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When the behavior of others negatively affects clients’ mental health

By Bethany Bray June 1, 2021

In a 1624 devotion, the English poet John Donne argued, “No man is an island, entire of itself; every man is a piece of the continent, a part of the main.” 

This sentiment still rings true in modern-day counseling. Behaviors exhibited by other people in clients’ lives — often the people they love most — can affect them acutely. When these patterns are codependent, manipulative or unhealthy, it can cause clients’ presenting issues to worsen, stall their progress in counseling or otherwise negatively affect their mental health.

Examples run the gamut from an adult client whose parent deals with anxious feelings by being critical of or over-involved in the client’s life to a client whose spouse has experienced past trauma and is prone to angry outbursts.

These types of scenarios are not uncommon, and they often surface as counselors and clients begin to unpack the issue(s) that brought them into therapy, says Jen Ohlund, a licensed associate counselor (LAC) who counsels adolescents and adults at a practice in Mesa, Arizona. One indicator that a client is not getting the support they need from the people in their life can be failure to make progress in counseling, despite hard work on the part of both the client and counselor.

In counseling, a practitioner might hear clients make statements such as “I feel like I’m getting better, but I go home and I keep being told the same [unhealthy] things over and over again” or “I am doing everything I can and nothing is changing,” Ohlund says.

“Any progress they’re making is being shot down by the other individual,” she explains. “That’s when we introduce boundaries. We talk about what a healthy boundary is and equip them with [psychoeducation] that we can’t control how other people react. We can’t always walk on eggshells. Sometimes other people have to work through their triggers, and if they’re not going to do that, we have to set boundaries.”

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Seeing the whole picture

Empathic listening and validation from a counselor can serve as important first steps with clients who are wrestling with guilt, aggravation, sadness or other feelings spurred by the behavior of loved ones, Ohlund says. Simply talking through what has and hasn’t been working can be powerful, as can receiving assurance from a counselor that many people struggle with similar challenges and the client is not alone in feeling those same emotions.

“A lot of times, they don’t want to feel this way. They care and love this person,” says Ohlund, a member of the American Counseling Association. “They might feel overwhelmed [or] frustrated with their loved one or turn inward and beat themselves up, feeling like they’re not doing something right [or] not doing enough to meet [the other person’s] needs.”

Counselors can also listen for indicators that clients are struggling with isolation, a lack of boundaries (such as receiving an extremely high number of text messages from a family member) or feelings that they can “never say no” to their loved one. In these cases, clients might not have other people in their life who can act as a sounding board to give them a clear perspective. One way counselors can help clients temper the unhealthy messages they receive from a loved one is to support them in finding connection with other people who offer positivity and a voice of clarity. This will help clients self-regulate, Ohlund notes.

Michelle Fowler, an LAC at the Arizona Center for Marriage and Family Therapy, urges counselors to help these clients through an attachment lens. “We are wired to need one another and respond to one another. Doing therapy in a bubble is very unrealistic,” Fowler says. “The relationships around the client have the greatest influence on their well-being. It’s neglectful of us to ignore those contacts or not address them when they are a source of [a client’s] distress or, potentially, a resource to help in recovery.”

Asking targeted questions during the intake process is a good way for clinicians to get a picture of the supportive factors in a client’s life, says Breanna Lucci, a licensed mental health counselor at a group practice in the North Shore of Massachusetts. These questions can include:

  • Who is in your support system? Who can you turn to for support?
  • Who makes you happy?
  • What are your standards in a relationship, and how do you know a relationship is a healthy one?
  • Does your family know that you’re going to therapy, and are they supportive of that decision?
  • Describe your living environment. Is it supportive?
  • Who (other than your counselor) are you comfortable talking to about topics related to mental health?

Lucci also finds that discussions about a client’s self-talk can uncover outside factors affecting their mental health. She uses motivational interviewing with clients to delve deeper into these external influences.

For example, if a client says, “I’m anxious, but I just need to get over it,” then Lucci, an ACA member, asks, “Why do you feel that way? Where have you heard that?” Or if they say, “I’ve been told I’m stupid,” then she breaks down what “stupid” means to the client and asks, “Who said that? How did it affect you?” Talking through a client’s language choices in this way helps them to recognize patterns and realize how things they have heard from others and internalized have become part of their self-talk and self-belief. The goal of this work, Lucci stresses, is always for the client to get to these realizations on their own.

Carrie E. Collier, a licensed professional counselor who specializes in Bowen family systems theory at her Washington, D.C., practice, agrees that the language clients use in session about their relationships can relay valuable information about the client’s context and how they respond to others.

“An individual is not in a vacuum — there’s always reciprocity in relationships,” says Collier, director of the Bowen Center for the Study of the Family in Washington. “Anxiety is contagious; if a person is living with other people, there are a lot of shared emotions that are going on. I try and help a person get really clear about what’s theirs and what’s the other person’s, and what he or she is putting into it and what [others] are putting into it. … As a counselor, it’s important to see the [client’s] entire context and the landscape. It’s not just one person sitting in the office with me. It’s not a cause and effect. It’s relationships and people reacting to one another, and that is what the counselor and the client are up against.”

Fostering understanding

With those who are surrounded by unhealthy patterns, it is vital for counselors to be aware of resources (both in their local area and online) that can help clients better understand what their loved one is going through and support the client outside of counseling sessions, Lucci says.

As a licensed drug and alcohol counselor, Lucci is knowledgeable about numerous addiction resources in her area, including a recovery center that offers interventions and free family workshops. She often recommends Johann Hari’s TED Talk, titled “Everything you think you
know about addiction is wrong” (see bit.ly/3aqbpV4), to clients whose family members struggle with addiction. She also has a ready list of organizations that offer support groups and other resources to help those whose loved ones live with mental illness or who struggle with parenting issues, caregiving roles, work stress, an incarcerated loved one and a range of other challenges. The support groups and educational materials from the Depression and Bipolar Support Alliance (dbsalliance.org) and the National Alliance on Mental Illness (nami.org) can be particularly helpful, she adds.

Finding avenues of safe support outside of counseling equips this client population to “be healthy in spite of their circumstances, and some of that is [learning] acceptance,” says Fowler, who counsels adolescents, individual adults and couples. Understanding the big picture that frames a loved one’s behavior (including, in some cases, mental illness) empowers clients and can help them “gain empathy or understanding so it doesn’t feel like a personal attack,” Fowler explains. 

Roughly one-third of Fowler’s caseload is adolescents, and for these clients, questions about the adults in their life can reveal important information about the support they are — or aren’t — receiving at home, she says.

“One place that I always start, especially with the adolescents I see, is the assumption that if they could go to the adults in their circle to deal with their [presenting] problem in a supportive way, they probably wouldn’t be in my office,” says Fowler, an ACA member. “Sometimes it turns out the parents have mental health issues and the client is doing as best as can be expected. It is definitely not happening in a vacuum. … If somebody else really is why, or part of why, they are struggling, is that a person who could be involved in therapy? Is this a person who could potentially help, or does the client need coping skills to deal with [this person]? If it’s a parent and child, I definitely want the parent to come in as much as possible. But if that parent isn’t going to be a safe person because they have their own struggles or are not willing to adjust, be open and see [the] child’s perspective, then how do I shore up [the client] with coping strategies?”

One example Fowler has seen among her caseload is clients who identify as LGBTQ and “have gotten very clear messages from their family that they’re not open to talk about it.” These clients are left to work through their identity and mental health issues on their own — an experience she describes as a “personal journey of how to make peace with themselves while staying in their current environment.” 

For couples and individual clients, a dose of honesty from a counselor about how much their situation could improve may be called for, Ohlund notes. “We [counselors] don’t necessarily give advice to clients, but I also think it’s important to be clear that in some situations, if you continue to stay in this relationship, this is what it will look like. If you learn all of these coping skills and boundaries and nothing else changes, the relationship won’t be better. You can maintain the relationship and be stable, but thriving is a completely different thing,” Ohlund says. “It’s important not to be vague. Be very clear [about] what it would look like if they chose different options so they can weigh it appropriately.” 

Even as clients grow through counseling, the other person in the relationship may not change. This concept is so important, Ohlund points out, that it is written into the informed consent forms at the practice where she works.

“This is one of the most difficult parts of therapy: When you grow and develop, the people around you may not,” Ohlund says. “Once [clients] learn coping mechanisms, communication skills and begin to feel more confident … they may find that the relationships around them change, or they may not even want [those relationships] in their life” any longer.

Counselors can serve as vital resources to help these clients work through self-judgment, anger and other feelings, while equipping them with coping mechanisms such as mindfulness, self-care and self-compassion exercises, Ohlund says. She acknowledges that helping clients learn to see things through a new, healthier lens takes time. Along the way, it is important to help clients focus on the things in their life that are going well, she says.

Rewriting unhealthy patterns 

Fowler once worked with a teenage client whose presenting issues were depression, self-harm and suicidal ideation. The client’s parents had gone through a tumultuous divorce seven years prior, and her father had since remarried. The parents had 50-50 custody of the teen and continued to squabble, sometimes in front of her.

The environments at her mother’s and father’s homes were opposite. The only communication she received from her father involved correction or discipline. His home had much stricter expectations around behaviors and schedules than her mother’s home did, and the client also had stepsibling relationships to navigate at her father’s home. Because the client’s friends lived closer to her mother’s home, she had more opportunity and freedom to connect with her peers when staying with her mother.

The teen was “upside down” on whom she could trust, Fowler recalls. She was exhibiting attention-seeking behaviors online and had been hospitalized for suicidal ideation before Fowler’s work with her. 

Fowler took a different approach from the teen’s previous therapist, who had not involved the parents in the counseling sessions. Fowler focused on rewriting the parent-child and parent-to-parent communication and response patterns that had become unhealthy. She also invited the client’s mother, father and stepmother into counseling, first in a group session without the client and later with one of the adults in sessions with the client.

Fowler used emotionally focused therapy with the teen to help her learn to explain what she was feeling to her parents. The method focuses on exploring primary emotions and practicing communication of those emotions in a way that the client’s attachment figure can receive, Fowler explains. By helping the client share — and the parents truly hear what she was saying — the mother and father were better able to understand the seriousness of their daughter’s depression and the impact their discord was having on her. This experience also tapped into her father’s empathy and allowed him to put his anger aside, Fowler recalls.

Fowler also worked with the adults on how to respond to their daughter in helpful and supportive ways. “I explained that [she] is looking for support and safety and is not feeling loved or feeling approved, so she’s looking for it elsewhere,” Fowler says.

The parents agreed to stop arguing in front of the teen, and the father had a change of heart and began to plan activities to be able to spend time with his daughter in a positive way. Within months, the teen was feeling much better, and her self-harm behaviors and suicidal ideation dissipated, Fowler says. Although her parents still have to monitor her cell phone use, the client’s situation has greatly improved.

“All of that contention, seemingly overnight, went away,” Fowler says. “I know that the changes that the parents made were a huge factor in helping the child.”

It “took some convincing” for the father to change, Fowler recalls. His frustration toward his daughter stemmed from feeling that she was being unsafe online and making herself available to strange men. Ultimately, Fowler used those feelings as leverage to explain that he had a chance to be the safe man in his daughter’s life.

“That was the window that helped him see … [and] understand how he had the opportunity [to make] his daughter feel loved,” Fowler says. 

Setting boundaries

Boundary setting is one of the most important coping mechanisms a counselor can provide to clients who are surrounded by unhealthy patterns. Even though clients cannot control a loved one’s behavior, they can control the boundaries they choose to establish in the relationship, Ohlund notes. This work must be client led and will look different for each person, based on their preferences and needs.

Exploration of boundaries is best done in session when the environment is calm — before the client needs to confront a loved one in the heat of the moment. Clients should not set a boundary until they are comfortable enforcing it, Ohlund stresses. The counselor and client should also talk through what it will feel like to enforce the boundary, including understanding and preparing for the possibility that it may make the other person feel worse, including triggering anxiety or feelings of abandonment.

Sometimes people may not understand these new boundaries. “Those who benefit from not having boundaries won’t want to deal with what’s going on with them and are going to fight it a lot,” Ohlund points out.

Ohlund often works with clients to establish boundaries that have stages that are customizable if or when a situation arises. For example, if a client has a spouse or family member who is prone to critical or angry outbursts, the first step might be for the client to leave the room or go to another part of the house. If the behavior continues, the client could leave the house for a brief time. Similarly, they could choose to temporarily block the phone number of a family member who is prone to sending a barrage of text messages when that person is upset.

“This is much better than just asking them to stop. What will you do when [the behavior] doesn’t stop? We have to set a boundary that we have control over so we don’t get sucked in or pulled in,” she says. 

Ohlund once had a client whose mother did not approve of some of the ways he and his partner chose to parent their children. She would repeatedly overstep her bounds and impose her opinions on the children. The situation pitted the client’s children against him, Ohlund says.

The mother continued the behavior even though her son spoke with her about it multiple times. Eventually, with Ohlund’s support, he set a boundary that if his mother continued to disparage his parenting style to his children, he would cut off his family’s contact with her for one month.

The mother did not stop her behavior, so the client followed through and cut off contact. During that time, his mother criticized him to other members of their extended family. “He knew it was the right decision, even though it was tough,” Ohlund says. “Eventually, the mom did come around, although it took a considerable amount of time to come to that point.”

This client’s decision to hold firm to his boundary resulted in a positive outcome, but that isn’t always the case. Sometimes people don’t agree with the boundary, which can create a disconnect or distance in the relationship, Ohlund says. “The reality is that [people] don’t have control over whether someone else is going to respond or not respond. It can be very disheartening and something to grieve and think of as a loss. It’s something you are working very hard on, but it’s out of your control,” she notes.

Collier stresses that the goal of boundary setting should be to guide clients to find what’s best for their own mental health, based on their principles. It also involves reflecting on what has and hasn’t worked in the past.

“The goal is not to get the [other] person to change. That’s very important [to understand]. If you are doing something out of your own principle, then it doesn’t matter how the other person responds. You want to say it to them not because it will help them or prompt change but because it’s your principle. It will only work when the [client] has done their own principled thinking,” Collier says. She advises counselors to ask good questions and stay out of the client’s emotional process: “Don’t jump in and become involved in [a client’s] emotions. Just get them thinking about ways to do things differently.”

Lucci agrees that effective boundaries must be rooted in a client’s values. Part of this process may involve having a wider conversation on what the client’s relationship standards are, including what they want out of the relationship and what they feel is required to continue the relationship.

“Setting boundaries can be extremely uncomfortable for people, and that’s why I emphasize that [boundaries] continually change and can be adjusted,” Lucci says. “[This process] is not one session. It’s a very slow process, and it’s adjust, adjust, adjust.”

Clients who are working to establish boundaries may find it helpful to practice the necessary conversations with a counselor before initiating them with loved ones. For example, what might it feel like not to respond to a text from that person? Collier notes that a counselor can talk this scenario through with a client, acknowledge how hard it will be and assess whether it feels like the right thing to do. “Know that there is going to be an uncomfortableness; saying no is going to be hard,” Collier acknowledges. 

It may also be helpful to focus on communication techniques with these clients, including how to bring up sensitive or triggering topics with a loved one in a nondefensive way, Lucci adds. Counselors and clients can practice taking in comments and information from loved ones and then expressing themselves without spurring debate or becoming defensive. In this vein, Lucci sometimes encourages clients to write a dialogue down and read it back to her in session.

“It’s natural to get really anxious about these conversations, and a counselor can help alleviate some of that anxiety by preparing [with the client],” Lucci explains. She asks clients what the goal of the conversation is and how they want to approach it. “It’s really important to listen to what the client wants,” she says. “I want the client to feel empowered and have knowledge, but ultimately it’s their own decision” regarding how to handle the situation.

The counselor’s role

Counselors play an important role in helping clients whose mental health is negatively affected by the toxic patterns of others in their lives. These patterns may indicate that the other person needs counseling themselves, but first and foremost, the counselor’s ethical duty is to help their client, regardless of whether it is appropriate or possible to involve family members or others in their counseling sessions. (An important caveat is when counselors take measures to protect clients from “serious and foreseeable harm.” See Standard B.2.a. of the 2014 ACA Code of Ethics.)

“It’s not ever my job to diagnose someone I don’t know and those who aren’t a client of mine,” Lucci says. “But I can listen and hear the behaviors described by the client and how it’s affecting them. Then, we focus on how [the client] can deal with those behaviors. I don’t ever want to assume how someone is feeling or what’s going on. … Most of all, I want people to feel connected and come to decisions about change on their own.”

Counselors can also equip clients in these situations with resources and serve as support while they decide what they want the relationship to look like, Ohlund adds. But this work will take patience on the part of the counselor, she notes.

“As a counselor, sometimes we can see really far ahead. We can see really clearly what needs to be done in a situation, but it may take a client a very long time to get there,” Ohlund says. “Sometimes it’s easy to feel frustrated: Why can’t they see [it]? Why do they keep these patterns?” 

She advises counselors to be patient and not feel like they are doing things wrong. Instead, “be assured that you’re doing all you can to support a client, and that’s what they need — they may have never had that in their life,” she says.

Similarly, Collier feels her role is to sit with clients and ask questions to help them explore emotions and come to realizations about their situation. Her focus is on the process rather than the symptoms that bring clients into counseling. “I’m interested in how the person is thinking about the problem and the challenge, what has worked and what hasn’t worked, what they’ve tried and how they understand it,” Collier says.

Counselors also need to work through relationship struggles in their own lives to better support clients who are seeking help for similar issues, Collier stresses.

“The client’s ability to change and really think about their situation is only going to be as good as that person who is sitting in the room with them and their ability to see and think about situations,” Collier says. “Our level of maturity lends itself to what will really help a person, and that comes from really examining relationships and patterns in our own lives. That is above and beyond any technique or anything that I can do with a client. We all have problems in our own lives and our relationships, and we need to work on those so we can help clients and think objectively.”

 

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Bethany Bray is a senior writer and social media coordinator for Counseling Today. Contact her at bbray@counseling.org.

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Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.

Explaining why opposites attract

By Ross Rosenberg April 29, 2015

The most potent of love potions, “romantic chemistry,” draws lovers into a trancelike experience that results in a steamy dance of infatuation, intrigue and sexual desire. Romantic chemistry, or the “urge Opposites_smallto merge,” typically controls our rational mind, so much so that lessons learned and pledges made are neutralized in an instant. Although conscious desires, choices and preferences are crucial to the pairing of a romantic partnership, they play a secondary role to the forces of the unconscious mind. No matter how we try to fight our relational destiny, we still fall prey to our reflexive urges.

The irresistible and hypnotic allure of romantic chemistry creates what I call a “soul mate conviction.” What seems so perfect in the beginning often unfolds into a disappointing, dysfunctional relationship. In my book The Human Magnet Syndrome: Why We Love People Who Hurt Us, I explain why, for so many people, the soul mate of their dreams often ends up becoming the cellmate of their nightmares.

Although the human magnet syndrome is an intuitive explanation for the ubiquitous forces that bring partners to and keep them in dysfunctional romantic relationships, it lacked a theoretical foundation. To account for these irresistible and predictable attraction forces, I was compelled to create the continuum of self theory. I believe it explains why all people, not just individuals who are labeled as codependents and narcissists, are predictably drawn to a certain type of partner who is their “opposite” match.

In a nutshell, the continuum of self theory offers an intuitive explanation for why so many people remain in relationships despite feeling lonely, frustrated or resentful. Similarly, it explains why some people tend to repeat their dysfunctional relationship choices despite wanting something different. Additionally, it describes why relationships become fragile and often terminate when one of the partners independently achieves greater emotional or mental health.

The self-orientation concept

The continuum of self theory rests on the self-orientation concept, which represents a distinctly human and universal personality characteristic — we all have one! Self-orientation is defined as the manner in which a person expresses or does not express his or her emotional, psychological and relational needs when in a romantic relationship. There are only two self-orientation types: “other” and “self.”

The “other” self-orientation (OSO) manifests as a natural and reflexive predisposition to be more oriented toward the emotional, personal and relational needs of others than for oneself. On the other hand, the “self” self-orientation (SSO) is the natural and reflexive predisposition to be more oriented toward one’s own emotional, personal and relational needs and desires than those of others.

Both self-orientation types are represented as dichotomous and inverse personality characteristics on the continuum of self. As opposite self-orientations, they land on opposite sides of the continuum of self. The most severe manifestations of both self-orientations are placed at the farthest ends of the continuum.

The most severe form of an OSO is codependency. The most severe form of an SSO is pathological narcissism, which is exhibited in narcissistic, borderline and antisocial personality disorders or an addiction. People are considered codependent or as having a severe OSO when they are hyperfocused on the relational and personal needs of others, while neglecting the same needs for themselves. Conversely, people who are considered pathological narcissists or who have a severe SSO are almost completely focused on their own relational and personal needs, while neglecting the same in others.

The middle of the continuum represents individuals whose self-orientation compels them to equally fulfill their “other” and “self” needs. The continuum of self, therefore, represents the full range of self-orientation possibilities, from healthy to dysfunctional.

Relationship math

The continuum of self is a qualitative construct because it can predict a relationship’s degree of healthiness or dysfunction. It is also a quantitative construct because it demonstrates relational compatibility and stability through the use of interacting numerical values. Through “relationship math,” or simple addition and subtraction of single-digit numbers (the continuum of self values), it is possible to identify relational compatibility and stability. The term stable is used to describe relationships that are enduring and resistant to breakup. Conversely, an unstable relationship is likely to either not progress beyond the initial courtship stage or end when frequent conflict or discord is present.

As a whole, the continuum of self measures the full range of self-orientation pairing possibilities. It is designed to measure only interacting self-orientations; it does not purport to measure any other personality construct.

The continuum of self theory suggests that all people are consciously and unconsciously attracted to romantic partners who have an opposite, but proportionally balanced, self-orientation. It predicts that OSOs and SSOs will be attracted to each other while experiencing feelings of relational compatibility. Like an award-winning dance couple, because the care “needer” (SSO) leads the dance and the care “giver” (OSO) follows, the dance is perfectly coordinated; neither steps on the other’s toes. The resulting bond of opposite yet balanced self-orientations may not be happily connected, but it will likely endure hardships and be resistant to change.

By definition, people who are codependent (severe OSOs) are prone to focus on the love, respect and care of others, while dismissing, devaluing or being afraid of seeking the same from others. Conversely, people who are pathological narcissists (severe SSOs) are disposed to satiating their own love, respect and care needs, while devaluing, ignoring or neglecting those same needs in their romantic partners. As opposite but balanced personality types, they almost always experience immediate and intense feelings of romantic chemistry.

Continuum of self values

In total, there are 11 values on the continuum of self, representing the full range of self-orientation possibilities. Continuum of self values increase or decrease in a series of single digits. (Examples of each continuum of self value can be viewed at humanmagnetsyndrome.com.)

Because individuals who are codependent and individuals who are pathological narcissists have diametrically opposite self-orientations, they are represented on the farthest ends of the continuum of self (-5 and +5, respectively). As a person’s relational health improves, so does his or her self-orientation, which is represented by a lower positive or negative continuum of self value. The middle value is zero, which represents an equal balance of love, respect and care given and taken in a relationship. The positive or negative designation does not imply that one self-orientation is better than the other but merely that they are on opposite sides.

COS

The farther the values pairing moves away from zero on the continuum of self, the less mutuality and reciprocity are evident in the relationship. In other words, higher negative and positive values pairings (for example, -4 and +4) represent a relationship that lacks a fair distribution of love, respect and care. Conversely, lower pairings on the continuum of self represent an increased mutual exchange of love, respect and care. The former represents a dysfunctional relationship, while the latter represents a healthy relationship.

According to the continuum of self theory, romantic relationships remain viable or endure because the matching opposite self-orientations create a sense of relational equilibrium. If one partner becomes healthier, as evidenced by a shift in his or her lowered continuum of self value, then tacit and direct pressure is placed on the other partner to respond with similar positive movement and growth. If the partner of the healthier individual does not want or is unable to change and grow, then stress is placed on the relationship. The stress will either lead to a breakdown of the relationship or create pressure for the healthier partner to regress to former levels of dysfunction. Failure to maintain a balanced inverse bond may result in the failure of the relationship. It should be noted that family systems theory influenced the conceptualization of the continuum of self theory.

Corresponding zero values do not signify an absence of self-orientation. Instead, they represent an exact balance of love, respect and care being given and received. Although having a zero value would be ideal, in reality, the vast majority of people fall somewhere on one side or the other of the continuum of self.

The lower inversely matched couples are able to ebb and flow because of the reciprocal and mutual nature of their well-matched self-orientations (continuum of self values). They are able to ask for what they need — and even disagree with each other — without experiencing resentment or conflict. However, higher inversely matched couples create a dysfunctional relationship. With polar opposite higher continuum of self values, the two are unlikely to reconcile their vast differences in self-orientation. In particular, the person who is a pathological narcissist is an unlikely candidate for any substantive personality change.

Except in the case of a pathological narcissist, who may have a personality disorder, a person’s self-orientation and continuum of self value are neither fixed nor permanent. A person’s continuum of self value typically rises and falls throughout his or her lifetime. It is even possible, albeit not usual, for a person to move from one side of the continuum to the other. In the case of a switch in self-orientation (from SSO to OSO, for example), the person usually begins with a lower positive or negative continuum of self value. In addition, this person has likely participated in some form of long-term or regular mental health service. With motivation, emotional fortitude and good counseling, most OSOs and SSOs are capable of learning to practice a mutually satisfying level of give-and-take in the areas of love, respect and care.

The zero-sum relationship

Relationship stability is achieved when the negative and positive continuum of self values of each partner equal a zero sum. In other words, zero-sum relationships occur when two partners have an exactly opposite self-orientation.

Note that the zero-sum relationship describes the quantitative state of a relationship, not the qualitative state. To illustrate, a -5 continuum of self value, or someone who is codependent, will likely form a stable and lasting dysfunctional relationship with a +5 value, or someone who is a pathological narcissist. On the contrary, a mildly giving and overly empathetic person with a continuum of self value of -2 would make an ideal partner for a mildly self-centered person with a value of +2. Therefore, a zero-sum relationship isn’t necessarily healthy or stable. It is just balanced.

Consider this vignette of a healthy -2/+2 zero-sum relationship. Sandy (-2) is a mother and wife who enjoys her role as a busy stay-at-home mom. She stays busy caring for her family and serving in several volunteer positions. She is married to Dan (+2), who is a successful corporate executive. With the support of Sandy, Dan works long hours to build his status and reputation in the family business. Although Dan likes the attention that being in the public eye brings him, he still makes himself available for the personal and emotional needs of others, especially when it comes to his family. Sandy and Dan’s lower opposite continuum of self values result in mutual feelings of love, respect and care. When Sandy is sick and can’t care for the children, Dan doesn’t hesitate to take a few days off work to cover her domestic responsibilities. If Dan needs help, Sandy steps up in any way she can to help him.

Now consider this vignette of an unhealthy -5/+5 zero-sum relationship. Ken (-5) works two jobs to care for his wife, Allison (+5), and their three children. Ken harbors deep resentment toward Allison because he has to work multiple jobs to make ends meet for the family. Allison has been largely unresponsive to and, at times, unaware of Ken’s unhappiness. Although Ken is highly bonded to his children, his work schedule keeps him away from many of the quality moments with them. When they got married, Allison unilaterally decided to quit her successful accounting career because she wanted to be a stay-at-home mother. Despite Ken’s repeated assertions that they needed two incomes, Allison insisted that she needed to be at home with their kids and that Ken was being unreasonable. Ken’s fear of conflict and fear that Allison might leave him resulted in the suppression of his resentment. Allison’s narcissism prevents her from understanding Ken’s need for mutuality and reciprocity in the relationship. They are likely to stay married but remain miserable (particularly in Ken’s case).

Relationship categories

Continuum of self values are categorized into three groups: healthy/balanced, problematic and unhealthy/dysfunctional. Lower values pairings illustrate healthier relationships that are characterized by higher levels of mutuality in the exchange of love, respect and care. Higher continuum of self values pairings demonstrate less healthy relationships that are characterized by a lopsided exchange of love, respect and care, with more going to the SSO and less to the OSO. Couples who fit into a specific category can move forward or backward on the continuum of self as they either evolve or devolve relationally.

  • Healthy/balanced: 0/0, -1/+1 and -2/+2
  • Problematic: -3/+3
  • Unhealthy/dysfunctional: -4/+4 and -5/+5

Unhealthy/dysfunctional relationships

According to the continuum of self theory, individuals who are codependent have a severe OSO, which is numerically represented by a continuum of self value of -5. When in romantic relationships, they focus almost completely on the needs of a pathologically narcissistic partner, while ignoring, diminishing or neglecting their own similar needs. Although unhappy and resentful, they remain in this relationship.

In contrast, pathological narcissists have a severe SSO, which is numerically represented by a continuum of self value of +5. When in a romantic relationship, they predominantly focus on their own needs, while ignoring, diminishing or neglecting their partners’ similar needs. They seem oblivious to their partners’ resentment or unhappiness about the relationship. Therefore, they have no investment or interest in changing the relationship.

The unhealthy/dysfunctional range for relationships is -4/+4 to -5/+5. Although “balanced” and “stable,” these dysfunctional pairings result in one-way “narcicentric” relationships. The +4 and +5 SSOs receive the lion’s share of love, respect and care, while the -4 and -5 OSOs are typically on the short end of the receiving stick. As such, the OSOs suffer in the relationship significantly more than their SSO partners do.

In an effort to avoid upsetting the narcissistic partner, the -4 and -5 OSO partner tolerates and, consequently, adapts to the SSO partner’s narcissistic ways. Because the OSO partner is neither adept at nor comfortable with communicating anger, displeasure or resentment, he or she is likely to suppress these feelings. In addition, the OSO partner may have learned that communicating resentment or anger is likely to result in rejection, conflict or harm (personal or relational), all of which he or she actively avoids. Therefore, the OSO partner perpetuates or enables the dysfunctionally balanced relationship by adjusting to the other partner’s narcissistic behaviors.

The -5/+5 zero-sum relationship is typically resistant to change, mostly because of the pathological narcissist’s inability to acknowledge his or her role in the relationship’s dysfunction. Denying culpability or responsibility for the relationship problems reinforces the narcissist’s position that psychotherapeutic services will be neither personally beneficial nor helpful to the relationship.

The partner who is considered codependent is correspondingly resistant to change because it would potentially result in emotional, psychological or even physical harm or in deep and profound feelings of guilt, shame and loneliness. However, people who are codependent are sometimes able to accept responsibility for their problems and seek help.

Although the -4/+4 relationship also constitutes a dysfunctional relationship, both individuals have some capacity, albeit minimal, to break free of their polarized self-orientation differences. To illustrate, the -4 OSO is minimally capable of setting and maintaining boundaries regarding the love, respect and caring imbalance in the relationship. Likewise, the +4 SSO partner, who does not have a personality disorder, has some limited capability to demonstrate concern and some limited willingness to better meet the partner’s needs. This relationship is still resistant to change because the +4 SSO is negatively reactive and fragile about accepting constructive or critical feedback about his or her narcissism.

Problematic relationships

According to the societal and cultural standards of most developed Western countries, the -3/+3 relationship is often considered problematic because the distribution of love, respect and care is not equally and fairly distributed. In this relationship category, the balance is significantly tilted toward the SSO. Even with the inequity of love, respect and care that is given and received, this couple is still capable of minor to moderate levels of mutuality and reciprocity. For example, the OSO partner is able to set some boundaries and communicate some of his or her needs. Conversely, the SSO partner is capable of minimal to moderate levels of empathy and motivation to meet his or her partner’s needs, while also being open to some constructive and critical feedback.

The delineation between healthy and unhealthy continuum of self values pairings is not always clear. From the vantage point of modern Western culture, a couple with a -3/+3 pairing may be considered unhealthy because of the distinct disparity between the exchange of love, respect and care. However, from the perspective of other societies, cultures or ethnic groups in which the norm is oriented toward an acceptable discrepancy between the giving and taking of love, respect and care, the relationship would be considered healthy and normal. If these romantic partners are satisfied and happy with their relationship and there is no harm perpetrated against the OSO, then their somewhat polarized exchange of love, respect and care may actually constitute a culturally specific healthy relationship.

Healthy/balanced relationships

The healthy values pairings in the continuum of self are -2/+2, -1/+1 and 0/0. Healthy relationships are defined by both a zero-sum balance and an equitable distribution of love, respect and care. Although a -2/+2 couple may not share an exactly equal exchange of love, respect and care, they still experience an affirming, balanced and mutually satisfying connection. This relationship is considered healthy because both partners are content and satisfied with their unique flow. In other words, this relationship works because both partners feel loved, respected and cared for in a manner that satisfies their healthy self-orientation.

An example of such a relationship is a healthy counselor who enjoys helping others but still sets boundaries when feeling ignored, or a healthy writer who lives for affirmation and recognition but can still fulfill his or her partner’s needs for the same.

Maslow’s hammer and nail

As much as the continuum of self theory attempts to identify and quantify human relational behavior, it is neither feasible nor appropriate to rely on just one theory to explain complicated human behavior patterns. There are inherent dangers to having a limited or narrow view of human psychology.

Abraham Maslow, one of the founders of humanistic psychological theory, said, “I suppose it is tempting, if the only tool you have is a hammer, to treat everything as if it were a nail.” My hope is that the continuum of self theory can serve as just one of the many tools in a counselor’s toolbox to help understand and change our clients’ or our own dysfunctional relationships.

I would also like to offer some disclaimers. First, because an addiction can mimic pathological narcissism, a significant period of recovery is needed before determining a person’s baseline self-orientation.

The continuum of self only measures a person’s self-orientation. It does not purport to measure more complicated and multifaceted personality or relational characteristics or dynamics. Also, the theory should be applied only in a clinical setting with a competent and qualified counselor who is trained in the continuum of self and other related psychological theories.

Although the continuum of self theory attempts to explain and simplify the complex attraction dynamic, it does not pretend to be bigger and more inclusive than it was designed to be. It is a narrowly focused explanatory paradigm that measures an individual’s self-orientation, while accounting for the attraction dynamic of opposite but compatible personality types. It is not intended to be a stand-alone or comprehensive theoretical explanation. However, it may be useful as an adjunct to other psychological theories.

As a new psychological theory, the continuum of self has not yet met the rigors of scientific scrutiny. However, I hope that it will contribute to the current understanding of human behavior and stimulate further thought and discussion on the topic.

 

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Ross Rosenberg is a licensed clinical professional counselor and professional trainer. He is the author of The Human Magnet Syndrome: Why We Love People Who Hurt Us. Contact him at
info@advancedclinicaltrainers.com.

Letters to the editor: ct@counseling.org

 

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Related reading: See Rosenberg’s 2014 Counseling Today article “The dance between codependents and narcissists.”

 

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Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.

The dance between codependents and narcissists

By Ross Rosenberg March 12, 2014

We therapists live for moments when everything “clicks” and our clients arrive at an understanding that had eluded them until that moment. There is nothing more rewarding than when a well-placed analogy or metaphor creates the breakthrough moment. When spot-on, the resulting “lightbulb” reaction or “aha” moment is priceless.

dancersOf all of the metaphors I use in psychotherapy, the “dance” has been the most provocative and powerfully impactful with my clients who are codependent. It has helped them understand their predilection for choosing “dance partners” who are ultimately controlling and harmful. It has also assisted them in coming to terms with their seemingly magnetic attraction to narcissistic romantic partners. Over time, the dance metaphor developed into one of my favorite psychotherapeutic techniques because it helped to facilitate perception of rigid thought patterns, break down systems of denial and enable emotional and intellectual understanding of dysfunctional relationship dynamics.

The dance metaphor works because it almost perfectly aligns with what we know about real dancing partnerships. For example, compatible dancers are well matched in their approach or roles: one always needs to be the leader and the other the follower. The leader always navigates the dance with precision, and the follower acquiesces seamlessly. These two choose songs to dance to that they know completely and intuitively. They are exquisitely attuned to the other’s dancing style, moves and idiosyncrasies. To an onlooker, it appears that they dance with ESP, each knowing and predicting the other’s moves before they happen.

Individuals who are codependent “dance” so well with individuals who are narcissists because their pathological personalities or “dance styles” are complementary. In other words, they are perfectly matched partners. Their well-matched dance preferences bond them together in a resilient and lasting partnership, even if one or both partners are unhappy, resentful or angry. As well-matched dancers, they perform magnificently on the dance floor because they instinctively expect each other’s moves. They dance effortlessly with each other, as if they have always danced together. Each knows his or her role and sticks to it. But it is dysfunctional compatibility that is the driving force behind this dynamic dancing duo.

As perfectly compatible dancing partners, the narcissist dancer is the “yin” to the codependent’s “yang.” The giving, sacrificial and passive nature of the person who is codependent matches up perfectly with the entitled, demanding and self-centered traits of the individual who is narcissistic. Like human magnets, codependents and narcissists continue their rocky and seemingly unstable relationship because of their opposite dance roles or, as I refer to them, their “magnetic roles.” The lasting bond created by these perfectly matched human magnets or dysfunctional dancers is interminably powerful, binding them together despite myriad consequences or shared unhappiness. Although their rollercoaster relationship provokes more anxiety and disconnect than happiness, both seem compelled to continue the dance.

These perfectly matched dancers always seem to nail their dance routines, which is to be expected because they have been practicing their passive and predictive dance moves their whole adult lives. The dancing skills of someone who is codependent are distinctly connected to the person’s reflexive dysfunctional agility — the ability to be attuned to the cues, gestures and self-serving movements of their narcissist partners. In almost every facet of their life, individuals who are codependent pride themselves on knowing what people want and need, almost before their friends, family members or partners know it themselves. Hence, the codependent person is adept at anticipating his or her narcissist partner’s moves, while still experiencing the dance as a positive experience.

Conversely, “dancers” who are narcissistic are drawn to codependent partners because they are allowed to feel dominant, secure and in control in an activity that brings them much attention, praise and appreciation. They habitually choose or fall in love with codependent dance partners because they are given open and tacit permission to be the center of focus, lead the direction of the dance and, ultimately, determine where, when and how the dance will proceed. In other words, the narcissist’s grandiosity, entitlement and need to be in control are not only allowed by his or her codependent partner, but also paradoxically make the partner feel safe and secure in the dance.

The dance metaphor has been instrumental to my work with codependent clientele because it helped them understand their persistent dysfunctional attraction pattern to hurtful and selfish narcissistic romantic partners. It also helped them in breaking their perpetual and reflexive patterns of choosing dance partners who initially felt perfect but eventually revealed themselves to be so wrong — even harmful — for them. As a relative who sadly is a narcissist once told me when explaining the nature of relationships: “The soul mate of your dreams is gonna become the cellmate of your nightmares.”

Therapy that utilizes my dance metaphor consistently provokes a deeper understanding of dysfunctional relationship patterns.  Over time, my clients have developed the confidence, insight and feelings of personal efficacy and power to break free from their dysfunctional relationship patterns. Released from their propensity to fall in love with narcissists, these “recovering” codependents are finally able to fall reflexively, if not magnetically, into the arms of a loving, desirable and emotionally healthy dance partner.

In 2007, following an inspiring breakthrough therapy session with one of my clients, I decided to consolidate all of my ideas about the codependent/narcissist dance phenomenon into an essay titled “Codependency, Don’t Dance.” The essay flowed from me with ease because I had been contemplating and talking about these concepts for more than five years. I would later realize that the ideas had been marinating in my mind ever since I made the promise to myself that I would put an end to my own penchant for dating, falling in love with and marrying narcissistic women. I have no doubt that if I hadn’t figured out how to change my own dysfunctional dance pattern, the dance “light bulb” never would have appeared above my head.

The essay was an immediate hit with my codependent clients because it seemed to galvanize their understanding of their own dysfunctional and self-defeating relationship choices. It represented my own truism about the psychotherapy process: You can’t change a long-standing dysfunctional pattern until you first understand what it is and where it comes from; the deeper the understanding of the internal processes, the more apt the therapy experience is to yield positive results.

Since writing this essay, it has become the most requested piece of my written work and is also included in my book, The Human Magnet Syndrome: Why We Love People Who Hurt Us. I’m honored and grateful that the essay has helped thousands of people to analyze and, ultimately, understand their seemingly mysterious and habitual relationship patterns with narcissists. What follows is an excerpt of the essay:

 

When a codependent and narcissist come together in their relationship, their dance unfolds flawlessly: The narcissistic partner maintains the lead and the codependent follows. Their roles seem natural to them because they have actually been practicing them their whole lives; the codependent reflexively gives up their power and since the narcissist thrives on control and power, the dance is perfectly coordinated. No one gets their toes stepped on.

Typically, codependents give of themselves much more than their partners give back to them. As “generous” but bitter dance partners, they seem to be stuck on the dance floor, always waiting for the “next song,” at which time they naively hope that their narcissistic partner will finally understand their needs. Codependents confuse caretaking and sacrifice with loyalty and love. Although they are proud of their unwavering dedication to the person they love, they end up feeling unappreciated and used. Codependents yearn to be loved, but because of their choice of dance partner, find their dreams unrealized. With the heartbreak of unfulfilled dreams, codependents silently and bitterly swallow their unhappiness.

Codependents are essentially stuck in a pattern of giving and sacrificing, without the possibility of ever receiving the same from their partner. They pretend to enjoy the dance, but really harbor feelings of anger, bitterness and sadness for not taking an active role in their dance experience. They are convinced that they will never find a dance partner who will love them for who they are, as opposed to what they can do for them. Their low self-esteem and pessimism manifests itself into a form of learned helplessness that ultimately keeps them on the dance floor with their narcissistic partner.

The narcissist dancer, like the codependent, is attracted to a partner who feels perfect to them: Someone who lets them lead the dance while making them feel powerful, competent and appreciated. In other words, the narcissist feels most comfortable with a dancing companion who matches up with their self-absorbed and boldly selfish dance style. Narcissist dancers are able to maintain the direction of the dance because they always find partners who lack self-worth, confidence and who have low self-esteem — codependents. With such a well-matched companion, they are able to control both the dancer and the dance.

Although all codependent dancers desire harmony and balance, they consistently sabotage themselves by choosing a partner who they are initially attracted to, but will ultimately resent. When given a chance to stop dancing with their narcissistic partner and comfortably sit the dance out until someone healthy comes along, they typically choose to continue their dysfunctional dance. They dare not leave their narcissistic dance partner because their lack of self-esteem and self-respect makes them feel like they can do no better. Being alone is the equivalent of feeling lonely, and loneliness is too painful to bear.

Although codependents dream of dancing with an unconditionally loving and affirming partner, they submit to their dysfunctional destiny. Until they decide to heal the psychological wounds that ultimately compel them to dance with their narcissistic dance partners, they will be destined to maintain the steady beat and rhythm of their dysfunctional dance.

Through psychotherapy, and perhaps a 12-step recovery program, the codependent can begin to recognize that their dream to dance the grand dance of love, reciprocity and mutuality is indeed possible. Through therapy and a change of lifestyle, codependents can build (repair) their tattered self-esteem. The journey of healing and transformation will bring them feelings of personal power and efficacy that will foster a desire to finally dance with someone who is willing and capable of sharing the lead, communicating their movements and pursuing a mutual loving rhythmic dance.

In conclusion, it is my belief that all codependents, if motivated and committed to a healing and engaging psychotherapy process, are able to stop their insanity-inducing dance with narcissists. Through a nonwavering belief in one’s self-worth and commitment to the ideal of healthy and resilient love, we all can finally experience personal and relational joy. The quote that best captures my philosophy of the codependency recovery process comes from George Eliot:  “It’s never too late to be what you might have been.” Or, as I might say it, “It is never too late to dance with the partner of your dreams.”

 

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Ross Rosenberg is a licensed clinical professional counselor, certified alcohol and other drug abuse counselor and national seminar trainer. He is the owner of Clinical Care Consultants and co-owner of Advanced Clinical Trainers and the author of The Human Magnet Syndrome.

 

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Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.