People I See In My Practice
Do you recognize yourself in any of the following “types”?
If so, you might benefit from therapy with me. Also, did you get instantly turned off by my use of the word “type”? If so, I don’t blame you. I fervently believe everyone is unique at the granular level AND I believe we (fortunately) have some broad, affirming similarities. So for what it’s worth…
1. Overachieving, Social-But-Lonely Urban 20s/30s Girl
I love working with these clients. These are smart, sensitive, conscientious, introverted or extraverted women who are killing it professionally but feeling adrift socially. The same hard work ethic that brought them straight-As and title bumps is a clunkier fit in relationships. They can feel like, and be perceived, as "try-hards" who wonder whether there isn’t an easier way. They haven’t had a significant long-term romantic relationship in a while and may be taking a break from app-dating guys who are avoidantly attached, or just immature, or both. Their friend group may also be in transition as folks couple off and/or move away. They may desperately miss their family of origin in another state, be eager to individuate fully from it if it’s not healthy, or both. They may feel ambivalent in their relationships to social media and alcohol, and again question whether undercontrol or overcontrol is a factor. They may undervalue themselves at times and they are often undervalued in their environments, which leads them to mask, which, unfortunately, leads to further feelings of alienation. This can and must change!
2. Neurodivergent, Sexual-Minority, Traumatically Invalidated 30s Client
I love working with these clients, too. Okay, I’m going to stop saying that every time (although it remains true for the types below as well). These folks spent their 20s digging in to identity issues. Now, in their 30s and over the initial self-acceptance hurdles they are taking the still-difficult but more fun and rewarding steps of building an authentic life. They may have named their neurodivergence — ADHD, autism, giftedness, sensitivity, etc. — and be learning to undo masking and unlock potential. They may feel guilt or shame about not making more money or being more conventionally, outwardly successful and struggle to define meaningful, stimulating work for themselves. They may have named their gender and sexual expression as well, or come to terms with ambiguity and fluidity. They are contemplating whether they see long-term partnership and kids for themselves, which reactivates both longing and trauma from their family of origin. Fear of failure remains a significant barrier to commitment in all areas of life, from relationships to doing taxes to therapy.
3. Highly Sensitive, Highly Out-of-Touch-With-His-Sensitivity 20s-40s LTR Guy
This person may have been referred to therapy by his wife or girlfriend and reticent at first but ultimately relieved she nudged him toward “getting help.” He has suppressed his emotions as a way of life since childhood, however he may experience intermittent and increasing panic that seeps through when defenses fail. Although in a relationship, he may be otherwise socially isolated. He has some longstanding but not close friendships, due to FOO (family of origin) and cultural messaging about vulnerability among men. As such he has largely outsourced his emotional and social life to his SO. He may feel more childish than other men. Raising a sensitive son and feeling conflicted about how to do so may finally push him over the edge into accepting the birthright of his own three-dimensional emotional life. He is often sexually frustrated, feeling that “good guys” and feminists are not sexually assertive, ashamed of his true (and not inappropriate) desires. He uses porn in part to get his disowned needs met but it feels sadly distant from his actual sex life, nor does it reflect the communication about sex within his relationship that he wishes he had.
4. Late-Bloomer Survivor of Narcissistic Abuse 20s-40s Client
A woman or a man, this client grew up in a household with a narcissistic parent and/or sibling. Often the more sensitive and empathetic of the kids in the family, they played the role of peacemaker and emotional fixer for the undercontrolled and immature family member. Their (understandable, and at the time adaptive) drive to reduce conflict often results in a stifled sense of self, highly contingent on being useful and agreeable to others. They may be very smart but mystified as to why they later choose partners who are just as self-centered and subtly or overtly dominating. Sometimes they struggle to launch and are the “identified patient” in the family, particularly when the NPD parent is outwardly (i.e., financially) successful. Other times they are the poster child of conventional success but are lonely, self-effacing, and may even feel worthless. Used to chronic gaslighting and manipulative emotional outbursts, they choose their words very carefully, or sometimes hide behind a wall of talk in order to remain safe in relationship. For this client, therapy can be a transformative experience of letting go of dissociation to uncover spontaneous, true, safe feeling.
PS: stay tuned for a follow-up post with more (of course there are more than four "types" of people I see!).