Leaving Home: The Art of Separating from Your Difficult Family

During my career as a clinical psychologist, I discovered that my best teachers were always my patients, since they illustrated just how the human personality developed and operated. One of the finest was “George,” a student from a private high school who was sent for therapy with me by his mother and by his school as a last resort before he was expelled. My task was to discover the reasons behind George’s habit of stealing from faculty members. He was an earnest and appealing young man who had a talent for mathematics and physics and had also proven to be an outstanding hockey player. He was assumed to be a prize student until it was discovered that wherever he went, items were found to be missing. In particular, he stole faculty members’ wallets, purses, date books, and other personal items. George reported in his wide-eyed way that he had no idea why he had such sticky fingers, though he did sense a thrill of victory when he examined the items he stole. He did not spend the money he took—rather, he returned the stolen items in odd ways. For instance, he would take a stolen wallet and drop it down a laundry chute, or leave it on a hallway floor where it could be found by someone else. After our first clinical interview, I felt a sense of certainty that I could work with George, but was flustered when I could not find a roll of stamps that had been clearly visible on my desk. George had managed to deftly lift them as he exited my office. I was equally surprised to find the same roll of stamps encircling the antenna on my car as I left my office later that evening. Clearly, George was involved in some sort of game, one that produced the uncanny feeling that I was the vulnerable one, and that George had maneuvered himself into a superior position. During the next weeks, George and I explored his history and I became ever more alert to the items in my office, but George managed, by sheer genius and single-mindedness of purpose, to take a number of them. I encountered a good number of pens, my stationery, a book, and a decorative item or two in the parking lot, on top of the garbage can (how appropriate), or on the lawn. I felt that George, who was supposed to be a patient seeking help, was actually demonstrating that he was “one-up” on me, an allegedly “helpful” authority figure.

I began to explore his childhood history and found that he was raised in a single-parent family that was generally supportive with the exception of dinnertime. His mother was extremely strict about eating—especially vegetables—and had rules that were nonnegotiable and often brought her into conflict with George, who was the older of her two children. When food was put in front of him, George was expected to eat it, regardless of his preferences. If he refused, his mother would impose a series of increasingly severe punishments. At first, his mother would require him to sit at the table until he ate. However, as he got older and older, George found out that he could out-wait his mother. Not infrequently, they both ended up sitting at the table for two hours, George stubbornly refusing to eat, while his mother sat angrily enforcing her rules. It soon became apparent to his mother that she was as trapped as her son, because she had to remain at the table in the role of enforcer. She devised a plan which imposed a time limit on each meal with punishments that would take place in the future. For instance, if he refused to eat his portion within fifteen minutes, he lost his allowance for the following week. Longer periods of refusal invoked more severe punishments, including being barred from visiting friends, loss of future birthday gifts, and restriction of his telephone privileges. A large calendar was marked far into the future with the restrictions and punishments that he had accumulated for his stubborn refusal to eat.

When George was seven, he began rummaging through his mother’s purse and took great pride in stealing change from her. He realized that if he were caught, more punishments would be forthcoming, so he was very careful to take small amounts of change that would not be missed. He also took his mother’s car keys and placed them in a spot where she would be frustrated yet unable to blame him. She would often be late and frantically looking for her keys, only to discover them on the garage floor or next to the kitchen sink. Interestingly, George’s younger sister was also subject to the same rules at the dinner table, but she adopted the compliant role, and therefore all the pressure and conflict was focused on George.

The pattern of attachment that developed between George and his mother was one between a dominant and implacable mother who treated him in an insensitive and autocratic manner. There simply was no healthy reason for this mother to treat her children this way. However, like most parents, she probably believed that she was doing the correct thing, even if it was a repetition of an unconscious destructive pattern that she experienced in her own childhood. Had I been able to question George’s mother (which I never did), I am quite certain that she would defend her severe training of her children, saying that was in their best interests. She might claim that she was teaching her children to eat all types of food for a balanced diet, or perhaps that she was teaching them healthy discipline.

A student of mine who heard this example in class suggested that the problem at the dinner table was this young George’s fault! Specifically, the student said that it was his stubborn refusal to eat that caused the problem with his mother. This reaction demonstrates the tendency to “blame the victim” and more importantly, it ignores critical information about the psychological development of the human personality. George’s refusal to eat was not just “stubbornness”—rather, it was the only way he had of preserving his sense of himself and his identity in the face of his mother’s overwhelming power. He was trapped by his human needs: he had to eat, and he could not dine anywhere else. His normal and expectable human needs were turned against him by the most important person in the world: his mother. He and his sister were totally dependent on their mother, as their father was not in the picture, like many millions of children today. They could not stop eating and they could not get a different mother. They simply had to adapt as best they could.

If George’s refusal to eat is more than simple stubbornness, what is it? There is another human need—a need as important as the need to eat—that was continually violated by his mother: his need for his individuality to be accepted and respected. George’s relationship with his mother taught him that his individual taste in food was not important and it had to be forcibly subordinated to his mother’s will. This was exacerbated by the fact that his mother would often provoke him by deliberately serving a variety of his most hated vegetables. His refusal to eat is the only way he could define himself in this situation. When he was forced to eat something that he did not like, he was giving up his position as an individual by accepting his mother’s demand that he eat whatever she put on the table, regardless of his personal preference.

Every time he gave in to his mother’s dominance, he simultaneously gave up his own individuality and experienced strong emotions of both humiliation and shame. We all faced numerous humiliations in childhood: failures at school, rejections from peers, and the difficulties inherent in doing many things at which we have limited natural talent. Generally, parents try to cushion the humiliations suffered by their children, but George had a mother who humiliated him within what should have been the “safe zone” of his own family. His solution to this growing anger at being humiliated was to steal. It was a perfect form of revenge, as he could enjoy secret victories over his mother and yet not be punished for them as long as they were cleverly disguised.

The struggle between George and his mother became and more painful as he grew older, because like all developing children, his sense of himself as an individual became stronger over time. The older he got, the more his sense of self felt compromised when he was forced to give in. By the time George was sixteen, the struggle had changed. He had developed an enormously angry, creative, and devious personality, and he had put in place a whole series of alternative dinnertime venues that neatly sidestepped his mother’s rules. He would secretly eat at the houses of his friends, where he was careful to ingratiate himself with his friends’ mothers. He also had several hidden stashes of food both in his room and in the garage, so he could secretly defy his mother while simultaneously maintaining his self-respect.

However, when he was six, there were no alternatives—no meals at friend’s homes and no stashes of chips to dampen his hunger and help defy his mother’s rules. These excessively painful humiliations were the primary sources of damage to George’s personality, making him deeply ashamed of his weakness and wary of closeness with others. However, his strategies for revenge against his mother constituted a second and more destructive type of damage to his personality. The secondary damage to his personality came from his “solutions” (his stealing and stubbornness) to his mother’s dominance. George might have succeeded in young adulthood if he had been able to shed his damaged personality (both his feelings of humiliation and his revenge behaviors) the moment he left home, but the human personality is like the shell of the turtle: we take it everywhere we go.

It was the second aspect of the damage to George’s personality (his revenge strategies) that became the problem for George after he left his home. His strategies for dealing with his intrusive mother were very important to him, as they helped to preserve his developing identity during his difficult childhood. In many ways, his creative strategy was like a parachute: in childhood, his solutions saved his self-respect, but in adulthood the same solutions, when applied to new people in parental roles, hindered him just as a tangled parachute on the ground can catch in the wind and drag the jumper to his death. In young adulthood, George couldn’t give up his revenge-based solution to his mother’s dominance because it was woven deeply into the fabric of his personality. All the insight from therapy, all his desire to change, and all the punishments heaped upon him had no effect on his stealing.

George, like many children, was caught in an unsolvable conflict because his mother, whom he loved and needed desperately, was the very person wielding power against him in a destructive manner. This paradox added an important level of complexity to his emotional response to his mother. The repeated dinnertime struggle created feelings of anger and fear toward his mother, yet at other times he loved and needed her. The emotional tug-of-war between the opposite emotions of love and anger toward the same parent produces a fundamental conflict within all children who are exposed to parental tyranny or neglect. One moment, George was filled with anger toward his mother, and soon after dinner was over, he returned to needing and loving her once again. The endless conflict between love and anger is one of emotional tangles that bind adults to their rejecting families. Many adults who were raised with this conflict cannot hold a single emotional perspective toward their parents for any length of time. The moment they feel a clear feeling that would allow them to act decisively, it is replaced by an opposite feeling. For instance, one moment they may be enraged by their parent and then—almost instantaneously—feel overwhelmed by pity and sadness about the same parent. These shifting emotional sands prevent them from separating from the family as they are continually dragged back by their emotional confusion. No single course of action is open to them. This key point will be revisited in chapter 5.

In sharp contrast to George’s family, a loving and functional family allows and encourages their children to define themselves by their natural skills: perhaps by success in a school play, sports, or academics. All of these are positive, self-enhancing building blocks that ultimately add up to a clear identity. Healthy parents exaggerate the success of their young children, often announcing their child’s success to relatives who join in the praise. These early layers of memories become the unconscious foundation of the developing child’s identity and they are essential later in life when inevitable difficulties require strength to overcome. We often label individuals who are able to overcome obstacles in life and ignore setbacks as being strong and having good “character,” which is the happy result of good early parenting. Sensitive parents also allow the child to “lead” by observing their child’s strengths and encouraging them in those areas. This requires that the parents be ready to sacrifice a great deal of their own time and freedom to support to their developing child.

The child raised in a healthy family takes in not only these positive memories of support but the countless repetitions of family scenes that inform him how to conduct his life, what is acceptable in relationships to parents and siblings, how to behave at social events, and countless other details that together form a large part of the child’s identity. Just as chaos and family dysfunction is passed from one generation to the next, so is healthy functioning, which is based on family relationships that foster trust, respect for each individual, and deep emotional attachment toward members of the family.

Another characteristic of healthy parenting is the existence of an often unspoken family plan or philosophy of life that guides the actions of the parents and lends a seamless organization to all family activities. Healthy family “plans” always include nurturing the children so they can begin their lives with skills and with a sense of how they should organize their lives. They may include having all the children go to college, or become members of one or another religious community, or become art lovers, businessmen, or serve in politics. Less healthy family philosophies that are transmitted to children may include grooming the children to be socially prominent, wealthy, or famous, without concern for others. However, even an unhealthy plan offers the child a long-term view of life and some sense of family organization. The least healthy family, developmentally speaking, is one with no long-term plans and no sense of organization or continuity. It is obvious why this last type of family is most damaging. As we have seen, the child’s personality is developed by memories of similar events that are repeated time after time. Constant chaos and unpredictability within the family disrupts the organization of a sense of self in relation to others, as there are not enough consistent interpersonal events for a single unified sense of self to emerge. As we will see with numerous examples, many parents had developmental histories that did not allow their own personality to mature or develop normally. They never experienced a family with a coherent plan and predictable daily organization, thus leaving them with a constant sense of emptiness and need that does not give them the capacity to give up their time and energy to help in the development of their own children.

Unfortunately, my patient George was a child who did not have the good fortune to live in a family attuned to his developmental needs, nor did he have a mother with a larger plan in mind for George’s future. Rather, her focus was on forcing her son to obey her demands, and consequently the most powerful events of personality building in George’s childhood were the creative and ingenious strategies that he developed during the angry struggles with his mother at the dinner table. In his family, he and his sister had only two possible pathways to define who they were in relation to their mother: they could either be rebels or clones. Adults often assume children are “resilient,” and are not affected by childhood difficulties, but in reality, the very core of George’s personality was formed by both the repeated humiliations he experienced at his mother’s hands and by his counteraggressive strategies. Together, they charted the course of the development of his personality.

Over a number of years, the childhood events that George experienced at the dinner table produced a “wounded self” within his larger personality. This is the first major defense mechanism of childhood, and its creation allows the child to remain attached to his parents who have either neglected or abused him. Loss of the attachment to the parent plunges the child into the terror of abandonment. Consequently, all defense mechanisms of the personality have the same goal, which is to keep the vulnerable child oblivious to the rejection he is experiencing and thus allow his sense of attachment to continue. If children raised in difficult and unnurturing families were somehow stripped of their defense mechanisms and could directly experience the reality of emotional abandonment, it would be analogous to dropping a five-year-old off in an unfamiliar city and driving away. All defense mechanisms work to help the child avoid experiencing the feeling of abandonment.

Every mealtime plunged George into a world of powerful expectations: memories and feelings of hundreds of past dinners where he experienced anger at his mother for setting up an impossible situation and anger toward himself for his weakness when he gave into her demands. Over time these intense feelings were formed into a large “package” within his developing personality that included feelings of hurt, humiliation, and rage. Each dinner added more memories to this growing package. These hundreds of separate but similar memories evolved into a sense of himself that is called the “wounded self.” Specifically, George’s wounded self was a sense of himself in a grim contest of wills with his mother at the dinner table: a sense of himself that was filled with impotence, anger, and a feeling of being trapped by a mother that he (at other times) loved.

All children who develop a wounded self do so in order to remain attached to their neglectful or indifferent parent. The wounded self allows the child to stay attached to the needed parent first by “packaging” all the memories of humiliation and neglect in a single and distinct container, much like a computer file, and then by closing the file by burying (repressing) it in the unconscious the moment the abuse or neglect ends. The moment dinner ended, George would repress the painful package of memories of humiliation by his mother in his unconscious and then return to loving and needing his “good” mother the rest of the evening. The defense mechanism of repression allowed George’s attachment to his mother (and thus his sense of security) to continue without being endangered by his angry feelings. Thus, during most of the time, George’s wounded self remained hidden in his unconscious and allowed him to avoid the powerful feelings of anger and vulnerability that it contained. No six-, seven-, or eight-year-old child can cope with constant feelings of anger toward his desperately needed mother and at the same time cope with equally painful contempt for his own weakness. Thus, away from the dinner table George was able to relate to his mother in a loving manner, with his emotional attachment to her intact. Repression of the wounded self is every child’s automatic solution to the problem of staying emotionally attached to a urgently needed parent who either deliberately (or inadvertently) frustrates his reasonable developmental needs. One of the most dramatic examples of a child defending against the reality of abuse is in Christine Lawson’s book Understanding the Borderline Mother. She describes the following short scene: “A toddler whose mother slapped him across the face looked at his mother and exclaimed ‘Somebody hit me!’” (139) This example shows how the child avoids the reality that undeserved abuse is coming from the person most needed, and the earliest defense mechanism of all—denial—is used to protect himself from an awareness that he simply could not tolerate.

The struggle between George and his mother was not really about food; it was a struggle between a child trying to defend his developing sense of self from his mother who was intent on crushing it. As he got older, George’s wounded self became more apparent, as it manifested itself in his stealing from authority figures who meant him no harm. Kathryn Harrison, the author of the powerful memoir The Kiss, described her awareness of her wounded self as it fought back against her abusive yet desperately needed mother. In the following passage, she refers to her anorexia as her way of defeating her mother’s constant intrusive comments about her weight. The only difference between Harrison’s description of her wounded self and the wounded self in others (like George) is the fact that she was conscious of its existence. Ordinarily, the wounded self is kept under tight wraps, so tight that the individual is not aware of its presence:

Harrison lays bare her anger as well as her childhood strategy of revenge against her mother who wounded her so severely. Her awareness is far greater now as an adult author who has spent years in psychotherapy than it was at the time of her anorexia. Therapy allowed her to identify the excitement she felt as a consequence of her sense of revenge against her mother, both for her intrusiveness and for her neglect. If we took each of her mother’s comments singly they would not appear to have the power to devastate Harrison. Their power came from the fact that her mother repeated them again and again, with every individual comment about her weight increasing the anger within her wounded self. This was particularly true in her history, as she also revealed in her memoir that her mother offered her almost no compensating experiences of love and support. The continuous criticism was coming from the very person who should have been supporting and cherishing her. This combination of criticism and lack of love are the two key ingredients that lead to the development of a wounded self in many children.

One of my patients, who had been in therapy long enough to accept and tolerate an awareness of his wounded self, described the problem of hiding from his anger at his parents as being similar to holding a large beach ball under water. He could do it for only so long by expending a great deal of energy, but it jumped back up into his awareness the moment a new frustration arose. This is exactly what happened to George at dinnertime: his whole closed computer file of intense feelings popped back onto his screen. He only became aware of these painful realities at dinner; the rest of the time they were completely hidden from his conscious mind.

Novelists also know a great deal about human psychology through intuitive pathways, as the prior quote from Harrison illustrates. Another remarkably wise novelist, Katherine Ann Porter, wrote about the wounded self in her 1948 essay, The Necessary Enemy. One of the most important aspects of the wounded self that Porter highlights is the fact that it is so hidden and unknown to the individual that its sudden appearance from its hiding place in the unconscious can be disruptive and frightening:

One must admire insights as intuitive and brilliant as Porter displays in this quote. She not only describes the existence of the wounded self, but understands that it develops in childhood and the feelings it contains can be transferred to others. She also recognizes that most of us try to hide from or otherwise deny the existence of the wounded self, and that it paradoxically contains a self-affirming kernel of truth. The truths hidden in the wounded self give the young girl “her own private life.” That is, her wounded self knows the truth about past angry and rejecting relationship events within the family, and these mostly hidden perceptions provide her with an authentic perspective. Unfortunately, these truths are encountered in frightening and disruptive ways that tend to make them less credible to the individual. Porter unerringly understood that most individuals experience the emergence of their wounded selves with horror and self-disgust. In this passage, the protagonist experiences her wounded self as being traitorous, instead of seeing it as a valuable and accurate source of personal feelings. One of the major steps toward separation from a difficult or neglectful family is to feel comfortable about the contents of the wounded self, without guilt for powerful feelings of anger about events that occurred years ago, and without seeking revenge on those neglectful or abusive family members.

All wounded selves act exactly the same. They remain alive but out of reach, deeply buried in the personality. The wounded self cannot remain repressed forever, as certain events provoke it to burst out of its hiding place and take over the personality. George’s wounded self emerged when he was in the presence of an authority figure, either in classrooms with a teacher or when in therapy with me. At other times, with peers, playing hockey, or when alone, it remained a closed file, hidden in his unconscious. The result of a large and active wounded self in adulthood can result in a tremendous outpouring of rage based on a small incident. As a teenager, I was a witness to a sudden upwelling of a wounded self while riding to work with a coworker, a man in his late twenties. One afternoon he stopped on the way home from work at an auto dealership to inquire about trading his car in on a new model. The salesman looked the car over and began negotiating a price. As we drove away, the hood of the car popped partially open, as the salesman had not closed it fully. The young man began swearing and calling the salesman names as he pulled over and closed the hood. Once back in the car he punched the dashboard several times, and threatened to return to the dealership and assault the salesperson. I was one startled and surprised young man—I had no idea what was going on, other than that his reaction was completely out of proportion to the provocation. This experience illustrates what the sudden emergence of a wounded self looks like to an outside observer. The explosive strength of his reaction strongly suggests that this unfortunate man experienced years and years of humiliations during his childhood.

The fury of my coworker’s reaction also illustrates another quality of the wounded self, which is its ability to freeze the emotions and perceptions that it contains over long periods of time. The emotions contained in the wounded self are accurate and appropriate feelings experienced at the time of the trauma. Thus, a five-year-old may feel intense humiliation about being punished for wetting his bed, and the intensity of the emotion will remain fresh in his memory and will not erode with time. The wounded self is filled with powerful and elemental emotions that can emerge suddenly and with enormous force.

Once the wounded self is repressed, the child or young adult can once again relate in a loving way to the parent. The obvious question arises: why does this go on over time? Why can’t we remember all the rejecting and negative events in our childhood and accept the fact that our parents failed us, and move on? The answer is deceptively simple. Only psychologically mature young adults can tolerate the reality that their parents failed them in certain areas, because their maturity frees them from needing false but comforting illusions about their parents. That is, their identity is firm enough to allow them to stand on their own without needing the support of their parents. When they no longer need parental support, they also no longer need the defense mechanisms that blinded them (in order to keep them feeling secure) to their parents’ failings. Ironically, only adult children of relatively healthy parents (or young adults from less healthy families who have profited from psychotherapy) can see their parent’s inevitable failings.

Conversely, young adults who were poorly nurtured cannot tolerate the reality of their parents’ failings because they still need their developmental help, as in the case of the toddler who looked at his mother and said “somebody hit me!” The undernurtured young adult simply cannot afford to recognize that the parents he relies on are incapable of offering the support that he desperately needs. This realization would shatter the child’s necessary feelings of psychological and emotional attachment to the parent, disrupting the child’s hope for the future, and plunging him or her into an abandonment panic. It is often hard to understand why a healthy-looking young adult is so slavishly dependent on his or her parents; however, a look inside their personality would reveal a child with the developmental age of six or seven. The lack of emotional support during their early childhood years traps them in adolescence (or earlier) and they are unable to continue on a normal developmental path. Because they are so desperately needy (and because they repress their active wounded self), they are unable to see that it is futile to hope for love and support from their family in the future. The result of this faulty parenting is large numbers of young adults who are unable to separate from their families. Instead of starting lives of their own, their dependency needs force them to maintain contact with their hostile and negative parents in the hope that someday they will be offered enough emotional support to allow their personality growth to continue.

Harrison is herself an example of a young adult who remained attached to the mother who failed her emotionally. Once again we can observe her uncanny ability to keep track of her wounded self while behaving in ways inconsistent with her real feelings. Like all young adults who were neglected as children, Harrison needed to remain emotionally attached to her mother in the hope that she would eventually receive the love she craved. In the meantime, her pathological mother required that she give up all evidence of self-direction and allowed her (the mother) to take over all decision making:

This wonderful description of her inner experience shows us that Harrison was aware of her lack of personal power in the face of her mother’s need to control. Despite the fact that she allowed her mother to think that she was completely in charge, Harrison was aware that her true self was deeply hidden and completely immune to her mother’s misuse of power. The willful repression of her true self was a conscious technique that preserved her sense of self in the face of her mother’s dominance.

Harrison allowed her mother to continue to rule her because she desperately needed her mother, and she needed her mother because (paradoxically) her mother failed her so completely in childhood. Her mother, too, had been so abused by her own mother (Harrison’s grandmother) that Harrison’s mother abandoned her daughter and fled to a secret apartment while Harrison was raised by her grandmother. Harrison had so little contact with her mother that she knew that the only way to continue the relationship was to appear to accept the submissive role without complaint. Her only choice was to submit or to face complete abandonment. Her memoir demonstrates the key paradox that will be examined again and again in this book: children who are neither loved nor emotionally supported during their critical childhood years face extreme difficulty in separating from their rejecting and abusive parents. All the rejection from her childhood did not discourage her from remaining attached to her mother; instead it made her all the more hungry for her frustrating and elusive parent.

Harrison’s example illustrates that neglect has a counterintuitive effect on the development of the human personality. Amazingly, neglect of a child’s normal developmental needs makes that child increasingly attached to her (faulty) parents as compared to a child who has been reared by nurturing and loving parents. At first glance, this seems to be completely backwards. It seems logical that a child who had very few developmental needs satisfied by her parents would end up being less dependent on others. One might assume that the chronically neglected child would give up the battle to get her developmental needs met and move on in life, but as I have noted, the individual cannot move on without the cooperation of the parent. Thus, no child (or young adult) can give up on her neglectful parents, for to do so assures that her psychological development will stop completely. Similarly, no child stops needing and seeking food if she is being starved. Children simply do not have the emotional fuel to power their own personality development. Thus, the unexpected outcome of childhood neglect is that the child clings to her unloving parent with an intensity and ferocity not seen in the normal child. This is a major part of the explanation of the dynamics of the adult who is unable to leave his or her family of origin. It also is the key psychological factor behind most battered womens’ attachments to their physically abusive husbands that I have detailed in The Illusion of Love.

This critical developmental reality can be illustrated with the use of numbers. Let us assume that each day in a healthy family results in one unit of emotional nurturance within the child, toward the many thousands of units required for the development of a healthy personality. Thus, a child from a functional, loving family will probably end up with 350 units of nurturance per year. Why not 365 units? Simply because even healthy loving families have some disruptive strife that prevents the child from getting his daily minimum requirement. Thus, each year the loved and emotionally supported child adds 350 units to the required number needed for mature personality functioning. Second, let us assume that it takes 7,000 units of emotional support in total, over a period of twenty years, to allow the child to develop into an adult with a fully mature personality. After ten years of supportive parenting the child has acquired 3,500 units, and after twenty years, 7,000 units, which allows this lucky young adult to achieve emotional maturity. Once achieved, the young adult no longer needs the frequency or intensity of support that was necessary during her development because she carries the thousands of events of emotional support in her memory. She can now separate from her family and eventually begin the process of nurturing the next generation of children.

Now let us compare the healthy scenario with a child caught in an emotionally neglectful family. The lack of support that she experiences allows her to accumulate far too few units of nurturance from her relationships with her parents during the year. Let us assume that she receives seventy-five units out of the 350 she needs, and so she develops a large emotional deficit. Her personality cannot develop normally without these units of emotional support, so it remains stuck at an earlier age. The next year she also receives seventy-five units, so as she gets older, she gets further and further behind in terms of her emotional development. The result of a childhood of continuous deprivation is an enormous deficiency in her identity, and she is left feeling odd and “left behind” as compared to other children her age. Equally damaging is her growing sense of worthlessness, as her wounded self accumulates daily evidence that even her parents do not love her. As time goes on, her damaged identity makes it more difficult—if not impossible—for social service agencies or even kindly relatives to help the deprived child. When outsiders offer her support, it will be reacted to with suspicion, since the child fears being exposed as either needing help or for being the misfit she assumes herself to be. She is therefore cut off from help from school or friends and ever more dependent and fixated on the very parents who are depriving her. As time goes on, she falls further behind in terms of social skills and achievements. As she gets older and her body continues to grow, she is placed in an ever more frightening position with increasing social expectations. Instead of allowing a complex, rich, and confident identity to emerge, she is left with a mostly unconscious wounded self and a childlike, need-driven personality. Many neglected children solve the problem of an incomplete identity by avoiding school functions and outside social relationships, which pushes them deeper and deeper into the web of their neglectful or indifferent family.

As the years go by, her need for a parent (and nurturing in general) will increase, because the previous years of unmet emotional needs are added to the present needs that are not being met. Again, this seems to defy logic, since we generally assume that the older a person is, the less they need the type of emotional support that we offer to children. Worse, the earlier needs are for behaviors that are appropriate at ages four and five, but are no longer appropriate for a young adult. The long-term consequence of emotional deprivation produces a young adult who will try to satisfy his or her unmet childhood needs. Many young people, both men and women, who were developmentally deprived “solve” their personality problem by attaching themselves to a partner who actually represents a parent (even if that partner is equally dependent and immature) and emotionally “weld” themselves to the other person. Often they become pathologically jealous (a reaction to the threat of abandonment) toward potential rivals in their partner’s life. These young adults shift their reservoir of unmet childhood needs from their parents to their young partner. Anything that threatens to take this partner away is potentially devastating to their psychological wellbeing, as they feel that they cannot survive alone. This is the source of most of the jealousy-based violence that takes place in our society.

The neglected child’s wounded self is in sharp contrast to the healthy developing sense of self in a child from a functional family who is able to add positive memories to her developing personality on a daily basis. The loved and emotionally supported child has an abundance of memories of affection and feelings of success to add to her ever stronger sense of self. Conversely, the loved child has little or no wounded self, because she has not been exposed to many frustrating and anger-producing events in her relationship to her parents. If a wounded self is not developed in childhood, it will remain undeveloped forever, simply because the child doesn’t have to “package” and repress painful events because they never happened. Even when there is conflict in a functional family, the child’s chance of humiliation is unlikely because these isolated events are cushioned by the much larger number of loving and supportive interactions that typically take place, as well as the large warehouse of emotionally supportive past events stored in her memory. The consequence of a supportive childhood is a young adult with a strong identity who is not interested in continuing relationships with others who are negative or demeaning. The personality that evolves will be positive and optimistic, unafraid of closeness with others, and based on a foundation of thousands of memories of small successes. This individual no longer needs the support of her parents on a daily, or even weekly basis, as her internalized sense of self becomes her guidance system. Many people mistake healthy individuation from parents as a rejection of the family of origin or lack of closeness. Nothing could be further from the truth. A healthy developmental history allows the individual to separate from his or her family, develop close emotional ties with a partner, and then produce and nurture the next generation. This is impossible for the poorly nurtured individual. They cannot trust others to love them because their own parents failed to do so, or they are consumed with wounded self (as was George), which results in distorted and angry relationships in the next generation.

The question that springs immediately to mind is: can the development of a wounded self be reversed once it has begun? The encouraging answer is yes, if the parent reverses their behavior before too much damage has been done to the developing personality of the child. One of my great sources of pleasure in the field of mental health came from working with parents who came in with a “problem” child and were open enough to recognize that they were a major source of the problem. Sadly, this tends to be the exception rather than the rule. Many parents cannot accept that they play any role whatsoever in the difficulty that their child displays. For example, I was consulted by Linda, a thirty-five-year-old graphic artist about her eleven-year-old son. She brought Mark to the session but he refused to come into my consulting room. Rather than engage in a power struggle with the young boy, I suggested that Linda and I talk together while her son remained out in the waiting room, glaring at me with undisguised anger. Linda reported that she was enormously concerned about her son’s negativity, hostility, and fascination with violent games on the Internet, particularly in light of the school violence that has captured the nation’s attention. She felt that she could not keep her son off the computer, as she had a home office with several modern computers on which she did graphic design. Mark had been given two of her older computers and she did not want to confiscate them, fearing he would continue at a friend’s house where she had no ability to supervise him at all.

I began by saying that since her son refused to come in, she and I would have to “cure” him without letting him in on the secret. This seemed to surprise her as she assumed her son was suffering from problems located within himself. Before exploring the problems she was having with Mark, I asked her to describe her own childhood. She immediately challenged me, as she did not see any possibility of a connection between her childhood history and her son’s problems. I explained that we often unconsciously bring our own developmental histories into the new family that we create. Linda then willingly described her history which was both emotionally impoverished and filled with verbal abuse from her depressed and bitter mother. She said her goal in life was to raise children who would never face what she went through. Her husband was a hard working and dedicated policeman, and they got along well as a couple, but he often worked a second job and consequently he was irritable and tired when he was home. “Well,” I noted, “then it’s all up to you.” Linda was astonished that I had the confidence to predict that she could “cure” her son’s problems without her husband’s help, and without seeking cooperation from her son—it sounded completely impossible.

I asked her to carry a small notebook in which she drew a line down the center of the page. One side was labeled “rejecting” and the other “loving.” I instructed her to rate every sentence she spoke to Mark as either one or the other. We practiced rating typical sentences she might say: for instance, all statements that demanded some activity from Mark without an affectionate tone were rated as rejecting. The very same sentence could move from the rejecting side of the scale to the loving side if it was said in a patient and supportive way. After twenty minutes of practice rating various statements, we both felt that she had understood and mastered the rating task and agreed that we would review her ratings during our second session, scheduled for the following week. Before she left, I emphasized that she was not to change any of her normal behaviors—the only new step was to secretly rate her statements to her son.

I received an emergency call from Linda’s husband on the evening of the second day after our initial session. She was locked in her bathroom crying hysterically, saying that she was a worthless parent who was better off dead. He convinced her to talk to me and she immediately (and frantically) described her ratings for the first two days: all of her statements to Mark were on the “rejecting” side of the scale—in two days, she had not made one loving statement. This was a little more reaction than I expected, and so I agreed to meet her later that evening in my office. She showed up escorted by her stunned husband and deeply worried son. Her husband’s look seemed to accuse me of driving his wife crazy—after all, she had been perfectly fine until she came into my office just two days ago! Linda’s shame prevented her from telling her frightened and confused husband what was going on and thus he had every right to be suspicious of me. I knew I was going to be occupied with Linda for quite a while, and I was worried that all the pained sounds that she was likely to produce would further panic her husband and son, who probably would be able to hear her despite the double doors between my office and the waiting room. So after sitting her down in the consulting room, I strolled back to the waiting room, affected my most casual appearance, and suggested that dad and son go out for a pizza. Linda’s husband looked at me as if I were a lunatic—his wife was having a “breakdown” because of my one session with her, and I had the nerve to suggest he take his son out for pizza! I assured them everything would be just fine in two hours or so and they reluctantly left.

Both Linda and I were relieved that she no longer had an anxious family in the waiting room. I began by saying that I thought that I knew what was wrong: she had discovered in the past two days that she had somehow become her mother. “It’s true, it’s true,” she almost wailed (I was very glad that dad and son were not close enough to hear Linda’s anguish). This was no wild guess on my part, but rather a simple conclusion based on Linda’s description of her mother’s behavior toward her, the family dynamic which left Mark with only his mother to rely upon, and Mark’s angry and wounded self’s withdrawal. Mark’s “problem” resulted from having no support from his father and constant criticism from his mother, and thus his only avenue was to withdraw into his own wounded self’s fantasies of revenge via the violent games on the Internet. I assumed that Linda was unconsciously enacting the same pattern with her son that she and her mother had engaged in thirty years before.

Linda’s two days of rating statements focused her attention on what she was really saying for the first time in her life. After every statement, she would silently rate herself for negativity, in both content and tone. She was amazed that everything she said ended up on the rejecting side of the scale—everything, from getting ready for school to checking Mark’s homework. When her son left for school, she sat down and reviewed her ratings, which were depressingly negative. She reassured herself that she was rushed in the morning and would surely have more loving statements in the afternoon when Mark came home from school. To her amazement, the afternoon ratings were even worse than her ratings from the morning. Before bed, she looked at her ratings once again and she reassured herself that the next morning would be better. To her horror the next morning produced more of the same ratings and she spent most of the day stunned by what she had discovered about herself. By the time Linda called me, she was filled with guilt, self-loathing, and despair.

After the shock wore off about my initial remark that she had become her mother, I reassured her that everyone has the potential to turn into their parents, but we could work together and reverse the trend. Linda noted that the worst thing that happened when she began rating her statements was that she remembered how it felt to be abused by her mother. This recognition produced even more pain, as she had broken her vow to never expose her son to the abuse that she felt as a child. Not surprisingly, Linda wanted to change her behavior completely and speak to her son with nothing but loving statements. I knew this was impossible and if she failed (which would surely happen), she would go through yet another bout of intense guilt. Rather than have that happen, I suggested that she continue with her negative statements but add just one loving sentence in the morning and one at night. Linda’s mouth dropped open and looked at me as if I was completely out of my mind, saying, “Two a day? That’s all I get to say? Two a day?” Now both she and her husband were ready to send me off for treatment of my own!

“Well,” I responded, “your son knows that you are coming here,” (which was a clear understatement) “and we don’t want to make him suspicious that you are saying supportive things just because I told you to. Just say two loving statements to him per day. One before he goes to school, and one when he comes home. That will completely clear up the problem.” By the time Linda’s husband and son returned, Linda and I were chatting comfortably, and she showed no signs of the deep distress that had overcome her just hours before.

I was confident that Linda was not going to follow our agreement. As expected, she returned the next week with altered scores on her self-rating scale. She had added a new category which she called “neutral,” which she used to describe her formerly sharp or cynical statements that she had stripped of their negative tone. Not surprisingly, she had many positive statements, far more than the two per day I had suggested, and had only made a few slips back to the “rejecting” side of the scale. Much to her amazement, Mark was spending less time isolated in his room, so the trend after just one week looked promising. My assumption was that Mark would be very responsive to his mother’s improved acceptance of him because his father was absent most of the time. Mark went from being a child of an absent father and a critical mother (equivalent to no parents) to a child with an absent father and a loving mother—a substantial improvement. Linda continued to meet with me regularly for nine months. After she got nearly complete control of her wounded self (that is, when we agreed that she was no longer acting toward Mark as her mother acted toward her as a child), we looked at her painful history with her mother. She was an unusual patient because of her willingness to see parts of herself that many parents simply deny. Happily, the positive trend in her relationship with her son continued and became effortless. This clinical example illustrates my previous point: children’s personalities are formed by the small day-to-day interactions with their parents. Both the problem and the cure in this family came in hundreds of small interactions between mother and child.

My work with Linda also demonstrates that many parents do developmental damage to their children inadvertently. Linda was a decent and concerned parent, yet the damage from her own childhood—specifically of the roles that she and her mother were locked into—remained in her unconscious and impelled her to demean her son in the same way that her mother demeaned her as a child. Many children are the innocent victims of their parent’s unconscious processes. The vast majority of parents want a good life for their children, yet the hidden power of their wounded self emerges the moment they have children of their own. This happens without warning, because prior to having children, their unconscious had no “actors” to remind them of their childhood role in their original family. However, the moment they have children their unconscious comes alive and begins to re-create their earlier family system, with each of their own children taking on the role of either themselves or a sibling. Thus the child with parents who had difficult childhoods of their own is born into a predetermined interpersonal universe where he or she is gradually defined in the same way that their mother or father unconsciously remembered him- or herself or one of their siblings. Thus, Linda’s son reminded her of herself as a child, and she took on her mother’s role of constantly criticizing him. This allowed her unconscious wounded self to purge some of the rage it had stored for thirty years, but at a great cost to her son. Fortunately, Linda worked with the insight provided by the rating system and with the motivation from her deep commitment to her son’s well-being, which together allowed her to change her behavior. Our work on her own painful childhood relieved much of the unrecognized pain in her abused self, and Mark indirectly confirmed that his mother was an improved parent by his diminished depression, decreased avoidance of family life, and enormous increase in cooperation.

The developing child’s need for a mother is not just motivated by the need for psychological support, but by the child’s need for help in developing a consistent identity. We humans live in a rushing stream of intimate relationships, continuously changing information, social demands, family and business relationships, and relationships to religion, countries, and localities. The bedrock of a mature personality is a fixed sense of self—an identity—that can place us in a realistic and consistent position with respect to this constantly shifting mass of information and relationships. For example, an extremely disturbed individual with a paranoid personality has a distorted identity in that he feels constantly abused and picked upon. He compensates for his feelings of inferiority with fantasies of importance and superiority. If he is pulled over for a traffic stop, his anxiety may overwhelm him and he might believe (because of his defensive grandiosity) that the CIA or the FBI is after him. He may try to flee, or even attack the policeman. His distorted identity has no way of adapting to new information, and he can not tolerate behaving in a submissive manner (that is, accept a relationship that runs counter to his illusions of importance) to an authority figure. Conversely, an individual with a healthy identity knows who he is in relation to a wide variety of circumstances and relationships.

The very beginning of the development of an identity revolves around the infant and his parents, who will hopefully respond to him in a consistent and predictable manner day after day. The child’s experience of the world is screened through his parents’ perceptions of the universe that surrounds them. Over time, the child finds himself at the same place in relation to the world and this begins to be remembered as a template of reality. The parents’ consistent responses allow the child to build up memories of himself and of the world and soon he will feel alive even when his parents are not present. The sense of oneself as existing separately from others is the first step on the road to identity development and it is dependent on the parents’ ability and willingness to reflect appropriate and consistent emotionality back to the infant. Chronic neglect and indifference can prevent this very first step in the development of a functional identity in the child, which is defined in the infant or youngster as the ongoing sense that he or she exists when others are not present.

In this passage, Harrison helps us feel how she experienced the abandonment during those times when her mother sought escape from her own rejecting mother’s (Harrison’s grandmother) oppression by continually sleeping. Once, Harrison purposefully woke her mother and was severely punished, so she learned to wake her mother “inadvertently,” just as my patient “George” learned to frustrate his mother by hiding her keys without getting blamed. Harrison, the adult writer, describes how her mother’s disinterest in her as a small child damaged her fundamental sense that she existed as a person. It is this need to be recognized, often trivialized as children’s need for attention, that supports the early development of a separate and functional identity, and without it the child’s sense of herself simply ceases to exist.

Harrison recognized that without her mother’s support of her identity she couldn’t “step even an inch back from her bed without plummeting.” This is a poetic way of saying that without her mother’s acknowledgment of her existence, her personality felt like it would disintegrate if she moved away from the source of her security. This is not an exaggeration, but rather the felt experience of all children who are severely neglected. It illustrates the paradox of neglect: the more a child is neglected the greater is her need for the parent. This is one of the two key psychological dynamics that continue to bind adult children to their elderly parents (the other is the illusory hope for future love). The intense dependency that one sees in “adult” children who still live at home is partly a consequence of the lack of a strong identity—an identity that failed to form because of chronic rejection during their development. The individual may be forty years old, yet their sense of self as a separate person who is able to navigate the complexities of the world may be as fragile as Harrison’s unformed identity described in the passage.

There is another telling sentence in this quote that Harrison makes her one of the most psychologically astute writers of our time. She recognized that her mother was “blank” when she actually did look at her. This blankness describes her mother’s lack of interest in her as a daughter and an inability to validate her (Harrison’s) reactions to the world. We now know from the memoir that this resulted from her mother’s experience of being rejected by her mother (Harrison’s grandmother). Her mother could not give love and nurturing because none was never “put into” her. Emotionally deprived parents cannot love their children because they are themselves “empty” and bereft of emotional attachments. Paradoxically, many have a greedy need to receive love from their children. Harrison had to defend herself from the knowledge that her mother was blank, and assumed that something was wrong with her as a child, rather than recognizing that something was terribly wrong with her mother. This universal false assumption that children make about themselves is called the “moral defense” in Fairbairn’s model of human development, and it shifts the blame for being unloved away from the faulty parent to the (innocent) child. It is a defense against reality, because the shift of blame makes the child more secure. It is better to be “morally” defective than to realize that the mother upon whom you are completely dependent is unloving and uninterested in your welfare. This defense will be fully discussed in the next chapter.

The frustrated child does not take neglect lightly, because she needs emotional support and validation from her all-important parent in order to gradually form a new and unique identity. In particular, neglected children become fascinated with and obsess about the missing parent because they need to know who the parent is in order to know who they are. Often children will seek out their parent’s possessions, as they help convey the identity of their parent, which in turn helps them form their own identity. Once again Kathryn Harrison has given us powerful insight into this need, this time in her autobiographical novel Thicker Than Water:

The neglected protagonist in this novel is motivated by her need to discover who her secretive and abandoning mother is in order to form her own identity. The neglected child is at a severe disadvantage as compared to the child with available and responsive parents, she has so little material from her parents to weave into her own developing self. When the need is not met, it does not just evaporate. Instead, the child who cannot identify with the parent often remains at home, enslaved by the unmet need.

The consequence of severe neglect is an incomplete identity, and it leads to the paradoxical observation that many “adult” individuals do not possess fully formed personalities. This statement may be difficult to accept at first glance, since we assume that adult human bodies contain adult human personalities; sadly, such is not the case. The lack of a coherent sense of self is far more common than is generally acknowledged, and there are many chronologically adult humans who have personalities that operate from a childlike perspective. An example that I have used before in The Illusion of Love is that of Frieda and Greta, two adult English identical twins who behave in ways appropriate for two young children. The following quote come from an article by John Leo writing for Time magazine:

These two women demonstrate that it is possible to develop physically but remain frozen at an earlier state of personality development. In many ways, their behavior would be acceptable if they were five or six years old. This example also illustrates the previous point, that without a strong attachment to a supportive parent, psychological development ceases. These twins cling to each other the way a child clings to its mother, however, neither could offer the other a mature personality and therefore could not act as a catalyst for development. Therefore they remained tragically stuck at a younger age. The same phenomenon can be observed when young adults with underformed personalities who join cults and fringe groups. These groups attract hordes of “adults” who never had the type of early care that resulted in a solid identity, and they eagerly give up what little personality structure they have and allow the cult to dominate their life.

An individual’s identity consists of a huge computer file of statements about oneself. At the most fundamental level, the first entry says female or male while the second probably states one’s age. Other important categories include lovable or unlovable, important or worthless, smart or dull, attractive or unappealing, powerful or ineffectual, and so on. There are thousands and thousands of these statements about the self in each of our identities. What is the “purpose” of an identity? Simply stated, our identity keeps us stable, organized, and functional when we are alone—when there is no one to supply us with feedback as to who we are. Those adults who emerged from faulty families without intact identities have to cling to others in order to keep their personality organized, just like Freda and Greta.

Secondly, and equally importantly, our identity serves as our measuring stick of the universe around us. It acts as a stable point of reference that allows us to define who we are in relation to other people, to the world of work, to our community, and to our families and loved ones. Without a firm identity, we don’t know what to believe, where to go, or what to do. Comedy is often based on mistaken identities, concealed identities, or individuals who misunderstand their own identity. For example, the late Peter Sellers played the stupid and bumbling “Inspector Clouseau” in the series of Pink Panther movies. Much of the humor involves the Inspector’s complete misunderstanding of his own limitations. He sees himself as brilliant, while in reality he is a fool and a buffoon. His inability to use his identity to locate himself in relation to the capabilities of others is both pathetic and humorous.

In real life, the lack of a firm identity makes everyday tasks an enormous chore. Many patients report that they spend agonizing hours trying to decide “who to be” in various situations. It is extremely anxiety producing to face the world without a steady inner compass and often one family member will prey on others within the family. I have previously used a number of passages from The Kiss, a memoir written by Kathryn Harrison. The controversy around this work is based on the fact that she engaged in an incestuous relationship with her father that began when she was twenty years old. She was technically no longer a minor, and therefore her (self-destructive) decision was assumed to be based on her own free will. However, her “free will” was clearly compromised by her deprived childhood which left her with an enormous need to remain attached to her father. Like many adults, her unmet developmental needs overruled both her common sense and her need for self-preservation. The following quotation comes from her father’s letters to her:

This powerful passage illustrates just how confused and childlike “adults” in dysfunctional families can be. In this instance, Harrison was in the role of parent while her father had regressed to the role of a five-year-old child who needed reassurance every few hours. Neither Harrison nor her father had a functional adult identity, and her father was now trying to use her “love” (which she offered in order to get from him the support that he did not offer when she was an child) to fill in the emptiness and lack of nurturing from his own developmental history. Neither had the ability to “parent” the other, an identical dilemma faced by Freda and Greta, who clung together in a futile attempt to get parenting from each other. Emotional development was not possible for either Harrison or her father in this situation, because both were seeking support for their incomplete identity from an equally incomplete other. Years after the illicit relationship, and after years of psychotherapy, Harrison recognized the impossibility of the situation in this passage, but at the time that she was actively engaged in the incestuous relationship her neediness did not allow her to accept the truth.

Her description of her father’s dependency on her is reminiscent of a young child’s dependency on his mother. Her father’s sense of well-being was completely dependent on Harrison’s (his daughter’s) feelings toward him. His identity was so weak that he could only sustain himself for a few hours before he had to call again for reassurance. Without that reassurance from his daughter “there is no meaning, purpose, or pleasure in his life.” This is as clear and as extreme an example of lack of a coherent identity that one can find. The fact that her father regressed back to this earlier stage clearly indicates that his early needs were not met and that his adult appearance concealed an infant-like personality. This example illustrates how vulnerable those with weak identities are to abandonment all through their lives. They live on the very edge of psychological collapse, and not surprisingly, are willing to engage in drastic, antisocial, and self-destructive acts to keep their identities from collapsing.

I have worked with many patients suffering from underdeveloped identities during my years of practice as a clinical psychologist, one of whom was Terry, an emotionally immature yet optimistic and delightfully humorous individual. She was an unmarried and severely overweight forty-five-year-old businesswoman who owned two wine and cheese specialty shops and loved to say, “Come on Doc, you’re the genius, get me outta this mess.” She came in for help because her mother would call her several times a day or would suddenly show up at the store and want to talk, thus interfering with her business. Terry had allowed such intrusions in the past, as she had been depressed and underemployed for many years, but recently her first shop had become successful and led to the opening of her second store. They were an important source of her self-worth, and her dependency on her mother decreased drastically. In effect, she was trying to change a longstanding relationship with her mother, which had once met her needs, but now was interfering in her improving life. Her businesses were taking up much of the time she used to devote to her selfish and never satisfied mother. Not surprisingly her mother had few if any friends and was increasing the pressure on Terry to return to their prior pattern of spending almost all of their time in each other’s company. The crisis came when the daily intrusions by her mother began to embarrass Terry in front of her customers or suppliers.

Terry’s mother was exceedingly self-centered and did not consider Terry a separate individual (which was once an accurate assessment of their relationship). She would call her and without any introductory remarks begin describing an afternoon television program that she was watching. On those occasions that Terry got the courage to hang up the phone her mother would call back and berate her for being an unloving daughter. Terry also cleaned her mother’s house for her and brought her limitless specialty food items from the store, most of which she rejected because they tasted “too ritzy” for her. It was clear that Terry had spent the first half of her life clinging to a mother who had failed her in order to keep her hope of finally being loved alive.

When Terry began to limit her contact because of her business pressures, her mother used a counterstrategy of testing her limits by making ever escalating demands—by being late when Terry went to pick her up and by demanding that Terry drive her around town to do errands because she got “lost” so easily. In utter frustration, Terry bought her a clock with an alarm and a detailed map of the city! Not surprisingly, her mother discarded both of them, complaining to Terry that all they did was confuse her further.

Terry’s mother was a perfect example of an undeveloped personality lodged in an adult body. Terry described her as behaving like a five-year-old, oblivious to the needs of others, while demanding that her daughter pay attention to every small detail of her life. Her demanding and childlike behavior illustrates that the hunger for developmental support lives on and on and remains as intense as it was in childhood, despite the fact that the person is now elderly. Terry’s mother managed to constantly focus attention on herself, like a child showing off. However, it was too late for that once-critical attention to help her (now) seventy-year-old personality to develop. Her underdeveloped personality still craved attention, despite the fact that it was unable to properly utilize the attention as a building block toward normal adulthood. It is similar to a person who was once exposed to near starvation and as a consequence of that experience continually overeats, but the food eaten today has no effect on the memories of past starvation.

Both Terry and her mother suffered from the same type of deprivation (like Harrison and her father). The only difference was that they were in different roles based on their generation and relationship. It is easy to assume that Terry’s elderly and self-centered mother failed to meet even a fraction of her legitimate developmental needs, leaving her in a state of psychological suspended animation. She still clung to her mother in the hope that she would somehow get her mother’s support in order to make up for all the years during which her needs were not met. Terry’s dependency allowed her mother to use her child-like attachment to her own advantage. Terry’s extreme need also blinded her to the fact that her mother did not have the love within herself to give to others.

When I am faced with an “adult” patient who demonstrates high levels of dependency and poor separation on a previously neglectful parent, I know that every suggestion I make for independent action will be seen as impossible, cruel, or excessive. Thus, I knew better than to suggest that Terry set limits on her mother since it was clear that her mother acted as half of her identity. Rather, I suggested that she meet with me twice a week. This had the effect of further compressing Terry’s time with her mother and it placed me “inside” their previously exclusive two-person world. I also knew that the emotional attachment that Terry would develop toward me would threaten her mother, which was indeed the case. During our third or fourth session my phone, which has an automatic answering machine, began ringing time after time. Terry sheepishly admitted that her mother planned to call her during the session and demand to speak to me. I simply got up and pulled the phone jack out of the wall. “Don’t do that!” Terry yelled. “My mother will kill you!” I looked down at my lap in stony silence and then in a deep and growling voice responded, “I eat people like your mother for breakfast!” Terry stared at me in wild-eyed astonishment, amazed that I could be so bold and unafraid of her seemingly all-powerful mother. She then said with mock horror, “Oh, you’re one of them tough guys I’m supposed to steer clear of—aren’t you, Doc?” “Yep, that’s me,” I said. “Your old mom doesn’t scare me a bit.”

Our light and humorous approach did not change my assessment of Terry as a child trapped in an adult’s body, and we spent many hours discussing small tasks that intimidated her, including developing her network of friendships, continuing her education, and the most frightening task of all: entering the world of dating. Her mother continued to remind both of us of her anger at being displaced—once she parked right next to my first-floor office and ran her car engine throughout the session to remind us of her presence and displeasure at Terry’s growing independence. After six months of sessions, Terry told her mother she could no longer barge into her stores during business hours and interfere with her customers. Her mother had seen the progress Terry was making, and agreed to this condition without any retaliation, as she recognized that her power over Terry was waning. Over the next three years, Terry gradually won the battle against her mother’s intrusiveness. For the first time in her life, she developed a healthier identity that could stand up on its own and develop a network of friendships that became the focus of her life experience.