Identify Markers for Task Work

As the therapist listened to the client, he was alert to markers that indicated openings for possible work in future sessions. In the first session, he had heard two main markers of possible underlying difficulties: (a) unfin-ished business around feelings of being badly treated by her family and (b) a self-criticism in which one part judges herself as failure and feels unentitled to approval and acceptance and another part that needs approval and accep-tance. As this was early in the therapy, these were simply noted as some-thing to be alert to if they reemerged. The following exchange from Session 1

jina 179 provides an example of Jina’s self-criticism embedded in the context of lack of family support. At this early point in therapy, the therapist simply notes the marker rather than initiate a dialogue.

Jina: I don’t think I’m bad, but I believe I’m a bad person, but deep down inside I don’t think I’m a bad person. And I don’t deserve all this. I haven’t raped and murdered and robbed banks, I have not done crazy things, there’s no reason for them (family) to treat me this way.

Therapist: So in a way, it’s almost like grieving for what you never had from them because you’re beginning to say: I do deserve bet-ter, I’m not a bad person, and it’s like I feel really sad about what I never got. And I deserve it more.

Jina: Yeah, I guess so, yeah.

Therapist: But the sadness is about all that you never got. The anger is.

Jina: Oh, yeah.

Therapist: But some part says I deserve more; how strong is that feeling?

Jina: Well, I say this but then I guess we all feel we deserve more and—yeah, I’m grieving for what I probably didn’t have and know I never will have.

Therapist: Yeah, probably that too. Because it’s how much you really can believe you are deserving even if they didn’t give it to you. Then somehow it’s how much can I get from other people . . .

Jina: For myself. I realize now you can’t depend on other people to make you happy. Not to be happy, you need to be happy from within yourself. That’s why I guess I’m doing this therapy. I figure if I can be content with myself, then that stuff won’t matter to me as much. But don’t forget, if you are told enough that you’re a failure, you start to believe it.

Therapist: Yeah, so that’s really an important piece to work on. And I guess that’s why this disapproval is so painful because it activates that I am a failure and being told all along that I’m a failure, that’s just like her voice almost in your head.

And then it kind of diminishes you and it’s hard to stand up against it.

In Session 2, a self-critical marker again arises when the client is talk-ing about possibly returntalk-ing to school. She quickly becomes hopeless in the face of the further possibility of failure in the eyes of her sisters. At this point, the therapist initiates a two-chair dialogue by suggesting that Jina put

her sisters in the other chair. Although this is a dialogue with another person, rather than a part of the self, it is viewed as a self-critical dialogue because her hypersensitivity to her sisters’ criticisms suggests that her internalized criticisms are being projected onto or attributed to the sisters. The sisters’

criticisms are damaging because they activate the client’s internal critic.

Yeah, unsupported, I feel inferior to them, I feel that I have no self-esteem left and it’s like I don’t want to try anymore with them. It’s like OK you win, I’m not as good as you, you win and that’s it. Fine. So leave me alone.

From this we see more clearly that what is of central concern is her shame-based feelings of being not good enough.

This core self organization of feeling not good enough is confirmed in Session 3 when the client talks about how she is so sensitive to criticism.

Therapist: When you say you’re so fragile and you’re so sensitive, how do you understand that? What’s that like for you?

Jina: I guess because I don’t have a lot of confidence, it doesn’t take much for me to feel bad. Some people take construc-tive criticism well and some people take criticism! They don’t care; I guess they’re so sure of themselves. I guess I feel that I’ve had so much negative criticism, I don’t have the tolerance for it that I used to. I guess I can’t let it roll off my back as easily as I did when I was younger. I don’t know.

Therapist: So somehow it’s like your self feels very fragile in relation to that. When you say you had so much criticism, what stands out for you?

Jina: We talked about our parents and how much we didn’t mat-ter as children, it was never good enough. If you got a B, you had to get an A. If you got an A, you had to get an A+, how you cleaned the house, how you did things, I think we all have that insecurity and I think it’s because we just were never good enough, we never got that reinforcement from our parents.

Therapist: That kind of support.

Jina: That we were OK and that we could do anything and we were successful young people.

By this point, self-criticism is emerging as a core theme. The therapist is confident that self-criticism is a central issue and that it relates to the invalidation Jina suffered from her parents when the above marker appears.

He suggests a chair dialogue with her parents.

jina 181 Therapist: Somehow you’re still very fragile and vulnerable to their

criticism, so I’m going to suggest we actually try to imagine bringing them in here and have a dialogue. [Jina puts both her parents in the empty chair, but this rapidly evolves into a dialogue with her father. This occurs not because the thera-pist has formulated that her relationship with her father is central but rather by following what is most alive in the cli-ent’s emotional experience at the moment.]

Jina: I believe I’m a bad person, but deep down inside I don’t think I’m a bad person . . . I’m grieving for what I probably didn’t have and know I never will have.

Therapist: Can you imagine him over here (pointing to chair) and tell-ing him how he has made you feel like a bad person?

Jina: You destroyed my feelings. You destroyed my life. Not you completely, but you did nothing to nurture me and help me in life. You did nothing at all. You fed me and you clothed me to a certain point. That’s about it. (She then talks about how he denigrated her and how he called her a devil.) Therapist: Tell him what it was like to be called a devil and go to church

every . . .

Jina: It was horrible. He made me feel that I was always bad when I was a child. I don’t believe that now, but when I was a child I felt that I was going to die and I was going to go to hell because I was a bad person.

Steps 6–8: Identify Underlying Core Emotion Schemes, Either Adaptive or Maladaptive; Needs; and Secondary Emotions

In Session 3, the therapist invites Jina to enact her disapproving father, and as him, she criticizes herself severely as not good enough and not as good as her sisters. On returning to herself in the chair, she is first reactive, express-ing secondary anger; the therapist guides her to her deeper underlyexpress-ing feelexpress-ing, asking what it was like for her.

Jina: Well, it was lonely. I didn’t know my father—all I knew you as was somebody that yelled at me all the time and hit me.

I don’t remember you telling me you loved me or that you cared for me or that you thought I did well in school or anything. All I knew you was as somebody that I feared.

[Her core painful emotions here are loneliness and fear, and the dialogue is shifting to unfinished business with father. The therapist guides her to say what she needed from him.]

I needed you to put an arm around me and hug me once in a while and tell me that you cared about me and that I was OK, that I was doing OK. [A core attachment need; the therapist then asks her to become the young girl and tell him what she felt.]

I’m afraid of being hit for something, afraid of being hit for everything, you know my whole childhood was always a fight.

I hated special occasions because there was always a family fight, big, big fights. So Christmas was ruined, Mother’s Day was ruined, Christmas and Easter were ruined, everything was ruined. [A core fear is accessed.]

I needed to, be hugged once in a while as a child or told that I was OK. I think that’s normal. [Core needs for both comfort and validation; clearly, there is much unfinished business with the father, which will be worked on in future sessions.]

Step 9: Identify Interruptions or Blocks to Accessing Core