When Clients Don’t Leave Dysfunctional Relationships…..
Is this scenario familiar to you? You are working with a client who has spent a great deal of time complaining bitterly about a relationship that doesn’t meet his or her needs, yet they cannot seem to ever fully extricate themselves from it. They may describe dynamics of emotional neglect or abuse; feeling invisible, invalidated, bullied, or ridiculed. There may be verbal abuse including name calling, yelling or a steady barrage of demeaning messages. The psychological abuse of a partner who plays head games, make them feel inferior, discounted or “crazy” can be just as debilitating. Oftentimes, substance abuse, compulsive gambling or shopping, sexual addictions, eating disordered behaviors, workaholism, toxic extended family dynamics, an inability to commit or sustain intimacy are thrown into the mix as well. The ante is upped even more when clients allude to scenarios of domestic violence. And we sit with our clients week after week, listening to their pain narratives and witnessing, even feeling, their suffering and unhappiness. We try to provide comfort, resources, strategies for change, validation for their feelings, even permission to contemplate leaving the relationship- and our clients won’t budge!
Our counter-transferential responses can legitimately range from frustration and anger to fear, anxiety, confusion and self-doubt. What starts out as an inquiry about the client’s issues can often morph into a questioning of why WE can’t get them to see the light, leave a bad relationship and get on with their lives. The clients who “sometimes” see the light- before it grows dim again- can be even more challenging! They nod their heads in agreement during the session, write down the resources and homework assignments, practice asserting themselves in role plays with you, and leave sessions stoked and inspired to make a difference in their lives. Then they come back the next week, reporting that either they’ve changed their minds because “things are good again” or they never integrated the concept of the relationship being troubled or abusive once they left your parking lot.
Obviously, in situations of domestic violence where our clients or their children are fundamentally unsafe, we need to educate, cheerlead, connect our clients to resources, make a report to the appropriate authorities, if necessary. But even in these cases, clients often go back to the abuser, forgive the alcoholic, cancel the restraining order, give the serial cheating boyfriend or girlfriend “one more chance.” And our counter-transference intensifies! These are some of the most difficult cases and they require a special amount of self-awareness and self-care in the clinician. We have to work hard to not give up on them, not pass judgment, and not take it personally when our clients choose to stay in these kinds of relationships. We have to re-double our efforts at psycho-education: exploring the dynamics of co-dependency, the re-enactment of family-of-origin trauma or neglect, the insidiousness of emotional abuse, the lure of the “honeymoon phase,” the power of learned helplessness, the definition of “healthy” love and intimacy. This work takes time, patience, good boundaries, unconditional positive regard and solid ego-strength on the part of the clinician. When all is said and done, I hold out hope that the healing power of the therapeutic alliance and the ways in which it can model safety, trust, emotional intimacy and healthy communication will win out in the end!