clients, “What is your overarching principle?” They often would look confused and go on to describe the person they would like to see themselves as: not fearful, honest, more assertive, a good mate, and so forth. But these ideas and aspirations weren’t overarching principles at all. They were more hoped-for notions of how we want to be perceived by others or how we wish to see ourselves. While being honest and more assertive are worthwhile and attainable goals, they do not reflect the deeply, if not unconsciously held overarching principle.

Development of the Overarching Principle
From birth and through the earlier years of development, we absorb information from the environment, our caretakers, and siblings. With attendance at school, our peers also influence our self-perception. Within this feedback, we develop our sense of ourselves—but not so much based on any real self-assessment of our strengths and challenges.

Such self-assessment requires a more highly developed capacity for self-reflection and attendant language. In early life, we are simply not at that level of development. We are dependent upon how others define us based on their words about us and their behavior toward us.

The overarching principal is how we come to view ourselves and how we operate in the world based on incorporating the messages from significant others around us. Rather than self-perception, internalized other-perception is more apt. Sadly for the child, that other-perception can be the caretakers’ projections of their own limitations, frustrations, anger, resentment, and even jealousy of the youth’s opportunities ahead that have been lost to the adult caretaker. Good-enough parenting is a valued goal, but the exigencies of life or even personality issues with the caretaker can interfere with that goal.

My Case Example
I was the second-born child in my family and was described as good-natured. My brother, described as mischievous, was four years my senior and unhappy that his position as only child was revoked by my birth. We lived in a rural area outside a Pennsylvania town and most weekdays it was just my brother, me, and our mom at home. While our mom and dad were loving and kind parents, my brother tried to extinguish my life on a regular basis until I was nearly nine years old. For him it was pathological, murderous sibling rivalry.

While my parents might easily qualify as good enough in their parenting, they were too consumed by my dad’s work and my mother’s anemia and then leukemia to notice what my brother was doing as a pattern of behavior. For me, I was too young with no frame of reference for how a brother treats a brother.

Our mother died of leukemia when I was six and we moved back to my parents’ hometown in New York State. My brother’s behavior toward me intensified, as he apparently believed that my birth somehow caused our mother’s death. By age seven, my brother and I were living with my aunt (our mother’s sister) and our dad would visit after work.

My aunt was morbidly obese, single, demanding, and appeared to be an unhappy woman. She also seemed to have a conflicted attitude toward men. She made it obvious that she did not like my father (for marrying her sister) and her husband, who abandoned her less than a week after they married.

From the day I arrived in her household, she added chores for me to accomplish. By the time I reached my eighth year I was doing the laundry, cooking, cleaning, and helping my aunt dress for work, including fastening her bra and girdle. If I complained (which was rare) she would curse and tell me that without her I would be on the street.

My brother had few (if any) responsibilities in the home and was often at odds with the law. My aunt would laugh off his behavior while warning me, “Don’t be like your brother.” He tried to electrocute me, pushed me out of our tree fort, and set me on fire, and it was around my tenth year he began to molest me on a regular basis. This abuse ended when he turned 16 and he directed his sexual attention to girls. Thankfully at that point he was rarely home.

Over the course of my early life I learned and internalized a strong fear of disapproval and a concomitant need for approval. I saw myself not as an actor in the world (like my brother), but a reactor and an object to be used by others. I was compliant, accommodating, and living from moment to moment. This “survival” tactic is often seen in the stories of abuse survivors. I was highly conflict-avoidant attuned to my environment, a necessary adaptational skill. The cost of this for me during the period of abuse and long after was a life spent going along to get along rather than a self-awareness that would allow moving along on my own path.

There are many scenes throughout my life where my strong fears of disapproval and strong needs for approval influenced my decision-making and how I carried myself in the world. This included my denial of my own gay sexual orientation until I was 35 years old.

Outlined are factors related to the causation and reinforcement of my overarching principle: be a responder, don’t make waves, avoid conflict at all costs, and be a pleaser. I viewed life as a series of events where survival of the ego is the goal rather than developing a more unified worldview and more unified sense of the self. It wasn’t all bad. I developed skills of assessing other people, good environmental observation, empathy, and keen listening, all of which served me in my career as a clinician.

Implications for Psychotherapy
By using the term “overarching principle” I refer not only to how we come to see ourselves but, perhaps more importantly, how we operate in the world. It is my belief, and reflected in my practice, that grasping this concept, regardless of what words we use to characterize it, is a necessary step in self-understanding. I have also come to believe that, while we can gain understanding and insight from psychotherapy, we live within the core belief of ourselves that was formed through interactions with the environment during our developmental years. At this point, there may be readers gasping and thinking, “Then what is the point of psychotherapy?”

Understanding your overarching principle and how it has shaped your behavior and self-dialogue is a beginning step. Accepting it as part of you is necessary and realistic to moving forward. Short of this, therapy becomes a disappointing exercise in trying to make part of who you are disappear.

The therapist may better serve clients helping them discern situations where they want to be more of an actor. This might take the shape of saying “No” or directly asking for something from another. To accomplish this, clients would have to work at diminishing the power of their core belief while still accepting its presence. The tension is not between clients and others, but within clients between their overarching principle and their desired behavior. By experiencing the heightened power of being a successful actor in an interaction, or at least a sense of self-mastery, clients are self-reinforced. The struggle is not with the environment but instead between our wished or hoped-for self and our overarching principle and learning how to exist with less internal tension.

Whatever our core self-belief or overarching principle happens to be, it is part of who we are and how we operate in the world. It can certainly be examined, understood, and its power diminished through self-reflection and therapy.

Therapy involves helping clients articulate and understand their self-view derived from earlier life experiences, accept the power of that self-definition in how they operate in the world, begin to define areas in life where other behaviors would be more constructive, and practice those behaviors in the therapeutic setting and in their environment.

— Louis J. Moran, LCSW, ACSW, worked in mental health for 44 years. His 30-plus years before retiring he had a solo private practice. Over the years his focus was eclectic but the presenting issues coalesced around anxiety, depression, borderline personality, eating disorders, poor self-esteem, negotiating life transitions, coming out as gay, and relational conflicts.