Howard was a retired sixty-seven year old senior, twice divorced without any close family despite having four siblings; he was boarding with his niece and her family who were openly displeased with his presence. His therapist constructed a genogram to help understand the family dynamics; his family of origin were completely disengaged from one another, Howard was cut off from two siblings and the sibling whom he shared a healthy relationship joined a cult. Furthermore, Howard was the product of immigrant parents who moved away from their extended family to pursue financial business opportunities in another state; their business venture failed and forced his mother to work in order to make ends meet in addition to absorbing the violent outbursts of her frustrated husband. Howard and his siblings had difficulty forming cohesive friendships which continued into adulthood.
The early attachments in life provide a person with the confidence and resilience necessary to succeed both in their interpersonal relationships and professional life. This patient did not have the secure attachments from his nuclear family since his father was abusive toward his mother, he and his siblings; therefore, he and his siblings were unsuccessful forming friendships in school and maintaining a stable marriage. The therapist assessed the client for a few months and noticed that he sabotaged every attempt to find a job or potentially meet a woman; she explored his actions which speak louder than words and refused to discuss his favorite subjects, opportunities for meeting women and potentially interesting volunteer opportunities. This technique forced the client to face his insecurities and address his underlying problem, fear of rejection which narrowed down treatment to overcoming his fear. Howard’s fear kept him frozen and immobile due to his traumatic youth; therefore, the therapist needed to reframe rejection as a less formidable experience.
Metaphors are a means of using analogies to help reframe difficult situations or fears so that they are manageable. The therapist used the metaphor of climbing a mountain which is the metaphor for success; she asked the client what the major difference between the people who stand at the bottom of the mountain and the people who are on top of the mountain. The people on top of the mountain accepted that falling was the price to pay for climbing the mountain while the people at the bottom of the mountain were afraid of falling. The people who stand at the bottom of the mountain envying the courage and success of the people who are standing on top of the mountain were afraid of falling and are unable to taste the joy of their accomplishments after investing hard work and suffering many falls. The adage, “Every stumbling stone is a stepping stone” describes the objective of this metaphor.
The therapist elaborated on the concept of secure attachment providing the people on top with the necessary confidence needed to protect themselves after falling to pick themselves up and resume climbing the mountain. They are not hungry for approval since they enjoy the supports of their attachment figures that provide them with the unconditional love that allows them to perceive failure as the necessary price for success.
The sessions that ensued allowed Howard to internalize the reality of failure; it is an uncomfortable reality of achieving a goal. Failure should be seen as a well meaning friend who is correcting a person’s errors; a wise person who is ambitious will accept this friend’s advice without being insulted. However, a sensitive person who is intimidated every time anyone tries to help him since he fears disapproval will resent this well intentioned friend.
Howard was able to internalize these lessons; he gradually participated in singles events and actively pursued women he found interesting. His therapist helped him analyze rejections; many rejections were due to the insecurity of the other party who enjoy being a tease and are not interested in a serious relationship. These sessions helped Howard be more objective and less vulnerable since his clinician’s unconditional positive acceptance that was missing in his formative years became the buffer he needed to accept rejection. Howard is presently involved in a relationship and volunteering in the community as a photographer for charitable events where he enjoys using his hobby to help his community.