We’ve gone to the moon and back in a spaceship, invented the Internet, computers, airplanes, internal combustion and electric automobile engines, electricity, television and radio, atomic bombs, antibiotics, antidepressants and antipsychotics, open heart surgery, the wheel, the outside jump shot, a great cup of coffee, the Cuban cigar and Sambuca, and of course the teeny weeny polka dot bikini.
So what’s with the fact that most of us keep doing downright stupid things and make recurrently bad decisions that lead to ongoing misery? If brilliant people can invent all that stuff, why can’t they give us the tools to stop making bad decisions?
When a patient describes an awful decision that he is on the verge of carrying out, I try to help. I say, “Are you sure that’s a good idea? Or; you’re doing the wrong thing! Or; don’t do that! It’s a terrible mistake. Or you’re reliving what happened when you were a boy.” You guessed it. Most of the time, they do it anyway. They are driven beyond reason to do what they have already decided. Rational discussion doesn’t work. It’s like they are psychotic, even though by any reasonable standards, they are perfectly normal.
Here’s one example. Ted, an attractive thirty-year-old attorney, had asked Sally, an attractive accountant, to marry him. In spite of their constant bickering, unsatisfying sexual relations, and a lack of emotional connection after three years of dating, she agreed.
So when I confronted him with these obvious red flags, he ignored my comments, and went ahead with his decision. Twenty years later, I ran into Ted at a party and learned that he was unhappily married and having an affair.
So what’s Ted’s back-story? He had a cold, verbally abusive father and a mother who never protected him from this man. Ted had spent his whole life trying to get his father to love him — he even chose a wife that was the emotional duplicate of him. And Sally, the perfect psychological choice, never disappointed. She spent twenty years verbally abusing him and he kept hoping that she would change and love him.
The underlying psychological dynamic is called a Repetition Compulsion. It is the need to undue early trauma and make it better. It is a very common occurence. Consciously a person chooses a spouse because of beauty, intelligence, money… Unconsciously, he or she chooses a spouse to fix whatever hurt was endured during childhood.
Repetition Compulsion is unconscious. A person doesn’t know he or she is doing this. It is the part of the iceberg that is far below the surface and invisible, yet it holds up the ice that is seen. It is only later, if one has the capacity to examine his or her life and the decisions that were made, that the destructive pattern emerges. Once one sees the pattern, it’s still not so easy to change. But, it can be done. That’s what psychotherapy is all about –- observing the unconscious and getting the courage to change. By examining patterns, dreams, behavior, and the transference relationship between the patient and the therapist, the hidden code of unconscious behavior can be broken.
Art Smukler is an award-winning psychiatrist and author of Chasing Backwards, a psychological murder mystery, Skin Dance, a mystery, and The Man with a Microphone in his Ear. All are available as paperbacks and eBooks.
Inside The Mind of a Psychiatrist 