Freud was the first to explain this concept.
Dr. Sigmund Freud, a neurologist, is the father of psychoanalysis and first identified the concept of “projection.”Source: Photo by Max Halberstadt via Christies (Wikipedia/Public Domain)
by Sue Kolod, Ph.D.
This post is in honor of Dr. Sigmund Freud on the occasion of the 165th anniversary of his birth.
In my psychotherapy practice, patients often complain that their spouse, close friend, or family member “projects” all the time. It usually sounds something like this:
“He was projecting on me!”
“I told her to stop projecting!”
Projection occurs when a person attributes a quality to another person that really comes from themselves.
Did you know that the concept of projection comes directly from Freud? Freud, who was trained as a neurologist, borrowed the term from neurology, where it referred to the capacity of neurons to transmit stimuli from one level of the nervous system to another.
People project all the time and it’s neither good nor bad, depending on which qualities are projected and whether or not they are denied in the self.
Projection can be the basis of wonderful qualities such as empathy, generosity, and romantic feelings—or negative qualities such as rage, greed, and contempt.
Projection both helps people to fall in love and also to hate and revile others.
But in common parlance, projection refers to negative qualities that are denied in the self and are seen as coming from the other person.
It’s easy to see when someone else is projecting. It’s a lot more difficult to notice when you’re the one projecting. Why? Because projection is unconscious.
Why Do People Project?
We often identify unpleasant, negative qualities in others that we hate in ourselves. This process occurs unconsciously.
Let’s take Freud’s classic example: a man who has been unfaithful to his wife but who accuses his wife of cheating on him. This man, who I’ll call Herr M, has high moral standards for himself. He thinks of himself as a good person, a good husband, a solid citizen. He is extremely critical of himself for engaging in infidelity but can’t seem to stop. Herr M unconsciously disowns and denies the fact of his own infidelity which he would find unacceptable in another person, and projects it onto his wife, thus making her into the “bad one.”
In Herr M’s mind, the fact of his own infidelity has nothing to do with his suspicions of his wife. This is sometimes called “compartmentalization,” as he keeps his infidelity in a separate, sealed-off compartment. This allows him to feel like a good person when he is engaging in behavior that is unacceptable to him.
Another Type of Projection
Here is another example from my practice: Sarah has always been a “good girl,” which to her means that she never expresses anger or aggression. If she ever starts to feel angry toward someone, she quickly pushes away that feeling and tries hard to be nice. If her husband, Jim, makes a request of her, like asking her to put away her mail, she often responds by insisting that he is angry at her. Jim is baffled by this since he did not feel angry when he made the request. However, Sarah, who is unaware of her own anger, agrees to put away the mail but then “forgets” which does make Jim angry, becoming a self-fulfilling prophecy.
Homophobia
Homophobia, defined as a dislike or hatred of gay people, is an excellent example of projection.
Consider Sam. He comes from a very religious background. Although he considers himself to be heterosexual, he sometimes finds himself having romantic fantasies about two very attractive gay men at his workplace. He dismisses the thought he could be sexually attracted to another man and avoids the men. Eventually, he convinces himself that they’re promiscuous and want to seduce him. He sees the sexual attraction as coming from them, not from himself. As a result, Sam views the gay co-workers as “bad people.”
Paranoia
In its most extreme form, projection is the basis of paranoia. Fears of persecution, irrational hatred of an individual or group, jealousy in the absence of evidence of betrayal, and the belief that a desired person who is taboo for whatever reason desires you, all result from the projection of unconscious negative states of mind onto another person. Paranoia, then, involves the denial of a personal tendency and the belief that this tendency is coming from the other person.
Are You Projecting?
It’s easy to notice when other people are projecting. It’s a lot more difficult to notice this tendency in ourselves.
Here are some signs that you might be projecting:
- Feeling overly hurt, defensive, or sensitive about something someone has said or done.
- Feeling highly reactive and quick to blame.
- Difficulty being objective, getting perspective, and standing in the other person’s shoes.
- Noticing that this situation or your reactivity is a recurring pattern.
If you notice any of these, ask yourself:
- Is the behavior I dislike in this person something I find intolerable in myself?
- In what ways do I act like this person?
- What types of stories am I telling myself about this person or situation?
- Who or what does this person or situation remind me of?
If you can accept all of your thoughts and feelings and not try to get rid of them, you won’t need to project them onto others. In addition, you will become a more tolerant and flexible person.
Difficult conversations require having respect, empathy, and patience.
By Sue Kolod, Ph.D.
Source: Prostock-Studio / Shutterstock
After months of isolation due to the Covid-19 pandemic, things are seeming a bit more “normal” as people get vaccines, with Public health officials stressing that COVID-19 vaccines are the best hope for achieving this new normal.
But, there’s a “but.”
A study from Kaiser Family Foundation revealed one-quarter of the population “probably or definitely would not take the coronavirus vaccine.”
Much is at stake. For life to return to anything approaching normal, 75% of the population must be immunized. If enough people avoid the vaccine, COVID-19 transmission will continue. Honest, fact-based conversations about the vaccine among family and close friends have an urgency that strikes close to the heart. Since some conversations are likely to be emotionally charged, it’s important to be able to communicate and listen actively. You’ll need to understand your own feelings about the issues, and also deal with someone else’s strong feelings — all while being able to think clearly and stay focused — basic psychoanalytic technique!
Difficult conversations
If a close relative or friend says they won’t take the vaccine, should you engage them in discussion? Is it possible to have a conversation about a deeply divisive and emotional issue? Should one try to persuade?
Those who believe the pandemic is a hoax and vaccination is foisted on us by the deep state are probably not open to either dialogue or persuasion. This could end in a bitter fight and it might be best to avoid the topic altogether.
However, many people are undecided and may be open to discussion.
What are some fact-based reasons people are refusing the vaccine?
- Concern about underlying conditions, such as seizure disorder, allergies, hypertension, HIV, diabetes
- Worries about unknown side effects
- Concern that methods used to develop the vaccines are unproven and testing may not have been sufficiently extensive
- Mistrust of government leading to mistrust in vaccine development
- Issues of consent: The history of abuse by the medical profession is particularly relevant among African-Americans. The infamous Tuskegee Study of “Untreated Syphilis in the Negro Male” is one example.
Even healthcare workers acknowledge ambivalence. In a New York Times article, Petrona Ennis-Welch, one of the first healthcare workers to receive the vaccine at Mount Sinai Hospital, stated, “Some of my colleagues feel they want to wait for the second wave [of vaccination]; they do not want to be a part of the first round. They want to see how people do — which is understandable.”
What doesn’t work
In most cases, vaccine hesitancy comes from a combination of rational and irrational factors. Starting a conversation about vaccine hesitancy requires a willingness to listen to both.
Shaming, calling people “stupid” or “crazy,” or laying guilt trips is not effective or useful in communicating.
Lisa, who is pregnant, told her sister she doesn’t think she would take the vaccine right now. Her sister, Jen, called her “selfish and ignorant—doesn’t Lisa realize how important it is for their parents to get together with them?” And their grandmother can’t see her at all until Lisa is vaccinated. Jen’s attitude made Lisa feel bad but didn’t convince her. Instead, she refused to talk about the vaccine with her sister at all.
Understanding the position of the other person
A more effective strategy is listening to the concerns of the hesitant person. Hear them out. Ask questions to better understand what facts or opinions they are basing their decisions on and the logic of their decision making. Treat them with respect and try to put yourself in their place.
For example, Alice, age 91, told her daughter, Emily, she wouldn’t take the vaccine if offered. Alice, who suffers from allergies and is concerned about her ability to withstand the vaccine at her age, decided she was unwilling to take the risk.
Emily was alarmed to hear this. She hadn’t seen her mom in person since March, and couldn’t wait for both to be vaccinated and finally get together. However, Emily, putting herself in her mom’s place, imagined how frightening it could be for her to take the vaccine, even though she knew her mom wanted to see her.
Emily researched the most up-to-date information about allergies, the vaccine, and older adults. She validated her mom’s concerns but, at the same time, provided her with data that put those concerns into context. After discussing risks and benefits, Alice agreed to reconsider but wants to wait until more people have been vaccinated, particularly people with allergies, to see how they react. While difficult for Emily to wait, she accepted that her mom can’t put aside worries until more data is available.
Suggestions for engaging in a conversation about vaccine hesitancy
- Try to maintain a neutral stance. It is not your job to convince the other person to take the vaccine but to open the dialogue for discussion.
- No interrupting or personal attacks.
- Tone down the rhetoric. This is critical to reaching people who are unlikely to agree with your message. Pay attention to questions you can’t answer and what you, yourself, don’t actually know.
- Strive to develop a greater understanding of the roots of others’ viewpoints; put yourself in the shoes of the other person.
- Provide the best, up-to-date scientifically approved information.
- Don’t give up right away. It may take several conversations to establish productive communication and discussion that is satisfying to both participants.
It is important to get information from reliable sources (CDC, AMDA, medical directors, providers) Social media is full of misinformation and opinions based on that misinformation.
Here are some links to information:
Tracey Ullman’s brilliant portrait of Betty Friedan in the FX series, Mrs. America features a real-life debate between Friedan and Phyllis Schlafly. Watching it led me to re-assess an interview I did of Friedan for a 2005 conference when she was 84 years old.
In addition to her seminal bestseller, The Feminine Mystique (1963), which galvanized the Women’s Liberation Movement, Friedan wrote a book about aging, called The Fountain of Age (1993). In 2005, I organized a conference panel on the psychological impact of menopause and invited her to speak. I found her phone number and cold-called. She answered the phone herself and readily agreed to speak at the conference!
Before the conference, however, she became ill and canceled. I asked if I could tape and present an interview with her instead. She agreed and invited me to Washington DC where she lived.
I sent her these questions prior to the interview:
- What is the psychological impact of menopause on women?
- What is the difference between menopause and aging?
- How does menopause affect sexuality?
- How is the experience of mid-life different for men and women?
Friedan, who had been diagnosed with Alzheimer’s, was not in a good mood when I arrived on January 12, 2005. Her housekeeper warned me to expect the worst. When I asked my first question about menopause, her famous “abrasive personality” was on full display. I went onto another question about menopause and she became increasingly angry and combative, finally yelling, “Why the f**k are you asking me this?”
Thinking on my feet, I quickly changed the subject and asked how Viagra had changed sexual relations between older adults. She brightened at this question and the interview continued in a more positive vein.
At the time, I understood Friedan’s reactions to questions about menopause to stem from her life-long advocacy of equality for women and her objection to any notion that women were disadvantaged by biology. I was interested in the effect of hormones on psychology. I believed that she and other feminists went too far by insisting there are no significant differences between men and women’s bodies and that biology played no role in psychological functioning.
But I also understood the extent to which Friedan recognized that a focus on the female body, i.e. the menstrual cycle, childbirth, and menopause, had been used to stigmatize women and to deem them ill-equipped to hold positions of power.
The debate scene between Friedan and Phyllis Schlafly in Mrs. America, however, gave me a more interpersonal perspective. At the time of the debate, Friedan would have been 52. She was in the middle of her own menopausal phase, newly divorced from a husband who had left her for a younger woman, and overshadowed in the Women’s Movement by the younger and more appealing Gloria Steinem.
Schlafly, who was losing the debate, in a viciously comedic performance by Cate Blanchett, is shown deliberately baiting Friedan with a personal attack on her vulnerability as a menopausal woman, “middle-aged and unhappy.” Friedan, just as she did in my interview over 30 years later, lost her cool. For Friedan, as for many of us who reach mid-life, menopause is not merely a topic of academic interest.
It happened so fast. We watched with horror as COVID-19 spread first in China, South Korea, Italy and then all over Europe. Now it is here in the US and many have opted to self-quarantine — even those who are asymptomatic. How should we expect to respond psychologically and what can we learn from those who have already gone through this?
What can mitigate the psychological impact of quarantine?
Longer quarantine is associated with greater psychological distress so the duration should be kept as short as possible. Yet, with COVID-19, quarantine could go on for quite a long time. Those quarantined need adequate supplies and up-to-date information. But the psychological impact of quarantine also needs to be addressed.
- Keeping one’s social network alive through phone or video is imperative. The inability to do so is not just associated with immediate anxiety but also longer-term distress.
- The ability to communicate with friends, family, and colleagues is essential.
- Clear communication with health officials is imperative.
- Reinforcing that quarantine will help keep others safe can make a stressful situation easier to bear. (Lancet, March 14, 2020)
Ms. A
Factors identified by Ms. A that helped her to cope included establishment of a routine, her son’s resuming classes and piano lessons online, and working together managing a household. Her sessions with Dr. Smaller provided consistency and connection that was crucial during nine weeks of quarantine.
“My role during this period,” Dr. Smaller said, “has been to provide an emotional outlet to vent, to be listened to, and to be a responsive witness to this traumatic event in her and her family’s life. As news of the virus spreading in the US reached Ms. A., she said, ‘Now, we must worry about all of you.’”
Finding creative ways to connect
In a recent New Yorker article (March 12, 2020) Robin Wright writes, “Across the globe, a coronavirus culture is emerging, spontaneously and creatively, to deal with public fear, restrictions on daily life, and the tedious isolation of quarantine.”
In China and Iran, where hundreds of millions of people are in some form of lockdown, creative responses to promote connection have included:
- Nightclubs do “cloud clubbing” where viewers watch D.J. sets on streaming platforms and send in messages to be read live.
- “Home Karaoke Station” features famous singers taking requests, engaging with viewers, and performing while self-quarantined in their homes.
- Gyms offer workout classes online.
- The Chinese app WeChat created a group where one can find lovers while under lockdown.
- In Iran, doctors and nurses participated in a coronavirus dance challenge, posting videos of themselves dancing to lively music in full suits of personal protective equipment.
- A third-grade teacher in Khuzestan Province went viral on Twitter when she improvised to keep her classes going online after schools closed nationwide. Stuck at home, she used the side of her refrigerator as a whiteboard and with a blue marker, gave geometry lessons.
During this time of great stress, anxiety, and fear, protecting the most vulnerable of our population makes it imperative to physically distance ourselves from friends and loved ones. The key to maintaining psychological health while doing so is maintaining regular routines and finding creative ways to connect with others. This is the task at hand until the crisis is over.
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Why quarantine?
Public health experts warn that COVID-19 has not been contained in the US. We are now in the mitigation phase. Everyone has been advised to limit social contact, work from home, continue to self-quarantine if exposed, and self-isolate if symptomatic.
Social distancing, quarantine, and isolation are stressful and difficult. Psychological response to quarantine can include:
- Post-traumatic stress symptoms
- Depression, insomnia, anxiety
- Confusion
- Anger
- Fear
- Frustration
- Boredom
An example from China
My colleague Dr. Mark Smaller has been conducting psychoanalytic treatment with people in China for several years. He reported about a patient who had been quarantined for nine weeks.
“Ms. A” lives in a “community” consisting of a group of 30 high rises that were completely shut down for nine weeks, like the rest of her city and country.
She and her family initially were shocked at being completely housebound. As time went on, she reported various reactions. First, shock, then denial (“this will only be for a few weeks”) and then an overwhelming sense of helplessness, anger, and sadness. Gradually she worked through it towards various levels of acceptance.
Ms. A’s son resumed elementary school classes and piano lessons online, and she maintained virtual contact with friends. She and her husband worked remotely and shared time together doing homework with their son. “Fun” was watching favorite movies and television. A daily schedule proved very helpful. Any family tensions before the quarantine quickly waned as they paled in comparison to managing being housebound.
Ms. A reported hearing of a colleague diagnosed in Wuhan and who died a few weeks later. This brought the ongoing fear in the back of her mind to the forefront.
Last week, she reported she would finally be returning to her office for the first time in over two months. Children were out playing soccer, or riding bikes, though always with masks on. Some stores and malls have begun to open. Her mood has noticeably improved.
Some say that women’s bodies become invisible after a certain age. Jennifer Lopez, who is 50, challenged this notion at her recent Super Bowl performance. She portrayed a sexy and confident woman, appearing to have a healthy relationship with her body and sexuality.
The performance evoked envy, praise, and criticism. A New York Times op-ed raised alarm that her body would increase pressure on older women to look as good as she does.
Time for a Reality Check
JLo’s look combines genes, talent, money, and a team of people whose job it is to make sure she looks amazing. Truth is, most women experience changes in their weight, fat distribution, and metabolism as they age. Wrinkles appear, hair turns grey, and their sex drive becomes less pressing. These changes can lead to dissatisfaction with one’s body and sex life which is exacerbated by a culture that overvalues youthful appearances in women.
An important task of middle age is to take stock of one’s life. What do I want to change, what do I want to keep doing, and what do I want to try that I haven’t tried yet? Rather than comparing oneself to some impossible external standard, this is a time to reflect on who you are and what you are still becoming. Maintaining a positive body image as one ages is challenging. In many ways, how you feel about your body is more important than how you look.
Double Standards
Philosopher Susan Sontag noted the “double standard in aging”: At 50, a woman is no longer considered attractive, while a man the same age may be just hitting his stride. Yet, as women go through menopause, men often begin to experience erectile dysfunction. And certainly, men have issues with their body image, too. But for most men, this doesn’t equate with irrelevance and invisibility. The recent trend of sexy “dad bods” is an example.
Body Image
Body image is defined as the subjective picture or mental image of one’s own body. Outside factors, such as the way a culture views the body of an older woman, affects one’s subjective view. Cultural denigration of the body of an older woman will, no doubt, affect her subjective view or mental image of herself. “Hag,” “crone,” and “witch” are words used to describe and denigrate older women. Words used to describe old men, such as “geezer” and “codger,” aren’t nearly as derogatory, nor do they contain the element of disgust.
Research on 1,849 women over 50 “captured the thoughts, feelings, and attitudes that women at middle age have about their bodies and the experience of aging.” The investigators looked for factors associated with adaptive aging, rather than aging marked by despair and regret.
Some older women have internalized an extremely negative body image: “I am ashamed of my aging body and ashamed that I am ashamed. I believe women pay an enormous price of cultural biases related to gender and age.”
Others were able to embrace their bodies: “I have earned every scar, every age bump and every grey hair. It sags and it aches but it keeps me upright and going.”
As a woman ages, there is a tendency to be less reactive to the external messages and more focused on how she feels about herself. Caring less about appearance and more about health and functionality are the keys to adaptive aging in both men and women.
Sexuality
Middle age is also a time to take stock of one’s sexual life.
As sex hormone production declines in both men and women, it has an effect on sex drive. For women, vaginal dryness can cause pain at intercourse. For men, problems maintaining an erection make sex difficult. In addition, as sex drive becomes less urgent, it can be more difficult to get aroused and reach orgasm.
Many people find it difficult to talk about sex with their partner(s). When bodies and needs start to change, it can be daunting to address problems and find solutions. Whether it involves estrogen cream or other forms of vaginal lubrication, Viagra for men or sex toys/vibrators, it is worth figuring out what you need to continue to enjoy sex.
By Susan Kolod, Ph.D.
In the musical, Guys and Dolls, Adelaide reads a psychoanalytically tinged medical textbook and concludes, “In other words, just from waiting around for that plain little band of gold, a person can develop a cold.” This is the basic tenet of somatic medicine: intense negative emotion can cause physical illness.
Black Americans have greater prevalence and earlier onset of disability and chronic illness, as well as significantly lower life expectancy, than any other ethnic group in the US (Williams, 2012). This has traditionally been explained as resulting from unhealthy diet, lack of exercise, and stress of economic disadvantage. New research supports a direct link between racism, especially when experienced in childhood, and life-threatening illness.
Somatic Medicine
Jean-Martin Charcot and Sigmund Freud were among the first to observe how repressed traumatic memories affect the body, leading to physical illness. Freud called this the “puzzling leap from the mental to the physical.”
During World War I, Freud’s ideas about emotional origins of physical symptoms were applied to shell-shock and other “war neuroses,” now called post-traumatic stress disorder. When soldiers displayed symptoms of paralysis, muscular contracture, or loss of sight, speech, and hearing which had no organic bases, Freud recommended looking for repressed trauma.
The “Weathering Hypothesis”
Arline Geronimus, a research professor at University of Michigan’s Population Studies Center, posits a “weathering hypothesis” of elevated rates of illness among Black Americans as a physiological response to structural barriers and daily slights, stereotypes, and other threats to one’s identity that comprise the Black experience in America.
If so, a strategy that may work for white people does not significantly improve health issues faced by Black Americans. As the latter attain higher levels of education and access to professions that were once closed to people of color, they often face new and more subtle types of discrimination. Affluence offers no protection against enforced segregation in a racist society.
A recent study (Simons et al, 2018) published in Developmental Psychology compares the weathering hypothesis to the traditional socioeconomic standing (SES)/risk factor hypothesis regarding health inequities in Black Americans. The latter assumes the remedy for poor health in Black Americans is improving socioeconomic standing and accounting for factors such as diet, exercise, and smoking.
The recent study looked at elevated systemic inflammation, a strong predictor and suspected cause of chronic illness and mortality in all ethnic populations, as a possible factor. Using data from the Family and Community Health Study, collected over a 20-year period from over 400 Black Americans, they investigated the extent to which exposure to discrimination and enforced segregation at various points in the life course predicted inflammation at age 28.
They found the effects of discrimination and enforced segregation, particularly when experienced in childhood, were significantly greater than that of traditional health risk factors such as diet, exercise, smoking, and low SES. While addressing SES/risk factors is important, the study suggests it is insufficient, as the impact of exposure to racism during childhood is a powerful predictor of serious, chronic, life-threatening illness in adulthood.
Psychotherapy can help reduce the stress of racism
This vignette, related by my colleague, Dr. Anton Hart, illustrates how talking about racist interactions can detoxify and alleviate the potential for trauma. Processing the racist event with a therapist, rather than “moving on” from it, makes it less likely that the trauma will be stored in the body, leading to physical symptoms.
A 20-something African American woman came late to her session, in a tearful, sweaty state. She had been shopping prior to her session and realized the long wait would make her late for her session. She had put her items back and was walking out of the store when she was stopped by a security guard.
After first protesting being stopped, she realized things might get worse if she failed to cooperate. They searched her backpack and, without apology, allowed her to go on her way.
“He actually put his hands on my body as if he was entitled to!”
The patient wanted to quickly move on from this upsetting incident but I gently urged her to stay with it.
“They already barged in on your session by stopping you, scaring you and on top of that, making you late,” I said, “So, I think, we might have to talk about what happened in order to get them out of here.”
What bothered her most was when the security guard detained her. He kept saying he did not believe she had anywhere more important to go; that as a “black girl,” an intimidating detainment experience was something she obviously had time to spare for.
I said, “Of course not; black people idle ‘cept when we is stealin’,” which we both laughed at, a kind of laugh that quickly migrates into a feeling of tearfulness after a moment.
Dr. Hart observes that psychotherapy can address and alleviate the trauma of racism particularly when the therapist is prepared to recognize the significance of such trauma.
What can be done to counteract the effects of “weathering”?
- Obviously, everything possible should be done to protect children from exposure to racism and other discrimination – by the family, the school, and by the society in which they live.
- If a stress-related illness is suspected in a child, medical and mental health interventions should be sought immediately.
- Medical and mental health professionals should educate themselves about implicit and explicit bias and the “weathering hypothesis.”
- Adult environments characterized by high levels of nurturance and support could reduce levels of inflammation. Trusting relationships with teachers, doctors, and mental health professionals who understand the impact of racism on chronic health conditions is key.
- The government should curb housing practices and education policy that perpetuate segregation.
Racism is a public health issue. There are actions that could be taken that would mitigate and protect people and need to be addressed.
It’s all about anxiety.
By Susan Kolod, Ph.D.
Patients often ask, “Why am I so anal”? Or, “Why is my partner, friend, parent, boss so anal?” Where does this term come from and what exactly does it mean?
The psychological usage of this term was coined by Sigmund Freud, born 163 years ago on May 6th 1856. Turns out many of Freud’s ideas remain firmly ingrained in our “collective unconscious” without awareness of their psychoanalytic origins. His theory of the “anal-retentive personality” is one of them.
Freud’s Theory of Anality
In Freud’s “Three Essays on a Theory of Sexuality,” he outlines three psycho-sexual stages of early childhood development: oral (birth to 1 year), anal (1 to 3 years), and phallic (3 to 6 years). The anal stage coincides with the era of toilet training, a time when, children realize for the first time they can control their bowel movements, as well as themselves and their environment. For the first time, a child can decide whether or not they want to comply with their parents’ wishes. “No” is a popular word among 2 and 3-year-olds. So far, few would argue with Freud’s observations.
The controversial part of this theory is that difficulties and struggles over toilet training can lead to an “anal-retentive personality” with characteristics such as excessive orderliness, extreme meticulousness, reserve and suspiciousness.
While anal-retentive personality is not included in the Diagnostic Statistical Manual, it has some commonalities with Obsessive Compulsive Personality Disorder: excess cleanliness expressed through repetitive hand-washing, extreme orderliness and need for control. Whatever one calls them, the aim of these behaviors is to reduce anxiety.
What is Anality?
Typically, someone asking, “Why am I so anal?” is usually referring to an extreme need to control their surroundings by attention to detail. This can be irritating to those around them because such behavior extends beyond what is felt to be reasonable, helpful or productive.
For example, Jason, a young associate in a law firm complained the senior partner supervising him on a brief demanded he investigate every possible theory involved with an aspect of the case, even those theories deemed far-fetched or unlikely. This required spending his entire weekend researching decisions that, in his opinion, had no bearing on the case and were a complete waste of time. He described the partner as “being so anal.” By this, he means that he experiences her as extremely anxious and controlling.
Similarly, people can become frustrated by their own need to control and focus intensely on non-essential details but feel unable to control this need or impulse.
Bob wanted to buy a new refrigerator. He checked on-line for the best models, finding one in his price range that was highly rated but with a couple of negative reviews. He spent several days researching the features that had been reviewed negatively as well as researching other models. Each highly rated model had a few negative reviews. After a while, Bob realized he was afraid he would make the wrong decision but his research just made him more anxious and was not helping him decide.
In each of these examples, the “anal” behavior is an attempt to ward off anxiety by creating the illusion of order. The anxiety comes from a sense of impending chaos and the anal behavior is an attempt to control or ward off chaos.
What to Do About Anality
Anality is in the eye of the beholder. Jason, for example, may feel his boss is being anal but she views her behavior as meticulous—a positive quality—and regards Jason’s resistance as an indication of sloppiness and laziness.
In Bob’s case, he himself is annoyed at his anal tendencies and would like to simply make a decision and get on with life. He would be happy if someone else could decide for him.
If you feel you are being anal, here are some things to think about:
- Is something going on in your life that is making you anxious? Your “anality” might be a way of controlling that anxiety.
- Ask someone close to you if your behavior seems out of control or excessive.
- Try to delegate tasks to other people and then let them determine the extent of attention to detail.
- Consider, what are the consequences of a result that is good enough but not perfect?
Everyone can become anal at one time or another. When you or someone else is being anal, keep in mind it is an indication that one’s anxiety is out of control. Anal behavior is an attempt to control that anxiety. It may not be connected to toilet training but it is an attempt to control a “mess.”
There are 4 reasons people typically lie to their therapist
Why would someone lie to their therapist? That’s totally counterproductive, right? You’re paying for it, so what would be the point? However, according to a study published in 2016 in Counseling Psychology Quarterly, of 547 adult psychotherapy clients, 93 percent reported lying to their therapist at some point. This in part, has to do with the nature of truth, which is never just black and white. In fact, in therapy, “truth” is something that emerges over time, when there is a trusting relationship between therapist and patient.
So why do people lie to their therapist?
The most common reason patients lie to their therapist are the same reasons people lie to those close to them—shame and fear of judgement. The lies could be about substance use, sexual or romantic encounters they feel bad about, even unusual thoughts they are having.
Dan, a man in his mid-30s, was often attracted to men who were inaccessible. With such partners, there were a few exciting encounters that didn’t lead to a real relationship and left him feeling empty and lost. When he became involved with a straight man from a religious family, his therapist expressed these concerns to Dan who experienced this as judgmental. Without even realizing he was doing so, Dan stopped reporting his encounters with this man to his therapist. Eventually, it came out that he had been omitting this topic from their sessions and they were able to address his feelings of being judged.
No truth without trust
In therapy, you reveal painful and sensitive feelings and memories. The “basic rule” of therapy is to “say whatever comes to mind.” This is a lot more difficult than it sounds, especially if you have a history of betrayal and difficulty trusting people.
It is imperative that trust is established early on. You should feel that the therapist respects you and is open to criticism. Often the relationship with the therapist becomes emotionally charged. At times, you may feel that you love or even hate your therapist. These intense feelings are difficult to state openly.
The therapist should be easy to talk to and able to listen to you without judgement. If you notice that you feel mistrustful of your therapist, bring it up! Over time, if that feeling persists, it might be time to find a new therapist. It is only through a trusting relationship with a therapist that the truth will emerge.
Lying to yourself
Oftentimes, a patient may intend to be truthful but is not ready to accept the truth about themselves or someone close to them. We all come into therapy with a story or “narrative” about ourselves. As therapy progresses, the narrative starts to change and we begin to see new things about ourselves and others that we may not have been able or willing to see.
April came into therapy because she had been depressed for several months and didn’t know why. She soon revealed a tumultuous relationship with her husband. She complained that he went out every night and came home late without any adequate explanation. One day she found a used condom in a wastepaper basket. When she confronted her husband with it, he told her he was trying a new brand to see if it fit. April accepted this explanation without question. She told the therapist that her husband was completely trustworthy. When the therapist looked skeptical, April reassured her.
To the therapist, it was obvious that April’s husband was cheating on her and she was not ready to admit this to herself—in other words, she was lying to herself.
Not connecting the dots
Some patients may be less than truthful with their therapist not because they intend to mislead or deceive, but because they have not processed past traumas and are disconnected from the ways in which these traumas are affecting their behavior. I call this “not connecting the dots.”
For example, Misha was unable to commit to a relationship because he could never trust anyone enough to let down his guard. He did not disclose to the therapist that his mother suffered from alcoholism and was unreliable and emotionally unavailable, not because he wanted to be deceitful but because he simply didn’t see any connection. This is not lying, per se, but an inability to connect the dots. Misha is aware that he has difficulty trusting anyone and is also aware that his mother suffered from alcoholism but keeps these facts carefully separated from each other.
Can therapy be effective if you are lying?
As stated above, the truth is often not black and white. There are always things in our lives from which we disconnect, and some are more important than others. There may be things that are too shame-inducing, embarrassing, or anxiety-provoking to reveal to even to yourself—let alone to your therapist.
If you are aware that there is something you’re not disclosing, it is preferable to tell the therapist that there are certain things you are unable to reveal at this time. You and the therapist can try to understand why something is so painful or difficult to talk about. Eventually, you might find that you are able to reveal the information.
But some issues take time. As with April, she and her therapist worked together over the course of several years before the truth emerged.
If you find that there are more and more things you are hiding or lying about, it is important to address the issue with your therapist. In some cases, you may want to evaluate whether or not a therapist is a good fit.
Susan Kolod, Ph. D 