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Psychiatric Times. Vol. 25 No. 9
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Practicing 

Reconstructing One’s Past

By Jerry M. Lewis, MD

| August 1, 2008
Dr Lewis is chairman emeritus of the Timberlawn Psychiatric Research Foundation and clinical professor of psychiatry at the University of Texas Southwestern Medical School. He is also in private practice of individual, marital, and family therapies in Dallas.

Over 55 years ago, I graduated from the then almost new University of Texas Southwestern Medical School in Dallas and went off to Boston and the Brigham to be a straight medical intern. I had been married for 2 years, and my wife was pregnant with our first child—neither of us knew a soul in Boston. I was on duty for 36 of each 48 hours (except for 1 weekend a month) and was of little help to my wife, who was alone in a strange city and was facing the imminent birth of our first child. It was, in short, not an easy year. However, we made friends, and I was encouraged to stay on at the Brigham. We not only survived but, in a sense, flourished. Although from a developmental perspective, survival and growth are important markers of outcome, there is more to the ways in which those experiences changed us than those markers suggest.

One change concerned what was to become my career in psychiatry. In the Dallas of the early 1950s, psychiatry was overwhelmingly biologic. There were no helpful psychotropic drugs, and the prevalent treatment paradigms involved electroshock, insulin coma, and, for some, sleep therapy. In Boston, psychoanalysis was the clearly dominant ideology, and whether stated explicitly or accepted implicitly, it was based, in part, on the biblical injunction that knowing the truth shall set you free. As a psychoanalytic premise, however, the biblical injunction was understood as meaning that knowing the truth about oneself led to freedom from maladaptive behavioral patterns learned in childhood. This emphasis on truth and the search for insight attracted some of the very brightest of my fellow house officers in Boston and had a major impact on my evolving ideas about human psychology.

How much things have changed since those early days! My reading of the current understanding of what one discovers about oneself in many forms of psychotherapy is not necessarily the truth but rather a more useful reconceptualization of one’s personal past. The emphasis on truth has been replaced by that of utility. What, it is now asked, is the most helpful way of understanding one’s personal past?

This movement away from the search for truth as a guiding principle of many psychotherapeutic schools has been influenced during the past 50 years by multiple factors. In this essay I will discuss only 3: longitudinal studies, narrative theory, and neuroscientific advances, particularly those regarding memory.

Longitudinal studies suggest that many adults’ recollections of their pasts—especially childhood and family experiences—undergo changes throughout life. One “truth” is replaced by another. For some, the parents of childhood are recalled more sympathetically. For others, the recollections are much more critical. Some believe that the difference between those who are more sympathetic and those who are more critical is to be found in the present circumstances of those who are doing the recollecting.

We found support for this premise in a longitudinal study of young couples before and after the birth of their first child.1,2 In the findings relevant to this topic, the participants’ reports of their childhood relationships with each parent and the nature of their parents’ marriage were relatively stable from the prenatal period to 4 years after the birth of their first child. Having a child and parenting that child for 4 years did not appear to induce systematic changes in the recollections of their own childhoods. There was, however, one intriguing exception to this picture of relative continuity. A number of the female participants changed their recollections of their fathers from positive to negative. After 4 years of parenting, they no longer recalled their fathers as being as affectionate and supportive during their childhoods as they had been before the birth of their child. In searching to understand the correlates of these changed memories, we found a clear pattern, and it had to do not with the female participants but their husbands. The women who changed their recollections had husbands who were depressed, who helped little with parenting, and who were observed to be less sensitive to their children than other fathers.

Why, then, would the women with less available and helpful husbands change their recollections of their fathers in a negative way? One possible answer to this question was found in the marital satisfaction data. The women with depressed, unhelpful husbands did not report lower levels of marital satisfaction; rather they were maintained at high levels. One interpretation of our data was that the women’s more negative memories of their fathers served the function of minimizing (or denying) their husbands’ failure to be as helpful as needed. If this is all that can be expected of men, then I can no longer recall my father so positively!

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