General Housekeeping
Hello!
A warm welcome to the new subscribers who found me from other publications in the last two weeks — it’s nice to have you here. I’m not entirely sure where you’re coming from, but thank you for your subscriptions and interest in my work. The current count is 115, up from 107 from last week. That may seem small to others, but it’s huge to me! So thank you for your interest and eyeballs.
As I announced last week, The Practical Therapist was sick over Thanksgiving weekend, and it knocked me off of my schedule, and as promised, here is the draft post that wasn’t quite ready on Friday for this week.
I also announced that I am working on a side project that will last approximately 15 months, starting in March of 2024.
It has been my goal since childhood to become a published author of a book. After the general success of writer
who has extensively documented her journey to serialize and self-publish her own novels through her Substack, , and as also covered in The Free Press about the wave of authors and creators also taking to a similar tact, I decided to follow suit.The newsletter is called
, started almost a year ago in February of this year, and has nothing on it—I noticed an uptick in people viewing it last week, which is great, but again it’s completely empty guys, ain’t nothin’ there—though there are about 10 drafts of items there ready to be published. In the coming weeks I will be mentioning it here in the General Housekeeping section, and it will be more freeform, with separate newsletters for essays, poems, short fiction, and the long-form novel. Ultimately, the plan is to use the subscriber fees from the novel, and set those aside to help pay for the editing, rewriting, and printing costs of the book. I believe there will also be a calculation for shipping costs as well included, and a full breakdown of fees will be given so readers know where their dollars are going. Free subscribers will get a partial preview of each chapter, but paying subscribers will receive the chapter in full.And now, without further ado, this week’s newsletter.
The Practical Therapist is a free enterprise. Please consider a paid subscription, or, you can donate through this nifty link/QR code through Buy Me a Coffee.
When I start my work day, I often have no idea what is going to come walking through my door. Not the upsets, issues, joys, problems, or meltdowns bubbling underneath the surface of my clients lives. From week to week, I have a general sense of what they’re working on—we have goals we work on, but sometimes that is derailed by the larger storms that crop up.
Progress is slow, as is personal change, for an entire person has to begin the process of transforming from who they’ve been, or how they’ve been looking at the world, into the person they end up becoming at the end of their time in therapy.
Back in late summer, a woman in her mid 30s came to me seeking help with finding a new job. She worked for a large corporation in their sales department, which had undergone structural changes earlier in the year, and it appeared, according to her intuition, that they were undergoing structural changes yet again. The spring had seen a score or more of salespeople let go, and this fall proved to be yet another wave of employees released from their positions as the company decided to consolidate all of its offices to another state as the headquarters, and to be fully in-person for work. With a month’s notice, all employees across the country were told to make the decision to stay with the company and move by next summer to their larger office headquarters in another state, or give notice within three weeks and receive their severance. It did not sound as though there were going to be any help to those moving with expenses, since there were likely many people who would have to sell homes and uproot their families. One former coworker of the client owned a farm in the south, and had worked remotely before they were fired; had that individual still worked there, they would have needed to completely up-end their life. It sounded like a mess.
My client came into my office for career counseling, which I generally limit to between 3-6 session spaced apart every other week. This helps clients have a chance to make some movement, and to take their time finding a job—it often takes several weeks to several months for there to be some type of change. For the first few sessions, I noted that she was indecisive. I would ask her my standard questions of what her interests were, what she enjoyed doing, what she dreamed about and wanted for herself. She didn’t know what she wanted to do. She didn’t know what she preferred, or what was important to her.
There were a few critical elements at play, before we proceed, which I think are important to note:
As our sessions progressed, it became clear that the woman had deep self-esteem issues, related to a family culture from her parents, who had been screwed over in their youth, that you could not rely on or trust anyone but yourself. She had been fighting all her life to be career focused and driven, and be totally self-sufficient.
As this family narrative had evolved over the years, the client had become concerned with perfectionism. Everything had to be done right and perfectly, so that she could avoid pain and discomfort.
She did this by seeking to be a people pleaser, and looking, as she said, “to everyone else to tell me what to do”. She had listened to the voices of others, in the form of podcasters, self-help books, and her parents, because she never felt she was good enough or competent enough to make her own decisions.
See my post on competency and maturity for more insight on this topic.I strove to be careful not to “blame the parents” and help her to remain objective that despite their own failings and dysfunction in their marriage, they had done their best for the client and her sibling.
As we sat there one afternoon, early on, I asked the client deep in her gut, what it was she really and truly wanted. Like a flash of insight, but also sheepishly, she told me she wanted to be a wife and mother more than anything else in the world, that she hated sales, and this was not what she had wanted for her life. For two sessions she had struggled, and had begun to veer on the edge of non-career related life topics. It was at that point that I began to ask her more general life questions, and allowed the session to veer outside the boundaries of what is considered career counseling. The points I listed above came out over the course of 12 sessions, but instinct told me there was something else bubbling underneath my client.
We classify clients into a few categories, and while it may seem harsh, it helps to understand the mindset of people who come in, and their expectations for therapy.
There may be more categories, but if I recall it’s broken into these conceptualizations:
People who are there by force, either court order, work, or some other external demand. They are resistant to therapy and don’t want to be there, generally.
Shoppers. People who are looking for something quick and easy, but don’t have a deep commitment to seeking long-term care. They terminate quickly or stop showing up altogether.
People who think they are the problem, but really, are actually the scapegoat. These are the people who can often come off as neurotic —in the colloquial, not Big Five Traits sense — and needy. They believe they are a burden and that they have caused all the problems. They are often the person on whom the family problems are pinned, and have been told by other family members that they are the ones who need to get help. These cases are heartbreaking, and are usually determined after several sessions and client interviews to determine the family dynamics. These people can sometimes be an offshoot of those that are there by force, though I think they deserve a category all on their own.
Clients. Client are the people who are there to genuinely seek help, who want to stay, and are committed from the beginning. They recognize there is an issue, usually have fair to good insight, but are getting stuck on something along the way.
This client would be an example of being a “client”, though like many people, is not or was not aware of the deeper issue causing her problem.
The client’s entire gearing was toward the avoidance of pain, and shame she felt for being herself. She is an attractive woman, and quite tall, which presented different body-related self-esteem issues than I had encountered before. What became predominant through our sessions was her constantly seeking others to tell her what she should do—generally in the form of “experts” who have figured out the game and how to hack life.
We’'ll come back to this client in a bit.
Hanging the curtains for a vampire
Recently, a girlfriend of mine held a get-together, and as we gathered in her cozy living room, books on shelves, warm cups of tea wafting aromatic scents of chamomile, jasmine, purr-eh, and cinnamon, we worked on our handicraft projects. Some knitted, like myself, while others embroidered or painted watercolors, as golden sunlight warmed the afternoon, providing a sweet respite after a hectic week.
As we got to chatting, several of the women vented about a male acquaintance. He was close to 40, and without a wife or children, and his frustrations in finding a Mrs. were well-known. Male friends have complained about this gentleman, who as they put it, “sucks the air out of a conversation by hijacking it to ask people to tell him what he should do”. He’s been dubbed something of an emotional vampire, though I don’t believe that’s completely fair as a label. Often, topics veer off track by the man in question soliciting advice and empathy from women on how to date women. Getting entangled in an hour, or two hours of conversation with this man can be difficult to remove oneself from.
As the women elaborated, more recently the man has been inquiring for help related to redecorating his house, and had been soliciting their advice more and more. The complaint was generally toward his indecision on making a decision, and yet again, the beast of perfectionism reared its head. Their concern was he took forever to make a decision, didn’t have a sense of taste—I may argue he doesn’t know he sense of taste since, if he doesn’t know what he wants, he doesn’t know himself—and constantly needed prodding help. I would go so far as to suggest that the people he solicits advice from either function as a stand-in-mother, or a stand-in-wife, as he primarily goes to women. In my ever gracious way, I am generally dismissive and tell him to suck it up, politely, hence why he does not bother me. I would tell him to get a therapist.
Showing me a picture of a very generic painting of a sunlit alcove in a Tuscan-style, one woman commented, “He picked this, and it looks like something that would hang in Olive Garden.”
Oof.
The Development of the Deprivation of the Emotional Life
At a point in time in our life, some of us may develop a difficulty in trusting our own judgment. There is nothing wrong with seeking a second opinion, especially from a trusted friend, when you have a difficult decision to make. Of course, that involves trial and error, accepting when you fail, and learning from the failure. For much of our adult lives, if we’ve successfully managed to make it through the tough parts, we can navigate large, medium, and small decisions. As we gain more practice in developing our decision-making and problem-solving skills, we have more experiences to draw from to help us navigate trials, with sufficient support from the people in our lives. Part of Erikson’s stage of development involve children learning competency and mastery over themselves, and that includes good formation to make prudent, wise judgements.
From my own experience when I was in the deep end of my own therapy, I solicited advice from everyone that I knew, because I did not have enough belief of faith in myself that I could make good judgements concerning even the smallest decision. Over time, as I worked through my own experiences and insecurities, my likes and dislikes became clearer over time, and I had to actively force myself not to solicit advice from other people. It became nearly habituated and addictive in its nature, to ask others to tell me what to do, to affirm me, to agree and encourage and approve of my every little action or choice.
Both my client and the man in the example above share something in common with myself, an attribute I see in numerous people and seems to be prevalent in our current age: the need for affirmation.
Some time ago, my husband recommended Healing the Unaffirmed: Recognizing Emotional Deprivation Disorder by Psychologist Conrad Baars1. It was a book he had been required to read by his spiritual director, a Dominican Friar located a the Dominican House of Studies in Washington, D.C. In the book, Baars and his writing partner, Dr. Anna Terruwe, detail a psychological condition that they had submitted for the DSM, but was consistently refused. DSM diagnosis are increasingly political. If you would like a brief history of the split that occurred between the American Psychological Association and the Association for the Psychological Sciences,2 I recommend Psychology as Religion by Paul Vitz3, and to check out their Wiki page.4
EDD, as it will be referred to hereon, is a condition of an adult who did not receive enough affirmation of the core self — that they are loved, for who they are, in both their flaws and weaknesses and strengths, and are emotionally stunted in key, critical points of their emotional development. They do as my client and the gentleman above do, which Baars details extensively: they seek others to approve and encourage them because they did not receive it, at some point, in some way, in enough volume, from the adult figures who influenced/raised them.
The symptoms are thus, taken from the Baars Institute website for further ease.5 I’m not typing up two chapters, as that will take too long. Or you can read the book.6
Here are the symptoms: (This will be quite long).
Symptoms and Characteristics of Emotional Deprivation Disorder:
Insufficiently Developed Emotional Life
Abnormal rapport
Incapable of establishing normal, mature interaction with others
Feels lonely and uncomfortable in social settings
Capable of a willed rapport but not an emotional connection in relationships
Egocentric
Childhood level of emotional development
Feels like a child or infant and expects others to focus their attention on them just as an adult would focus on a young child
Incapable of emotional surrender or giving to a spouse
Reactions around others
May be either fearful by nature or courageous and energetic
More fearful people tend to become discouraged or depressed
More courageous and energetic persons can become more aggressive or self-affirming
Uncertainty & Insecurity
Fear or anxiety
Can take the form of a generalized anxiety
Fear of hurting someone else’s feelings
Fear of hurting others or contaminating them (e.g. with germs or a cold)
Need for frequent reassurance
Feels incapable of coping with life
Worries that they’ll be put in a situation they can’t handle
Can be easily discouraged or depressed
May pretend to be in control in order to mask inner feelings and fearfulness
Hesitation and indecisiveness
Difficulty in making decisions
Easily changes mind
Oversensitivity
Overly sensitive to the judgments of others, criticism or slights
Easily hurt or embarrassed
Need to please others
Pleases others in order to protect self from criticism or rejection and gain approval of others
Easily taken advantage of or exploited
Fear of asking for favors or services needed
Self-consciousness
Worried about what other people think
Self-doubt and need for reassurance
Helplessness
Does not dare to say “no” for fear of rejection
Inferiority and Inadequacy
Feeling unloved
Believes that no one could possibly love them
Feels devoid of all feelings of love
Believes they are incapable of loving others or God
Suspicious of any token of affection – continually doubts sincerity of others
Physical appearance
May have feelings of inadequacy due to physical appearance
Feelings of intellectual incompetence
May have difficulty completing projects
Repeated failures or fear of failure
Shows signs of disintegration in new circumstances
Fear of new situations and challenges
Difficulty coping with new job, boss, landlord, moving, etc.
Sense impairments
Undeveloped or underdeveloped senses (touch, taste, sight, smell)
Lack of order, disorganization
Fatigue
Further symptoms found in some individuals with emotional deprivation disorder:
Deep feelings of guilt
Kleptomania
Need to collect and hoard useless things
Paranoia
I highly recommend the book, however, Baars and Terruwe were/are devoutly Catholic. There is an element of God, and some discussion of Catholic theology and philosophy that runs as an undercurrent through the book. If that will be an issue for you, I wanted to give you a heads up, although the reading is quite compelling and I suggest pushing through and giving it a go.
Though I am not licensed and have not been practicing for a little more than a year-and-a-half, based on what I have seen in many of my clients and using clinical judgment, as well as the training models they gave us, I would say many, but not all of my clients, fall along a sliding scale or continuum of severity for many of these symptoms. I haven’t seen kleptomania or hoarding, but the most common of the “Further symptoms” at the end, is deep feelings of guilt. Guilt and shame is incredibly common.
Without that affirmation, we do not know who we are, leading to confusion, lack of surety in our choices, and the inability to know what we want for ourselves and for our lives.
Relying on life hackers and experience experts
My female client stumbled on the revelation that she was relying on everyone else to tell her what to do, because she felt she’d had no real clear guidance from her parents. As I reminded her, and she affirmed for herself, her parents had been wounded people who did their best to help her and her sibling, in an effort to protect them from the same hurts and fears that dictated their own lives.
She often listened to many self-help guru’s and podcasts, telling her to be her own boss and the author of her own destiny. But this can be a challenge for someone who does not know their own values, is unsure if their decisions are the right ones, struggles with critical thinking and decision making, due to fear of making a mistake, whilst needing others to tell them their choices are good ones.
Sounds a bit like a child, doesn’t it?
I don’t mean this unkindly, but observationally. The client needed to learn what her values were, separate from those of her parents, and learned that her desire for money, aesthetics, and a comfortable life, were directly the result of having felt insecure as a child. Although her parents provided for her physical needs, her emotional life — knowing that she was loved and cherished just for who she was — had not been sufficiently nurtured. As a result, she had become very oriented toward achieving in her career, which isn’t a bad thing in and of itself, with moderation and awareness of why you strive for career success. However, it had been at the expense of her own pleasure and enjoyment of life, and sadly, at the denial of who she was at her core and the unique traits that separated her from her siblings. The client had a bright, boisterous personality, loved dancing and hiking, making people laugh, and being with others (she was quite extroverted), but in the corporate world where she worked, those values and traits particular to her had not jived with either her family or the people who were her supervisors. Despite being in sales, one would think that kind of personality would fit right in.
She sought podcasts and “experts” to guide her in the way parents might, but listening to a recording is not the same thing as having a living, breathing person affirm you that your natural traits, talents, and gifts, are unique and wonderful to you. It is a one way interaction, and the communication does not invite anything more than absorption of the information, rather than an exploration and conversation that allows one to process and chew over if what they’ve heard is what they believe or wish to adopt for themselves.
In a similar way, the man from the example above does much the same. His personal traits are that he is deeply melancholic quite naturally, and dismissive of things that he doesn’t believe without “hard evidence”. He whinges and is deeply stubborn. But for the smallest things—from his curtains to his furniture— he does not know his own preferences and needs everyone to affirm that his choices are the right ones, that his preferences are “acceptable”. His furniture is not of his choosing, but by the consensus of those around him.
To an extent this is alright, if one is unsure of a particular color and you aren’t great with color theory.
While I have every hope my client will continue to grow and develop more quickly to the appropriate emotional age she should be in concert with her biological age, I do not have the same hope for this man. Only time will tell if he learns to trust his own judgment, or continues to rely on others to make his choices for him.
This week sadly got away from me. People terminated therapy and I have several more piles of paperwork to do than before. Sigh.
Today is the feast day of St. John of the Cross. A mystic and doctor of the Catholic Church, if you’re celebrating today, say a little prayer for the souls of purgatory.
I’ve been working on the story for a children’s book. If you are an illustrator or can recommend a good one, please shoot me an email at thepracticaltherapist@substack.com.
Happy Second Week of Advent, for which we light a candle for peace.
Till next time.
Pax Christi 🕊️
This fascinating website, I believe, was highlighted by
. It is a recently founded organization looking to help young men and boys who are struggling with their mental health. I’m all on board for rescuing those that are drowning.Substack Shouldn't Decide What we Read. I think an excellent essay by Elle Griffin on why Substack works. Give it a read and lend her your ear.
Conrad W. Baars, M.D. and Anna A. Terruwe, M.D., Healing the Unaffirmed: Recognizing Emotional Deprivation Disorder, Staten Island, NY: ST PAULS/Alba House, 2002.
Paul Vitz, Psychology as Religion: The Cult of Self-Worship, Wm. B. Eerdmans Publishing Co.; Subsequent edition (March 7, 1995).
Wikipedia, Association for the Psychological Sciences, accessed 12/14/23.
The Baars Institute, What is Emotional Deprivation Disorder?, accessed 12/7/2023
Baars, 2002.