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When hope gets in the way | Aeon

Photo by Fotoholica Press/LightRocket via Getty

Photo by Fotoholica Press/LightRocket via Getty

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When hope gets in the way

Hope is usually seen as a positive agent of change that spares us from pain. But it can also undermine healing and growth

by Santiago Delboy + BIO

Photo by Fotoholica Press/LightRocket via Getty

The word ‘hope’ seems to hold an unambiguous quality in our vocabulary, imbued with a kind of purity that makes it unquestionably good. From old sayings to modern slogans, we are encouraged to develop and sustain a sense of hope. As a psychotherapist, I believe there is good reason for this. I have repeatedly witnessed the overwhelming burden of hopelessness and the centrality of hope in healing and growth. This is particularly true for people who experienced chronic childhood trauma, including emotional abuse or neglect, which undermines their ability to imagine that a different future is possible.

But I also believe that hope is a complex concept that deserves a more nuanced understanding. For example, hope may be considered both an antidote to helplessness and a source of helplessness. As the psychiatrist Harold Searles observed, we tend to consider hope our ‘last repository of … innate goodness as human beings’. It can be challenging, he suggests, to accept that our hopes can indeed be permeated with ambivalence and conflict.

Even though hope is seen as curative and a critical agent of change in a clinical setting, are there times when persistently holding on to hope – consciously or not – can get in the way? If hope is oriented towards the future and can make the present more bearable, what is the role of our past in the experience, function and meaning we give to hope? More specifically, when our emotional wounds were created by old relationships, how do they shape the conscious and unconscious hopes we hold for new ones? I would like to explore these issues through Alex, a composite fictional patient who represents some of the experiences people bring to therapy. The clinical process I describe is influenced by my own approach and illustrates how psychotherapy can help.

Alex entered the waiting room 15 minutes early for our first appointment. He started talking as soon as he sat down, without pause or hesitation, telling me about his background and why he came to see me. He was articulate and charming, yet something felt rehearsed and guarded. Were his words and his demeanour an attempt to prevent a silent crack through which pain could filter? A successful professional, Alex was worried about how unmotivated and stuck he felt lately, and how anxious and irritable he was in his close relationships. Before he left, he asked me, with a tremulous voice: ‘Am I depressed?’

Alex worked hard to be a good patient. He was eager to talk, astute in his observations, and open to hearing mine. Thanks to prior rounds of therapy, he could articulate some of the struggles he had endured as a child.

‘I know about my family issues,’ he said a few times, as if to convey: ‘So let’s move on.’ I continued to wonder what he was protecting behind that veil of self-awareness. His apparent desire to leave the past behind may have conveyed fears of opening old wounds, anticipation of being disappointed by me, or wishes to protect something he may not want to surrender.

At first, Alex approached our work like other new relationships. A coat of confidence and engagement covered a wall of ambivalence and mistrust. As we scratched the surface, I learned that he grew up fearful of his distant, critical and fragile father, whose expectations felt as unclear as impossible to satisfy. He kept a few fond memories of his mother, whom he experienced as occasionally tender and warm, but mostly depressed and emotionally absent.

It is hard to underestimate the impact of these experiences on Alex’s sense of hope. As Erik Erikson suggested, our primal sense of hope and doom springs from the dialectic between trust and mistrust during the earliest stage of human development. Conscious and unconscious hope and hopelessness coexist, not always peacefully, throughout our lifetime.

Alex managed to recruit the same cast of characters to rehearse the lines for a role he knew too well

This paradox appeared in Alex’s vivid childhood memory of hiding under the bed when his father seemed angry. It was a heartbreaking image, which found its way a number of times into our conversations. Each time, I felt a deep sense of desolation. I imagined a scared little boy in the darkness, his face against the cold floor, learning to identify every footstep while secretly hoping to be found by his mother. ‘I always had to come out on my own, my mom never looked for me,’ he said the first time I saw him cry.

Alex’s attempts to be heard, accepted or valued were either met by his father’s anger and rejection, or by his mother’s passivity and neglect, leaving him feeling unloved, ineffective and alone. He developed what Donald Winnicott called a ‘False Self’, a way to organise his personality and locate himself in the world that allowed him to adapt to a misattuned, unresponsive and traumatic environment, protect himself from hurt and disappointment, and regulate emotions that felt overwhelming to his young mind. For Winnicott, the function of the False Self is to hide and protect the True Self, where spontaneity and authenticity reside, by becoming compliant to environmental demands; over time, it will hide larger parts of our inner reality.

As an adult, Alex found himself oscillating between two familiar ways of relating, expressing different shades of his insecure attachment and different aspects of his False Self. He either felt anxious, fearful and unsafe with those he felt more distant from – especially if he placed them in a position of authority – or impatient and angry with those he felt closer to. This pendulum between taking on roles of victim or aggressor left him feeling depleted, disappointed and disconnected. ‘Why do I care so much about what they think?’ he said, exasperated, in both a sincere attempt to understand himself and as a wish to get rid of what he saw as the source of his problems.

Over time, we began to appreciate how these patterns infiltrated his relationships, turning them into a stage where familiar scenes from childhood were stubbornly repeated. Alex managed to recruit the same cast of characters in order to rehearse the lines for a role he knew too well. This casting process in the external world was a reflection of the rich and complex constellation of mental representations in Alex’s internal world, based on past relationships with significant others. Each of these representations is associated with different experiences of self, leading to what psychoanalysts have called ‘internal object relations’. This concept is intrinsically tied to a model of mind based on the notion of multiplicity of self, a central concept in both trauma theory and relational psychoanalysis. The repetition of roles and scenes constitutes a form of reenactment, which is one of the ways in which traumatic experiences become part of the fabric of our lives. Repetition, the psychoanalyst Peter Shabad observes, ‘is an attempt to remedy [a sense of] lack, and resolve the nostalgia of homesickness’, becoming ‘simultaneously an obliteration of memory and a form of remembering’.

Alex started seeing this repetition not only in the relationship with his parents, but everywhere he looked. There it was, in the ways he bent over backwards to get his boss’s validation, which never felt enough. There it was again, in the anger he felt when his partner seemed to ignore him, which always left him feeling ashamed. And again, in how he minimised his own disappointments and accomplishments.

This recognition brought up painful memories and unsettling feelings. Alex was familiar with the traumatic nature of his early experiences, but now he was starting to see how he kept them alive. He understood how his childhood wishes for love and connection were thwarted, but was less acquainted with the despair behind his adult demands for the same. As Stephen Mitchell, one of the central authors in contemporary relational psychoanalysis, reminds us, childhood trauma is always transformed in adulthood in one way or another.

Alex’s chronic longing for a mother who would ‘find’ him fed fantasies of being rescued by other people’s recognition. His passive endurance of his father’s rage, turned into vengeful anger and emotional passivity. Adam Phillips’s words resonate with this process: ‘Wanting to be understood, as adults, can be, among many other things, our most violent form of nostalgia.’ Alex’s anger, with himself and with others, was not only a reaction to fear and hurt, not only a ‘secondary emotion’, but a protective anticipation to disappointment and injury. I started to realise that, sooner or later, I too would become the disappointing and injurious Other.

One session, after a family visit, Alex seemed sad and burdened. He paused for a moment and said: ‘I can’t do this anymore.’ He had said this before, but this time his voice had a heaviness I did not recognise. I did not ask what he meant, worried that my search for cognitive clarity might obscure his emotional experience. Alex’s intellectual defences (along with mine) would have likely derailed a process that needed us to embrace uncertainty. We remained silent for a few minutes as he started to weep. Unlike other times, when Alex cried out of sadness, frustration or pain, these tears seemed to come from a different place, an old well of grief that had long been forgotten.

Hope involves not only a wish, but the belief that its fulfilment is possible

Over time, thanks to his increasing openness and vulnerability, we came to understand Alex’s repetitions and reenactments as unconscious expressions of hope. Maybe this time things will be different. Maybe this time he will see me and love me for who I am. Maybe this time she will care enough to come find me. Maybe this time I won’t feel alone, powerless and broken. Alex had never allowed himself to say these things out loud, as they would have required him to accept wishes he worked hard to disown. These wishes were frozen in time, leading to unconscious hopes that were in conflict, as Searles suggested, with his conscious hopes for ‘not caring’ about other people’s opinions. Dissociation, a central feature of trauma, kept these wishes in the realm of the unthinkable, both protecting Alex from unbearable yet familiar pain and allowing him to keep deeply held wishes from being destroyed or taken away.

Hope involves not only a wish, but the belief that its fulfilment is possible and, for Alex, that he had the power to make it come true. If only he found the right words, if only he became who they wanted him to be, he could make things right. This type of response is a common feature of how trauma stays with us. Subject to an abusive or neglectful environment, our developing mind will carry the blame or responsibility to preserve a sense of control, avoid the reality of a dangerous and painful experience, and preserve the goodness of our caretakers. As Winnicott observed, the False Self cannot experience life and feel real. Indeed, Alex’s attempts to be someone else left him feeling like a shadow, growing more distant from his own needs, wishes and desires, and trapped by alienation and disconnection.

These attempts were aimed not only at seeking safety, but also allowed Alex to hold on to the hope of being able to change the end of the story, to make them accept him for who he truly is. At the same time, he knew this was futile, feeding feelings of hatred and resentment. Hope and hopelessness coexisted in his mind, even if defended against by dissociation or denial.

As we deepened our work, we fluctuated between struggling to stay afloat and daring to visit the depths of the well Alex had started to open. The hopes and dreads he held made an unavoidable appearance in our work together: he started expressing his frustration with me more openly, whether for judging him against impossible expectations or for doing nothing to help him while he struggled. He initially rushed to offer me apologies and reassurance, feeling ashamed and fearful of his own anger. I acknowledged that at times I felt impatient, which may have come across as judgmental or withholding. Through our work, I felt both grounded and decentred, confident and inadequate, close and distant. As a therapist, I believe it is critical to pay attention to my shifting states to understand more about my patients’ experience. Why would Alex need me to feel in this way? I consider my emotional reactions with him, part of what therapists call countertransference, as an expression of my participation in our unconscious communication. This type of communication has long been recognised by psychoanalysis and more recently conceptualised by neuroscience as a process of right-brain-to-right-brain communication and affect regulation.

Over time, Alex and I became better able to appreciate how we were enacting the scenes from his childhood in our sessions, allowing us to relate to each other in a more authentic way. The recognition of how historical relational dynamics enter the relationship with a therapist is an important development. The therapeutic relationship is recognised as a central agent of change, but I believe its importance goes beyond the therapist’s attempts to provide empathy, attunement or safety. It involves the recognition of our mutual influence and an understanding that what happens in the therapy room, the direction of treatment itself, is co-created in conscious and unconscious ways. My countertransference was essential in developing a sense of shared meaning with Alex.

Through these experiences, Alex and I started to understand that his unyielding hope served him to avoid experiencing the overwhelming pain of disappointment and loss. He was employing what the psychoanalyst Martha Stark has called ‘relentless hope’, a defence against the unbearable pain of grief. Hope got in the way of healing and growth by impeding Alex’s movement through mourning. Trauma experts such as Judith Herman consider this a crucial stage of trauma recovery. For her, people who experience psychological trauma ‘must mourn the loss of the foundation of basic trust, the belief in a good parent. As they come to recognise that they were not responsible for their fate, they confront the existential despair that they could not face in childhood.’

Attachment theory has, too, recognised the centrality of mourning. John Bowlby suggested that the way we respond to early attachment rupture and loss may impact personality development, particularly when we don’t have a witness who can help us make sense of our experience. Bowlby emphasised our attempts to recover the ‘lost object’ driven by our attachment system. Mourning as a process to perpetuate the bond with a loved ‘object’, whether a real or imagined person, was also discussed by Sigmund Freud in his seminal paper ‘Mourning and Melancholia’ (1917).

The work of mourning, Freud suggested, involves accepting the painful reality of loss. When this loss is too overwhelming to accept, when the bonds of love will not be relinquished, the natural process of mourning is transformed into melancholia (roughly equivalent to what later was called introjective depression). In this case, Freud suggests, a person might become aware of the loss, ‘but only in the sense that he knows whom he has lost but not what he has lost in him’. Alex may have been aware of how he lost his father each time he instilled fear in him and how he lost his mother each time she emotionally withdrew, but he was only now starting to recognise how he was transformed as a result, what was lost in him. In fact, his conscious insight may have served to disavow this unconscious transformation.

In melancholia, Freud’s thinking goes, rather than letting go of the lost object, we unconsciously identify with them. Once this happens, reproaches towards them become reproaches towards ourselves, resulting in a deflated sense of worth. In later writings, Freud acknowledged that identification plays an important role not only in melancholia, but in ‘normal’ mourning and in the development of our ‘character’.

For an alternative view of the process of identification, I turn to the psychoanalyst Sándor Ferenczi. In his classic paper ‘Confusion of the Tongues Between the Adults and the Child’ (1933), he proposed that children who experience intense trauma from significant adults (he writes in the context of sexual abuse) may feel such intense anxiety that they will be compelled to ‘subordinate themselvesto the will of the aggressor, to divine each one of his desires’, rendering them ‘completely oblivious of themselves’.

For Ferenczi, identification involves internalising our aggressors in order to make them ‘disappear’ from external reality, ensuring psychic survival while keeping our emotional attachment to them. The price we pay is steep: the experience of trauma is perpetuated in the child’s mind, and we continue – consciously or not – fighting with the dramatis personae in our heads well into adulthood, like Alex did with many people in his life. Ferenczi’s notion of identification involves becoming highly attuned to the aggressor’s needs and desires, accommodating our personality and subordinating our sense of self to the internalised other: we become whom we learned they want us to be, forgetting ourselves in the process. As a result, our own developing subjectivity is evacuated and our own needs, wishes and desires become dissociated. This process does not require severe transgressions such as sexual abuse. Environmental and parental failures to provide attunement to and recognition of the child’s inner states, needs and experiences can also trigger this process.

Mourning the loss of what we never had involves becoming open to imagining a new future

It is in the context of traumatic identification and repetition that we develop unconscious hopes – hope that we can right old wrongs and experience repair, feel recognised by those who didn’t see us, win fights that we lost, or be rescued by those we needed but who never showed up. These hopes include not only dissociated wishes for a different experience, but omnipotent fantasies about our role in making those wishes happen, since we have organised our personality and found safety in the deep-seated belief that we are responsible for our misfortune. Complex relational trauma during our childhood, when the chronic nature of our sorrow becomes embedded in life itself, hampers the mourning process. It keeps us in a suspended state of infantile hope while, at the same time, leading us to deflate our own desires and detach from wishes that we learned would only lead to perpetual disappointment.

My work with Alex involved understanding some of his symptoms in this context. For example, together we realised the way in which his lack of motivation could be understood as an attempt to escape the unconscious mandate to be someone else. More importantly, however, our work involved facilitating, through our shared relational experience, a process of mourning that included deconstructing the old hopes he unconsciously held. If his wounds were created in relationships that left his needs unmet, his wishes unrecognised and his cries unheard, it only makes sense that their healing would take place in a relational context. The old hopes Alex held, Mitchell would suggest, were soaked in pain, frustration and longing, a complex blend of wishes and needs, of restorative demands and magical fantasies. The process of mourning included acknowledging the longings Alex disavowed and protected behind a wall of compliance. It entailed decoupling these wishes from the possibility of their realisation, which allowed him to hold space for both his desires and his disappointment. Finally, it involved recognising, with acceptance and compassion, the ways in which he attempted to repeat old scripts that he could not change on his own.

Mourning the loss of what we never had is always complicated and painful. It involves not only dealing with the past, but becoming open to imagining a new future. I appreciate how Shabad describes mourning as a ‘process of internal transformation by which the old is relinquished and the new is engaged with an open heart’, which is ‘at the crux of how human beings change and grow’. Alex’s old hopes had tightly sealed a well of grief and sadness that he never fully abandoned despite his best efforts. He started confronting the despair he managed to avoid for so long, doing so not only intellectually but also in his relationships, including ours. Our work offered not only the opportunity to have a witness to his grief, but the possibility to start holding the feelings he had worked so hard to forget. This process opened up space in his mind and his heart, where he became able to tolerate and experience the desolation of a wish orphan of hope.

After some time, Alex started, not without ambivalence, reclaiming his own wishes and desires, disentangling them from the ways in which he insisted on their fulfilment, accepting the limits of his power to make them happen, and finding new ways of relating to others with authenticity and vulnerability. In the space we were able to create, he was finding, as Mitchell puts it, ‘new growth embedded in old hopes’. Recognising the complexity of hope involves, he suggests, acknowledging the dialectic interplay ‘between the static and familiar and the longing for something fuller and more rewarding’.

Redefining his sense of hope through mourning, anchored in an acknowledgement of his wishes and a recognition of his limits, was central to Alex’s healing process. He started to become able to experience hope for a new future inside his old hopes for a new past, shifting his attempts to right old wrongs for the ability to imagine new possibilities. From his deep well of grief, despair and disappointment, new waters started to flow. Alex was on a path to meet and embrace a child who was starting to feel found.

Psychiatry and psychotherapyMood and emotionPersonality

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