Vulnerability for the Wrong Reasons?

Vulnerability is powerful! Championed by heart-centered leaders like Brene Brown, Simon Sinek, and Michelle Obama, we’ve taken notice of how it can pave the way for authentic leadership and deeper connection. Vulnerability has its place in allowing people to feel seen. Learning to lean in to the discomfort to grow, It can serve as a catalyst for change. 

I myself have experienced the positive power of vulnerability as a leader. Yet what if there are times we embrace vulnerability for the wrong reasons? To manipulate others? Forced intimacy to get our needs met? Learned helplessness to be seen and cared for because we find we are unable to help ourselves? Showing up in the form of:

People Pleasing.

Co-dependency.

Manipulation.

It’s not uncommon to support vulnerability as a meaningful tool after trauma. For some, it starts with addressing the absence of vulnerability in a person wanting to feel strong, independent, and in control. For folks with mental health diagnoses of Complex Post-Traumatic Stress Disorder (C-PTSD) and Borderline Personality Disorder, vulnerability within relationships can feel even more complicated.  C-PTSD, for example, recognizes the impact of repeat relational trauma that challenges a person’s sense of safety and security. The unpredictable environment of not knowing if their needs will be met, when they will be met, or how often. Attachment trauma. Rupture with no repair. If vulnerability has the capability of bringing people closer together, can it manifest as a learned behavior with significant consequences? 

As a therapist, I find myself worried that vulnerability can be contrived in response to trauma, pressure, and pleasing of others. Concern that individuals who have had their boundaries violated will embrace vulnerability as a tool but not recognize the risks. What are the consequences of strategic vulnerability for agenda-driven reasons? Perhaps the person receiving the fabricated expression of vulnerability finds it draining or false. Individuals engaged in forced vulnerability to get their needs met may find themselves in burnout, resentment, or fatigue. By embracing inauthentic vulnerability, are we unknowingly elevating our risks of being physically or emotionally hurt again?

With these challenges in mind, I continue to engage clients in an energy wheel exercise in order to explore their relational boundary work each week. Presented as slices of pie, I ask them to map out their energy dedicated to various tasks each week, both personal and professional. Emphasizing relational energy, I encourage clients to remain curious by asking, “what’s my energy pie look like today?”

In the example above, the client indicates spending a lot of energy in Week 1 pleasing her father by spending time with him, meeting his needs, and putting out emotional fires. By actively practicing boundary work over the next several weeks, the client indicates a more balanced energy towards her primary goal of finding a job. By processing the shift in energy, the client recognizes an increase in self-confidence and improved well-being in not feeling as drained by the interactions with her father. This discovery not only reinforces her motivation to continue her important boundary work with family members, it also helps her explore her relationship with vulnerability.

As we can expect, boundaries and vulnerability go hand in hand. From a trauma lens, boundaries and vulnerability are equally challenged by the maladaptive coping skills we develop to survive a threatening experience. Therefore it is important to explore a client’s relationship with vulnerability, identifying how they feel about it, when they embrace it, and how it can serve as an opportunity to bring them closer to connection in healthy relationships while protecting them against unhealthy patterns.

Estrangement Energy: A Cycle for Ruptured Mother-Daughter Relationships

It’s a pattern of devastating hurt. Safety and security are risked again and again. First introduced as the evil step mothers in Cinderella and Snow White, we have even more extreme portrayals of unhealthy mother-daughter relationships such as in White Oleander, Flowers in the Attic or The Sixth Sense where Mrs. Collins poisons her daughter Kyra to get attention from others. Characters we learn to hate due to their psychological and sometimes homicidal behaviors and repeated abuse of their offspring. These characters represent dramatic examples meant to produce an emotional reaction and feelings of protection by the audience for the daughters who are survivors of such abuse.

What about the real-life experiences of attachment trauma? The phenomenon we see for complex trauma survivors who open up about their experiences of their mothers being less than loving? In working with dozens of women over the years, it has become clear that the damage done in a ruptured mother-daughter attachment has long lasting effects. Powerfully captured in Dr. Karyl McBride’s book, Will I Ever Be Good Enough?, daughters go through patterns of grief and loss, questioning their own worth due to the spoken and unspoken messages of their mothers. If young children worry that their parents’ divorce is their fault somehow, it’s not surprising that an adult child of an estranged mother may also feel some sense of responsibility for the damaged relationship.

The responsibility and grief they feel may spur them to come to therapy to find some peace with the estrangement. Let’s take a look at several examples of adult women who are estranged from their mothers after the painful realization that the relationship was unhealthy, unsafe, or unable to shift in ways that felt empowering and worthwhile.

Kendell* has been estranged from her mother for more than 16 years. She left home at 15, got pregnant at an early age, and consumes alcohol daily to calm her nerves. Kendell is a committed mother to her four children, stating she wants to provide for them in ways her mother couldn’t. When engaging Kendell in her trauma work, she recognizes her mother’s mental health challenges prevented affection and her mother saw her as competition for the men she dated, leading to conflict and verbal or physical altercations until Kendell left the family home.  Kendell struggles with being gaslit by her mother who still tries to call her occasionally and has enlisted Kendell’s younger sister to convince her that it’s all “water under the bridge now.”

Nicolette* is celebrating seven years sober from heroin. She has identified her childhood consisting of her mom criticizing her looks, weight, and intelligence. Nicolette’s experience with her mom captures a pattern of manipulation through her teenage years which led her to believe she was flawed, unlovable, and mentally ill. She found herself marrying a controlling man and suffering from various addictions until she was able to get a divorce when the relationship turned violent. Although Nicolette entered substance recovery programs voluntarily to get well, her mom accused her of relapse throughout her sobriety, even physically assaulting her and getting Nicolette arrested under false charges due to her stigmatized label as a former drug addict. Nicolette struggled to release herself from family ties in spite of the abuse, believing she had to work harder to earn her mom and other family member’s love. She has been estranged for four years now and finds herself questioning the estrangement 1-2 times per year, asking herself if there was more she could have done.

Sophia’s* father reconnected with her as a teenager, dying of a rare cancer not long after. Raised by a mother who struggled with poverty, mental health, and substances, Sophia was left to take care of herself and her younger brother in their rural upbringing. Sophia was determined to find independence, moving out on her own and pursuing a career as a helping professional. Sophia currently struggles with high anxiety and demands for control. She doesn’t like change and finds herself on edge and reactive when anticipating outreach by her estranged mother every holiday. She struggles with perfectionist tendencies and rigid thinking. Sophia’s goal is to have stability for herself and her family and she maintains strong conviction to remain estranged from her mother. Sophia prides herself on building other meaningful relationships that feel supportive and loving. 

Each of these women’s stories is unique and their own yet they have something in common, the grief and loss patterns associated with the ruptured mother-daughter relationship. Some daughters are left wondering if they could have done more to salvage or repair the relationship with their mothers. Others hold anger and determination to be nothing like their mothers. Their therapeutic work could begin with questioning their own role or actions. Or perhaps they have concerns about other relationships present in their life. They may work through the core beliefs of feeling unlovable, unworthy, or a failure in believing they were unable to earn their mother’s love or affection. And eventually, with time, they may redefine their identity without a mother in their life, embracing their strengths and boundaries to support healthy, meaningful relationships with others. 

Estrangement Energy, what I call the process for individuals doing this deeper work, can feel exhausting. Here’s the pattern I’ve witnessed in many clients over the years. 

·      There is a cycle of abuse or patterns of negative behavior that have happened for years between daughters and their mothers.

·      The cycle of negative interactions contributes to how the daughter measures her self-worth.

·      There is questioning if this pattern will ever shift, improve, or change for the better, especially when the daughter is aware that other mother-daughter relationships look different than their own.

·      The relationship rupture happens when the daughter has had enough. She makes moves to distance herself from the pain or abuse experienced in the relationship. 

·      With space or at the urgings of others in her life, the daughter is prompted to remove the relationship, labeling it as “toxic” and estranged.

·      The daughter tends to pursue therapy after the estrangement has happened or is in the process of happening in response to immense hurt, pain, and grief reactions that result from the estrangement.

·      Grief and loss followed by new identity development is done in therapeutic settings or through self-discovery over time.

·      A new sense of self emerges, with deeper work on self-worth related to core beliefs of being lovable and worthy in relationships.

·      The Estrangement Energy Cycle can be triggered to continue if current relationships mirror the estranged mother-daughter relationship, leading to resumed questioning of self-worth.

As you can see from this cycle, it can be an emotionally challenging if not draining process to work through estrangement and what it means to an individual. It’s not an easy or fast process, so here are some ideas to help clients do this meaningful work:

·      What’s Your Impression? Understand that some clients will be worried what you think of them as they share their grief and loss of the mothering relationship. Remain curious and neutral, exploring how these worries can become part of the therapeutic process.

·      I’m Second-Guessing Myself. It’s not uncommon for a client to question if the estrangement is still valid after a period of time. Like Nicolette mentioned above, perhaps they find themselves checking in to see if the estrangement still feels right. Normalize the experience of questioning and hold space for them to evaluate the pros and cons of resuming contact.

·      Reconnection or Relapse? Some of your clients will move from thinking about rekindling an estranged relationship to giving it a try. As therapists, it is important that we do not force our own values on our clients, instead supporting them through the process of outreach and connection with their estranged parent while encouraging healthy boundaries, safety needs, and deeper processing in weekly sessions if needed.

The bravery of daughters and clients who choose to work on themselves in order to heal the attachment trauma they’ve experienced is both powerful and inspiring. My hope is that this introduction to theEstrangement Energy Cycle can support both clients and clinicians alike in the journey to being one step closer to healthy self-worth and a renewed, empowered sense of self.

*Client information has been changed to protect confidentiality.

Engaging Adolescents and Caregivers in Family Therapy

“Do I have to do family therapy?”

Yep, that's such a common question I get from my adolescent clients at the start of therapy. Here are some other common questions and statements a therapist may receive in regards to parents and caregivers being a part of an adolescent's therapy process:

"So how much are you going to tell my parents?"

"I hate these family things; i just feel so awkward."

"Do I have to be in the room when you talk to my mom/dad/guardian?"

“I’ll talk to you, but I will not talk to my parents about this!”

“Why try, nothing is going to change!”

“They/she/he just doesn’t understand me.”

Do any of these sound familiar in your therapeutic work?

When reflecting on these common initial responses and questions about family therapy, it has been my professional experience that I see a clear pattern of fear, lack of trust and shame arise as barriers to adolescents getting their needs met by their caregivers. Additionally, many adolescents seem to have a common misunderstanding (and caregivers too) that family therapy is about pointing fingers and being the “problem” of the family. So with this in mind, I’m excited to share some strategies I use to build rapport, connection and trust with adolescents to empower them in engaging with caregivers in family therapy.

1) Be Transparent! In other words, BE REAL with your client. Adolescents are smart, clever and can read through any BS or tip-toeing going on in the room. I give them the direct and transparent version of confidentiality and expectations of what therapy entails. 

“I know you may or may not be wanting to communicate certain things with parents, but I want you to know what I must report immediately. Any safety concern including suicidal ideation/planning, abuse, neglect, witness to violence, and self-injury must be reported to caregivers or appropriate authorities. With that being said, there may be things that come up that you are not open to sharing but would be beneficial to do so in order to get your needs met from your parents/guardians. When this happens, I want you to know I will challenge but not force you, and together we can figure out the best way to schedule a family session around it when you are ready.”

2) Build trust immediately: I know this one is a given, but I start with every first session letting my adolescent client know that I don’t expect them to trust me right away in an effort to ease any tension or pressure someone might feel.

“I want you to know that I don’t expect you to trust me right away. Trust takes time and is earned so that’s exactly what we are going to do. We will take time to get to know each other. You can ask me any questions you need to about myself or the process. I’ll let you know if I can’t answer it for any reason. And I want you to know if I ever ask or discuss something that you are not ready to answer, you say so, and we will use the time for what you are ready for and need. This is your time and space, and I want you to feel safe.”

3) Share the responsibility and “workload”. It’s essential to dispel any myth or belief with the adolescent and caregivers that a) they are the problem child and b)your job is to “fix” them in some way. Again, this is where I use transparency in the first session or parent consult (as well as throughout ongoing treatment) to set clear expectations for all involved.

To caregivers: “I want you to know that if i’m working with your child, I’m working with you also.  In many ways, this work can be equal or more for the parent.  My job is not to “fix”. Rather, i’m here to provide assessment, education, skill-building and a safe space to process and build awareness so that you and your child can more effectively communicate, understand one another and connect in a meaningful way to address the barriers.” I always let adolescents know that I’ve had this conversation with the caregiver(s) as well so they know it’s a joint effort.

4) Empower the adolescent voice. I like to give my adolescent clients as much choice and opportunity to lead as possible when it comes to parent involvement. Here are a few different ways, I frequently go about this in session:

“Would you like me to check in with mom/dad alone or with you it the room?”

“Is there anything you’d like to share with mom/dad/caregiver from our session today?”

“Is it alright if we bring mom/dad in at the end to share any skills we worked on so they can practice it too?”

“Is it ok if I emailed mom/dad about (a specific one or two things from session) so that they can be more aware and better understand what you are going through or how to support you?”

“Is there anything you want to teach mom/dad today?”

“Would you like me to explain (specific pattern or skill) for you to caregiver with you in the room?”

“Would you want to do a family session with mom/dad on this? If so, when do you think you’d like to do it?”

5) Parent Coaching Sessions are a must! Along with letting parents and adolescents know that this is joint work, I let them know that some sessions will be just with the parent(s). I am transparent with the adolescent and parents about the purpose of these sessions from the start.

“These sessions with your mom/dad are NOT to report all that you’ve said or processed in session. Instead, they are an opportunity for you parent to explore their own barriers getting in the way of supporting or connecting with you. I will always let you know when i will be having a session with you parents in case you have any questions or anything you would like me to share or work on with your mom/dad.”

To caregiver: “These are sessions where you can explore challenging emotions, patterns, behaviors that you are struggling with that might be acting as barriers to your relationship with your child. The main goal is to empower you as a caregiver and strengthen your relationship.”

6) Provide Outside Resources to Caregivers and Adolescents from the start.

At the end of an initial session or consult, I provide at least one book and internet-based resource that will help parents get a head start on some of the topics and ideas we will be addressing in therapy. Throughout the process, I continue to provide both the caregivers and the adolescent ongoing supports based on what is coming up in therapy and what the family barriers may be.

Some of my favorite resources are:

Ted Talks: Especially for the adolescent and caregiver to watch together at times.

Wellcast videos: Here is one of my favorites, but they have them on all topics! I often show to adolescent in session and send to both caregiver and adolescent after session. https://www.youtube.com/watch?v=UMIU-Uo8cZU

Phone apps: mood meter, calm.com, Headspace are just some of my favorites.

Books: there are so many; here are a few favorites

The Gifts of Imperfection, Daring Greatly and Rising Strong by Brene Brown (also has great ted talks to introduce the concept of vulnerability and shame)

Whole-Brain Child, Yes Brain and Brainstorm by Dan Siegel and Tina Payne Bryson

Emotion Focused Family Therapy resources: This includes caregiver webinars and in-person workshops, book recs, links to articles, etc. All greatly support parent coaching and family work. http://www.emotionfocusedfamilytherapy.org and http://www.mentalhealthfoundations.org are two helpful websites.

Review/summary emails: These I send with adolescent permission to specifically review a skill, idea or new strategy that would be helpful for the caregiver or adolescent from session. This way, they can refer back to it as needed.

Engagement with adolescents and parents can be difficult at times, but I have found the more i’m able to focus on empowering families and setting clear expectations of what family work is and isn’t, the more willing adolescents and caregivers are to engage in the process. My goal is never to be the one the adolescents trust or “go to” the most, it’s to help them build that with their parent(s) or caregiver to be able manage their challenges and barriers in life in a sustainable and connected way.

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Guest post written by Meaghan Burns Sablich, LCSW

Meaghan Burns Sablich, LCSW is a Licensed Clinical Social Worker, Licensed Colorado State School Service Provider and clinical supervisor with 10+ years experience in the field. Meaghan received her Masters Degree in Social Work from the University of Denver with a concentration in Families and Children. Meaghan has worked in a variety of therapeutic settings including inpatient hospital, residential treatment center, day treatment center, schools, non-for profit organization and private practice. Areas of clinical focus include: depression, anxiety, ADHD, eating disorders, family therapy and parent coaching, grief and loss, school/learning concerns and self worth work.

Adult Attachment: Creating Connections from Childhood

I panic when I don’t hear from them. I just want to be left alone. I want to reassure them that I’m here for them. These statements may capture several examples of responses from clients in your office engaging in work around their relationships. One powerful perspective on the functioning dynamics of intimate partner relationships is to look through the lens of attachment. In other words, by exploring childhood attachment and how it sets the foundation for interaction within relationships, we can experience an increased sense of awareness on how attachment translates to current relationships from needs being met or ignored in our early childhood experience.

Bonding Background

The study of attachment can first be linked to Mary Ainsworth and John Bowlby in the 1970s. Mary Ainsworth devised the Strange Situation, an experiment that placed babies in a lab with their attachment figure/parent and observed reaction in the baby as a stranger entered the room, as well as each baby’s ability to be soothed when the parent left the room and later returned. Based on Ainsworth’s research findings, we were able to identify three types of attachment: secure, anxious, and avoidant. Mary Main, another colleague, later identified a fourth type of attachment called disorganized to capture responses that were inconsistent and unpredictable when exploring a baby and their attachment figure.  

Attachment Attributes

Secure attachment in childhood looks like a distressed infant that is easily comforted when the attachment figure engages them, such as picking them up and soothing them with soft voice, physical touch, and proximity. In adulthood, the secure attachment individual is highly desired for their ability to reassure their partner and present as calm, grounded, and confident in the relationship. Anxious attachment in children can be portrayed as significantly distressed when the parent exits the room, with increased difficulty to receive soothing or reassurance when the parent returns. In adult relationships, the anxious attachment individual’s anxiety prevents them from feeling reassured in the relationship and can drive their behaviors to present as needy, anxious, and sometimes paranoid that the relationship will fail or that they aren’t “good enough” for the relationship to work.  Lastly, the avoidant attachment type in childhood will manifest in a baby as unaffected, cold, disconnected, and unconcerned with the parent leaving the room as well as an inclination to self-soothe, such as engaging in thumb sucking or playing with toys independently. The avoidant attached child has learned to rely only on themselves in not having the parent fully present, which can occur when parents are working long hours away from the child, are inconsistent in their reactions to soothe the child, or can occur in response to a parent’s mental illness such as depression preventing interaction and ability to attach in healthy ways.  In adults, avoidant attachment continues the theme of self-sufficiency and “not needing anyone” in a relationship, preventing them from connecting at a deeper level with others and can be portrayed as reluctance to commit to a serious relationship.

Linking to Literature

With John Bowlby’s Attachment Theory in mind, Amir Levine wrote an insightful book called Attached, that explores intimate partner attachment more deeply and offers examples of adult behaviors that can provide insight or identification of attachment styles. For client use, there are also helpful YouTube videos that can provide a brief overview of adult attachment such as the one found here. Another author, Stan Tatkin, took the idea of attachment a step further by providing symbolic representation of attachment that can also help one identify their attachment style.

Secure Attachment: An Anchor

Anxious Attachment: A Wave

Avoidant Attachment: An Island  

The imagery associated with attachment styles can help a client identify their reactions and resulting behaviors in intimate relationships, as well as assist them in identifying their partner’s attachment style and needs.

Creating Connection

In supporting your clients with exploring their attachment, you may find yourself pursuing additional training, such as Emotionally Focused Couples Therapy (EFT) that encourages vulnerable connection in couples and supports healing of attachment wounds. Or perhaps you link your attachment work to Gary Chapman’s The 5 Love Languages or communication and connection strategies from John Gottman’s training for couples’ work. Whatever means you choose to further dive into attachment needs, educating your clients on the possibility of positive shifts, such as moving to more secure attachment with their partners, can support movement towards healthier relationships. Levine and Tatkin emphasize that relationship attachment can shift and a person can present differently in each romantic relationship over their lifetime. With this in mind, exploring attachment can support your clients in discovering their own attachment styles as well as assist them in connecting and fostering healthy attachment in their intimate partner relationships.