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Editor's note: Being a Therapist features intimate portraits of psychotherapists in their own work spaces.
One relationship problem I have had a chance to work on I have called “role reversal.” Some women’s treatment starts with their mother’s pathology-mothers who are childlike, helpless, self-absorbed, and not sufficiently attuned to their child. A mother may struggle with her own traumas, become depressed, and withdraw from the child. The little girl feels this withdrawal acutely and will try anything to “repair” her mother, comfort her, cheer her up in order to reestablish the bond. She finds when she does things for her mother, the mother notices her, is more loving, and often feels less depressed. The little girl may gradually become a mother to her own mother; she behaves like the mother she wished she had. This I have called role reversal.
The little girl can feel secure again by feeling needed, but the price is high. To be loved, she begins to subordinate her emotional needs to those of her mother. Feelings of guilt about leaving her mother, who needs her as her emotional caregiver, are likely to develop. This interferes with the development of the girl’s self-image. Mother and daughter are not sufficiently differentiated, and the girl’s identity formation is inhibited. This really creates a pathology of the self.
It is best when this mother-daughter relationship gets played out in the transference. As the therapist, I might have a minor injury such as a scratch, and the patient may ask with great concern: “Oh, what did you do to yourself?” as if it is a big wound. I will first reassure her: “This is really nothing to worry about, it is a minor thing.” Then I will take it back to her and probe: “What was happening to you at the moment when you were so concerned about me?” Together, we will explore what she remembers from her formative relationships and discover some repressed feelings toward her family and the ones she has about me.
In her relationship with me, the patient will try to find the mother she never had in her childhood. She will want to experience me as the “ideal mother” or devaluate me when I am unable to gratify her real needs in the transference. As she begins to re-live painful injuries that her “child mother’s” behavior caused within her back then, she is likely to express protest, anger, and rage. As the therapist, I will not withdraw or abandon her. We will continue to explore and understand the minutiae of her revived feelings. This analytic healing process sets in as the pain recedes and the woman’s treatment will allow for a new, inner vitality in her sense of herself.