Re-imagine and Rebuild the Self to Stand Up Straight with Shoulders Back:

 Re-imagine and Rebuild the Self to Stand Up Straight with Shoulders Back:

Restore Optimism and Hope for Everyday Life 

John A. Caliso,PhD

Introduction:                                                                                                                                                                                           

Jordan Peterson’s book (2018) “12 Rules for Life” positions “Stand Up Straight With Your Shoulders Back” as rule number 1.  Peterson basically stipulates it is critical to achieve this erect posture by adulthood.  I believe that the ability to metaphorically stand erect represents a strong internal sense of self.  A strong conviction within one’s self leads to a passion for family commitments, community contributions, professionalism, socialization, and an acceptance of self (strengths and imperfections).  A strong sense of self helps us to freely offer our observations, thoughts and feelings to others without shyness and/or shame or fear.  Similarly, we are able to listen to others despite differences, and maturely enter into collaboration (effective communication), negotiations, and compromise with others.      

Peterson states, 

“To Stand Up Straight with Your Shoulders Back” is to accept the terrible responsibility of life, with eyes wide open.  It means deciding to voluntarily transform the chaos of potential into the realities of habitable order.  It means adopting the burden of self-conscious vulnerability, and accepting the end of the unconscious paradise of childhood, where finitude and mortality are only dimly comprehended.  It means willingly undertaking the sacrifices necessary to generate a productive and meaningful reality” (p.27). 

This paper explores Jordan Peterson’s (2018) “Stand Up Straight with Your Shoulders Back” in the context of psychoanalytic thinking.  I believe it is critical for children to grow into adulthood with this capacity to “To Stand Up Straight with Your Shoulders Back” to achieve independence in thought and feelings, and to preserve their individualism even in the face of differences or crowd pressure.  In Lukianoff and Haidt’s  (2019) they state: 

         “Given that risks and stressors are natural, unavoidable parts of life,

          parents and teachers should be helping kids develop their innate abilities 

          to grow and learn from such experiences. There’s an old saying: Prepare 

          the child for the road, not the road for the child.”  But these days, we seem

          to be doing precisely the opposite: we’re trying to clear away anything that 

          might upset children, not realizing that in doing so, we’re are repeating the 

          peanut allergy mistake.  If we protect children from various classes of 

          potentially upsetting experiences, we make it far more likely that those 

          children will be unable to cope with such events when they leave our 

          protective umbrella.  The modern obsession with protecting young people

          from “feeling safe” is, we believe, one of several causes of the rapid rise in

          rates of adolescent depression, anxiety, and suicide.” (pgs. 23-24). 

Although Lukianoff and Haidt’s  (2019) emphasis is on overprotection, I believe the rise of serious mental health issues also stems from the under-protection of children.  Both concepts lead to a forfeiting of a strong conviction to Stand UP Straight with Shoulders Back” as you walk through life’s experiences.                

    Purpose and Method: 

     There is some debate as to whether psychotherapy and/or psychoanalysis is a science (Lomas, 2001).  It is proposed that direct observations of children in their natural environments provides ample opportunity for the scientific study of  development (Pine & Mahler, 1975; Nock & Kurtz, 2005; Pellegrini, 2013).  Equally relevant is the knowledge gained from the person sitting in front of us in the therapeutic relationship over time.  Although we can recognize the frailties in the therapeutic relationship, it is the ongoing empathic immersion over time in the patients experience that provides the knowledge base for intuitive data (Lomas, 2001).      

This paper is intended to help professionals, nonprofessionals, (e.g., parents) and young and older adults to understand the benefits of working within the psychoanalytic 

     platform. This platform enables one to look at life through a different lens, and eventually achieve greater constancy of emotional equilibrium despite its ups and downs. Although life may have its various challenges, Lomas (2001) provides a holding place for us: 

“This sobering thought (ups and downs of everyday life) may help us to keep a balance while recognizing that we have the good fortune to live in the period of one of the greatest innovators (reference to Freud) of all time.  The recognition that our perceptions are coloured by an inner world of which we are largely unaware, yet which can bring havoc to our lives, is one of the most important contributions to twentieth-century thought” (pg. 1).   

This paper will discuss the growth of selfhood from the perspective of a number of significant contributors in the field (Winnicott, 1958; Kohut, 1971; 1979; Aron, 1996) and reasons for a compromised self, e.g., the role shame plays in derailing the self (Broucek, 1991; Morrison, 1998; Mollen, 2001).  

There will be a discussion of (1) direct observations of children illustrating a healthy growing sense of self at different ages; and (2) a discussion of three central concepts from my work with patients: (a) the “self-care voice” (b) the legacy of compressed memories in daily behavior, and (c) the emotional safe room in our minds.  This begins to take shape in our earliest experiences and is strengthened or weakened during development.  All three concepts provide the impetus of understanding the person, and promote incremental steps toward change.        

Finally, case material from the author’s private work will be introduced to illuminate the effectiveness of the therapeutic relationship to unpack the injuries of childhood and temper their influence in daily living.  Interventions are discussed that I have found useful to unlock potential and personal freedom.  

Theoretical Formulation:    

Many authors (Pine & Mahler, 1975; Winnicott, 1958; Kohut, 1971; 1977) have discussed that the journey for a strong sense of self begins at birth.  If successful, Peterson’s “Stand up Straight with Your Shoulders Back” signals a way of approaching life day to day.  However, success depends on many variables in our environment.   Heredity also undoubtedly plays a role in the child’s development.  

Among the crucial environmental variables a clinician needs to ask the question, “How prepared were the patient’s parents for parenthood?  All parents enter parenthood with strengths and imperfections.  There is no question, I believe, that most parents feel a deep sense of love and desire to care for their children right from birth and onwards. Having said that, however, some enter parenthood with a wider berth of imperfections and deeper wounds from their own childhood.  The residual trauma unbeknownst to them unintentionally leads to the weakened core self, or as I define a diminished “self-care voice” in their children.  

As simple as “STAND UP STRAIGHT with Your Shoulders Back” sounds, it requires a “good- enough” environmental beginning (Winnicott, 1958), and frankly ongoing opportunities for a multitude of good enough positive human interactions thereafter. In the early stages of psychoanalysis, Freud (1929 ) theorized that the infant was primarily pleasure seeking with no interest/interest of the other.  Fairbairn (1949) expanded the theory with the idea that the infant also felt joy and pleasure with the other.  In another words the mutual interpersonal interaction was equally part of the experience.  Sullivan (1953) later broadened our view of the critical nature of the social network in development.  Experiences go beyond immediate family interactions.  A strong beginning allows us to venture out comfortably into the world.  New human interactions are welcomed and new experiences embraced.  This sets the stage for meaningful sustained growth, and the freedom to leave the emotional home we grew up in (Celani, 2005).  Few events will cause the self to dissolve into an incoherent and chaotic state of mind. Reactions of intense anxiety and/or depression do not surface.   Kohut (Elson, 1987) would say we strive always to maintain a “narcissistic equilibrium” throughout the life cycle.  This balanced sense of self prevents disequilibrium internally.  In my clinical work, I use the terminology of a “self-care voice” to help patients understand our work is to establish an emotional steadiness.

Kohut (1971; 1977) had a significant impact on the psychoanalytic world.  It is worthwhile understanding his contribution.  Kohut (Elson, 1987) speaks to the strength of self-structures that regulate self-esteem.  One of the primary achievements in life is to be able to regulate self-esteem, or as Peterson has said, be able to maintain a steady “Shoulders Back and Stand Up Straight” stance.  Kohut (1971) believed that the child internalizes the necessary self- structures to regulate self-esteem with the positive experiences with his/her parents. Kohut believed that it was a lack of parental empathy in the child’s early years that led to an inability to regulate self-esteem (McLean, 2007). Adults demonstrating narcissistic personality traits in Kohut’s view displayed a vacillating self-esteem. There would be swings from being overly impressed and overly evaluated with themselves to feeling depleted and inferior to everyone around them (McLean, 2007). The self-care voice begins with the infant’s first cries for food and comfort.  The cries evoke a response from the parent (mother or father in modern- day living).  The infant becomes aware that the cries lead to a self-care activity albeit outside the infant.  

With cognitive development, the infant-child becomes cognizant of “I can have an effect on others that leads to a positive internal reaction, and thus mutually satisfying experience with the other” (parent).  The parent’s ongoing “empathic attunement” with words and actions promotes self- cohesion or a strong “self-care voice” (Rowe & MacIsaac, 1989).  The “good enough” environment is established with routine dependability (Winnicott, 1958).  In slow, incremental steps, the infant-child’s growing awareness leads to the beginning of motivation, productivity, social confidence, joyful attachments, and meaningful and purposeful direction.  Elson (1987) states, “It is the parental environment (I replaced maternal environment) that responds to the individual body parts rising up, e.g., lifting the head, cooing etc. that draws the parent to react with recognition and joy.  Eventually there is the response to the whole child with maturity.  This begins with the parent saying the child’s name, and the child eventually connecting the name to his/her actions.  The baby’s “exhibitionism” yields the verbal and physical expressions of joy from the parent”. There is a mutually satisfying experience for both. 

There is an integration of actions into language as the primary mode of communication.  In the preschool years, the emergence of language illustrates such a powerful experience for the toddler to further express desires and intentions.  A rudimentary beginning of mutuality and reciprocity is recognized in relationships as well. The “self-care voice” and “layers of compressed memories” take on a formidable and enduring shape.  The child learns that the reciprocity between others can promote sustained feelings of joy and happiness.  Yet, there is cognition that the environment is not a perfect one.  There are times when frustration, disappointment, and anger are experienced, but temporary in nature.  This begins the ability to tolerate and postpone need satisfaction but also resilience begins here in these experiences. 

When the parents’ imperfections lead to a delay in meeting a child’s needs for care the early beginnings of frustration, anger, and disappointment begin. Prolonged delays for touch, eye contact, holding, snuggling, soothing, calming, or pleasant voice or ignoring basic primary care for food, bathing etc., the child grows up into adulthood seeking self- esteem regulation from others.  The child learns early on that the response by the parent was insufficient. Therefore, the seeds for regulating self-esteem do not develop, and in my opinion the “self-care voice” is destined to be derailed or in some cases nonexistent.  These adults for a lifetime become overly dependent on the other for validation and confirmation to maintain self-esteem.  Disequilibrium is experienced often, and thus they seek admiring experiences to help them feel good about themselves.   It may rise to the level of an addiction.  Without the others validation anxiety attacks, whether general or panic are experienced frequently, depression abounds, moods swings may prevail, e.g., impulsivity or inertia, and narrations of self-harm may permeate ones thinking.    

As a therapist I have grown more attentive to explore with my patients the moments of disequilibrium with others.  This mutual collaboration leads to understanding the reasons he/she feels less than, unacceptable, unwelcomed, rejected or unloved by the other.  Reactions may vary from open hostility, resentment, quiet anger or withdrawn, reclusive passivity.  I like to state, “the crime does not fit the punishment” to draw their attention to the intense reaction they are having to a current situation.  It requires an unpacking of these reactions that typically symbolize residual layers of compressed memories from childhood.  Restoring a sense of emotional equilibrium begins to take place in our face- to- face meetings.  The first sliver toward growth is that the patient begins to develop the belief that he/she is being accepted and understood by another human being for the first time in their lives.             

 I have mentioned that I use the concept of a “self-care voice” with my patients. 

 The “self-care” voice maybe defined as the ability to be strong minded, ambitious, self-regulated, productive, free to venture out and make order from chaos, connect with the outside world, meet new challenges, and develop new friendships and long- lasting companionship with a loved one.  The self- care voice also includes another dimension.  It has the capacity for self- soothing, forgiveness, empathy, and care for oneself. For some individuals this self-care voice has been derailed by developmental injuries in the early stages of childhood.   A strong or weak sense of  “self- care voice” is linked to how equipped our parents were for parenthood.  None of us enter parenthood fully up to the job, but we find our way because of the “good enough” experiences we had in our own childhoods (Winnicott, 1958). 

So the “self-care voice “ is strengthened or weakened by our early experience from birth to adulthood.  As Lomas (2001) has explained, our experiences can profoundly impact our behavior, choices, and actions in adulthood.  In my clinical work, I try to explain to the patient this influence with the concept of “ layers of compressed memories”.   We may define it as a stacking of memories that begins with our earliest experiences and continues on as a storehouse of thoughts, observations, and feelings relevant to ourself, and the way we interact with the world.   We hope that the layers of compressed positive memories outweigh the negative to fulfill the “good enough” parenting environment that is crucial for healthy development (Winnicott, 1958).   With our patients the compressed memories typically tilt in the direction of negative experiences.  The greater the tilt, the more difficulty the person has in adult life.  There is typically a significant amount of negative feelings and thinking that holds the individual back.  The initial phone call for assistance is based on the fact the pain is too great!  The cycle begins with our own parents. 

The development of a self-care voice and compressed memories lead to what I describe to patients as an “Emotional Safe Room” in our minds.   This concept is actually drawn from the work of Brandchaft (1994) from his wonderful article entitiled “To Free the Spirit From the Cell.”  He first inspires with a brief excerpt from Henrik Ibsen’s Ghosts an interaction between Mrs. Alving and Pastor Manders referring to being haunted by ghosts, 

but I am inclined to think we’re all ghosts, Pastor Manders; it’s not only the things we’ve inherited from our fathers and mothers that live on in us, but all sorts of old dead ideas and old dead beliefs, and things of that sort.  They’re not actually alive in us, but they’re rooted there all the same, and we can’t rid ourselves of them (pg. 57).

This exchange aptly describes Brandchaft’s notion that our patients live in a rigid, selfimposed cell that stifles change.  He references it as a defensive structure with the explanation, 

“Rather, operating at an unconscious level, this formation acted as a stubborn resistance to change by dismantling and preventing the consolidation of new structures of experience.  He continues, “The fear here rose with the patient’s perception of the approach of imminent and profound change.  It appeared whenever the process of inquiry illuminated and thus threatened some deeply entrenched unconscious principle of organization of experience of the self, a principle in which the essence of an archaic tie to a primary caretaker continued to live on” (pg. 59). 

The “Emotional Safe Room” is described metaphorically as a place in our minds that we walk back and forth between our internal life and the outside world.  We have these mutual experiences daily.  The emotional safe room has two doors: (1) one leads to the outside world and (2) the other leads to our past experiences.  When we feel freely to move between the two psychological spaces we nourish ourselves experientially with further development, and promote opportunities for the self-care voice to strengthen.  Yet we are not dependent solely to be constantly stimulated by interactions with others or things.  We can also feel comfortable being alone with ourselves.  There is a quiet happiness and joy. We come and go from the emotional safe room at ease and with a certain certitude that “I am safe, strong, and resilient to take care of myself” despite the possible hurdles of the day. I am comfortable and satisfied to say that “It has been a nice, solid, and good day, and there is no need to be overly stimulated and or feel it had to be special or great.  

With our patients, freedom to move about is met with restrictions.  They prefer staying in their “Emotional Safe Rooms” as much as possible. Visits to the outside world, consciously and subconsciously, is typically fraught with the traumas experienced in childhood. They cautiously and carefully open the door only to be exhausted, overwhelmed, burdened, and threatened by responsibilities and interacting with others. Our patients tightly hold it together but experience considerable emotional disequilibrium and ups and downs during the day. They experience depression, anxiety, and even panic if they do not restore some sense of equilibrium by returning to their emotional safe room quickly and firmly shutting the door. The emotional safe room, therefore, is a refuge. Some clinical examples will help to illuminate where our patients have lived during their lifetime and what the challenges are for us as clinicians.

Examples of the Emotional Safe Room:

Case of “O”

Patient “O” is in his mid-fifties. “ O” entered treatment for chronic issues with anxiety and depression. “O” has been in treatment before on several occasions and has taken antidepressants. After nearly 25 years in the business world he was released with other coworkers during a downsizing process. In his youth and upon entering a prestigious university in New York City he wanted to be a musician and songwriter. In fact he enrolled in the music degree program but during the first semester dropped out. Upon dropping out “O” pursued a young woman down South for a short period of time before moving back with his family. He worked at his job and pursued his music late at night. When he enters treatment he has 300 unfinished songs. With no full time employment, he wants to devote his time to learning whether he can make it in the music world. “O” and his brothers grew up in a very tight knit family. Traditional work was held in high esteem. We often spoke of the healthy aspects of his loving family, but also the enmeshed quality to it. Strong beliefs for traditional values and responsibilities in contrast to “O’s” passion for the uncertainty and ups and downs of the music world.

O’s “emotional safe room” as a child was constructed mentally to promote a constancy of coddling, safety and strong connection to primary caretakers. The feeling of closeness was needed so strongly that any movement away to construct his own life independent of them and family members created anxiety and fear. O’s movement in the world has always been filled with many activities and clutter to distract him from his life- long passion for music, but exhausted from the day he returned to the emotional safe room always giving as we came to know a “wink of the eye” to the guitar and unfinished songs that occupied a small space for hi. The wink and nod of recognition was to say “I will see you later tonight from 11 to 2 AM”. With the layoff, O was excited and joyful that finally he would get his chance. Nothing could stand in his way. As time went on we understood that his full-time employment was never the issue standing in his way because now with no work and 6 months of severance and insurance coverage, he still found his days full of distractions with no time for his music and song writing.

“O” ultimately was afraid to find out if he would be welcomed and well received by an audience, and perhaps, more critically, capable of leaving his emotional home that he grew up in. The deep archaic messages of primary caregivers to remain close to home and never leave was in full force. The “emotional safe room” contained him for months in a state of inertia by a wide set of mindful distractions and clutter. He could not just sit with his music and songwriting for an extended period of time. The fear to change was so ingrained that to explore and pursue with abandoned freedom was smothered with activities and distractions unconnected to his passion. So he stays within the comforts of inertia but deprives the self of his freedom to pursue his passion. The emotional safe room he returns to permits him to dabble in an individual pursuit briefly, but then tucks it away to resume the daily beleaguered, dreaded nose to the grindstone deep rooted belief.

Case of “M”

Patient M is in her early sixties. She is a mid- manager of a team of experts in the software industry. She is responsible to coordinate efforts for the implementation of software solutions to customers. M’s stress level can be very high at times. She has a very strong work ethic, deep sense of responsibility and always wants to please the other. Her spouse has been in private work, but over the past several years she has had to shoulder the financial load. She suffers from intense anxiety (panic attacks at times), fear, and depression. She is especially fearful of authority figures and annihilation if not pleasing the other. In comparison to “O”, “M” grew up in a more loosely knitted family. Her father was a hard worker, but rather meek and submissive. Three words to describe her mother’s interactions are critical, judgmental and accusatory. M has a brother who did not bear the brunt of her mother’s cruel and very mentally abusive behavior. M was not welcomed with open arms of affection, respect and care. These three words and actions by a primary caretaker express a constant bond of love. The unavailability of a loving mother, intuitively informed “M” to grow up and mature well before her years to take care of herself. She really did not have the opportunity to be nurtured emotionally. M‘s emotional safe room may be visualized as under a bed or sofa staying out of her mothers way to be as invisible as possible. By day “M” kept a metaphorically protective arm up just in case the criticism, judgments and accusations would fly her way at any time. Just imagine walking through life with ones arm up always to protect oneself from the misguided hurts of a primary caretaker. We have come to know this posture as waiting for the “sledgehammer” and how it has been prominent in her life’s endeavors.

“M” says “I always feel I had to do the right thing but even if I did, it was never good enough and pow the sledgehammer came out anyway”. “M” never felt on solid ground with her mother and carried that feeling into her life’s interactions. In meetings at work, “M” carries with her the fear of the “sledgehammer”and that she will be judged for doing something wrong or not coming through in one way or another for her superiors. By the end of the day, she retreats back into the safety of the emotional safe room. She is tired and exhausted from her anxiety and fear that some criticism or accusation would have come her way. Her emotional safe room permits her to be invisible for a time. To hide safely away without the burden of responsibility and a strict compliance. We discuss that in the back of her mind “M” fears being immediately fired for an error in judgment or disappointing a superior or just making a mistake. We unpack together that her immediate supervisor is helpful to her, values her work, and protects and depends on her expertise. That she does not need to walk around with her arm up in a defensive posture nor expect the sledgehammer per her interactions with her mother. We use as an example of how her immediate supervisor helps her out of a difficult situation recently for legitimately delaying a certain decision on customer service. The “sledge hammer” was not coming out helps her to have more confidence in interpersonal interactions, but more critically “M” begins to change the emotional safe room of childhood into a more free and easygoing way of opening the door to the outside world safely and calmly. The defensive arm can be lowered with less feeling of threat.

Case of “N”

“N” is in her mid-thirties. She is single but will marry soon. “N” is employed by a local township to be a director of one of their community- based programs. Our work has helped her expand her professional identity to assume a leadership role. “N” enters psychotherapy with periods of depression and at times rather severe anxiety. Her days are filled with worry and negative thoughts. She feels burdened by her daily responsibilities in her professional life, and if she had her way would not have to interact with the staff members she is directly responsible for in her department. “N” states “If I could I would prefer to stay in my office all day and not feel the pressure to have to answer questions or ask people to do things”. “N” prefers to do most things by herself, and only out of necessity and through our work relinquishes control over things. She does not like the feeling of being dependent on anyone. Most days she has left depleted of any energy and hopes to just be able to crawl into bed under the covers.

She is an only child from an intact family. Both parents were employed while she grew-up. N’s father was a businessman who travelled quite a bit. Her mother was a public school elementary teacher. Her mother suffered from alcoholism for most of her childhood. The alcoholism is in remission. She has stayed in recovery through psychotherapy and AA meetings. She to this day suffers from depression and anxiety. “N” has a close relationship with her father. He is characterized as supportive and understanding. He is a kind man who is easy to talk to and she enjoys her time with him. “N” and her mother are entangled in an up- and- down relationship. Her mother seeks much attention. To illustrate, “N” describes her worst nightmare is preparing for her wedding day. She fears her mother will attempt to upstage her at the ceremony. She is trying to “grab the attention in walking down the aisle ahead of me”, alluding to the fact that it is her wedding day. There is worry that she wants her dress to be more outstanding than hers given that “N” likes to be understated and unnoticed. “N” states “It is always about her” as we discuss an underlying pervasive feeling of irritation with her mother for years.

“N” describes her childhood as growing up in a very sedate and quiet home. Most times she is alone with her mother who is a problem drinker and unavailable to “N”. She learns to be quiet, compliant and not cause a fuss. As we collaborate to unpack this “N” and I come to learn that her emotional safe room is constructed with her playing hours alone on the floor. No one around to play with and no interactions with a primary caretaker. She stays in this emotional safe room quietly trying to figure out how to put things together on her own. The isolation is a relief as a way to avoid her mother’s negativity, depression, and drinking habits. She does not have to be there for her mother nor be responsible for her mother’s loneliness. Hours alone with her mother’s drinking leads to seclusion and, in effect “N” becoming familiar that seclusion is a comfort zone as well. They share this emotional bond as she grows and matures.

“N” never really feels comfortable in the outside world. She prefers being alone but recognizes that she has made some good friendships and now has found a man who cares deeply for her. However, she can never ask for what she wants from others. She fears they will never acknowledge and actually give it to her. She states “Why be disappointed?” in reference to them will not caring enough to hear her request. She brings up that she cannot become engaged in any activities nor has interest in work. She is fighting against her emotional safe room that begs for her to return to a “private room that is a tiny one to be left alone with just peace, quiet, and no responsibilities”. She speaks of her impatience with her fiancé or a friend in telling a story about their day. We discover that what surfaces is that it is all about them. A similar feeling that she has with her mother, and that she fears to push herself into the conversation to say what is important to her. “N” cannot push her needs to the front, for example, to ask for affection from her fiancé. “N” elaborates, “I bailed out on a friend last weekend because I just wanted to be alone.” With further collaboration, we unpack that her friend since high school has always gotten under her skin. She continues with, “ I just did not want to deal with her, she is too much, and it makes me exhausted,” I ask well how is she too much? “Well it has to be always about her story and things in her life.” We conclude that like her mother she bailed out on her friend because she could not turn the tables as it were to put herself front and center. She continues, “I never thought about it that way. My reaction is about her making it about her and I get nothing out of it.” We now make the connection that the emotional safe room is her retreat, but she can learn to make herself a priority when needed, and not cancel plans with a close friend.

Her pending marriage is a relief to her. “N” in our work has embraced the need for companionship and love. We have worked to de-stress her feelings of working in the world and lowering her expectations. More importantly, asking staff members to help with certain duties, and learning how to trust so she does not have to do it alone. She can walk more freely in and out of her emotional safe room with greater ease, but recognize the importance of some downtime and soothing. She recently was able to explain to her future husband that she feels more comfortable falling asleep before him, and recognizes it cannot happen all the time but could he keep it in mind. It leads “N” to have a more restful sleep.

The “Emotional Safe Room” for these patients is a refuge from the outside world. Early in their lives they mentally constructed a space that seemingly protected them from the toxic feelings with their primary caretakers. They return to the safety of this room at days end to find relief from the anxiety, fear, worry, and depression that permeates their conscious lives. It is a refuge of detachment, quietness, and relief from the daily pressures of trying to please others, work with others, or meet expectations of authority figures. They do not approach each day with a sense of joy, happiness and a sense that the world accepts them for who they are. Performance is critically important because there is intense fear that others will view them as a failure. In their world, they are careful, watchful, and react with little spontaneity. In fact, it is as if they are looking over their shoulders all the time hoping they do not make a mistake. In contrast to Kohut’s view of the narcissistic personality (McLean, 2007), the cases described above had one very common theme. They showed no signs of an overly exaggerated sense of self, but have a muted self-care voice that impoverishes their self-esteem. Life activities burden and deplete them.                

Some parents have had a paucity of good experiences that lead to lower confidence in parenthood.  As a result, their children may experience more trauma and unmet needs in their childhood.  In Peterson’s terms (2018), they do not develop the “Stand Up Straight With Your Shoulders Back” stance in life. These are our patients.  Thus, as a therapist, our relationship with our patient places us in a unique position to help them learn to develop a stronger “self-care voice,” and live a more fulfilled and free life.   A sense of freedom however comes with responsibility to face life’s challenges.  

  Freud (1929) said,

 “Most people do not really want freedom, because freedom involves responsibility, and most people are frightened of responsibility”.  

 Freud’s wisdom is absolutely correct.  I suggest that we pursue freedom if we have a strong self-care voice. There is always a degree of trepidation to pursue freedom, but we manage the risk and unsafe nature of it.  Inertia does not grip us to stay in one place.  Rather we take the steps to make changes despite the feeling of anxiety pulling us back to a more familiar and comfortable place.  Here in lies the dilemma.  There is no happy and delighted feeling initially to face and struggle with the anxiety to start moving forward and resist the inertia that grips us.  The strength of the self-care voice is our companion and gives us the will to begin.  The layers of compressed memories whether attained within our “emotional home” growing up (Celani, 2005) or achieved in the therapeutic relationships, provides the power.  Others think of freedom, but the idea to reach for it promotes too much tension, anxiety, and depression, and thus there is inaction and inertia.            

A psychotherapeutic relationship, therefore, has the potential to help the individual to heal, but more critically it can revitalize the “Stand Up Straight and with Shoulders Back” feeling (Peterson, 2018). I believe this essential life characteristic has remained dormant in individuals we work with only to be nourished and brought back to life by the hard work of therapy. 

Can we help the individual achieve what Peterson (2018) adeptly describes with,  “Attend carefully to your posture.  Quit dropping and hunching around.  Speak your mind.  Put your desires forward, as if you had a right to them at least the same right as others.  Walk tall and gaze forthrightly ahead.  Dare to be dangerous.  Encourage the serotonin to flow plentifully through the neural pathways desperate for its calming influence” (p.28)  

In Peterson’s framework this is crucial for healthy development, and if derailed earlier, it can be recovered later in one’s life.   It will hopefully restore a vigorous resumption of energy, productivity, enthusiasm, resilience and optimism to make a meaningful life.

Stand Up Straight With Shoulders Back for Peterson (2018) is “accept the terrible responsibility of life, with eyes wide open” (pg.27).  Peterson’s message is that life is painful and hard. Accept it.  I support his thinking that life requires hard work to move forward and meet the various hurdles in the way with strength and conviction.  There is no easy path for most of us.  It is making the “order” from “chaos” but recognizing that order and chaos must be an active part of our lives.  We need to straddle the fence between both to make life interesting, exciting, and meaningful.  

I often refer to this with the old adage as a “FIRE IN THE BELLY” to help them understand the psychological term “ego strength” (Kohut 1971; 1977) to pursue something in the world.  The individual welcomes the world realistically, and accepts there will be ups and downs to face.  Resilience is necessary to overcome them and achieve a happy internal feeling state.   The development of the “self-care voice” and “layers of compressed memories” in our patients help them restore the blocked “Fire in the Belly” feeling derailed by early experiences.  

The Fire in the Belly means the generation of a thought to do, promotes a dream or an idea to do something that in its early stage may be filled with high hopes and expectations, yet as time goes by, he/she begins to feel comfortable with the idea that something does not have to be great but just good and solid.  The Fire in the Belly still powers forward, however with realistic goals.  In adulthood it could be a profession (professional identity), business venture, relationship, parenthood, etc.  In childhood/adolescence where I believe the FIRE IN THE BELLY begins with observations, feelings and thoughts to imagine something for yourself. It is the young boy who thinks he will be a famous baseball player and blends words and actions into a spirit of teamwork (words), and ongoing practice to get better (actions).  At some point he may discover that his dream will not materialize (a painful recognition), but the inspired image, words, and actions woven into the environment are seeds to propel him forward to other realistic pursuits (and perhaps cultivate an ongoing interest in baseball).  He learns to “Stand Up Straight With Shoulders Back” during the process.  He has experience with chaos, but learns that he can make order out of it. The integration of a dream and actions of being part of a team create the chance to influence life in a similar and more realistic way. There is a strong feeling of autonomy (I can do it attitude), and yet a sense of mutuality (I cannot go it alone). Yes, a great achievement developmentally.                                    

We, as clinicians, therapists, parents, and educators, need to keep in the forefront that  “Stand Up Straight With Shoulders Back” develops from the ebb and flow in relationships.  From the very beginning mutuality exists, and with growth the formation of a sense of self is created from the mutual interactions with others.  We learn to tolerate the inevitable disruptions and repair work that goes on in our relationships.  With these experiences intimacy is achieved.  

Aron’s (1996), in discussing the therapeutic relationship, discusses the creative tension bar between mutuality and autonomy that leads to the human spirit to embark upon a journey of self- exploration and interactions with the other.  I frequently use with my patients the words “exploration and curiosity” as a way of learning about them, and expanding the healthy boundaries of our relationship.  It is worth understanding the existence of this bar of tension.  I believe it is the backbone to Peterson’s  (2018) concept of “Stand Up Straight With Shoulders Back”.   

Aron (1996) referring to psychoanalysis expresses, “ If psychoanalysis is to promote the capacity for intimacy, it must function with principles of mutuality and autonomy, of interaction and self-regulation.” He continues with, “ Mutuality of recognition is really recognition of each others autonomy.  A person’s sense of autonomy in a relationship is itself a mutually regulated state.  For mutuality of recognition to exist in a relationship, there must be two participants who feel themselves to be autonomous people capable of agreement and disagreement” (pg.151).  

Within this statement Aron (1996) amplifies the concept that intimacy between two people is a combination of compatibilities and sameness that bring us together, but also the ability to differ in opinions, observations, ideas, and feelings that strengthens the sense of intimacy.  We must have both to sustain a healthy relationship. It is this combination that I believe promotes the capability to “Stand Up Straight with Your Shoulders Back” and can restore the vigor in the self but also in a relationship.  We bring these ingredients to our patients.  

As explained, the development of a “self- care voice” begins very early in life and strengthens over time with positive layers of compressed memories.  This strength begins initially with parental interactions, and continues to grow with the child’s broadening interactions in the world.  I try to help the patient see that perhaps the care and work in the therapeutic relationship can restore and strengthen the self- care voice.  I have found the concepts of a “self-care voice” and “layers of compressed memories positive and/or negative” are very useful in orienting the patient to our clinical work. Clients are able to hold on to the idea that there is a self care voice inside that needs to be strengthened and that compressed memories have influenced behavior   Working on both concepts helps to achieve Jordan’s first rule to “Stand Up Straight with Your Shoulders Back.”  

While on vacation I had the chance to randomly observe two young children that perhaps illustrate how to “Stand Up Straight” begins in life.

Illustration #1

We were at the beach vacationing, and of course biking one day.  On the way back we noticed a young girl approximately 8 years of age on her way to the tennis club on her bike.  What struck us was the fact she was alone on her merry way for her lesson.  This sparked a conversation of how she seemed so self assured and at ease with her journey.  We wondered, of course, not actually knowing how this one experience is just another building block to a sense of self that “Stands Up Straight with Shoulders Back.”  It encourages venturing out, exploring and discovering independently from others. She is on her way to meet an instructor.  She will learn from this instructor and have a different experience apart from her parents.  They will interact differently with words and actions giving her a different relational exchange that adds to her experiences.  

Illustration #2

The next example occurred on the same bicycle ride.  As we are making our way back to our vacation home, here is a young man no more than age 8 years of age walking very deliberately with cooler in hand to his family’s vacation home.  He walks with a strong stride and a sense of purpose to return the cooler home after his day at the beach.  Here is a young man walking on his own away from his family doing a job that he needs to complete.  As in illustration #1, this young man has a sense of purpose to pull his weight.  He “Stands Up Straight with Shoulders Back” which is portrayed in his gait.  He mans up to complete the job. 

In both incidences the children are alone with a sense of purpose.  No supporters are around to assist or make sure that their mission is complete.  For them to get to this point at such young ages demanded layers of experience and patterns of orderly behavior to promote such independence.  Though this observation on my part is pure speculation, I firmly believe there is a strong sense of self in the moment.  But now I turn to my personal observations of two of my grandchildren in order to elaborate upon the beginnings of a strong sense of self, and then to apply it several clinical cases where it was derailed.   

Illustration #3

The next two case illustrations are from personal experiences.  We have two grandsons.  Enzo and Bradley are 3 years of age.  Now officially into childhood I have had the good fortune to make quite a few observations of their interactions with their parents.  The two previous cases were casual observations but without direct knowledge of their development.  Yet I can safely say that I believe they will be able to venture out on their own just like the two children in the first two illustrations. 

Enzo and Bradley are both enjoying age 3 years.  I say this because of their expressions of joy, enthusiasm, excitement and energy level for life’s activities.  They are being raised in very different environments.  Enzo lived in Manhattan until age 2 1/2 and moved to Germany just shy of his third birthday.  Bradley lives in suburban New Jersey.   Surroundings are obviously different, but both are thriving in their different homes.   As with many households today, both parents work so childcare has been for both boys divided amongst family, school, and private help.  

First and foremost, there is a constancy of love and care that both boys experience in these early stages.  The constancy is a critical element to the beginning roots of “Stand Up Straight With Shoulders Back” stage. I believe the direct care by people other than their parents has given them a one leg up as well.  Experiencing other people in their lives has strengthened and shaped their sense of self.   These others express a constancy of love and care with different words and actions than their parents.  The parents are not “helicopter parents” that seem to be so very much part of our culture today (Lukianoff & Haidt, 2019). 

So between birth and 3 years of age I would say that both Enzo and Bradley have successfully become attached to their parents and they to them. The research on attachment indicates that the unconscious is shaping impressions of the reciprocity of these interpersonal positive exchanges (Fisher & Crandell, 2001). The more practice with experiencing “contentment” and less chaos builds the idea that human exchanges are pleasant and satisfying, and thus is the forerunner of a desire to be with others.  They want to form friendships and ultimately find someone to love (Bowlby, 1980).  These early attachments are the foundational structure to desire to be with others.  

  Ongoing human interactions between child and parent(s) promote strong                                                                                              attachments. An internal sense of self filled with joy and excitement depends, however, on the quality of the interactions between parent and child. Derailment occurs when there are a series of disruptions that defuse the beginning feeling in the child that “I EXIST” in your eyes (Broucek, 1991).   Broucek (1991) explains that layers of positive experiences blend together to strengthen “intent” on the child’s part.  Intentionality “has to do with knowing what one is doing and why and involves, even in the infant, a degree of what might be called “willing” (p.28).  The child’s efforts can result in getting the intended response from the parent or not.  

 When intentions are rewarded with the experience of self-efficacy the sense of self is fortified (Broucek, 1991), and I believe promotes a deep rooted feeling of “I have a purpose”, “I feel good”, “I am motivated”, and “I am meaningful”.  These experiences are compressed into deepening layers so that in later development one feels contentment, joy, pride, passion and confidence in ones actions.  Failure to get the desired response leads to early vague feelings of the self, and with more serious trauma a chaotic defuse of energy.  It is here that the early signs of shame may begin to emerge and cascade into a lack of self efficacy or the will to do.  In my own work over the years, I have noticed that many patients suffer from strong feelings of shame.  These feelings generally have blocked potential and happiness in their lives.                 

I can see that since birth early experiences have led to a positive growth trajectory for both boys.  Prior to moving to Germany, Enzo lived in NYC.  NYC presented an abundance of experiences for his first 3 years with the different sights and sounds.  More importantly the layers of compressed memories of attachment to his parents laid the foundation to the emerging strength I now see in him in Germany.  On a recent trip, Enzo’s language is progressing to the stage of conversation and give- and- take.  Even traces of humor have emerged with funny exchanges and bantering going back and forth.  At one point for example we spoke about his dad needing a haircut and shave (my son has grown a rather long beard and lengthy hair given COVID-19 restrictions).  I made a joking comment to which Enzo spontaneously reacted with a laugh “You’re not the salon hair guy Pop-Pop!” as if to say hey you don’t cut hair, what do you know.     

Recently my son sent us photos and videos of Enzo.  He is now playing with others.  He frequently holds hands and walk together with his playmates.  He also shows a strong attachment for his father and mother.  They both engage him with language but also in a variety of experiences since he was born.  No challenges stand in their way and I truly believe there are compressed layers of interactions that promote a strong sense of self.  Although Enzo resides in Germany, technology allows us to stay in touch through FACETIME.  

He just moved to a suburb of Frankfurt a month ago.  In our FACETIME he already seems to have a confidence and safe freedom in his space.  This day he frolicked in the back yard nakedly with a hose sprinkling himself with free abandon.  Just as he delights tin this activity, a neighbor suddenly appears on the corner with his spouse and son.  Enzo has already made a friend as he zooms past his dad to take an invitation to walk in the woods.  He is without his parents with newly developed friends, but not only that, he has developed a trusting feeling with the parents.  His world has extended to other adults and a new friendship. He separates because of a strong sense of self.

Bradley is in sync with Enzo developmentally. He has an ability to express himself very well. His language skills are developing quite rapidly. Thoughts and opinions flow with clarity and purpose. Bradley and I have a strong relationship. But one day I said to him, “Hey you’re my best friend!” expecting of course that he would reflect the same feeling back to me. My naive and excited momentary grandiosity was toned down with Bradley’s momentary deliberation. He then stated with self assurance “Pop Pop my dad is my best friend!” My response of course was “Yes your absolutely right!” Momentary exchanges like this one, and in the therapeutic relationship require our acute attention. Bradley’s eyes turned away for seconds as he contemplated his response. In the end, he stated with certainty the opposite of what I was feeling, but said it with a sense of humor and banter. Letting me down gently with grace and charm, and I returned it with a spontaneous validation and acceptance that he was indeed right.  

It is very interesting to me that both boys’ spontaneous humor and bantering shows a degree of confidence and safety in human relationships.  Additionally Bradley wanted me to know that he has a strong emotional bond with his father.  Compressed memories of bonding have already taken shape and stored in his memories.  As much as he is attached to me, I cannot be his “BEST “ friend.  This honor is bestowed upon his dad now and forever.  There are glimmers of interest in other children now emerging confirming he is beginning to see the world in a more expansive way that encompasses not only home domain but school experiences and other adults.  As with Enzo there is a confidence growing to expand his horizons freely and with trust in others. 

As I write about my observations of Enzo and Bradley, I am trying to be as objective as possible.  It is critical that nonprofessionals understand the beginnings of a healthy sense of self and the defused and at times chaotic self that invariably produces shame.  Morrison (1998) says it quite eloquently when he states that we, through positive experiences and Broucek (1991) the growing sense of self-efficacy become the architects of our self- image and do not depend on others to define our image. 

In my work with patients I frequently use the metaphor of a small room in their minds that they reside in emotionally.  The room is filled with their symptoms of anxiety, fear, thoughts and depression. As I explain to them, there is a door to the room that they look at with excitement because to open it means joyful freedom to uncover different parts of their personality and to pursue their dreams.  This metaphor is similar to Brandshaft’s  concept of the cell (1994).  I use the term inertia to describe to my patients the “stay put” emotional compromise they live in.  They chose the inertia because of the overwhelming fear to open the door of new experiences (change the feelings states in the inertia), but on the other side of the room is another door that leads to their “emotional home” (Celani, 2005) that caused their earlier childhood traumas and wounds.  They fight hard not to go back there, but they fear the pull because they have never really separated from that emotional home.  Inertia equals safety.  The familiar signals comfort.  Both are a compromise that is fulfilling emotionally yet filled with confinement, rules doubts and restrictions.

Enzo and Bradley are becoming the architects of their selves. The emotional floor plan is beginning to take shape with a strong foundation developed in the attachments at birth to now. Parts of the self are beginning to be defined more clearly in consciousness.  There is the firmness of intentionality (I know what I want to do), alertness to be in the moment, and thus orientation to reality, and mutuality/reciprocity to share thoughts, observations and feelings with others (Trevarthen,1979). 

The parts of the self that are emerging in Enzo and Bradley are evident in not only their thinking patterns, but also in pausing/reflecting before they say something, thoughtfulness in recognizing the other and sensing how they feel, expressing with freedom a range of emotion and thoughts, and having a sense of humor.  All these behaviors indicate a confidence in the self.  More critically is the consolidation of these into more spontaneous signs of a strong sense of self and a deeper intimacy with the other.  There is a bantering back and forth with the other, a serious thinking side for contemplation, and also observing events or just roaming the environment.  

So the room in their mind is filled with excitement-joy, pleasure, anticipation, and engagement for new learning, and interpersonal experiences.  These feelings and thoughts illustrate it is a “happy room” thus far.  These emerging parts of the self reflect that Enzo and Bradley are able to freely open the door to the room to venture out.  There is a trust building that it is safe to think about new adventures (friendships, activities, and novel settings) without trepidation.  The earlier compressed memories leading to a strong sense of self will be added to with more positive experiences.  Hopefully layers upon layers of experience will lead to fortify the already beginnings of freely opening their minds to different and robust types of experiences alone and with others with energy and delight. There are no enduring feelings of “shame” taking hold.  As Winnicott (1958) so adeptly realized, and thankfully understood, both boys experience “good enough” parenting (did not use mothering given fathers are more actively involved with their children).  Without experiencing steady messages of shame, their self-image is actively free to expand the room within their mind with joy-excitement.  There is a next crucial milestone to achieve, that is, resiliency as time goes on.  I believe this is a critical step in development.  Dealing with frustration, failure, disappointment, rejection, loss and general setbacks begins when the “room” in their minds eye is decorated with pictorial images and memories that help them over the hurdles of life. The old term “brush yourself, get up and move on” applies.  Adversity is seen as an opportunity to overcome. Negativity is not to be dwelled on.     

One can only hope that Enzo and Bradley will continue to strengthen their self-efficacy and expand their self-image room. Fear is always present venturing out, but it is not the gripping fear some of our patients’ undoubtedly feel as crystallized in the acrobatic thinking to stop them from reaching for the door. Remaining in their room, that purportedly is safe, only leads to a weakening of the self.  The element of shame I have found is nearly always at the core of our patients’ issues.  The depression, anxiety, panic attacks, and OCD thinking are the symptoms of being in confinement.  Most often they appear when one is considering reaching for the doorway to change something in their lives.  The behavioral reaction, e.g., panic sends them packing from the desire embedded in the inklings of joy, pleasure, and excitement that something new is possible. They don’t want to go back to the original “emotional home” that caused the wounds.  So they curl up into the state of inertia to restore emotional equilibrium.  Certainty and safety provide temporary relief, but soon after sadness resumes.  

The greatest challenge for therapists is to help our patients learn to reach for the door in small steps.  We need to help them develop self-efficacy and success.  Our goal is not to remove the wounds in their childhood but to lessen the influence and tame them, so that the fear does not overwhelm.  Uncovering and identifying the shameful experiences that curtailed in my clinical opinion is crucial to a healthier life.  The following case illustrations I hope will highlight some of the advantages of working to understand how early childhood wounds contribute to the small emotional room that produces a feeling of confinement and at times suffocation.                                                              

Clinical Cases:

Several cases from my clinical practice demonstrate how earlier developmental issues prevented a “Stand Up Straight with Shoulders Back” sense of self.  This weakened posture, physically and emotionally, contributed to generalized anxiety, panic attacks, and depression in child and adulthood.  The case illustrations describe an inability to “Stand Up Straight with Shoulders Back” throughout their lives.  Analytic work and the therapeutic relationship helped to develop a stronger sense of self and achieve the” Stand Up Straight with Shoulders Back” mindset.  We are focused on the therapeutic interventions that helped strengthened these patients to improve their functioning in everyday life.

Abbreviated Case of “Q”:  This case is abbreviated to illustrate some of the concepts that have been discussed in this paper.  It represents a variety of sessions.  By way of background Q is in his mid-forties.  Q is a single parent of a middle school age child.  Q has been divorced for approximately 10 years.  He is an executive in a very prominent company in New York City.  Q’s parents were divorced when he was 10 years old.  He has an unmarried older brother.  Q attributes the parents’ divorce to the mother’s domineering behavior over the father’s meek passivity and lack of masculinity.  Q’s father would show his masculinity with sudden angry and intense outbursts when he could not tolerate Q’s mother’s criticism, using demeaning and cruel words.  These eruptions faded quickly only to rise again like a volcanic eruption.   Q was a rather passive and self conscious child.  Mother’s dominating and forceful behavior spilled over into her parental interactions.  She was judgmental, critical and disapproving.  She wanted things her way.  Q married a woman with mother’s characteristics.  She was strong willed, domineering and full of criticism. Pushed Q around emotionally and because of unbridled spending placed them in bankruptcy court. 

In this session, I asked, “Do you have any reflections about our last session?”  He states “I was focused on our topic that I need to go out more post COVID” (Q seldom socializes and attempts to meet women strictly on dating sites.).     He expresses, “I set up all these walls.” The “emotional safe room” in his mind metaphorically is arranged with lonely one-person activities. Q seldom includes a desire for others, but he brings women in with pornography.  He continues, “ That idea about going out more is the last thing I would do.”  I say, “Let’s unpack this together to see where it leads us.”  Q continues, “I would not be good at it” he explains “it is not safe, I don’t know that person-are they healthy?”  I ask, “But what about pre-COVID? What was your experience?”  Q replies, “ Well I don’t have the confidence and I am very self- conscious about approaching anyone.”  

At this point we discussed the emotional safe room he has established in his mind.  This room was established in childhood with varying experiences with his mother.  He recalls staying away from her in his room to be in a quiet solitary place.  He was avoiding her loud voice, criticism, disapproval and judgmental statements of his father, him and his brother. Q recalls the tension, unease, and anxiety that accompanied the hollering and discord. He never knew where it was going the anger with the conflict.   “I spent more time in my head listening to music with headphones on.  Q wished for peace and quiet and added, “I would do anything to avoid conflict with my mother,” and this mirrors the way he walks in life. In another session Q reveals in reference to his mother. “ She is so difficult if she were not my mother I would have no interest in knowing her”.  We make another connection in that his checklist for women, “If I can’t check off all the boxes I have no interest to know her” (in reference to getting to know a woman).  So this very high expectation makes it nearly impossible to be open to anyone, and indeed keeps him in the safe room.     

The compressed memories were negatively layered in his daily experiences with his mother.  With age the emotional safe room in his mind was a refuge.  It represented a quiet place for soothing, but at the same time the safeness promoted a false sense of security.  Opening the door to the outside world initially is started up by the resourceful “self-care voice”.  The “self–care voice” is strong enough to create a sense of confidence, inspiration, joy, and excitement for mapping out a way to meet daily experiences, whether for the routine parts of life or new endeavors.  Q remained in the small confines of his emotional safe room.  It was passively soothing and safe but lacked any real energy or excitement.  In fact, I have found clinically that the people I work with seemingly feel it is comfortable and safe, but when you peel back the onion you discover that it is really a feeling of emotional “inertia/paralysis.”  This discovery I believe is the first step toward change.  This “inertia” needs to be unpacked over and over again to identify the ways the mind puts up roadblocks and hurdles to open the door to new experiences.

In a more recent session, Q and I discuss his preoccupation with stirring up anxiety repeatedly with the political news of the day or environmental concerns or world events. He spends a fair amount of time trying to track down the truth about things but is always as I said to him turning over dirt continually in his mind to create anxiety. No source of information is sufficient. With time to think, I suggest to Q that he has lived with anxiety as a child into adolescence, and throughout adulthood. The “turning over of dirt repeatedly” metaphorically is the same tension, fear and anxiety of childhood. He recreates the deep-rooted bond with the primary caregiver.

The layers of compressed negative memories are felt but externalized onto the outside world. The constant immersion into the environmental things beyond his control resembles the old emotional connections of childhood. We discuss the burdensome ordeal of going into meetings. The conscious and subconscious fears of not being approved of or the potential for conflict in these benign interpersonal relations. Working from home due to COVID restrictions “is like a vacation for me I don’t have to deal with a lot of the worries I feel in the real world. I am safe at home, but I am really beginning to understand that it is not a safe place to be.” The realization that he has created the old emotional bond of worry and fear allows him to begin slowly to make a change. We also begin to understand that the volume for energy and excitement for real life experiences was turned up with pornography.  Sadomasochistic adventures combined sex and aggression.  The erection he could not achieve with women was easily obtained with the pornography.  

In discovering the emotional “inertia” safe room it is critical to unpack the defenses that hold us as Brandshcft (1994) labels in the  “cell”.   For example, Q came to a most recent session discouraged and sad.  He has been thinking about our discovery of the emotional safe room but added that he was discouraged that “I could never see myself going to a bar by myself.  It literally scares me to think of making a move like that all alone trying to approach someone I don’t know”.  In this moment we discussed just making such a paradigm shift is the mind driving us back into the emotional safe room.  Into the state of inertia and creating more stress to subconsciously make you not want to leave.  We discovered that the emotional safe room of inertia keeps at bay the fear of two extreme emotional poles.  On the one hand there is the fear of loneliness and isolation.  No future companionship or social network.  On the other hand, his mind tells him he must make a big giant move to mean anything.  The aggressive boldness of the giant leap scares him as well.  He is driven back into the safe room of inertia.  Feeling like a failure on both ends with a sense of despondency. 

 At this point we discuss that we are working to make small shifts in his thinking to make his way out of the emotional safe room.  To practice certain steps incrementally.  For example, maybe attending work- related socials, joining hiking clubs etc as a way of branching out.  It is critical to help the patient unpack the defenses and to lower expectations for success.  The protective membrane that has been developed over the years cannot just be ripped apart or taken off.  Recently, Q had several dates with a woman he met on a dating site.  There was immediately a strong chemistry and an exaggerated sense of hopefulness that she checked all the boxes for a relationship.  Soon after, she backed away, declining any future dates.  Q was dismayed, confused and noticeably saddened/depressed with the abrupt turn.  The powerful excitement of the attachment to this woman was far and away a giant leap to “this is the one” and thus a significant fall into a black hole of despair with rejection.  It drove him back into the emotional safe room of false safety.  The false safety is really to restore the sense of inertia.  The thinking that “I cannot go out there” with any sense of confidence.

At this point I would like to present two cases in more detail to illustrate the concepts I have discussed in this paper. The following concepts will be applied to these two cases: Self-Care Voice; Emotional Safe Room; Layers of Compressed Memories; and Fire In the Belly. The implications are the way Peterson’s concept of “Stand Up Straight with Shoulders Back” can be derailed but restored through unpacking the issues that have hindered freedom to be in the world, empathic work together with the patient, and being mindful that change proceeds slowly in incremental steps.            

Case of “A”

”A” is in his mid-forties.  Currently has an excellent position in a major corporation.  He is well regarded and admired for his skills by individuals on his team.  “A” is viewed with a high level of expertise to illustrate to prospective clients how software may assist their business, and eventually promote sales.  Prior to the past several years “A” struggled to get his footing in the work world.  In young adulthood, he gambled with his career on a variety of start-up companies.  Needless to say start-ups are risky adventures in contrast to A’s understated and unassuming way about him.  He would prefer not to be seen.  He never gained a solid footing in any one particular place.  Despite a high skill level, “A” would do anything to stay in a small confined work life. For example, one company filed for bankruptcy that led to his unemployment.  Soon after the filing, the principal owner offered him a new job at a reduced salary pending re-organization procedures. Despite the wobbly financials, he retreated into his small room in his mind with the proposal in hand.  It was deliciously tempting to accept and the thought of rejecting it was only a faint feeling.  The proposal created the “inertia” that feels so safe and comfortable and is a recurring fantasy.

“A” wanted to be back in what he thought was a familiar safe environment.   Leaving the proposal on the table and walking away promoted an unruly chaos in his mind.  Anxiety, panic and depression forcibly emerged due to the disequilibrium.  There was no need to venture out, apply for new work, interview and broaden his opportunities.  He wanted to retreat and withdraw into the comfort of the emotional safe room of childhood. It represented a quiet, less threatening place of being alone without interactions with others. The construction in the early stages represented sitting alone watching TV as a child after issues of separation anxiety in attending school, and into adulthood with the comforting fantasy of just being in a cabin in the woods alone with his carpentry skills.    

 “A” lived metaphorically in an “emotional safe room” of his own creation as a result of intense trauma in childhood. In the therapeutic relationship, we want to unpack the issues of childhood to consciousness that prevented a stronger ability to “Stand Up Straight with Shoulders Back.” It is to be respected as the patient’s “creation” for survival and defense in response to trauma that occur in reaction to primary caretaker imperfections. For “A” it provided a natural boundary between him and the world.  “A’s” emotional safe room was filled with a variety of emotional states: feelings of inertia or stay put and be safe; and/or anticipatory excitement and joy for the fantasy of living in the woods alone working with carpentry tools. He wanted to ward off and try to manage the anxiety, fear, and worry to open the door to the outside world. It is a defensive structure because “Once hurt, human beings have remarkably creative ways to repel and avoid harm, and so relational trauma engenders a wide spectrum of self-protective symptoms” (DeYoung, 2015, pg.3) 

As explained earlier, the emotional safe room has two doors.  There is one that leads us back to the emotional home that promoted “good enough” healthy childhood experiences or one that left us with a lack of ability to “Stand Up Straight with Shoulders Back” because of the scars and wounds of childhood.   The other door leads to the outside world.  The healthy self has the flexibility to open that door anytime it wishes to do so. There is anticipatory excitement and an adventurous feeling to the open the door.  The self will feel manageable anxiety for the new experiences, but it does not stop the desire to move forward.  There is a desire to bring the experiences into the self to embellish upon the emotional safe room in one’s mind.  It releases the creative juices to make the self stronger and more vibrant.  There is no gripping inertia to stop the forward movement of the self toward expansion and health nor the preoccupation with escape fantasies that comfort and soothe.    

As we came to understand, A’s childhood experiences shaped a small and confined emotional safe room. The emotional safe room could be described as stripped down to the bare minimum, gloomy, self privacy, controlled, and limited living space. The feeling that he was a minimalist.  Though his creation had severe limitations on emotional expansion, it felt safe and comfortable.   As a child and young man, “A” was unable to see life “out there” as an adventure, but as a worrisome burden, and something to be feared.  So restriction and confinement of actions influenced all his actions from childhood into adulthood. His fear was always just below the surface in “A’s” work and social lives.  

“A” seldom felt the excitement-joy to have a strong “self-care voice” to propel him forward.  The fire in the belly remained dormant given the belief that he lacked self-efficacy to succeed.  It was safer to be unassuming and understated in his approach to life.   His fantasy life illustrates his desire not to be seen, and more importantly, to escape from the unpredictable and uncertain nature of the world.   “A” had this fantasy of becoming a woodworker in the backwoods for ultimate privacy.  Away from the world’s ongoing demands and pressures despite his high-level skills. As we came to understand, “A” was afraid of stepping out into the more competitive and action oriented world.  “A’s” emotional safe room also had a glimmer of a small dot of light that encapsulated the self-care voice.   Childhood hurts and scars smothered the self-care voice.  The self-care voice was hidden away and looked at for brief moments to entertain thoughts of expansion, but only to be withdrawn and muted.  

The challenge for our therapeutic relationship was to help “A”  (1) recognize that the self-care voice as small and insecure as it is can grow stronger in the therapeutic relationship; that is, the self-care voice has been neglected and avoided because of anxiety and fear of criticism and judgment; (2) understand the repetitive cycle that movement toward paying more attention to that small dot of light of self-care (aspirations, ambition, creativity, and adventure, joy and excitement), to try new things leads to anxiety and sometimes panic results in the withdrawal of the “Fire in the Belly” to Stand Up Straight with Shoulders Back; (3) synthesize that the expansive self feeling “what more could be out there for me” is crushed by fear and worry that leads to a sense of depletion, disappointment and depression; and (4) process that feelings of shame emerge in direct reaction to withdrawing from life experiences intensifying feelings of incompetency and weakness in not living freely. 

We worked slowly to bring that small glimmer of a self-care voice forward to nourish it with new experiences (new employment and more responsibilities and a stronger presence in the home).  In our work we learned to respect that part of the emotional safe room that promoted a feeling of safeness, albeit a false sense of security, and continually reminded ourselves that we were only tempering it so his self-care voice could gain strength, and as I like to say, “kick the inertia aside and open the door to living”.           

 Before continuing, it is critical to mention here Kohut’s (1971; 1977) concepts of selfcohesion versus fragmentation of the self.  Self-cohesion means the mature ability to tackle life’s experiences and ups and downs.  There is a steadiness and core belief that one does not need to retreat. Within development the tri-polar self emerges.  Part of this tri-polar self is the “grandiose self.”  This grows in the child as a result of primarily the parents acknowledging the child through words and actions, and providing “good enough” (Winnicott, 1958) experiences of admiration, validation and also confirmation that “you are like me.”  There is also the child’s “idealization” of the parent.  This is formulated in the initial belief that the parent is perfect.  So Mollen (2001) expressed, the child’s illusion is “I am perfect” while also maintaining the secondary illusion that “You are perfect and I am part of you” in reference to the parent (pg 31). 

Only through experiences with the parental caretaker’s natural unavailability at times (parental imperfections) does the child begin to lose the notion of perfection.  At this critical juncture, the child is able to integrate the normal ups and downs of parental care, and the satisfied versus frustrating episodes of getting needs met.  As a result, a balanced realistic picture of the self emerges that promotes confidence, maturity, social interests, ambition, and resiliency. Or, as I tell my patients the “self-care voice” grows stronger.  The realization that the parent is imperfect leads to the formulation of being able to admire others, define ideals, and temper expectations (Mollen, 2001).   With the freedom from perfection, it creates the sparks for joyful interests, pursuits, and enthusiasm without the fear of failure.    

Simultaneously occurring within Kohut’s (1971; 1977) tri-polar self, is the distinction the child makes between the private self versus the public self (Broucek, 1991).  The public self is shaped by the way others treat the child, they act on him/her, and the private self contains the observations, feelings, thoughts and reactions unique to the child.  Consequently, the child reaches the stage when they can begin to make “comparisons” between him/her and others.   Therefore, the comparisons can be healthy ones, e.g., “I can compete” ,” I am strong” or weak, “he is better than me,” and “I am never good enough”.   The feeling of shame becomes imbedded in the latter experiences (Broucek, 1991).  

To summarize, positive experiences with parental care and availability contribute immensely to a strong sense of self.  There needs to be a reasonable and healthy “constancy” to these positive experiences to ensure a strong sense of self.  As I explain to my patients, we all leave our “emotional homes” with our families with scares and traumas.  It depends upon the frequency and intensity of negative parental care and availability that weakens us.  In healthy development we according to Lukianoff and Haidt (2019) “Prepare the child for the road not the road for the child” in their discussing the coddling of the American mind.  In the work of psychotherapy and more importantly modern versions of psychoanalysis, how do we prepare the patient for the road given his/her derailment?       

In “A’s” development, the grandiose self was unable to gain a footing and to flourish.  As will be seen in the discussion of family dynamics, there was little opportunity to ensure a strong sense of self and the impetus for a sustained and growing self-care voice.  Thus, the shyness from the limelight, and a reluctance to ever feel simply good on stage in front of others, e.g., coworkers, other children, etc.  There is also an inhibition of healthy assertiveness and aggression. Or as I like to say a “fire in the belly” that acts as a driving force to go after something that you want in the world.            

 “A’s” reaction was typical throughout life.  The seeds of the anxiety and panic existed in childhood experiences.  “A” is the youngest of nine children. There is a wide age gap between “A’s” birth and the next sibling inline.  We often characterized that his mother and father had one family and he was their second family.  His parents’ relationship was a contributing factor to his weak sense of self or inability to Stand Up Straight with Shoulders Back”.  A’s father was described as passive and meek.  He also expressed that his father was a kind, considerate and gentle soul.  “A”, however, did not feel his father had a strong manly presence in the household.  In contrast, A’s mother was a sturdy, opinionated and strong female figure.  She leaned very much toward negativity, judgment, and criticism.  She was overprotective but cold, and distant.  You might say she was one dimensional in that she administered to the running of the household in an orderly and managerial way.  You could say she “called the shots” in the family.  She was the decision maker with his father who said little and made no effort to intervene.  The mild mannered and ineffective ways of the father and strong, negative opinions and judgmental behavior of the mother led to a weakened sense of self and muted self-care voice to guide “A” in life.    

While growing up, he was frequently handed off to his eldest sister. In many ways she was a surrogate mother figure.  “A’s” earliest memory around 2 to 3 years of age was sitting in a potty in the kitchen in front of his family.  This training went on for some time.  He recalls straining to go to the bathroom so he could be freed from the potty. A‘s layers of compressed memories lean more in the direction of unpleasant and negative. Beginning seeds of shame start here with these experiences in training. DeYoung (2015) in describing chronic shame states, “Shame is the experience of one’s felt sense of self-disintegrating in relation to a dysregulating other” (pg. 18). Being in the open kitchen in front of other family members debilitated the self. There seems to have been a lack of empathy on the part of his mother that did not solidify more emotional bonding. Perhaps after having eight other children, his mother welcomed the help of the oldest daughter who seemed to administer to “A” but certainly could not replace the nurturing efforts of primary caretakers. These episodes represented the earliest experiences with shame

Subsequently, he did not make a smooth transition to school.  There was the presence of separation anxiety from the beginning.  Fear and anxiety resulted in frequent visits to the school nurse.  Somatic complaints contributed to being sent home.  Later on, he recalls being bullied at school on the playground or made fun of during interactions with others.  He expressed having a timid, fragile and awkward sense of self. He felt a desire to withdraw and feel safe at home.  Often, the school nurse sent him home.  “A” withdrew into comfortable and isolated periods of TV watching.  The behavior was acceptable and supported by his mother. In our conversations we came to understand that it was her way of taking care and protecting him.  Though as it turned out this form of protection only weakened “A”, and made him more fearful to join the world as an active participant. He was timid with children preferring to stay in the background.    

These emotional/behavioral characteristics continued into adolescence and adulthood.  These experiences and resulting worries about life’s endeavors akin to how “A” refrained from stepping out in the world. He   pursued employment beneath his skills.   As noted above, “A” was laid off because the fledgling company was struggling.  He returned after some time with a reduction from his original salary because the owner asked him to.  In our work it became clear that he took the pay cut with no real promise that the company would be robust financially, because it was safe, comfortable and familiar.  In our work we began to unpack the experiences in childhood that undermined a stronger sense of self and inability to “Stand Up Straight with Shoulders Back.”  His major step was to take a position with more responsibilities, and actually become a team leader in a major company.   

 He did “Stand Up Straight with Shoulders Back” to move into a new position. A interviewed and obtained a terrific position in a nationally recognized company.  The move forward was in a position of leadership.  He had more responsibilities and led a team of coworkers.  He faltered primarily because he was trying to change the old narratives of childhood.  “A” slid back into crushing his good performance (feedback from supervisors) with weaker and undermining thoughts to push him back into the inertia.  Hospitalization was required because of severe depression, panic, and anxiety.  The routine negativity of his mother who imbedded him in the feelings of I cannot succeed in the real world, and I need to be anxious and fearful of it. 

At this point I would like to refer to Arons work (1996).  He makes a critical point that I believe fits into this first rule of “Stand Up Straight with Your Shoulders Back” by discussing the need to preserve the concepts of “identity” and “multiplicity.”  

Arons states (pg .74), “ Identity emphasizes a person’s sense of continuity, sameness, unity, constancy, consistency, synthesis, and integration. This is akin to “order.”  He continues, “While people certainly need a cohesive and integrated sense of self, they also need to be able to accept a lack of integration, and to tolerate perhaps, enjoy confusion, contradiction flux, and even chaos in their sense of who they are.  They need to accept their own internal differences, their lack of continuity, their multiplicity, their capacity to be different people at different times, in different social situations and interpersonal contexts.” 

“A” bounced back to be successful in his first real endeavor to help him integrate a stronger sense of self with experiences on the job.  Slowly and gradually with interactions and practice he began to see a stronger part of himself.  He could be successful by putting forth his own ideas, opinions, and feelings to others, and in turn have a positive response from coworkers.  

He became a well-respected leader of his team and was rewarded with a more prominent position with a highly regarded and financially solid technology company.  It is a leader in the industry.  He has proven himself on the job in the last several years.  “A” desires to move up the ranks into a managerial position but he has been overlooked.  We have concluded in a recent consultation that his helpful, good natured and kind manner may be good qualities but not sufficient to be recognized by upper management.  He refers to a colleague who was recently promoted in the position he desires. “A” states ”She made sure she touched base with the right people frequently got noticed for her work or made sure they knew about it always doing favors for the people who could move her chatting with them”.  We discussed that he emulated all the characteristics of his father-“I thought he was a really good man”, but we also came to the conclusion that healthy aggression maybe necessary to acquire the position he wants.  We will be working on bringing that part of himself out more without shame.             

Case of “B”

 “B” is a young man in his mid-twenties.  We have been working together for approximately three years.  B’s father made the initial contact to arrange individual sessions for his adult son.  He described a young man with little direction.  His transition into young adulthood, post high school, was very problematic.  In our work together, “B” went briefly to a local college.  The first semester was marked by erratic non-attendance to classes.   “B” was unprepared to assume the responsibilities of independent living and having to be self-directed.  Once high school ended he had no structured template to follow, and had little self-discipline to create his own internal roadmap to respond to the academic demands of college work. The transition into young adulthood was too much of a challenge. “B" was unable to “Stand Up Straight with Shoulders Back” as it were to take on life’s responsibilities.

Metaphorically B’s emotional safe room in his mind, in contrast to A’s, was constructed as a utopian place to dwell in from night into daylight. “B” constructed and retreated into this emotional safe room from a young age. “B” began to smoke marijuana at 14 years of age. Although showing very little discipline during the day, “B: organized a night routine for years. Hours could be spent between a place of heightened stimulation, intense activity, and then a subdued, sleepy, and withdrawn stupor.  The fluctuations in mood were triggered by hours thinking about and playing video games.  The passion was strongly reinforced by a social network of young men with a similar vocation to be the “best”. This social network was crafted so that “B” did not have to leave the comfort of his room. The games were interconnected between others in other local communities or other States.  Nightly forays into this magical and intense arena were eventually tempered with interludes of intense weed smoking until stoned, and in some incidences incapacitated for the night.  “B” would drift into a sleepy, loss of interest in his surroundings, and an inability to draw any pleasure from real- life activities.  There was no routine bedtime with day light hours blocked out until later in the day.  

“B” is an only child. After more than 25 years of marriage, B’s father has asked for a divorce.  They are now separated pending an agreement to finalize the divorce.  Through our work together “B” has expressed that his parents were unhappy in their marriage for as long as he can remember.  He explains with some degree of uncertainty that his mother may have had an affair some years ago.  He believes his father discovered the unfaithfulness and the relationship was never the same.  With certainty, “B” knows that his father has had an ongoing relationship with a coworker for years.  When asked how he can he be so sure, he expresses that over the years there have been times when he has spent time with the woman and her children at work related outings.  In our work it becomes clear that the family lacked a sense of cohesion and closeness. “B” reflects back that there was always tension and an underlying and simmering frustration between his parents. There was no high degree of conflict but an ongoing silence. Deafening silence that prevailed all these years. “B” spends time with his father more so than with his mother. They are bonded around sports. They either spend time watching sporting events on TV or they are spectators at the actual event.  It is interesting that “B” and his father ate dinner on snack trays in front of the TV while his mother eats alone. He indicates that his mother drank a significant amount of alcohol in the evening. After dinner, everyone went their separate ways.

In our sessions we discussed that this was a family of three absent of emotional closeness and intimacy.  They lived separate lives in their rooms apart most of the time. Our sessions early on were devoted to understanding the lack of “togetherness” in the family. In fact, there were little meaningful interactions or displays in words and actions of respect, caring, and affection. These outward signs would convey a feeling of love amongst family members.  

“B” is over six feet tall.  He played high school basketball and could have been outstanding if not for his weak work ethic, lack of discipline, and just overall apathy.  This lack of motivation and ambition carried over into his academics as well.  He explained that “no one really took a strong interest in trying to motivate me.”  Yes there would be some conversations when teachers placed calls to stress a lack of motivation, but overall there was no sustained intensity of interest in getting him on track.. The collaboration with his parents faded quickly.  The video games and smoking marijuana became the daily routine. Even at this young age with obvious talent he was unable to show the “Fire in the Belly” spark needed to be successful on and off the court.

As mentioned above, “B’s” emotional safe room was his escape to defend against the lack of family cohesiveness and intense feelings of loneliness. His “self-care voice” turned more and more inward in order to emotionally survive the discomfort felt day to day in his family. He did not find joy or pleasure to enter the world in a productive and meaningful way. B’s compressed layers of memories in his family were more negative than positive. Though there was not the open high level of conflict that may arise within some families, there was a deadness of emotional experience that prevailed. The addiction to weed brought with it a different experience. The weed helped to promote a calming and soothing experience. One he welcomed after a night of intense game playing. What was absent in his family in real life activities, he created in his private emotional safe room. The joy, excitement, playfulness, togetherness, soothing of family life had to be created in someway. The emotional deadness led “B” to seek out stimulation in anyway possible in the confines of his emotional safe room. In his mind, he was seeking refuge through the excitement and joy of games and human connections associated with such endeavors.

In normal development, during childhood to adulthood, the “self –care voice” becomes solidified and the a sense of self becomes invigorated with optimism. Well being depends on a strong sense of an “integrated” self. The positive experiences with the primary caretakers provide the child with a sense of wholeness. Their “empathic attunement” to the child’s needs and the ongoing relational opportunities set the stage for self- cohesion and wholeness ( Rowe & MacIsaac, 1989; DeYoung, 2015). The child learns that parental reactions to misbehavior temporarily and briefly create feelings of shame, but soon the positive relational experience is restored between them (DeYoung, 2015). The constancy of restoration helps the child toward moving confidently outward with emerging rudimentary signs of ambition, productivity, defining life experiences, social network endeavors, interests and passions.  There maybe some insightful glimmers of a vision of a professional identity or thoughts of “what are my possibilities?.”  These outward directed characteristics energize joy, excitement, and happiness.  There is also a perspective on anxiety that needs to be held in check to deal with frustration, anxiety, rejection, and disappointment (Lukianoff & Haidt, 2018; Peterson, 2018)  The self cannot be overwhelmed by these experiences.  The self care voice has a protective component of soothing the self when these setbacks occur.  The soothing part is essential to back bounce back and brush yourself off.   

For “B” there was a lack of sustained emotional connections in his family life. We explored that the simmering, underlying tensions and unspoken feelings of lost love created a lack of family cohesion. With collaboration, we unpacked that the core issue for “B” was a weakened sense of self that limited his ability to “Stand Up Straight with Shoulders Back.” More critically, there was recognition of a deep sense of shame. As DeYoung (2015) quotes Judith Jordan, “Shame is most importantly a felt sense of unworthiness to be in connection, a deep sense of unlovability, with the ongoing awareness of how much one wants to connect with others… There is a loss of the sense of empathic possibility, others are not experienced as empathic and the capacity for self-empathy (or as I like to say a Self-Care Voice) is lost” (pg. 18). DeYoung (2015) further helps our understanding to add that shame is the experience of the self disintegrating in the presence of the primary caretakers dysregulation in being available in a good enough way. The ongoing lack of continuity created in “B” so that the self feels unlovable.

Without the development of the ability to “Stand Up Straight with Shoulders Back” “B” felt the demands of the world were overwhelming and threatening to the self.   “B” in the absence of his parents helping him to create a self care voice he constructed one on his own. The sounds and intensity of video games, sports trivia and the comfort of marijuana was his way to take care of himself.  These external distractions warded off the outside competing pressures e.g., academics, socialization, post high school interest and direction. Hopes and dreams were not clearly defined, but vaguely felt only to become unglued into unassembled in pieces that he could not put together with any cohesion.  “B” had no solid soothing self care voice to bring his intellect and emotional life together to face the eventual separation from his emotional home into the world. 

In our work, “B” found a safe and empathic setting to establish a consistent emotional connection. The therapeutic relationship helped him unpack the reasons for his own dysregulation in approaching life, but also brought to the surface his inability to have that self care voice that is so critical in tackling the challenges of life. It brought out his need to have more constancy and structure in pursuing his goals. Eventually, he reentered college to earn a degree in accounting, and reduced his dependency on weed and video games. He found comfort in being able to maintain normal living hours and established a relationship with a woman.

Final Thoughts:

I was hoping to present to the general public and colleagues some thoughts on how I work with people to help them develop a stronger sense of self in dealing with the world. Peterson’s concept of “Stand Up Straight with Shoulders Back” I believe is a useful concept in our work. Whenever someone makes a call to arrange for a consultation it means that they are seeking relief from emotional pain. They have admitted on his/her own that they cannot go it alone. They are at a weak moment but their willingness to call also illustrates their strength to ask for help. It is their first step toward “Stand Up Straight with Shoulders Back.” Professionally it is perhaps our responsibility to extend our hand to help them understand some of the concepts I have outlined that convey a structure to insight- oriented psychotherapy. I have tried to educate my patients so that we have working tools to add meaning to the way their lives have unfolded, and to help them make connections so that they have a stronger sense of self. The ultimate goal is for them to find joy and pleasure in their lives without looking into the rearview mirror too often or looking into the uncertainty of the future.

I am thankful to many people who have shaped my thinking in helping others. I am especially thankful to Dr. David MacIsaac, Dr. Lawrence Chasin, Dr. Stanley Teitelbaum and Dr. Lew Aron. In order to work at this “impossible profession” you have to have guidance and most of all help to understand yourself. I have been enormously influenced by the work of Dr. Heinz Kohut but also by Dr. David Celani. Additionally, Dr. Andrew Morrison’s work on the influence of shame in one’s behavior. Finally, my gratitude to Dr. Jordan Peterson’s work and many presentations.

This article is dedicated to my sons and grandchildren. I hope one day my grandchildren will find the time to read about the passion I have for my work. I sincerely hope they will follow their passions so they may have a meaningful and productive life.

Credit for editing goes to BETH  

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