A very important issue that I have only fairly recently begun to investigate is the difficulty in self regulation or perhaps better termed, Self Care or Self Support , many of my clients have had. This difficulty occurred in various areas: physical health, emotional functioning, financial problems, work-related issues and others. Of course people frequently have self-regulation problems across domains, but one can be self-supportive in one area, but poorly self-supportive in others. For example, one can be financially methodical and successful, but deficient in taking care of their physical health.
Many of my clients have not even seen their relative inability to organize themselves in certain important areas as a therapeutic issue, so tended not to bring it up with me. They took the viewpoint, “that’s just the way I am.” Or they felt ashamed at not being able to do “simple” functions they thought should be easy. The difficulties came to light when I began to comment, after they had been with me for awhile, on certain observations I made about them. For example, in numerous cases I remarked on a pattern of frequent lateness for their appearance at therapy sessions. I of course thought to myself that their chronic lateness could be a sign of negative feelings about their therapy, which I felt needed exploration. But it was frequently the case that the client reported being late to every appointment they had. And when that came to light, it has almost always started a very fruitful exploration of difficulties in self-regulation which, although starting with time management , extended to other domains.
In general when clients and I have addressed the self-organization problems fully, they have achieved the ability to give themselves more self-support. This, by the way, often included the ability to ask others for support when needed, and their lives improved greatly.
Here are some of the other clues I got from clients that motivated me to explore issues of self-support: working overly long hours which meant neglecting time with family and friends; being poorly dressed even though they made enough money to buy decent clothes; having had a spotty work and educational history even though they obviously had superior intellectual and creative abilities; having problems dealing with money, including little or no savings or investments for retirement; a chaotic relationship history; having nagging health problems, including being very overweight or extremely thin, dental problems, and difficulties in elimination or chronic insomnia.
Note that my exploring issues of self-support is a departure from my major therapeutic approach, which is to allow my clients to bring up what they want to deal with in any specific session. But to me this questioning is akin to my asking a client about any obvious avoidance of significant topics. And I don’t bring up the specific issue until I have established a solid relationship with the client and noticed certain significant patterns existing over time. I bring up the relevant issue in the spirit of being curious, rather than accusatory. I feel this is important lest the client feel defensive or ashamed.. I can say with much experience that adult difficulties in self regulation are almost always connected to some care-taker lack during childhood. But the client may not be ready to explore what they experienced during their childhoods, either due to suppression or repression of significant recurring events, or a need to protect their care-takers from blame. In any case, if they indicate they don’t want to discuss the issue, I drop it. I may bring it up in a later session, including inquiring why they don’t want to discuss it if they still take that tack.
I shall discuss a number of these important self-regulation domains in future postings.