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Archive for the ‘Intriguing Patients’ Category

I wrote a column a few weeks back on Prince William and Kate Middleton.

I possess no expertise in the British royal family.  I merely stumbled upon an article in a gossip mag comparing the Prince’s girlfriend to his mother, and it provided an excuse to discuss why you might choose a spouse who resembles your parent.

The column became a best-seller.  I still get hundreds of hits each week from a stream of readers fascinated with the British royal family.  I’ve been posted on royal chat sites, Prince William discussion forums, Kate Middleton fan blogs – the works.

It was so popular that now I’m writing another column on the British royal family (or, as I’ve come to know them, Elizabeth, Philip and the kids) to explain why the first one did so well.

You – or a great many of you – are fascinated by these people.  It doesn’t take a genius to see why:  you want to be them.

Everyone does.

That’s because the British royal family are treated like children.  And you want to be treated like a child, too.

How are Elizabeth, Philip, Charles, Andrew, Edward and the others infantilized by their role as royals?

They live the life of a pampered young child.

They do not work – and they do not have to work.

They have everything they could ever want, let alone need, provided for them.

And most importantly:  they have your attention focused on them like a laser beam.

Someone’s eyes are on a small child perpetually – or they should be – making sure he doesn’t get into trouble, and celebrating his every achievement.  A child’s first pair of shoes are bronzed, and his first lock of hair preserved.  His first steps are photographed and met with applause.  Like Louis XIV at Versailles, even his bowel movements are cause for furious activity.  And a young child never has to apologize for demanding so much attention – it is simply taken for granted that it is his due.

William and Kate exist in a similar world.  They can’t go swimming without a paparazzo recording each stroke through a telephoto lens.

That must be just awful (you say to yourself, tut-tutting sympathetically.)  They can’t get a moment’s peace.

And they rebel sometimes, too, don’t they?  Spitting fury when an annoying scandal breaks, an embarrassing revelation about a legitimately personal aspect of their lives which none of us has the least right to know anything about.

At this point they become like teenagers, rebelling against adoring parents – insisting that when they lock their bedroom door they bloody well want mum and dad to stay out and leave them alone.

Poor things.

And yet…you never had that problem…because…it’s a good problem to have, isn’t it?

You never basked in one ten-thousandth the attention – or the adoration – to which William and Kate are subjected on a daily basis.

It must feel like heroin, directly into a vein.  A major rush.  All that attention – directly on YOU.  And you don’t even have to ask for it – let alone apologize for taking up everyone else’s time.

So you fixate on them.  And identify with them.  And dream about winning the lottery of life and actually BEING them.

It would be heavenly, wouldn’t it?

Let’s not kid ourselves, either.  You cannot love people intensely without also being angry at them.  It’s Newton’s Third Law of Motion translated to emotions:  for each and every emotion there is an equal and opposite emotion.

You adore William and Kate.  And you are angry at them, too – because they are receiving what you never received.

You deserve that attention, too.  You always have.  You are just as good as William or Kate, and you know it.

Your anger is expressed as an aggressive sense of entitlement.  You are entitled to photos of them swimming.  You are entitled to juicy bits of gossip about their personal lives.  Fair’s fair – isn’t it?

It all works out in the end.

The royals seem to be doing just fine – and your celebration of them is a way of celebrating yourself.  Lavishing attention on William and Kate (and dreaming of being them) amounts to lavishing attention on yourself because you are dreaming of being them all the while.

That’s why it feels so good.  It’s nothing more than play.

It’s perfectly natural for adults to unwind and relax through healthy regression – playing at being children – just as children prepare for the challenges of life in the opposite way, by playing at being adults.

No harm in fantasizing about being the royals – the most pampered children of all – so long as it doesn’t become an obsession that occupies your every waking moment.  (For most of us that isn’t an issue – it’s just a hobby.)

So go ahead and have your fun.

Imagine what it feels like to step out of that Rolls Royce and into the bursting flash bulbs.

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Watching the most recent Oscars ceremony was a healthy reminder of the most fundamental instinct in human nature – the desire to please.

You want everyone to like you.

Admitting that is a big step towards authenticity.  Because it’s true.

It is also true that everyone will not like you.  Not even such masters of public relations as Bill Clinton and Barack Obama can make everyone like them.  Some people have their own issues – they might dislike you simply for being liked by so many other people.

Why do you want to be liked so much?  It relates back to the evolutionary necessity to please your parents.  A young animal must please his parents in order to survive.  Often, in the wild, where food and care can be in short supply, only the young animal who pleases survives to adulthood.

You crave delighting others because it regresses you into a happy child, secure in having pleased his parents and thus surviving and flourishing.

Even as an adult, you have a place in the back of your mind where everything you do is still directed at pleasing your parents.  That promotion at work, the book you published, the shiny diploma on your wall – there’s some part of you that’s hoping mom and dad will notice, just like those folks up on the stage at the Oscars, thanking their mom and dad.  And you’re watching those people because you enjoy identifying with them – pretending to be them for a few moments of rapturous pleasure in receiving approval.

Some part of you also wants to experience that cliched but endlessly replayed scene from every “feel-good” movie ever made.  It’s the scene where, after a lifetime of commitment and hard work, the unsung hero is finally recognized by…everyone.  Think “Mr. Holland’s Opus” or any of thousands of other cheesy Hollywood films.  Finally, after quietly doing your part to improve the world, you get your standing ovation.  The entire auditorium (or the stadium, if it’s a sports flick) is on its feet, cheering, applauding, weeping with joy – for you.

Moi?

I’d like to begin by thanking the Academy.

The problem with this instinct to please others and seek their approval is that it displaces your source of assurance about your own value onto other people.  They become the arbiters of your value as a person.

It’s lovely to receive accolades – the little kid within you dances for joy.

But the judgment of others cannot become a referendum on your value as a human being.  An adult needs to look within himself for approval.  And you can only achieve that approval by becoming your best self.

That means staying conscious of who you are at all times, and checking in to be certain it is your most authentic identity, the person you want to be – the person you can look back on afterward and be proud of.

Your respect for yourself must be earned.

The respect of others is nice, but it can be fickle.  Back in 1985 , when Sally Field won the Oscar for Best Actress for “Places in the Heart,” after having won in 1980 for “Norma Rae,” she didn’t actually say “You like me, you really like me” – although that’s what she’s remembered as saying, and that’s what she still gets made fun of for saying.

Here’s what she actually said in 1985: “I haven’t had an orthodox career, and I’ve wanted more than anything to have your respect. The first time I didn’t feel it, but this time I feel it, and I can’t deny the fact that you like me, right now, you like me!”

Perhaps it was her putting it so bluntly – telling the audience that they liked her – that made them flinch, and change their minds, and switch to making fun of her.

Sally Field probably realized once and for all in 1985 what will always be true – that you must look within yourself for the approval that matters. No one else – not even your parents – can satisfy your craving to be accepted as the person you truly are.

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My patient sounded bewildered.

“It was like I was watching myself going through the motions – repeating the same old pattern.”

He’d just broken up for the umpteenth time with a woman he’d been dating for over a year.

“It’s always the same thing.  I do something nice for her.  Then she tries to do something for me, but I freak out, and insist she doesn’t like me.  Then I do something mean, like flirt with someone else in front of her, just to prove she doesn’t like me,  and she gives up and we break up again.  So we’re back where we started, and I do something nice again, and off we go.  Eventually, even the women who hang on give up.  Then I find someone else and start over.”

He was caught in an endless loop – around and around and around.  The same thing had played out with every women before this one.

Freud might have called this a “repetition compulsion.”  I’ve heard other therapists refer to it as a “learned behavior.”

Whatever it is – it’s very common.  Left to your own devices – in other words, acting unconsciously – you will keep doing the same thing over and over again.

What you’re doing is replaying a pattern you learned as a child – clinging to it because no one has woken you up and made you ask yourself what on earth you’re doing.

My patient’s father was a frustrated scientist, trapped in a humiliating job, deeply insecure, very unstable.  My patient tried to please him by doing well in school, winning science prizes, trying to be the son he wanted.

Initially, the father would seem pleased and proud.

Then, once my patient allowed himself to relax in his father’s acceptance, disaster would strike.

The father would swing back into a frustrated rage – and take it out on his son.

It probably had nothing to do with the boy – it was the father’s own anger at his work situation – but the effect was devastating.

The pattern played out over and over again.  The son would over-achieve, and believe he’d won his father’s approval – then, as he relaxed into acceptance, the old man would turn on him with vicious criticism.

My patient learned it was okay to give his father – or any person – what they wanted.  But he could never relax and let down his guard.  That’s when the inevitable turn-around came.  He expected it – and braced himself for it – so he’d never again get caught by surprise.

You’ve probably heard of “Pavlov’s dogs.”

Ivan Pavlov was a Russian psychologist who performed a series of experiments on dogs at the end of the 19th century.  One of his chief discoveries was the “conditioned response.”  When a dog – or a person – is trained through repetition to expect an outcome from a certain set of variables, it is difficult to un-train that expectation.  It becomes a reflex.

Pavlov trained his dogs to expect to be fed when he rang a bell.  Eventually, just ringing the bell would make the dogs salivate, as they came to predict food was coming when they heard it.  The bell and the food were firmly linked in their brains.

That’s what happens with people when they get stuck in a loop, like my patient.

He learned he could please his father briefly, but his father’s acceptance would soon be followed by a mood reversal and attacks.

Now, with his girlfriends, he once again sought to please, but then shut down.  He was certain the old pattern would play out, so he refused to let them get close.

The problem was obvious: my patient was not a dog – and his girlfriends were not his father.

The instinct that once protected him from the pain of his father’s rages now sabotaged his chances at a healthy relationship.  To shed this old conditioned response, he needed to become aware of it.

A psychotherapist doesn’t change you.  He creates awareness.  If I show you a pattern of behavior that’s not working for you, you’ll figure out how to change it on your own.

If I tell you that you’re standing in a pot of water over a fire, you’ll jump out of the pot.

I show you the situation – you handle the fix.

There’s something psychotherapists call “the observing ego” – it’s like a little guy who sits on your shoulder and watches you from the outside.  He represents self-awareness.

My patient was developing an observing ego.  He kept having “deja vu” moments.  He’d been down this path before, and he knew it.

Now he wanted to change the old pattern – and try going someplace new.

I’ve worked with enough patients over the years to recognize that human beings are flexible – they change.  When I meet someone I haven’t seen in a long time, I suspend expectations, because I know people are moving targets.

You can change, too.  You don’t have to walk in circles forever.

If you spot a pattern that feels like a loop, take a turn and head someplace new.  At least you’ll know it’s really you at the controls – not one of Pavlov’s dogs.

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Sarah Palin’s nickname in high school was “Sarah Barracuda.”

Supposedly, this reflected “her competitive streak.”

Charming.

How did this happen?  How does a child grow up with a grasping nature so extreme that she becomes nicknamed after a vicious carnivorous fish?

There aren’t many clues in Palin’s early biography, which reads like a carefully pruned and polished star cheerleader’s resume…which, of course, it is.

Sarah was born the third of four children.  That’s our one clue.  Perhaps she had to compete for attention with older and younger siblings.

At some point in Sarah’s life – I’d guess the first five minutes – she decided there wasn’t enough out there for her.  At least, not enough out there for her if she was going to share any of it with anyone else.

Maybe it was a sense of poverty.  Maybe the Palins were poorer than their neighbors.  Or maybe competing with those siblings was enough.  But somewhere during that childhood, profound feelings of deprivation developed in Sarah’s psyche, and a famine mentality set in.

After that, all we can do is sit back and watch a mighty appetite gobble everything in its path.

When people are subjected to a severe deprivation, like a famine, they hoard and deny others and generally act in ways they aren’t proud of.  During the famine in China that occurred as a result of Mao’s Great Leap Forward campaign in the late 1950’s, widespread starvation led to cannibalism among the rural peasantry.  Hunger can drive people to do terrible things.  They can turn vicious.

A bit like a barracuda, tearing off hunks of flesh to gulp down its maw.

A bit like Sarah Palin.

Here’s a charming quote from the Barracuda herself:  “I love meat. I eat pork chops, thick bacon-burgers, and the seared fatty edges of a medium-well-done steak. But I especially love moose and caribou.”

The mental image is of a gaping mouth, with sharp teeth.

How about her politics?  Could they even be considered politics?  Mostly, it boils down to Sarah, Sarah, Sarah – and making money for Sarah.

She quit her job as governor to give speeches to the highest bidder, write a book and work on tv – all for enormous sums of cash.

She was willing to speak (and no doubt thrill and inspire) the Tea Party wackos – for many, many thousands of dollars.

Even when she was working for John McCain, it was clearly all about Sarah – her expensive clothes, her big family (she has five children), her gigantic super-church, her enormous state – even the humongous “big box” stores she enticed to the little town of Wasilla to replace its now-moribund downtown.

Something in Sarah’s background left her feeling hungry – deeply hungry – and she is still grabbing up everything at the table.  Her “politics” are a philosophy of greed.  She can get married – but gay people can’t.  She doesn’t want to pay taxes – even to help other Americans survive.  She’s got her healthcare – if you don’t have yours, well, tough luck.  She’ll drill for every drop of oil in a nature sanctuary until her giant SUV is purring like a kitten, slurping it all down, belching, and demanding more. Immigrants can stay out – this country is Sarah’s, securely stolen from indigenous peoples and guarded with guns guns guns and more guns, wonderful guns.  Sarah doesn’t like government – she wants to go it alone, because she’s got hers, and you can worry about yourself, thank you very much.

Sarah wants to get a gun and go out in nature and kill something beautiful and devour it.

A couple more charming quotes:

“If God had not intended for us to eat animals, how come He made them out of meat?”

“I always remind people from outside our state that there’s plenty of room for all Alaska’s animals – right next to the mashed potatoes.”

Sarah is a predator.  She’s earning a lot of money chomping her way through a frightened minority of mostly older, white Americans who are terrified of the future and will buy all the double-cheeseburgers, super-size fries and giant cokes they need to maintain a secure perimeter of human fat cells.  Hunkered down in their gated retirement communities, clinging to their beloved guns, they crouch by the glow of their wall-size flat-screen plasma tv’s and defend what’s rightfully theirs – which is to say, everything.

Sarah represents insecurity in love.  Somewhere along the way, early on, she decided there wasn’t any love out there for her.  So she had no love to spare for anyone else.

Kill or be killed.  Eat or be eaten.

There’s room for you next to the mashed potatoes.

That’s the barracuda’s creed.

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The other day, I was listening to a patient explain to me why he was ugly and no one could possibly find him attractive.

This was news to me, because so far as I could tell he was a very handsome guy – film star handsome.  It was a puzzling case.

Let’s talk about beauty – plain old physical appearance.

The first steadfast rule is summed up by the old cliche – beauty is in the eye of the beholder.

If you’ve never thought about what that really means, let’s do it here.

The fact is there is no standard for beauty.  That’s a myth.  The gossip mags and entertainment shows on television hold up one star after another as the ideal, but it’s not true.  Only you decide to whom you are attracted, and your taste doesn’t have to match anyone else’s.

Different eras have held widely varying ideas about what is beautiful.  Even now, Americans are only beginning to open their eyes to the beauty of different ethnicities whose images were almost entirely absent from the popular media for centuries.

Just as you have a right to decide whom you think is beautiful – other people have that right, too. And it is quite possible someone might decide his ideal of beauty is…you.

My patient had been told by various people that he was handsome, and some had even attempted to pursue him, but he’d always dismissed their interest.  He couldn’t accept that other people didn’t see what he saw when he looked in the mirror:  he was too short, had bad skin, bad teeth, a bump on his nose.  Even as he enumerated these terrible flaws, I strained to see what he was talking about.  I looked – and saw a handsome guy.

The problem wasn’t with how this guy looked.  It was with the messages he was given as a child.

His parents had him when they were very young, and their marriage soon broke up.  The father, caught up in a nasty divorce battle, fought for custody of my patient and won it, only to dump the boy on resentful relatives.  My patient grew up receiving the message that his presence was a nuisance – that people wished he wasn’t there.  He learned that he was nothing special – certainly no one whom anyone would notice or be attracted to.

My patient went on to succeed in his career, against the odds.  Despite his parents’ disinterest, he worked hard in school and rose to an impressive position in the business world.  But he still felt ugly – nothing special.  His physical appearance became a container for all the feelings his parents put in him about himself.

In our session, I reminded him that his parents were old now, and far away – he hardly saw them anymore.  Nowadays he was the one in charge of parenting the little boy inside him.  And he was doing a lousy job of it.

I asked him when he first became ugly.

He shrugged.

I asked him whether he was ugly back when he was a little boy.   Was he ugly at 6?  At 10?  At 12?  When did the ugliness first arrive?

He shrugged, and said he’d always felt that way.

I asked him if there was such a thing as an ugly little boy.

He said, no, probably not.

So were you ugly when you were 7?

He said he didn’t know – probably.

I said of course not.  There is no such thing as an ugly 7 year old.  In fact there is no such thing as an ugly child.  No child is ugly because every child is unique and beautiful.

So why are you treating this child with such cruelty – telling him such terrible things about who he is?

The messages my patient was addressing to his child were the same ones his parents sent him.  A psychotherapist calls these messages “negative introjects” – voices that were put inside you as a child, messages that keep playing years later, like:

You are a nuisance.  You are nothing special.  You are always in the way.  We wish you weren’t here.

I asked him to create some healthier messages for his child self.

He looked at me blankly.   Like what?

Well, let’s pretend your mother wasn’t absent from your life when you were little.  Let’s pretend she took you up in her lap when you were a boy and said something like:

You are my little one, my precious little fellow.  You are handsome and good and you make me proud.  You are my boy, my special boy.  You are beautiful.  You are my treasure.

Tears started to run down my patient’s face.

She never said anything like that.

I know.  But you can say it.  You don’t have to feel ugly.  There’s nothing ugly in you and nothing ugly about you.  You deserve love because you are beautiful.  Inside and out.

Please don’t tell your child he is ugly.  He isn’t.  He’s you, and he deserves your love, so he can learn to accept love from the world outside.  It’s critical to his happiness.  Please be a better parent to that little child.

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Children need a lot of attention.  When they don’t get it, they’ll often act out – misbehave – in a desperate attempt to be paid attention to, even if the result is negative attention.

I had a patient who used to vomit frequently as a child.  It became an unpleasant regular event during family meals – but he managed to distract his mother for a few minutes.  Even if she was cross and impatient with him, at least she was paying attention.

Scott Brown, the newly-elected US Senator from Massachusetts, grew up in a family where there wasn’t much time available to devote to raising children.  His parents divorced when he was an infant, and both the mother and the father have since remarried three times each.

Scott’s mother was living on welfare at various periods during his youth, and Scott sometimes ended up getting shipped off to live with his grandparents or his aunt.  He had siblings, too.  My guess is there were enough other children around to consume whatever time was available for Scott.

How did the young Scott Brown respond to this situation?  He acted out – badly.  By the time he was 12 years old, Scott was arrested for shop-lifting from a record store and brought before a judge.

This is where things get interesting.  Brown’s story is that the judge, Samuel Zoll, shamed him by sentencing him to write a 1500-word essay on how his siblings would feel watching Brown play basketball in jail.

The People’s Therapist suspects something else happened, too.  Scott had finally forced a father figure – Judge Zoll – to pay attention to him.

That’s why he stole from the record store in the first place.  He didn’t need records.  He needed a parent-figure’s attention.  And he got it – even if it was negative attention.

From that point on, we see a string of events suggesting that grabbing attention – even negative attention – became an unconscious impulse in Brown’s life.  Here are a few examples that jump out at you:

1.  Posing nude for Cosmopolitan Magazine as a law student;

2.  Using the “F-word” as a State Senator during a debate on gay marriage at a high school; and

3.  Presenting his daughters, Ayla and Arianna Brown, as “available” (whatever that was supposed to mean) during his acceptance speech for the US Senate.

The biggest attention-getter of all was politics itself.  Brown seemed to run compulsively for everything there was to run for, from Property Assessor to Selectman to State Representative to State Senator.

This latest campaign, for the US Senate, was an even bigger attention-getter, and once again, it was negative attention. Brown’s role was the spoiler.

Teddy Kennedy, a legend in the Senate, devoted much of his life to fighting to guarantee decent healthcare for all Americans. On the cusp of achieving this goal, Kennedy died after a courageous battle with brain cancer.  Brown’s job?  To get elected on a wave of Tea-Party cash, so he could shatter Kennedy’s dream.  Brown had to get elected so he could be the 41st vote that would allow the small Republican minority from mostly under-populated states, representing an even tinier minority of Americans, to abuse the filibuster rule and destroy years of hard work by blocking healthcare reform.

We can only hope a father figure – perhaps President Obama could fill in for Judge Zoll? – will arrive to give Brown the attention he needs.  Maybe he should be forced to write a 1500-word essay on how his siblings would feel watching him destroy a chance at decent, affordable healthcare for millions of Americans.

This country has had enough of angry little children in positions of authority.

We need leaders who can behave like adults – who win our admiration for what they achieve.  We do not need another attention-grabbing miscreant who will stop everyone in their tracks by throwing up at dinner.

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The People’s Therapist was working out at the gym on the elliptical trainer the other day when he realized he’d come to the end of an issue of The New York Review of Books – his customary cardiovascular/literary fare.  In desperation, I reached for whatever other reading material happened to be lying around, and discovered a deliciously tacky gossip mag.

Flipping open at random, I found myself confronted with a headline about Prince William, the future king of England.  Apparently, he’s got a new girlfriend – Kate Middleton – and the rumors are that she’s “just like his mother, Princess Diana.”

What caught my psychotherapeutically-inclined interest was how commonly this trope – marrying someone like your parent – emerges in popular culture.  It’s so unremarkable that we take it for granted.

But it raises an interesting question:  Why does it seem like people really do choose partners who are just like their parents?

The answer relates to how you adapt, as a child, to your early environment.

One of the patients I saw this week, for example, grew up with a father who was extremely narcissistic.

When I use this term, I don’t mean it in the sense of merely being egotistical, but in the Freudian sense of being unable – like Narcissus in the Greek myth – to see past his own reflection and realize that others have separate needs and concerns.

The whole world, for this woman’s father, was about him.  He sucked up all the attention and ignored everyone else’s needs.  His wife – my patient’s mother – fell into a caretaker role, appeasing and placating him.  When dad had one of his rages, mother and daughter ran around doing whatever it took to calm him down.  Their own needs were ignored.

My patient evolved behaviors to handle living in an environment with a narcissist – mostly running around doing everything for him and always letting him have his way.  When she grew up into an adult, she went out into the world expecting to find another narcissist for a partner.  That would feel familiar, and almost comfortable, since it was what she was used to – it matched the skills she’d adapted as a child.  She knew everything there was to know about handling a narcissist – dating anyone else would bring fresh challenges she wasn’t sure she could handle.

Sure enough, later in life, my patient found herself dating guys just like her dad – high-maintenance guys who demanded all her attention but never seemed to notice her needs.

It’s as though my client – and perhaps Prince William and everyone else – adapted to an environment the way an animal evolves.  If you live in a pond, you evolve web feet.  Once you have web feet, you expect to live in water, because you aren’t much good anywhere else.

But humans aren’t ducks, and the strategies you adopt to survive in your childhood environment don’t have to become permanent physical characteristics.

Children have little choice but to adapt to their environment.  They don’t control much of anything – they need to adapt to survive.

But adults can choose the environment in which they wish to live, and they can shed an old adaptation if it becomes self-sabotaging.

My client didn’t have web feet, and she didn’t have to live in a pond.  She could change, and choose a new environment that better suited her adult needs.

That meant she could stop dating men like her father, and ask herself who she really wanted in her life.  It also meant she could learn new adaptations to address this new sort of person.

For someone used to placating and pleasing a narcissistic tyrant, it was an adjustment to meet someone calm and relaxed and caring – someone who expected a balanced give and take in a relationship.  My patient had to remember not to do everything for her new boyfriend, and to enforce her own boundaries as well as respecting his.

It was all rather new, and a bit scary – like a duck acquiring new feet and learning to live on land.  But she caught on fast.

Prince William, for his part, might choose to marry someone like Princess Diana, or he might not.  His mother may well have been a lovely, giving person and the perfect model for a mate.

The key is that the prince be aware of his unconscious adaptations and ask himself what he, as an adult, truly desires in a partner. He’ll never find what he needs marching blindly into an old pattern simply because it feels familiar.

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