Tales of a Troubled Childhood
One afternoon I received a telephone call from an anxious young man in his mid-20s. He wanted to see me for counseling regarding a relationship problem. I asked him the typical scheduling question - "Tell me what might work for you in terms of availability?" His response was "How about in an hour?"

Fortunately, his urgent request worked for me. Alex was a massive-sized former Big-10 football player who came for the first time to therapy to find answers to his problems. After getting comfortable in my office, he said, "I'm so upset because my partner just broke it off with me; "She says I'm too intense - she's probably right."

I never had a chance to respond to his presenting problem. Without taking another breath, he continued - "And my father died suddenly." - "I'm sorry to hear about your losses - "How long ago was your dad's death?" "He died of a heart attack 15 years ago and it was devastating." The tears started flowing. “Do you think there's some connection between my two losses?"

Is there a Relationship between a Perilous Past and the Present?
Such wondering about one’s troubled past and the present was validation of what I had discovered from other patients. That is, that troubled childhood experiences have a significant impact on adult functioning, including relationship wreckage.

Many adults from troubled childhoods want to know, "Why do some adults remain mired in the turbulence of adverse childhood experiences, whereas others are able to navigate the problems of family history and lead productive lives?" Through my clinical practice and writings, I have sought to answer this question in a meaningful, hopeful manner.

After the death of Alex’s father, the dynamics and energy within the family system dramatically shifted. There was no mourning, grieving and no exploration of the family's loss. His mother turned inward, becoming self-absorbed and avoidant and compulsively buried herself in work – she never grieved. All three children took their cues from mom, and chose to suppress their feelings, creating a conspiracy of silence. Alex learned to care-take for his emotionally absent mother by being compliant, trying to make her happy, and seeking to minimize the significance of everyone's grief.

What is the Magical Illusion of Childhood?
This is how many kids cope in response to adverse childhood experiences. After his father's death, Alex began performing to please in order to gain the validation and love of his emotionally frozen mother. Ultimately, when his mother's emotional availability was not forthcoming, and his needs were unmet, he unknowingly came to a conclusion - "I guess there's something wrong with me, I must be unlovable." By internalizing the dilemma, Alex could assume the blame and let his mother off the hook. Alex began to feel defective. Kids from troubled families typically carry a magical illusion and believe that somehow, in some way their parent will morph and become the loving, nurturing person they have always yearned for. Alex longed to have his family back the way he once envisioned it.

What are some Unwritten Family Interpretations?
It was my responsibility to help Alex to process his past so that he could make sense out of his present troubled relationship. After his father's death, there were a number of unwritten rules that governed his dysfunctional family system. These interpretations were:

1. I must behave admirably at all times
2. It is my obligation to take care of my mother
3. The family appearance that all is well is more important than my feelings
4. I must avoid conflict at all times
5. Life must always be taken seriously
6. If I deny my grief and loss, it'll go away
7. If I don't watch my step, someone or something could hurt me

These underlying assumptions derived from childhood adverse experiences affected Alex's closest relationship - an intimate three-year connection with his partner.

What are some Personal Qualities, Borne out of a Troubled Past that create problems in the here and now?
Here are some personal characteristics that led to Alex's relationship wreckage that were fostered by adverse childhood experiences:

1. The inability to be assertive
2. The need to take life too seriously
3. Emotional mood swings due to unresolved grief
4. A lack of emotional expressiveness
5. Trying to fix others problems
6. Self-preoccupation
7. Poor boundary setting
8. Social anxiety
9. Idealizing a relationship
10. Being overly-responsible for problems

What is the Backdrop of the Patient's Problem?
Alex and his partner lived together in an apartment that he was renting and paying for. Alex had moved to Arizona from the Midwest to commit himself to Tammy. Frustrated and shocked, he was faced with a mate who suddenly confronted him and said she was finished. However, she wanted to remain friends with Alex, stay in his apartment indefinitely until she could find a new place. She was reluctant to move in with her parents, because it was inconvenient for her. She invited Alex to Thanksgiving dinner with her parents in order to maintain civility and reduce her guilt. Alex was devastated by the loss of Tammy and was conflicted about continuing to share living space with her in his apartment. He put up with it because he was still hoping that he could win her back - the worse she treated him, the more he was determined to change her mind – he kept trying to please her, maintaining an illusion that she would go back to the way things were.

The Key to Change is processing the Past
In order to change our adverse childhood experiences and the impact on current behavior, we must process the past. Most people with troubled childhoods either avoid the past through mechanisms such as intellectualizing, by keeping overly-busy schedules, or numbing out through self-medicating. Others choose to deal with the past by victim-posturing through self-pity and blaming others rather than taking responsibility for their own behavior.

Processing adverse child experiences is the key to a hopeful, productive life - processing entails facing the full emotional impact of the way things were and the way things are. Courage is a quality that Alex needed to address his issues. After all, he had three losses to grieve - the finality of the death of his father, his mother as he once knew her, and the woman he dearly loved.

With much support and encouragement, he accomplished this task. He did what was necessary – he learned to accept life they way things were – he grieved and mourned his losses – he released them and began to reframe his thinking in the here-and-now - his grief work helped him come to terms with all that had gone wrong. As he felt more empowered, he began making other changes:

1. He set more appropriate boundaries with his mother- more emotional detachment from her distressful feelings.
2. He let go of false hope for his partnership and gave her an ultimatum to leave
3. He began asserting himself with others, and quit allowing others to control and manipulate him
4. He began listening to his own voice and gave up the burden of owning other people's feelings
5. As he reinvented himself he began looking to the future with hope and confidence
6. He became more emotionally expressive with others, learning to feel empowered yet vulnerable when appropriate

Specific Strategies used to Assist Alex
Alex and I worked on specific strategies to modify his thinking and behavior in the present. We worked on cultivating unexpressed emotion, reframing negative thinking and modifying underlying interpretations. Some examples of strategies we used are:

1. Cultivating unexpressed grief. Write a letter that you do not deliver.
2. Teaching assertiveness skills – Exploring styles of relating, including passivity, aggressiveness and his right to express his needs and wants
3. Identifying cognitive distortions - Are you personalizing events? Do you accentuate the negative and minimize the positive? Do you “catatrophize” about difficult situations?
4. Reframing underlying assumptions/thoughts. "I must perform admirably at all times. - It's okay to be less than perfect. I must avoid conflict at all costs. Confronting conflict is empowering and necessary to managing relationships.
5. Rationally responding to distortions with a reasonable appraisal - "Where is the evidence that this problem is so awful? What's the worst thing that can happen?"
6. Providing homework assignments with accountability

“It’s not your Fault”
In my practice, when I tell a patient that their traumatic childhood experience was not their fault, it is powerful. When I tell them they had no control over what happened to them as a child, the healing begins:

1. It never was Alex's fault that his father died of a heart attack
2. It never was his fault that he was shielded from the details of the death
3. It never was his fault that his mother insulated herself in response to her loss
4. It never was his fault for not having the guidance and support of a father during childhood
5. It never was his fault for having a mother who need to be nurtured
6. It never was his fault for the emptiness, depression and anxiety he experienced within his home
7. It never was his fault that he was unable to take the risk to share his feelings

With the relief that it never was about them, comes the reality and responsibility for adult victims to process the past, picking up the pieces toward a more meaningful, productive life. This is the hopeful message we must provide in helping individuals release their troubled past, finding more adaptive ways of living in the present.

Note: This case is a composite drawn from my practice as a psychotherapist. It has been altered to protect the individual’s right to confidentiality and privacy.