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Case Study - Page 4

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Most clients eventually learn the difference between an internal sense of authenticity (who they are at the deepest level) and the self-righteous satisfaction of feeling wronged by the disappointments and abuses they’ve endured. When they experience that tipping point, many are finally ready to do the hard, repetitious work of building new habits of emotional regulation and commit themselves to their deeper values. At that point, they can let go of their sense of victimhood and embrace the rewards—and risks—of living and loving fully as they move forward in their lives.

Case Commentary

By William Doherty

There are a dozen admirable features of Steven Stosny’s work with this client, but I’ll focus on just one here. A key challenge to conventional psychotherapy with clients who’ve been betrayed by a loved one is the risk that we’ll inadvertently encourage them to remain stuck in a victim identity. When we spend session after session on the betrayal experience and related events going back to childhood, we may think we’re helping them work through and transcend their painful experiences, but the reverse may occur: they may come to see themselves as lifelong victims of bad or flawed people, ultimately becoming tragic figures in their own life dramas.

Stosny deftly avoids this risk by taking another path. After the necessary first step of showing deep empathy for Debbie’s feelings of betrayal, he moves quickly to work the resilience side of her experience, her “healing identity.” Although this may seem like conventional psychotherapy (don’t we all work on our clients’ strengths?), he also helps Debbie confront how badly she’s treating other people around her. My therapist colleagues Noel Larson and James Maddock, who’ve worked extensively with trauma, have observed that victim and perpetrator are often paired identities, with the victim identity giving permission to the inner perpetrator to lash out or take advantage of others. Stosny talks about it as mirroring the unwanted behavior of the one who’s hurt us.

In working with Debbie, Stosny demonstrates how we heal ourselves by understanding how we treat other people when we’re in pain, and how self-compassion must be paired with compassionate, fair treatment of others. Therefore, he highlights the importance of helping clients access their core values for how they want to live in the world. Stosny is that rare therapist who talks explicitly about values (dare I say moral values?) and invites clients to live consistently with their deepest values. Since the days of Freud, therapists have been ambivalent about values-talk in therapy, seeing it either as intellectualization not worth exploring, or as something imposed by the superego or society, to be deconstructed.

However, we now know more about how closely interpersonal values and a healthy sense of self are intertwined. Forming healthy personal boundaries—a primary goal for anyone who’s been abused and betrayed—means learning to respect the boundaries of others. In the hands of therapists like Steven Stosny, psychotherapy heals by bringing out the healer in clients.

Steven Stosny, Ph.D., is the director of Compassion Power. He’s the author of Love without Hurt and the coauthor of How to Improve Your Marriage without Talking about It. His forthcoming book is Living and Loving after Betrayal: How to Heal from Emotional Abuse, Deceit, Infidelity, & Chronic Resentment. Contact: stosny@compassionpower.com.

William Doherty, Ph.D. is director of the Minnesota Couples on the Brink Project at the University of Minnesota and cofounder, with his daughter Elizabeth Doherty Thomas, of the new Doherty Relationship Institute. Contact: contact@drbilldoherty.org.

Tell us what you think about this article by leaving a comment below or sending an email to letters@psychnetworker.org.

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