The Therapist Within

Applying Reflective Psychotherapy to Help Alleviate Suffering

Marlin Brenner

• Publisher: Routledge
• Year: 2021
• ISBN:
  9780429614910
• Edition: 1
• Topic: Psychology
• Subtopic: Psychotherapy Counselling
• Index: Psychology

The Therapist Within introduces an original, systematic approach for understanding and treating suffering clients through reflective processes, providing readers with the essential tools needed to alleviate their own personal suffering and live a fuller, more enjoyable life.

Developed from knowledge gleaned from his five decades of clinical work and his own journey with anxiety, isolation, and despair, Dr. Brenner's novel reflective psychotherapy is influenced by psychoanalytic psychotherapy, relational therapy, and psychodynamic psychotherapy. Advancing this innovative therapeutic method, the book provides a strong framework for guiding clients through the process of reflecting upon and re-encountering their life history, consciousness, inner and outer worldview, intrapersonal dynamics, and relationships, as well as for applying specific methods of intervention.

Rejecting conventional approaches to therapy, this book provides therapists with a holistic treatment plan to use with clients and will teach all readers to use self-reflection, meditation, and journal writing to achieve a greater sense of wellbeing and psychological strength.

Part One

Theoretical Framework

Part 1 of the book contains the essential building blocks of Reflective Psychotherapy. Through my own personal life experiences, and the lives of my patients, these concepts evolved and led to a deeper understanding of the psychotherapeutic healing process. None of these concepts emerged spontaneously, but over the course of 30 years, through the tools discussed in Part 2, each construct was imagined, cultivated, and eventually practiced in treatment, producing extraordinary results.

1

Empathic Envelope

One of my earliest memories of growing up in Harrisburg, Pennsylvania, takes place in a small backyard behind a rather modest two-story house. I was about 11 or 12 years old, and my father, a short, stout man – to be honest, he was obese – invited me to have a catch. He was wearing a baseball mitt and hurled a pitch my way that was executed with the elegance of a major leaguer. I was stunned. My father was not athletic nor, as far as I can remember, was he ever a baseball fan. No wonder our backyard catch stayed with me. It was so uncharacteristic of him and the kind of relationship we never had. Had this bonding experience occurred more often, I probably would not be writing about it right now almost 80 years later as a psychotherapist with a story to tell.

That experience, in fact, never happened again, and sometimes I wonder if it ever happened at all. You see, a much darker memory of my father – one that still evokes in me a sense of terror – is certainly more in keeping with the relationship we did have. I am perhaps 10 or 12, the age does not matter, and I am climbing the stairs to my bedroom, wracked with fear as my father follows close behind carrying a leather strap. I know that I will be punished, that I will feel pain as the strap strikes my bottom, that I will cry, and that I will hear my mother's voice from the kitchen crying out, “Jake, don't hit the boy. Please leave him be”. While I clearly remember the anxiety of anticipating the sting of that strap as well as the pain itself, what I can never recall is why I was being punished. What did I do? What could I have done to deserve such a beating? To this day, the answers remain a mystery. What is not so mysterious, however, is the reality that my father was an angry man and that his anger colored all aspects of my early years in a household that included my mother and a brother who was two years older than I.

My father died when I was 13. He suffered from a heart condition and I have sometimes wondered whether this is in part what drove his anger. After his funeral, a relative asked if I felt sad that he had died. I do not remember if I answered truthfully that I did not, but I do know with absolute certainty that I did not grieve his loss. Many years later, when I briefly saw a therapist, I broke down crying over my father's death. I have to wonder if those tears were for the man whose birthright I shared – or for the father I never had – a man who would have a catch with his son in a small backyard in Harrisburg, Pennsylvania.

When I delve deeply into the earliest days of my life, I encounter darkness accompanied by a profound fear. Even today, after five decades as a psychotherapist, I still feel it. Why? It is a question that has informed much of my life. I have often looked for answers in old photos that record the smiling face of a rather slightly built boy of perhaps seven or eight years old. I know that I am the subject of those photographs, but I fail to recognize the boy grinning into the camera. Those pictures, like many others of a supposedly happy childhood, do not capture the underlying sadness and sense of isolation I felt then and which still haunts me.

Where was my mother? Where was my father? My brother? I grew up in a family, but I cannot recall too many warm happy occasions usually associated with family gatherings. All I remember is the sensation of aloneness.

I shared a room with my older brother Lenard. We never became playmates or buddies or confidantes, as many brothers often do. After climbing into bed, I would break the silence and say, “Good night”, waiting patiently for Lenard's reply – a somewhat muffled “Good night”. It was an utterance that was momentarily reassuring, but it did not dispel my fear. So, I would say it again. “Good night”. And he would echo back, “Good night”. This exchange would go on for maybe ten minutes as Lenard drifted off into a hypnogogic state, mumbling automatically “Good night”. I honestly believed he was able to bid me good night while sleeping soundly as I lay wide-awake trembling.

These bedtime “conversations” stay with me. What I cannot remember is if we ever engaged in real boy-talk. I never knew what he liked or disliked, what he did in school or outside the house. I never knew his friends and when I finally acquired a few of my own, I never introduced them to him. If I had asked him any questions – and I must certainly have – I never received any answers. Like my father, Lenard was emotionally absent from my life.

Years later, I attended his funeral in Harrisburg after he died of heart failure, a condition he fittingly shared with my father. Going to the service was like attending the burial of a complete stranger, though, for many years, we shared a mother, a father, and a bedroom. At the burial site, I said farewell to my brother under my breath, a barely whispered version of the “goodnight” I used to say as a boy. This time, however, the only response was a deafening silence that sealed forever the wall between us, a barrier that only intensified my isolation.

Although I earned a BS and MS in economics at Penn State, I was inevitably drawn to the study of psychology, driven by the emotional anxiety I had felt growing up. For a time, I went into therapy while I was in the Navy, but that experience did not give me the understanding or healing I needed. It was at that point that I started to explore on my own the nature of my psyche, relying on self-reflection, journal writing, meditation, and dream analysis.

In 1961, I received a Ph.D. in psychology from Columbia and, by 1966, began a private practice which is still thriving. However, I never again went into analysis with another therapist. What I share with you now is what I learned by initially confronting through self-analysis my troubled boyhood as well as every other phase of my life as a man. These findings became inextricably related to the kind of therapy I employ now, in which client and psychotherapist collaborate in understanding the repressed and incompletely understood content of the patient's mind. I firmly believe that we all possess the unique capacity for self-reflection, which can ultimately lead to a revelation of the most powerful and effective therapist - the therapist within.

Coming to terms with the past is at the heart of the therapeutic process. For both patient and therapist, the first goal is to uncover what caused the pain of depression, anxiety, or alienation. The second is for the patient to experience relief and healing. The more I engaged in self-reflection, the more I realized that just as my fears began in infancy, many of my patient's fears began then as well. As a result, I conceived of a concept I called the “Empathic Envelope”.

Through my years of working as diligently as I could to deeply listen to each individual person's story, I began to see several broad, common aspects to their development and central ways in which any child's development can be derailed.

Let me explain. Children are born with an inherent expectation that there will be an abundant supply of all they will need to survive and grow. Such needs are met by significant others, usually a mother and father or anyone else who provides the physical and psychological support for a healthy development of both body and mind. The image of an envelope connotes an enclosed space of security with the capacity to expand as the child matures psychologically. The term “empathic” suggests reciprocity of feeling between the child and the other. This connection begins with nursing and feeding to be accompanied by tactile gestures of affection, such as touching, caressing, hugging, and kissing. The empathic envelope is a middle stage between the unconscious dependency that occurs in the womb and the ever-growing independence of a fully developed ego. What was once purely biological and unconscious gives way to the complexities of a burgeoning consciousness. As the envelope expands in time, social awareness increases. Sounds, words, and music invade the envelope and stimulate an even greater awareness of the external world.

An ideal empathic envelope requires loving parents or caregivers who behave similarly. The empathic envelope into which I was born was hardly perfect. From all I could remember and learn about my birth and boyhood, I concluded that my parents lacked the capacity to provide the kind of warmth and security children need. As I said, my father was distant. I never understood the source of his anger, though I often suspected, as any child might, that it had something to do with me. My mother, on the other hand, was a kind woman who performed her wifely and domestic duties adequately. She kept the house clean, cooked nutritious meals, and washed and ironed our clothes, all without ever complaining. She seemed to get special satisfaction out of getting my brother and me into bed at night with scrupulous regularity. I believe that doing so fed her sense of orderliness, a way to counter the moody hostility that my father brought into the house. Nevertheless, I felt personally abandoned by her though she rarely ever left the house. She was never that far away from me even behind a closed door. She was there but to meet my emotional needs, she really was not “there” at all. I clearly wanted more from her than she was able to give. Realizing now that she was not so different from most women of her generation and class, I make no judgment. I strongly believe she did her best.

Through self-analysis and interactions with patients, I began to deepen and widen the concept of the empathic envelope. It became clear that an infant's physical and mental well-being depends on the positive behavior of mother, father, or caregiver. When that behavior is negative, the consequences can be dire and long term. What are negative behaviors? First and foremost is neglect. To leave a child unattended, unfed, unclean, untouched, for any length of time, will produce emotional scars. The physical consequences can be easily corrected. The psychological issues, however, can last a lifetime. Where there should have been some sense of fulfillment, there could be deprivation. Where there should be a sense of being loved, there may be a sense of being unwanted; instead of a sense of a positive growing connection with the significant others, there might be an overwhelming feeling of emptiness. Whatever happens within the original empathic envelope will have an enduring impact on the life of the individual. Reflecting on the persistent fear of isolation I experienced as a young boy, I must conclude that my mother, father, and brother were not mindful of the attention I surely craved. What child does not want undivided attention and unqualified love? We all desire empathic others to satisfy our needs. The healthy development of the psyche depends to varying degrees on how those needs are met. It is important to note that the empathic envelope that appears so secure for the child in early life may be easily disrupted. Significant others may face difficulties and change emotionally from being caring and attentive to be partially unavailable or dysfunctional. These changes – financial setbacks, illness, marital problems, divorce, addictions – will have profound effects on the dynamic relationship between child and caregiver, and will cause traumatic reactions.

To understand how vulnerable the empathic envelope can be, I offer this image. Picture a nomad child living with his parents within a tent in the desert. The space inside the flimsy walls of the tent, along with the presence of significant others, provides an illusion of an ideal form of security. As long as the nomad child exists within the confines of the tent with the support of the others, the child will continue to thrive and grow. The child, however, is unaware of the dangers and threatening forces lurking outside the tent. If he should accidentally leave the tent alone at night and enter the outside world, he will experience anxiety, terror, isolation, and the threat of death. These are automatic responses that occur in dangerous situations, and they act as a signal to the child to return to the security of the tent, using any means possible.

The experiences outside the tent without the significant others symbolize premature exposure to the potential dangers lurking within an unfamiliar environment. Without the support of the empathic envelope, the child is likely to experience the eruption of the terror associated with isolation. Such harsh reactions, which arise within the child's mind, can be devastating because the immature ego of the child is unable to handle the kind of vulnerability that leads to lasting psychological suffering.

When we consider the emotional states associated with being inside and outside the tent, we realize how dramatically different they really are. The state of mind within is secure. There will be ups and downs in this positive state due to the exigencies of interacting with significant others. If the child is outside the tent, or if the tent is invaded by outside dangers, there will be a generalized destabilization of the mind of the child.

While the empathic envelope is formed at birth, it is an ongoing ever-expanding entity. As we grow and mature, new others enter the envelope, at first relatives and close friends, but eventually, as our circle of others widens, so does the envelope. Each experience brings in others who become significant to the degree that they interact with us. Lovers and spouses are most important, and then children and grandchildren, but close friends and colleagues also have an empathic impact on our psychological wellbeing, providing us with the security we once experienced as infants. For religious people, communal empathic envelopes provide the strength to deal with the trials and adversities of everyday life. What greater significant other is there than God? Having faith and being part of a congregation of fellow worshippers allow for a powerful empathic envelope that can sustain one throughout life. But even nonbelievers are drawn to various kinds of communities that nourish and enrich the psyche. We are by nature tribal, and require a sense of belonging, an antidote to the debilitating effects of alienation and isolation.

2

Creative Connection

If there is one event that marks the first turning point in my life, it is the experience of entering third grade. I was nine years old and my family had moved from a small apartment building to a two-storeyed house on a treelined street in Harrisburg. In ways I could not have understood at the time, it was a small step up the social ladder for my family. For me, what mattered most was discovering a world that was both new and different, which is not to say that I did not bring along many of the old fears I had endured during the first eight years of my life. “Newness” has its own challenges, and I now realize that I must have felt anxious about being the new kid on the block. Making friends is hard enough for anyone, but my situation was unique, for I had never had friends before. Friendship was, indeed, something new and different. For other boys my age, making the transition from leaving old friends behind to starting new alliances was probably met with mixed emotions. I had no pals to feel sad about leaving, nor did I have any happy memories of what it was like to spend time with kids away from the presence of adults at home or in the classroom.

Being invited to join in the rough and tumble games of tag, street hockey, and cops and robbers introduced me to excitement I had never known before. The word “adventure” entered my vocabulary through games played outdoors rather than from tales found in books. There were no books in my house, and no one read to me stories of knights or soldiers battling enemies or fairy tales with heroes and monsters. So, you can imagine the thrill of overcoming danger vicariously and conquering made up fears on the streets and parks of the neighborhood, especially because those real fears of isolation that had been dominating my life still existed at home and in my bedroom at night.

Going to a new elementary school in the middle of the year was fraught with much trepidation. That was only natural, but thanks to the way memory can play tricks with our sense of reality, it has become easy for me to mythologize the experience as a rite of passage. Looking back from the perspective of eighty years, I rely on impressions that have stayed with me through deep reflection, meditation, and even dreams. I picture a young female teacher, younger than any I had seen before in my former school. She looked kind, not at all threatening. Her smile welcomed and reassured me, and by the way, she touched my shoulder, she clearly sensed how nervous I was. I wish I could remember her name, for many times, throughout the years, I felt compelled to write and tell her how important she was at this pivotal moment of my life.

She must have known that my family was Jewish because she introduced me to a group of boys who were also Jewish and who seemed to have formed a private clique of their own within the room. It was her intention to have them make me feel comfortable, to show me the ropes in a way that no adult ever could. Unless you are a third-grader, you probably cannot appreciate fully the social dynamics of nine-year-old boys. What makes the experience even more memorable is that I was introduced into a small circle of my peers with an identity that ensured my belonging. I had always known I was Jewish, but it meant no more to me than being aware of my gender, height, and weight, or being an American living in Pennsylvania. I eventually realized that being a Jew did not just connect me to others but that it also separated me from some, not only in that classroom but in all the classrooms throughout my education. I slowly learned and experienced over the years that anti-Semitism could be both subtle and overt. That was a small price to pay, however, for now, I finally had friends.

The only way to explain the impact of that experience on the rest of my years as a student from elementary school through college and graduate school is to jump ahead to another even more significant life-changing event. While I was in the Navy just after the Korean War ended in the early 1950s, I felt compelled to seek therapy for the very first time. The fears I had experienced from the very beginning of my life and had artfully concealed behind the false persona of a very smart, charming, articulate gu...

Table of contents

• Cover
• Half Title
• Endorsements
• Title
• Copyright
• Contents
• Acknowledgments
• Part One Theoretical Framework
• Part Two Psychotherapy
• Index