When I was young and deeply involved in Latin American anti-imperialist political work, the freedom fighters who organized and fought clandestinely against authoritarian dictatorships were called La Resistencia, the resistance. They boldly left their insignia, a capital R in a circle, as their quiet battle cry to show that they were not vanquished, ferociously not gone. I have always rather liked that it was also my initial, and I could sign off, if not in battle, certainly as a champion of the oppressed and unfree. However, the ways the word “resistance” has been used in the world of psychotherapy and, to some extent, in common parlance has irked me. I even occasionally hear disgruntled spouses hurl it crudely in an unruly couple’s session before I get a chance to nip it. It suggests intentionality, a willful thwarting of something. I rarely see psychological pushback that way. It invariably represents something else, certainly where trauma is concerned.
The core dilemma at the heart of neglect trauma is a profound internal conflict about attachment. Starting from the initial heartbreak, the child interprets the neglect scenario the only way they can, as rejection: “I am not good enough. I don’t matter. I am worthless. I am invisible. I don’t exist.” At first, if the neglect is early, which it often is, there are no words, only a quaking emptiness, hunger, agitation, a shapeless, rudderless flailing disorientation and confusion. After a while, there is collapse into the futility of waiting, and perhaps a freeze. Later, what most often emerges is a default to rock-solid self-reliance. What other choice do they have but to become strong, fierce, enduring, and to do it all themselves? It is the signature of the child of neglect, perhaps their/our version of the defiant “R.” But it is far more than a statement; it is survival, a way of life.
I began to learn about the ferocity of self-reliance in my work as a therapist. Often the child of neglect is reluctant to seek psychotherapy in the first place because they are not used to thinking of another person as a resource, or as being of any use. Often, these children of neglect are some of the most competent, accomplished, and outwardly successful people one might ever hope to find. The fact that there is a gaping interpersonal vacuum or “disability” might slip by unnoticed, even by themselves. They might know that they feel bad, or maybe they don’t even “have time” to notice that because they are too “busy” or too practiced at whatever their chosen medium of numbing out.
The core dilemma at the heart of neglect trauma is a profound internal conflict about attachment. Starting from the initial heartbreak, the child interprets the neglect scenario the only way they can, as rejection.
I had a humbling lesson about my own, perhaps avoidant, self-reliance only a few short years ago. My beloved therapist was undeniably getting old. I had been with her forever and had come a long way in letting myself know how important she was to me. I had always said to her, “I am going to keep coming here until you shut the door!” I was committed to that. By now, she was 89. In all our years together, she had never forgotten things. That stunned me when I first met her. She actually listened to me and tracked what I said! My parents had never even known my friends’ names, if I ever had any. Here was someone who was holding my whole life. Unbelievable. Now at 89, she was occasionally slipping, understandably, of course. I could not deny it.
I am a rather compulsively punctual person. All my years of therapy, I paid riveted attention to the clock, always cautious not to “overstay my welcome.” I liked to pay first, so I had “earned my keep.” I never wanted to impose in any way. And I scrupulously arrived on time. Until now. “Suddenly,” I began arriving at my sessions late. I would walk the mile or so from my office to hers. I had always enjoyed the walk, and window shopping on College Ave. It was a lively, colorful street, and now post-pandemic, it is coming back. I enjoyed being out in the world. And I made a point of managing my work days so there would be time to walk – until this point in time, when things started “running late.” I was unwilling to give up the walk and drive to be on time for my sessions. I stubbornly insisted on walking. We observed me arriving later and later to therapy. My therapist, always attentive to everything, especially where our relationship was concerned, would ask me, “What is up with this lateness?” I shrugged it off. My work… but it seemed I was starting to be sometimes almost 20 minutes late for a 50-minute session.
It took a long time to recognize that I was starting to fear not only her retirement but her death. Anything remotely related to losing her completely unnerved me. Except I did not even let myself know that. She worked to nudge and delicately steer me into that material for a long time before I “got it.” If she or anyone had dared to call it “resistance,” I am sure I would have had a righteous hissy fit.
The fear of loss is so profound it evokes the first “loss,” which was not really having anything in the first place, so far beyond conscious awareness. It took many months of wasted, lost time I could have had with her. She did retire before she turned 90. Now she is 93? I’m not sure. We are still in touch, and I still struggle sometimes to let myself call and see how she is doing. I know she will not live forever, and somehow that is unbearable. Need and loss are two sides of the same lousy coin. Neglect makes one desperately vulnerable to both, so we toggle back and forth, keeping them, as much as possible, outside of awareness. We deny, disavow, OK, resist. It can be a tragic waste.
Yes, our core dilemma is that the source of longed-for comfort and the source of perceived terror, loss, and/or rejection are the same person. What is a child to do?
Yes, our core dilemma is that the source of longed-for comfort and the source of perceived terror, loss, and/or rejection are the same person. What is a child to do? They push and pull, reach toward, recoil from, rock and roll, and ultimately culminate in collapse, freeze, or both. The same conflict can unfold in psychotherapy. On the one hand is a desperate longing, not only to connect, but to have the therapy “work” and actually be helped. On the other hand, is the seemingly lethal danger of interpersonal need, of letting the lifeline of self-reliance be punctured, and the puffed up, imagined, even experienced safety of isolation, whistling airily away. It is perhaps like a balloon with a hole, hissing and shrinking, spinning away from the risk of being abandoned, rejected forgotten again.
Some clients “resolve” or avoid it by having something like “serial monogamy” with therapists: going from one to the next as if they are interchangeable parts, not relationships, as if we therapists have a “shelf life.” It makes logical sense, but it is not what the heart craves. It is not “really” safe. It can most definitely be a challenge for therapist and client. Some view the method as the vehicle of change: the neurofeedback, EMDR, IFS, SE DBT, whichever of the alphabet soup, rather than a person. Those are all essential, don’t get me wrong. But the deepest healing comes in the relatedness.
It is a long-term challenge that I have been at for many years. I try not to think of it as “resistance,” even my own stubborn lateness, my preference to look at all the beautiful clothes in the shop windows. That makes it sound purposeful. Rather it was an urgent gasp to maintain autonomy, to save my life, and to protect my long-ago broken heart. I have come to think of the vacillation, the reciprocal reaching for, pulling back, perhaps as a kind of rocking? Perhaps it is a simulation of the loving somatic experience of being cradled, having a large and containing other’s body gently embrace, enfold us in gentle, rhythmic movement. It is often a grievously missing, even dreamlike experience, and people can try in vain to give it to themselves. What a terribly lonely, if logical, formulation.
We must go kindly with this. It takes its time to heal. Many of my comrades, the Resistance fighters I knew and did not know, I fear have died. Some I know about, some I never heard about again. They quietly slipped undercover, and who knows what happened? A different kind of cover than the craved cradle blanket. I still cherish the mighty R and the songs that honor them. And it is essential not to confuse different avenues of survival: both are heroic, each in their way in the service of freedom and life.
It is turning to spring in my hemisphere. Best wishes for whichever of the season’s holidays you observe.
My book “Working with the Developmental Trauma of Childhood Neglect: Using Psychotherapy and Attachment Theory Techniques in Clinical Practice” was published on August 31st. It provides psychotherapists with a multidimensional view of childhood neglect and a practical roadmap for facilitating survivors’ healing.