Chapter 29 Promised risk

Making a commitment is one of the cornerstones of true love.Concrete and deep commitments can go a long way, if not guarantee smooth sailing in a relationship.At the beginning of a person's concentration on something, his or her emotional input may be very limited, but as time goes by, he (she) should invest more emotionally, otherwise, the emotional relationship will sooner or later disintegrate, or remain in a constant state of depression. A superficial, vulnerable state.Still take me as an example, before the wedding ceremony, I didn't feel any strange feeling, and my performance has been very calm.Gradually, I felt nervous and even trembling, and I couldn't even remember the wedding process, or anything that happened after that.After a period of time, I gradually adapted to this life change, put more emotions into my family, and finally got out of the state of falling in love and found the driving force of true love.Generally speaking, after having children, we can grow from the instinctive stage of biological inheritance to caring and responsible parents as long as we invest more emotions.

For a relationship based on love, giving wholeheartedly is an indispensable prerequisite.Only a lasting emotional relationship can make the mind continue to mature.If we are born with insecurities, not only in constant fear of abandonment, but also in the sense that our future is bleak, we will never be able to mature mentally.Couples face problems such as dependence and independence, manipulation and obedience, freedom and loyalty, etc. If there is no solution, or even magnify the problem, and live in the shadow of suspicion and fear all day long, they will not be able to find a way out calmly, and eventually the relationship will be broken. Relationships are ruined.

Making a promise can bring a person a sense of security.However, most people with schizophrenia have difficulty making commitments.Getting the patient to make a commitment is often a crucial part.Not knowing how to achieve "cathexis" and being unwilling to make any commitments can easily lead to psychological dissonance.People with negative personality disorder are unwilling to commit, or even lose the ability to commit. They are not afraid of the risk of commitment, but may not know how to make a commitment at all.They may have never received love from their parents or promise of love from their parents when they were children, so they have never had the experience of promise until they grow up.

Neurotics are able to understand the meaning of commitment, but the extreme tension and fear make them lose the motivation to make commitments.In their childhood, most of their parents were loving and able to make them feel the sense of security brought by the promise, but later because of death, abandonment or other reasons, this sense of security was terminated, making the promise unable to be responded to, and Becomes a painful memory, and they fear making new commitments.Once a patient has experienced spiritual trauma, unless an ideal emotional relationship is established, the wound will be difficult to heal.Sometimes, as a psychiatrist, I feel uneasy at the thought of seeing patients who need long-term treatment.After all, in order to make the treatment go smoothly, the psychiatrist must establish a good relationship with the patient, caring for the patient wholeheartedly like a caring parent treats a child, and not give up halfway, so as to open the patient's heart and prescribe the right medicine.

27-year-old Miss Rachel suffers from severe sexual frigidity, and is withdrawn and too reserved in words and deeds.She had a short marriage and came to me for therapy after her divorce.She told me that her husband, Mark, had parted ways with her because he couldn't accept her frigidity.Rachel said: "I knew my problem. I thought, marrying Mark would be a good thing. I wanted him to warm my heart and make me change, but I was wrong. It wasn't Mark's problem either. I can't experience sexual pleasure with any man, and I don't want to find pleasure in sex. Although I sometimes think that I should change and live like a normal person, unfortunately, I am used to the current state.Although Mark often reminds me to try to relax, even if I can, I don't want to change the current state. "

In the third month of treatment, I reminded Rachel that every time she came to the doctor, she had to say "thank you" at least twice before she sat down in her seat—the first "thank you", It was when we first met in the waiting room; the second "thank you" was when she first walked into my office. Rachel asked, "What's wrong with that?" "There's nothing wrong with that," I replied, "but there's no need for you to be so polite. From the looks of it, you look like a guest who lacks self-confidence and thinks you're not welcome."

"But I was originally a customer, this is your clinic after all." "That's right," I said, "but don't forget, you've paid for the treatment. This time and space is yours, you have your own rights, you're not a guest. The office, the waiting room, and us Time spent together, it's yours. You paid for it, it's yours, why thank me for what's yours?" "I didn't expect that you would really think so," Rachel said in surprise. "If I'm not mistaken, you still think I'm going to drive you away at any moment, don't you?" I said, "You think I might say to you one day, 'Rachel, it's really hard to treat you. Boring, I don't want to heal you anymore. You just go away and good luck.'”

"You're right," Rachel said, "that's exactly how I feel. I don't feel like I have a right to demand anything. You mean you'll never kick me out?" "Oh, that might or might not be the case, any psychiatrist could do that. But I wouldn't do it, never will. It's against the ethics of a psychiatrist. Listen, Rachel," I said, "By taking on a long-term patient like you, I'm making a commitment to you and your condition. I'm going to try to help you with your treatment, and I'm going to work with you for as long as I need, whether it's five years or ten years, Until the problem is resolved, or until you decide to terminate the treatment. In short, the decision is in your hands. Unless I am not alive, otherwise, as long as you need my services, I will never refuse."

Rachel's aetiology is not difficult to understand.Mark told me from the beginning of the treatment, “I think that Rachel’s mother is very responsible for what happened to Rachel. She is an executive of a well-known company, but she is not a good mother.” It turned out that Rachel’s mother Rachel is too strict with her children, and Rachel lives in the shadow of her mother and has no sense of security at home.Mother treats her like an ordinary employee.Unless Rachel lived up to all the standards she had hoped for, there was little security in her place in the family.She doesn't feel safe at home, how can she feel safe with a stranger like me?

Parents did not give Rachel enough love and caused serious psychological damage to her. Relying on simple verbal comfort, the wound will never heal.A year into therapy, Rachel and I discussed how she never shed tears in my presence, evidence of her inability to free herself.One day, she kept nagging, saying that she should be more vigilant and guard against other people's harm.At this time, I felt that as long as I gave her a little encouragement, tears might well in her eyes.I stretched out my hand, stroked her hair gently, and said softly, "Rachel, you are really pitiful, really pitiful." But unfortunately, this unconventional treatment model was not successful, Rachel still didn't shed a tear, and she was discouraged: "I can't do it! I can't cry! I can't let myself go!" The next time Rachel walked into my office, she Say it out loud to me, "Okay, now you have to tell the truth."

"What do you mean by that?" I asked strangely. "Tell me, what is my problem?" I was puzzled: "I still don't understand what you mean." "I think this is our last session. You're going to sum up my problems. Tell me why you don't want to treat me anymore?" "I do not understand what you are saying." Now it was Rachel's turn to be confused, "Didn't you want me to cry last time?" She said, "You always wanted me to cry, and you tried to help me cry last time, but I couldn't cry." .I think, you must not want to treat me, because I can't do what you say. So, today is our last treatment, right?" "Do you really think I'm going to give up treatment, Rachel?" "Yeah, anyone would do that." "No, Rachel, you're wrong, it's not anybody. Your mother might have done that, but I'm not her. Not everyone is like your mother. You're not my employee, you're here, no In order to do what I want you to do, but to do what you want to do, this time belongs to you. For healing, I will give you some kind of inspiration or urging, but I have no right to force you to do it to what extent. Also, you can come to me anytime, for as long as the treatment takes. " If we didn't get love from our parents in childhood, we will have a great sense of insecurity. In adulthood, a special mental illness will appear-we always "abandon" each other pre-emptively, that is, we will "abandon" each other in advance Before you abandon me, I have to abandon you" mode. There are many manifestations of this disease, and Miss Rachel's frigidity is one of them. She undoubtedly declares to her husband and former boyfriends: "I will not give myself completely to you. I know, you will sooner or later." Dump me." For Rachel, letting herself go, sexually and otherwise, meant commitment, an emotional commitment that past experience had shown didn't pay off for her. , so she never wants to "repeat the same mistakes". The closer Rachel got to others, the more she feared being abandoned, a pattern of "before you abandon me, I have to abandon you" at work.After a year of treatment (twice a week), Rachel suddenly told me that she couldn't continue because she couldn't afford the $80 a week.She said that after divorcing her husband, she was very poor. If she continued to receive treatment, she could only have treatment once a week at most.I know she is lying.She inherited a $50,000 inheritance and had a steady job.In addition, she comes from an old and wealthy family, and there are no financial problems. Normally, I could have just pointed out that she was more able to afford modest treatment fees than other patients.She gave up treatment on the pretext of lack of financial resources, but in fact she avoided getting too close to me.Here's another reason: That legacy held special meaning to Rachel.She believes that only inheritance will not abandon her and belong to her forever.In a world that made her feel insecure, that legacy was her greatest psychological security.While it is reasonable to ask her to pay for her treatment with a paltry portion of her inheritance, I worry that she is not prepared enough.If I insisted on her twice-a-week sessions, she might stop there and never show up again. She told me that she could only afford $50 a week for treatment, so she could only visit once a week.So I told her that I could reduce the treatment fee to $25 a session and still get two sessions a week.Her eyes were mixed with suspicion, apprehension and surprise, "Is what you said true?" she asked.I nod.Rachel was silent for a long time, and finally shed tears. She said: "Because my family is rich, everyone who deals with me in the town wants to make more money from me, but you have given me such a big discount. I was touched that no one had treated me like this before." For the next year, I treated Rachel well.Rachel was always in a state of struggle, unable to relax herself, and even tried to give up treatment many times.It took me a week or two to persuasion and encouragement, writing letters and making phone calls, to make her persist in the treatment.The second year of therapy made a lot of progress and we were able to talk to each other from the bottom of our hearts.Rachel said she liked to write poetry, and I asked to read her work. She refused at first, but then said yes.In the next few weeks, she always said that she forgot to bring the manuscript.I told her that she didn't want me to see her work, that she didn't trust me, the same way she didn't want to get too sexually intimate with Mark and other men.I can't help but reflect on the following questions: Why does she think that letting me appreciate her works represents commitment and emotional investment?Why does she feel that experiencing sex with her husband means giving up on herself?If I have no reaction to her work, in her mind, does it mean that I dismiss her, or even completely reject her?Am I going to terminate our friendship because of her poor poetry?Why didn't she think that letting me share her works would deepen our friendship?Is she really afraid that our relationship is getting closer? It wasn't until the third year that Rachel really realized that I was completely emotionally invested in her therapy, that her psychological defenses began to retreat, and she let me read her poems.She started talking and laughing, and sometimes even joked with me.Our relationship, for the first time, became natural and enjoyable.She said: "I never knew what it was like to get along with others. For the first time, I felt a sense of security." Taking this as a starting point, she also learned to communicate freely with others and gained a wider network of people. relation.She finally understood that sex is not necessarily a unilateral effort without return.The process of sex is self-release, physical experience, spiritual exploration, and emotional catharsis.She knows that I can be trusted. When she encounters setbacks and hurts, I will listen to her grievances and solve her troubles.In a way, I was like the competent mother she had never been.She also clearly realized that she didn't need to suppress her sexual needs too much, but should listen to her body's call.Her frigidity was completely gone.At the end of the fourth year of treatment, she became lively and cheerful, enthusiastic and optimistic, and fully enjoyed the happiness brought by good interpersonal relationships. As a therapist, I was lucky because I not only made a promise to Rachel, but actually kept it.Throughout her childhood, her lack of this commitment led to physical and mental illness.Of course, I'm not always so lucky. The "empathetic" computer technician mentioned above is a typical example-his need for commitment is too strong, so that I can't and I don't want to meet his requirements.The promise of a therapist is limited, and even basic therapy is impossible without the ability to adapt to the complex changes in emotional relationships. If the psychiatrist's commitment is sufficient, sooner or later the patient will also make a commitment—to the psychiatrist and to the therapy itself, and this is often the turning point in the therapy.Rachel let me look at her poetry, which meant that this turning point finally occurred.Oddly enough, some patients are in therapy for two or three hours a week for several years, never being able to commit, while others may reach this point in the first few months of therapy.In order to successfully complete the treatment, the doctor must make the patient make a commitment, and it is a commitment from the heart. At that moment, it is a great luck and joy for the psychologist, because the patient's commitment means that he dares to take responsibility. Committed risks, their psychotherapy is more likely to be successful. Psychologists make a commitment to treatment, and the risk lies not only in the commitment itself, but also in the possibility of experiencing unexpected challenges, and even making substantial revisions to previous understandings.Changing a person's outlook on life and the world (including the psychological phenomenon of empathy) usually faces many difficulties.To achieve self-improvement, enjoy the joy of good relationships, and make true love the center of your life, you must be fearless and dare to make changes instead of sticking to the rules.Of course, any adjustment that is different from the past may be subject to great risks.For example, a homosexual man who is determined to live a normal life can imagine the stress he feels when he goes out with a woman for the first time. In addition, patients who lack trust in anyone need to pay enough courage to lie on the sick bed in the psychiatrist's consulting room for the first time.Other examples include: a housewife who is too dependent on her husband declares to her husband one day that she has found a job outside, regardless of whether her husband agrees or not, she wants to enter social life and gain real independence; , has been obedient to his mother's words, and finally one day, he told his mother solemnly and resolutely that from now on, she must never call his baby name again, because it is childish and ridiculous; Finally, in the public, I shed tears full of true feelings; including Rachel—she finally relaxed one day and cried loudly in my consulting room... Such changes make the parties take such risks that they are not even worth it. It's like a soldier in danger on the battlefield.If the soldier is held against the back by the muzzle of the enemy, there is no possibility of escape.In the same way, a person who pursues mental maturity may at any time revert to the old state of thought and emotion, to the previously familiar and narrow way. Psychiatrists must also have the same courage and wisdom as patients, and they must bear the risk of self-change.I myself am.During the years of treatment, I often break the conventional treatment mode according to different situations.Following the treatment principles of the past may take less risk, but for the smooth recovery of patients, I need to take risks and practice. Sometimes I would rather go against the traditional and conventional methods, refuse to follow the old ways, let alone perfunctory.Looking back on the past, every successful treatment has traces of risky attempts, and each time I experienced more pain.Therapists are more likely to achieve unintended results when they bear the necessary pain.Sometimes, letting patients understand the difficult choice of doctors is also a profound shock and a powerful incentive for them, prompting them to better cooperate with doctors in treatment.Only when the healer and the treated are connected with each other and encourage each other can the treatment be more likely to be effective immediately. The role of a parent is similar to that of a psychologist.Listening to the voices of their children and meeting their needs will help parents achieve self-improvement, instead of blindly sticking to authority and bossing them around.Only by making appropriate changes to continuously improve the personality and soul can we take on the responsibility of being a parent. In the process of education and self-improvement of their children, parents will also mature together, which is of great benefit to both parties.Many parents were conscientious before their children reached puberty. Gradually, their thinking became backward and dull, unable to adapt to the growth and changes of their children.They don't want to make progress and give up the process of self-improvement.Some people think that it is an act of martyrdom, or even self-destruction, for parents to suffer and sacrifice for their children. This is completely alarmist.In fact, the gains for parents may be far greater than for children.Parents who adjust themselves to adapt to the changes of their children will not be out of touch with the times, and it will be of great benefit to their later life.Unfortunately, many people ignore this and miss the opportunity to mature themselves.