When anger trumps compassion

compassionate-700x500   Can compassion  be learned or is it something inherent in certain people? Often times, patients will say they are understanding and empathetic to a particular individual in his or her life, but the actions demonstrated run counter to what is being said. I’ve begun to notice a trend in some of my patients, one that ties into my initial question of compassion: anger, resentment and hostility are usually the expressed before compassion.

One patient of mine, we’ll call him Eric*, came to see me and told me about a friend of his who needed a favor: money. Eric’s friend was in a hole and wanted to borrow some cash to buy Christmas gifts for her family members. As Eric continued to tell the story, he seemed to become enraged at the thought that his friend was asking him for money! As I let Eric continue on with his story and his remarks on the friend’s character and how he no longer saw this individual in a positive way, he mentioned how sorry he was for her. However, his tone, facial expressions and initial reaction said something completely different. When Eric was done presenting his case for why he was mad, I asked him why he appeared so angry and did not show much compassion for someone who was down on her luck. After all, Eric’s story is similar to his friend’s in terms of life experiences. I noticed Eric becoming a bit angry with me for questioning his compassion, or lack thereof. What was I to make of this? Did Eric think I did not believe he was genuinely compassionate? Did I fail to validate his anger? Possibly. After all, I can identify with Eric’s reaction as many of us probably can. People, sometimes even friends, ask us for favors we do not want to perform and we become angry with them. But why?

While it might be specific to Eric’s case, I’ll make the argument that what happened was a narcissistic injury and then a narcissistic rage (something that is common). Eric felt insulted and undermined, thinking that his friend wanted to take advantage of him, use him for her own gain. He unconsciously might have felt the same feelings as he did with an earlier experience in his life- one that produced anger, shame and hostility toward a needy individual. Perhaps Eric thought his individuality was being undermined. Maybe he wanted retaliation and was trying to gain the upper hand as a reaction to a prior feud.

All are possibilities, but for the work moving forward, it is important to see if compassion is ever the primary emotion. It will be important to explore the reasons for the conflict: verbalizing compassion, demonstrating anger.

Compassion is a hybrid of both nature and nurture. We are all products of our environments and often model what was mirrored for us as children. If compassion and sympathy were two emotions that were absent from childhood, it should not be expected that an individual will know how to have these feelings.

My work with Eric and other patients who present similar issues will require me to have compassion and and patience while I seek to  gain trust to explore the anger.


*name has been changed to protect the identity of the patient


Confronting the past

fork-in-the-road-what-now     It is often repeated that one should live life with no regrets. Live life to the fullest! For many, this is easier said than done. Actions we’ve taken (or not taken) can cause tremendous psychic stress, whether we know it or not. I was stunned to learn this morning that there exists a website, http://www.exaholics.com (link not provided), that almost operates like a 12-step program for people trying to get over an ex. Naturally, break-ups can be hard for both parties involved. Causes are often murky, closure is routinely not had and blame is hurled across the room.

What can happen next might seem obvious, but to many, is often unknown. In psychoanalytic terms, the defense mechanism of “undoing” might present itself and lead one down a path filled with obsessions, compulsions, regrets and guilt.  Undoing is a primitive defense that is almost self-explanatory: one tries to undo something that has been done that caused harm or that one regrets. What is not so obvious is that the act of undoing is an unconscious act, hidden from our awareness. If we look at breakups to make the case, we might find individuals analyzing past events during the relationship that could have gone a different way- if only I hadn’t yelled at her, if only he answered his phone, etc. We dive back into the past and recreate a scenario that is acceptable and favorable to our new, yet alternate view of reality. The undoing process can cause intrusive thoughts, painful feelings and tremendous guilt.

If we look at childhood trauma that relates to divorce, bad parenting, abuse or neglect, the belief that the past can be changed is often in the back of the mind.

Undoing is relevant to treatment, because it emphasizes the dynamic approach to therapy that the past dictates the present, and eventually, the future. Regrets often consume our thoughts and we delegate tremendous amounts of psychic energy to wanting to undo the past. As a result, the memories are all-consuming and the past events might lead to drug use, alcoholism or poor work productivity.

Confronting one’s past is painful, but can be helpful in dealing with the present. I see patients who, as adults, are still beholden to the past ills they faced- abuse, neglect and drug use to name a few. One common theme that presents itself is a sense of “if onlys.” These patients are frequently reminded or triggered by past events that almost haunt their daily lives. So, what, if anything, can be done to alleviate such pain and suffering?

If possible, confront the individual(s) who are the source of your pain. For many this is hard, given that past events might have led to a cut-off in communication or legal barriers stand in the way. But, going to the source of the problem can be cathartic. Talking about your feelings is important in the healing process. The goal is not to have the individual apologize and admit to wrongdoing. The goal is for personal healing. The individual in pain can come to  a point of acceptance or reconciliation regarding the event. There is almost a weight lifted off the shoulders that allows for a more tranquil life.

Sometimes, the undoing defense presents itself in multiple aspects of one’s life: relationships, decision making, etc. This would require a deeper self-analysis to explore why one is exposing him or herself to repeated situations that will cause regret. I talked about this briefly in my post on personality and sadomasochism.

Closure is tricky, as many individuals are expecting the other party to be involved. It is good to know that closure can be had on your terms and that regrets can truly before overcome through a healthy process of confrontation and communication.



Today’s sadomasochism


When the term sadomasochism is heard, one usually thinks of sex, chains, whips, and leather. But sadomasochism, which involves those who enjoy receiving pain (masochist) and those who enjoy being the punisher (sadist) is more complex and more common than you might think. Today, sadomasochism can be seen in almost every aspect of our lives. Think marathon runners who routinely take a beating to the body or MMA fighters who suffer concussions, bruisings and broken bodies. What about those who tattoo their entire bodies? These can all be seen as masochistic behaviors. Not all acts of giving or receiving pain should be viewed the same. Running marathons can be a cathartic experience.

Where sadomasochism becomes complex is when it is found in interpersonal relationships. We always hear about the self-sabbotaging and self-defeating individual who finds him or herself in relationships that are doomed for failure from the onset. Yet, the question is, why does this person continue down the same doomed course? I think there are certain explanations for this. One example, which can be viewed through the psychoanalytic lens, is that people create and enter into relationships that are filled with cruelty, manipulation and punishment because of a family history of sadomasochistic behavior. This can involve physical brutality or emotional scarring. Often times, if abuse on any level is witnessed at a young age, the individual (usually a male) begins to identify with the aggressor.

Second, sadomasochism can be viewed as a power struggle between two individuals. People from a dysfunctional family where unhealthy alliances, boundaries, roles and attachments were present seek out relationships where self-sabbotage and manipulation can be exerted. In other words, someone who grew up in a dysfunctional environment creates a new environment where he or she is now the individual in control.  The defense mechanism of displacement is used to literally “displace” aggression and emotion. This can be seen through decision making, extreme criticism, manipulation and emotional instability.

Masochistic tendencies are seen in the clients I work with. Individuals will share stories in group that they know will lead to harsh reactions that involve slurs, scoldings and name calling. Despite the evidence that positive feedback will not occur, these men continue to expose themselves to punishment. Why? One explanation that seems fitting is that any connection, positive or negative is welcome. For one individual who routinely (and most likely unconsciously) welcomes the criticism, he is able to seek a connection with other group members. For him, this could be a libidinal (emotional) expression. While it is hard to listen to as the group facilitator, I believe the masochist enjoys it.

As an aside, I reject the notion that men tend to be sadistic and women tend to me masochistic. If childhood trauma or conflict is an underlying reason for sadomasochistic behavior, women and men can be both the punisher and the punished.

With all this being said, I do not think all sadomasochistic behavior needs to be or should be pathologized. Somebody who enjoys rough, punishing sex can simply enjoy…well, rough, punishing sex. An individual who is covered in tattoos might really enjoy self-expression. Sadomasochism is also not the same as aggression. Self-defense is not the same as instigating a fight.

As you think about sadomasochism, you’ll realize how prevalent it is around you.  Our culture is filled with violence, sexual exploitation, power grabs and manipulation. Politics is now a sport, the movie industry is consumed with sex and violence and we legitimize sports where the objective is to “kill” or “crush” the opposition.

On “Modern Love”

Every Sunday, The New York Times Style Section has a “Modern Love” column that is written by an author. This week, the column was written by Edan Lepucki, whose anticipated debut novel, “California” is to be released this week. Lepucki describes her “marriage anxiety” and thoughts of not loving her husband while on their honeymoon in Paris. Lepucki writes “Imagine being told by the person you love that they’re afraid they don’t love you back, that they’re afraid they never loved you, despite all the evidence to the contrary. And imagine staying.” Wow, that is a powerful acknowledgment! As the article continues, we learn that Edan’s parents had a nasty divorce before she turned five, and her parents still do not speak to one another.

This anecdote got me thinking about the current state of relationships. Edan’s ambiguity toward Patrick, her husband, seems to be a common trend. Why does Edan constantly think she does not love her husband? After all, Edan states “Patrick’s love was bottomless, and that scared me.” First, I think divorce plays a significant role in one’s ability to fully love another individual. If divorce is experienced by a child at such a young age, themes of abandonment, loss of love and resentment can set in. Secondly, there seems to be little risk left in relationships. Too often, our culture’s focus on immediate rewards and instant gratification seep into our love lives. We want our partner to be someone we’ve constructed in our mind. We say we want to grow with the person, challenge one another and express uncompromising love and kindness. But is that true? Often times, our overt wishes for a partner contradict our unconscious feelings and actions.

Finally, people often “fall in love” at such a young age that they forget all the challenges that lie ahead: money, in-laws (!!!) and work. Lepucki’s article ends on a happy note: the couple has been married for more than seven years and they have a child. Her tale of fear and love is refreshing. Not many people are willing to admit being depressed during a honeymoon in Paris.