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Ron IIHere’s a story from a bit later in treatment that also illustrates this logical approach to treatment as well as how you can tell if treatment is working. Ron eventually developed a rather solid relationship with a new girlfriend. He found he was telling her things about himself he’d never told anyone except me. He was openly discussing his treatment, his anxieties, his struggles with his "demons". These were completely taboo subjects for him in the past, and quite a change from his previous retreat behind the one-way fog. He was happier with her than he’d been with anyone and felt better than he could ever remember feeling. But one day he came in and asked me why he felt so driven, just as this relationship was becoming so rewarding, to go out and sleep with every woman he could get his hands on. He said, "I think I want to push her away". Well, this bit of analysis was pure speculation, and it doesn’t even make much sense. You can push a woman away without running to all the others. It also does not account for Ron’s degree of anxiety, the driven quality to his philandering. Most telling, however, was his next answers. I asked him, "Does that (his analysis of his behavior) ring true?" He decided it did not. So I didn’t even have to go into my reasons why this analysis of his was not plausible. I then asked him to think about exactly what he feared in being close to his girlfriend -- feared in fantasy, because in reality there was of course nothing to fear. This woman was not about to leave him or "turn psycho". He thought a moment and then said, "abandoned, desolate, empty, having nothing, and I’ll close up forever". I asked did this statement ring, and his answer was a resounding "Yes! Big time; I can feel that." These thoughts resonated with Ron; they "clicked"; they felt right to him, like accurate descriptions of his inner life, his experience, his self. This is data one can never argue with; and compare it to his tepid reaction when I asked if his original hypothesis resonated in this way. This "abandonment" interpretation makes sense from the outside as well. As a child Ron really was "abandoned, desolate, empty, having nothing" when he was left in those parking lots. It seems plausible that the fear of repeating that horrible experience surfaces when, after all the years of keeping a distance, he finally becomes intimate with someone. Further proof that we are on the right track is the flood of thoughts, feelings, and memories that gushed out of Ron, all from this insight into how he felt about his girlfriend. He recalled incidents in childhood and beyond when he felt similarly desolate, empty, and isolated, similarly desperate for but hopeless to obtain comfort and reassurance. He realized how constant the fear of such feelings was in his life, how it affected our interactions in session, his friendships, his relationships at work, and more. He realized he was keeping everyone at a distance because of a fear that he would be left high and dry, awash in these old agonizing feelings, just as actually did happen with his family. Finally, the real proof is in the change. Ron no longer needed to frantically chase women, he began to enjoy the relationship with his girlfriend, and he was much more relaxed with friends, me, and his job. In fact, his performance evaluations reflected this change in that they no longer reported him being "distant and insufficiently engaged".
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