In thinking about the new videos on psychodynamic psychotherapy I plan to do, it came clear to me this week that an early focus of treatment with many clients is helping them to recognize the internal saboteur at work. Some people begin therapy highly aware of their “internal critic”; others suffer under its harsh regime but aren’t conscious of the saboteur operating behind the scenes.

As I said to one of my clients this week, “The cruelty is so pervasive and unnoticed that it’s like the air you breathe.” One of the videos should be about this issue — helping clients “tune in” to their superego as a first step in challenging its dominance.

Sarah, in particular, struggled with this idea and said she was having a hard time grasping it — that there could be a force inside of her that keeps her down, chokes off her voice, stops her from doing the things that matter most to her. I tried to link for her (1) the narcissistic mother who envied and sabotaged her as a teenager, (2) her subtle forms of self-sabotage; (3) the way she hears my interpretations as if I’m dismissing or discounting what she consciously says as being unimportant, and (4) her night terrors, where she’s afraid there’s something in her apartment that wants to kill her.

It feels as if she’s completely under its thumb; I used the analogy of someone living under a cruel and repressive regime who has never experienced freedom. It will take more time before this idea comes fully alive for her. It must be so frightening and painful to recognize that the killer is inside and not out.

This issue also came up in Phillip’s second session this week. Like many people familiar with the tenets of cognitive-behavioral therapy who have read a lot of self-help books, he thinks in terms of mistaken beliefs or habits of mind, learned from his harsh and judgmental parents; I’m trying to help him instead to see how those parents are alive and well and living inside of him now.

Right away, he seemed able to connect this idea to the ongoing internal criticism. CBT might focus on changing belief systems or automatic thoughts; psychodynamic psychotherapy (at least the way I practice it) tries to shed light on the living people inside of us (our internal objects) and how they may actively observe, criticize and sabotage us on an ongoing basis, often without our even noticing. Hearing the voice and identifying the enemy is the first step. Learning to stand up to the saboteur is the work of many months.

As always, I was reminded of Dr. P and how he used to quote Thomas Jefferson to me: “The price of freedom is eternal vigilance.” Getting free of domination by a cruel and destructive superego takes a lot of hard and relentless work. I love that quote from Jefferson — so apposite for the kind of work we do.

Girl with barbed wire photo available from Shutterstock.