Saturday, September 20, 2014


So many of our clients have difficulty asking others for help and/or are unable to receive help, even when someone who genuinely cares about them offers it. Why is this? In this brief blog entry I will discuss just two underlying dynamics that I have witnessed in my 40 years of private practice as a psychotherapist. One is a survivor mentality developed because of childhood experiences; the other is the underlying "measuring stick" of masculinity that is prevalent in american culture.


By not being able to ask for help or not receiving help when it is offered we block ourselves from a powerful source of love -even when we most need it. To understand how this pattern gets established it is essential to look at the childhood experiences of our clients. What children need the most - a sense of safety, affection, warmth, kindness, valuing of their uniqueness - was is short supply for many of our clients. For some, in addition to neglect, they experienced physical/psychological/sexual abuse wherein their bodies and souls were under attack. They were living in a psychological war zone and often feeling emotionally alone.When they recall these childhood experiences our clients remember thinking,"How do I get out of here? How do I get through this?" at some point they realize that their main task is to survive,to somehow keep their bodies and souls alive until they can leave. So, because they feel that others cannot be trusted to take care of their needs, they become emotionally reliant only on themselves. They develop a strong self-protective inner wall. They don't ask for help feeling,"I'm strong. I can handle it myself, I don't need anyone's help." They are unable to receive help when it is offered feeling,"If I open myself to help from someone I'm putting myself in their hands and they are either unreliable or they will hurt me."
Working with this block is a profound therapeutic challenge. With these clients it is especially important to provide a warm and welcoming environment wherein they can begin to feel safe and know that they can rely on our compassionate caring presence.Simple acts of loving kindness are important. For example, having a welcoming attitude,personally offering them a tissue when they are tearful, offering water/tea/coffee as a symbol of nurturance, praising them for some small act of growth etc. Of course ,these clients often have trouble receiving these acts of kindness. These are very important moments in the therapeutic relationship. It provides us with an opportunity to explore more deeply why they have so much difficulty in receiving these simple acts. More of the childhood history will be uncovered. These moments also lead to another aspect of their relationships that these clients don't usually consider - how their rejection of human kindness affects the person who offers the help. These exchanges within the therapeutic relationship often are the turning points. As they gradually learn to accept help from us, our clients become more open to receiving help from others who genuinely care for them.


Most of the men that I've worked with struggle with this difficulty in being able to ask for help and/or receive it when it's offered. At some level of consciousness they have internalized as a "measuring stick" of their feelings about themselves as a man the archetypal American image of a "real man". A "real man" is someone who can do everything, who accomplishes everything on his own and needs no one. Even though in recent decades this definition of what a man should be is changing, at an unconscious level this old ideal still holds psychological power. What happens for most of my male patients is that whenever they are unable to live up to this totally unrealistic "measuring stick" they feel inferior, smaller than other men. That internal "measuring stick" makes it very difficult to ask for help and/or receive it when offered.
I spend a lot of time in sessions continually bringing this cultural implant into conscious awareness. In addition, I help my patients to look at what aspects of their personal story have contributed to this internal image of what a man should be. I suggest to them is not that they are inferior, but rather that they are using the wrong "measuring stick." the one that has been implanted does not fit who they are. They need to develop a different "measuring stick."
I have written extensively(the "Men" chapter in "Working From the Heart: A Therapist's Guide to Heart-Centered Psychotherapy") about how,within the therapeutic relationship, we can further help our male clients with this issue.