Many of us know the feeling – the pull to do what another person wants and to let our own needs take a back seat. Whilst to put another person first can be a generous and courteous thing, when it becomes compulsive and our own needs become impossible to assert, we may well be in the grip of what can be termed ‘pathological accommodation’.
In a recent book, Bernard Brandchaft explores this issue in depth. He builds a compelling picture of what it is, how it arises and how therapists can work to help their clients that suffer from it. Pathological accommodation is often a very deep pattern and can impact our home and working life. You see it all the time.
So how does it arise? According to Brandchaft it is something that has its genesis in childhood and is a response to the lapses of our caregivers. In the normal caregiving situation, a growing child will express needs (such as needs to be fed, nurtured or even understood) and the caregiver will, to the best of their ability and to the extent that they can, respond to the child’s needs. In this way the child gets to understand that it can express needs and that they can be satisfied; knowing this, the child doesn’t need to enter an agitated state when a need arises – it knows that it will be responded to. Further, this met expectation of responsiveness will help do some of the critical work of building the connection between the child and the caregiver into a secure relationship.
Sometimes the caregiver isn’t able to respond to the child. This is normal, and whilst it can cause distress for the child the damage is often not long lasting and can be repaired with further responsiveness. However, Brandchaft claims that some of those in a caregiving role are not consistently and reliably able to respond to the needs of the developing child. In this situation, the child can no longer take for granted the connection to the caregiver, and this is the most important thing in the world for the child, even if the connection is to an abusive caregiver. In order to maintain this essential connection, the child will start responding to the needs of the adult in order to elicit the responsiveness it craves. If this successfully starts to restore this needed connection, the child will quickly embrace this new behaviour. In essence, the child forestalls its own development for the sake of attachment.
One of the persistent difficulties with this is that the child learns to shelve its own sense of self in order to better respond to the caregiver. The child’s sense of self becomes stunted and more marginalised until the need to accommodate the adult becomes pathological. This is insidious as there can develop a seemingly unbreakable dichotomy between the child’s developmental needs and the possibility of connection – the existence of one seemingly destroys the other, and this split grows ever stronger. As the child grows into adulthood and their needs turn from the need for nurturing into the need for self expression and to have their own sense of self, the person feels that they can have their own sense of self or they can have connection to another but that they can’t have both. Since most people need connection to other people above all else, our sense of self becomes muted. Even more tragically, an unconscious link becomes entrenched between the expression of the self and destruction of the link to other people; “any expression of my own thinking or self-expression, even privately, may lead to a re-emergence of my supressed sense of self and if it does, this will destroy my connection with the people I love”.
In a very cruel twist, the constricted adult, unable to express his own needs adequately and limited in the way that he can respond and be responded to, becomes the sort of caregiver that has such difficulty in responding to the needs of his own children, and only feels comfortable when his children respond to him; in this way is the cycle perpetuated.
So how do we deal with pathological accommodation? Because the damage happens at a pre-reflective stage of development, the full pattern is outside of awareness. It is also outside the area of conscious revision, so that therapies that focus on the cognitive and the behavioural will seldom effectively penetrate to this level. The treatment for pathological accommodation is to firstly bring the mental process that underlies the need to accommodate the other into awareness. We do this by giving minute attention to the way that the pathological accommodation unfolds; what triggers it, the thinking that accompanies it and the process by which that the needs of the self are relentlessly ceded to the needs of the other. Throughout the treatment the therapist will pay great attention to aligning himself with the client’s state of mind (especially how the client experiences it) and welcomes the client’s expression of himself. Through allowing and encouraging this expression, the therapist fosters the client’s growing sense of self and holds onto the possibility of it, even when the client feels they are sliding back. It can be a slow process. The therapy will start to awaken the entombed sense of self, and this awakening will give rise to a sense of panic that the relationships that the client depends on will be threatened. The more the self starts to grow, the more the client will feel a sense of panic that his connection to other people is at risk. In the face of this, the client may retreat better to what they best understand and can trust – responding to the needs of the other so the relationship remains unthreatened. It is only by slowly realising that the needs of the self can grow and that the relationships – including the therapeutic relationship, which becomes a template – can still exist and not be threatened that the emerging sense of self finds its feet.
- Tim Hill
Reference:
Brandchaft B., Doctors S. & Sorter D. (2010) “Towards and Emancipatory Psychoanalysis” Routledge, New York
image credit: R-J-Seymour
Disclaimer:
This blog is for informational and educational purposes only. The information provided, and any comments or opinions expressed, is intended for general discussion and education only, even when based on a hypothetical. It should not be relied upon for ultimate decision-making in any specific case. There is no substitute for consultation with a qualified mental health specialist, or even a physician, who would be the best to evaluate and advise based on a careful, considered evaluation of all pertinent facts. Likewise, it is understood that no guarantee or warranty arises from the information provided or discussed here.
