Tales from the Therapist's Couch

A man in his late forties has just been describing the dinner party he recently gave at which a woman he is very keen on was present.

A man in his late forties has just been describing the dinner party he recently gave at which a woman he is very keen on was present. At the end of his cautiously optimistic narration of the event, he sighs deeply and says in true Eeyore style: "Oh well, I don't suppose she really likes me. I mean, she probably only agreed to come because she had nothing better to do."

We have been working together for a few months and I am getting used to these self-deprecating stings in the tail. They have become something of a hallmark in the descriptions of himself and his life that he brings to therapy. I have often drawn attention to them, and he has always acknowledged them, but I have never felt that he is really concerned about his pernicious self-mockery. He always delivers it as easily and unseeingly as someone who continues to wear a threadbare, but comfortably familiar, coat that should have been rejected ages ago. And when I suggest that the reasons he initially gave for wanting therapy - because of "feeling unfulfilled and on the edge of life" - might be inextricably bound up with this habit of self-deprecation, he just looks at me blankly.

Self-mockery, which this man has developed to a fine art, is a pervasive trait in the consulting room. When clothed in witty garb it can be seductively humorous. Yet it's also immensely frustrating. Being with people who riddle their conversations with put-downs of themselves leaves you feeling that, at some important level, they haven't been with you at all. Some vital part of them feels hidden. In my last column I wrote about betrayals that we may have suffered from or inflicted upon others. Yet perhaps the saddest betrayal of all is the capacity and habit of self-betrayal, when it becomes second nature to mock our fragile hopes and dreams, and so to hide our light under a bushel.

So what makes some people feel the need to consistently put themselves down? And what effect does it have upon their lives? As the man above recalled his early life, it was clear that there were ample reasons why he had retreated behind self-deprecation in the face of emotional pain. He had been immensely unhappy as a child, and much of his pain had been caused by the mockery of others: his brother, his mother, and later in life a lover. Things that had deeply mattered to him had too often been treated with sarcasm, so he had learnt to hide his innermost hopes and desires. Now, as an adult, he was simply doing what others had done to him: undermining and devaluing his own nature.

One day he brought a dream to a session. It was the first time he had done so and, as so often happens with an important dream, it proved to be a turning point. In the dream, he was standing at the edge of an outdoor pool. It was joined to a river and people were diving into and swimming in it. My patient described how wonderful it looked. Part of him wanted to join in, but another part was afraid. So he stayed by the side, watching.

Images of water are extremely common in dreams, and you don't need a lengthy analytic training to interpret the above scenario as a fear of letting go and embracing life. This certainly seemed to fit with the life situation of my patient, and his feeling of being "unfulfilled and on the edge of life". Somehow, the emotive imagery of his dream enabled him to feel what I had been unable to convince him of with words. He could suddenly see that being on the sidelines and being afraid to join in was utterly connected with his fear of others' rejection, and that continual self-deprecation was simply a way of hiding from that fear. He awoke from the dream frustrated at still being at the water's edge, and filled with a painful sense of his unfulfilled, because unlived, life. It left him hungry for change, and eager to learn how to jump into the pool and swim.

Insight is one thing; grafting it onto action is, of course, a harder task. But what this man went on to show both to himself and to the world around him was that the defences we build up to protect our early wounds are not an essential part of us. With determination, psychological insight and some help from the unconscious, it is possible to understand both how and why we treat ourselves the way we do. It is also possible to change it.

Elizabeth Meakins is a psychoanalytic psychotherapist in private practice. No clinical material refers to specific cases

elizabeth.meakins@blueyonder.co.uk