Therapy is...NOT a place to assign blame

I am seeing a young woman who has recently ended a long-term relationship.  She tells me how within weeks of this relationship ending, despite making a promise to herself that she needed time to be single and on own, she found herself in another romantic relationship.

She was perplexed by this because she says she and the other woman made it clear that they did not want anything serious, they were both still healing from recent break-ups.  But my patient found herself confiding to this woman and connecting with her on an emotional level that felt very deep.  She learned that this woman felt neglected in her previous relationship and so my partner set out to correct this, by making her breakfast in bed and spending all her free time with her.

Within a month, they made plans to travel to an exotic location where this woman, who had more money than my patient, wined and dined her and even hired a private boat for the two of them.

My patient comes to me after this trip feeling in over her head.  She tells me that on the trip she saw a side of her new partner that made her feel uneasy.  She told me her new lover was jealous and highly critical of my patient's past and interactions with other love interests.  My patient, looking for freedom and autonomy after her last relationship found herself feeling trapped and guilty.  Feelings that were all too familiar to her in the relationship she had just left.

Therapy is a place to be curious about how one is in relationships because of what this can tell us about the self.  When I attempted to point out how there seemed to be an inconsistency between what she said she wanted (something casual) and her behavior, she quickly shut down telling me how she knows everything is her fault, and that she just needed everyone to stop giving her advice.  Her friends have made their opinions very clear to her and they made her feel worse, like she could do nothing right.

Therapy is not a place for blame.  I was very aware that her comments about unwanted advice were directed at me, as well as her comment that this advice was not only unhelpful but very demoralizing.  This is an example where being aware of how a patient feels about me, the therapist, and how I feel about the patient is so very important.  I was aware of my frustration with her.  The fantasy of saying, "well you did this to yourself!" played out in my mind.  This is how she makes her friends and family feel.  But I also felt compassion.  I knew she was hearing this feedback from me (whether it was my intention or not) and I could tell she had received this message from those around her.  Memories of when I felt responsible for the pain I caused others and myself, rightly or wrongly, came bubbling to the surface of my mind.  I also know very well what it is to not feel good enough.  I think most of us do. 

I tried a different approach.  I first wanted her to see how she takes on blame (even when it is not hers to take) to look after the other.  This is the role she takes on in relationships.  By blaming herself, the other person who has caused her grief moves on without anything on his/her conscience.  That person not only has a scapegoat but also ammunition she can use against my patient for later.  I then told her I did not believe she was to blame, and asked her why she connected with this woman so deeply in the first place.

"Being totally isolated and on my own is not good for me either," she said.  "I was looking for a connection that was free of the guilt and shame I had in my last relationship."

She was lonely.  She had demons of self-criticism and self-loathing that made being on her own terrifying.  Connecting with another person, in the short term, could keep this at bay and provide her connection she could hope would be free of other expectations of her.   I get that.  I hope we all can get that on some level.

I chose my next words carefully so that she did not again feel blamed by me.  I said, "having a meaningful connection with you, you investing your time and emotion into another, well, that is precious.  What you have to offer others is highly valuable, and I want to encourage you to treat it that way.  We need to be very protective of this, of you.  The people you give this to need to have earned it."  I added, "I just wonder if the woman you have started a relationship with has proven herself worthy."