Wednesday, April 04, 2007

Now for the Words--Deepest, Darkest, Part 1

Creepy tree

Deep, dark

Does this mean I have to tell you a secret?
In my professional life, I get told secrets all the time. I regard it as an honor to be the repository of people’s secrets and for some it is an important part of the treatment. I believe that many, or even all of us, feel that we carry these terrible skeletons in our closets that will drive away anyone who knows of them. These skeletons rarely are actual skeletons. To date, no one has confessed a murder to me, thank heaven.
Some people tell me of things they actually did that they find shameful; others are more ashamed of a thought, feeling or fantasy. The common theme is the shame.
The whole issue of secrets is a tricky one in therapy. I think that secrets are a necessary and often healthy part of life. But some people feel that they are obligated to tell me their secrets and it puts them in a bind. I will explain to them that they never need to rush something like this. A forced revelation is often too traumatizing. I also tell people that if anything is truly important we will get to it in the future, so there is no hurry.
What is so important about these secrets? Secrets are part of a question that people carry inside them which is whether they are truly likeable and loveable. As long as they hold back a secret or two or three, they can continue to believe that no one truly knows them for who they really are. It is a Catch 22—the secret holds them hostage to their belief that they are unacceptably ugly inside, but the secret is too shameful to be told. Amazingly, most of the secrets I am told are pretty easy to accept. There have been a few exceptions but I have never stopped respecting and liking someone because they told me a “deep, dark secret.”
In a way, I think this is because the capacity for guilt means the person has qualities that I can empathize with. Once many years ago, I treated a man for a medical condition who had been imprisoned for two murders. I found I couldn’t feel a genuine physician-patient relationship with him. He scared me and he was a thief and manipulator while in the hospital. We would diagnose such a person with anti-social personality disorder. People with this diagnosis rarely seek out therapy.
Even the few kids I see with severe behavior problems, what psychiatrists call Conduct Disorder, have the potential to improve. So I try my best to give them a fair chance, although on occasion I have had to call it a day if the lack of honesty and cooperation is too extreme. I don't think I'd ever want to treat antisocial adults. It is just not in my ability to invest enough of myself in this personality type.
I’m not sure if this essay isn’t too frank to post on my blog so I am going to save it for another day. Maybe one day it will lead somewhere.

Addendum: Obviously I decided to post it after all. The comments on my previous post suggested that I should go ahead and stick my neck out a little. We'll have to see how it goes.


Kathe said...

I don't think it's overly shrinky. :^)

Brian said...

I don't think this is too frank at all. Rather mild in fact. What I find interesting about therapy, is how easy it is to talk, but so hard to change.

tarakuanyin said...

I was expecting something much more terrifying! And now I want to blog again because you've made me think about something related to the capacity we humans have for acts of true compassion juxtaposed against our capacity for great darkness. Maybe that's a good thing...

Chelle & Chel said...

I love the tree!

Loved your sharing.


GEWELS said...

Interesting! I, too, find that I can have compassion for others no matter what. The fact that they are shamed by their "secret" tells me that they have a conscious, know right from wrong and are not comfortable with that "dark" side of them. That is a positive attribute, in my eyes.
We all have deep, dark secrets. Some not as bad as others. Such is human nature.
Beautifully written.
And wonderful photography to boot!

Rayne said...

One of my brothers is in his 30's and he has built up such a web of lies and 'secrets' and alternative scenerios around his life that he is hard to deal with and it's hard to remember that he is not well or 'normal' and hard some times to love him. I wonder if the 'secrets' he has, if he is telling me because he wishes they were real, because they are fears, or which ones are truly real.
It must be hard dealing with things like this on a day to day basis.
Love the tree photo by the way. Looks like a portal to another world, maybe Alice's Wonderland?

Attila The Mom said...

Lovely lovely picture. And the post? That was great too! :-)