How to live with a neurotic

Dr. Albert Ellis October 26 1957

How to live with a neurotic

Dr. Albert Ellis October 26 1957

How to live with a neurotic

If you are married there’s at least one chance in five that your husband or wife is emotionally disturbed. Here a recognized authority offers advice on

Dr. Albert Ellis

One of the most frequent questions asked by my patients and acquaintances is, "About what percentage of people would you say are neurotic?” I generally reply, "Roughly, about a hundred."

I'm not entirely serious about this. From an ideal standpoint, anyone is neurotic who is potentially intelligent and capable but who actually falls below the level of his capabilities and behaves in a needlessly over-emotionalized way. In this sense, virtually all of us are more or less disturbed.

From a more practical standpoint, however, psychologists usually label as "neurotic" only those individuals who sooner or later get into rather serious difficulties of their own making. In this sense, I would say (and this, frankly, is a rough guess) that between twenty and thirty percent of our citizens are neurotic.

This means, if I am correct, that millions of people on this continent are more or less troubled and many are so disturbed that even the untrained layman can sense this from their everyday behavior. The question is: What, if anything, can be done? Assuming that you are not too neurotic yourself, and that one of your close relatives or associates is, what can you do to live comfortably with this troubled individual and to try to help him over his difficulties?

To illustrate what often happens when a relatively well-adjusted person is closely associated with a seriously disturbed individual, consider the cases of two troubled people who happened to consult me on the same afternoon.

The first was a woman of thirty who had been married for six years continued on page 74

Continued from page 30

“The most important requirement ... is a concept the emotionally disturbed person can be helped”

and whose husband, while not doing anything outlandish or negative, had given her no money during this time. He paid the rent and food bill, sat at home with her reading the paper when he was not at a meeting of one of the many organizations to which he belonged, and had intercourse with her about once a month. Otherwise, he did nothing to earn the name of husband. Vet, when I spoke to this husband he could see nothing unusual about his marriage, could not understand why his wife was so unhappy, and sincerely believed that theirs was a comfortable, fine relationship.

The other client was a fifty-year-old man who had been married for twentynine years and whose wife, during all this time, had confined herself to their home. She maintained friendly relations only with her mother; had sex relations with her husband about four times a year; and insisted that she was an excellent wife because she never missed cooking a meal or taking her husband's dirty clothes to the laundry. She, like the husband of my first client, was obviously a seriously disturbed woman who was so fearful of doing anything outside a very simple, rigid routine that she had no idea about what a good marriage should be.

In both cases the problem was what the more normal spouse should do. I explained to both of them, as soon as I realized how disturbed their mates were, that they had essentially three choices: 1, seek a divorce or separation; 2, see that their spouses received psychological treatment; 3, continue to live with their untreated mates and learn to adjust to these mates’ disturbances.

Usually, in cases like this, the first of these three alternatives is undesirable or impractical, since separation or divorce, especially when children are involved, usually means hardship and heartache. The second alternative is desirable but often impossible to achieve, because the disturbed mate will in many or most instances absolutely refuse to go for treatment. Consequently, the third alternative, that of living with a neurotic and avoiding being driven to the brink of despair oneself, is the one solution that is both desirable and practical.

When the person who comes for professional help wants to try this third solution, I have developed a technique of teaching him or her exactly what has to be done in order to live successfully with a neurotic.

In the case of the thirty-year-old woman, for example, I was able to show her that her husband was an exceptionally frightened, insecure person who had been seriously hurt in his relationships with his mother and two previous girl friends and who, consequently, was loathe to become emotionally involved with anyone else for fear of being rejected and hurt again. When his wife understood this, and persisted in giving him all possible warmth and security in spite of his coolness, he gradually warmed up, committed himself to the risks of emotional involvement, and became a more devoted husband.

The case of the fifty-year-old man was not so easy to resolve. His wife proved

to be a borderline psychotic who barely maintained her hold on reality by existing on an exceptionally restricted plane. She didn't want to be helped psychotherapeutically; and even consistent kindness and devotion by her husband were not sufficient to unthaw her. He had to be adjusted, finally, to accepting her as she was and understanding that she was terribly sick. His choice was only twofold: separating from his wife or accepting her with her severe mental illness. He did not wish, partly for religious reasons, to take the first choice. To save his own sanity, he took the second alternative and became realistically inured to the fact that he was living with a very disturbed person.

These two cases are typical, not of the problems that beset individuals living with neurotics or psychotics, but of the choices confronting these individuals. For assuming that you must, whatever the reasons may be, live with a disturbed spouse, relative, friend, or business associate, you have innumerable bad and two or three good choices of conduct. Either you can act in such a manner that your disturbed spouse or associate becomes less disturbed and easier to live with; or, if you are not able to help this troubled person, you can become philosophically inured to living with him or her in spite of the continuing disturbance; or, in some instances, you may use a combination of these two sensible approaches.

The most important requirement for living successfully with and helping emotionally disturbed individuals is a concept that they can be helped. And they can. Emotionally disturbed people are hopeless just as long as they think they are hopeless, and as long as they make no effort to change.

Applied to the neurotic with whom you may have steady contact, this means that if you believe that he (or she) is not hopelessly disturbed, you will probably be halfway along the path of helping and living successfully with him. It is this concept which, as a practicing psychotherapist, I have spent the last

Answer to

Who ÍS it? on page 69

Dr. Sidney Smith, who re|| signed the presidency of the University of Toronto in September to become Minister of External Affairs.

several years giving to scores of my clients who are intimately associated with troubled people.

Consider one man who consulted me because, while he was finishing up his work in graduate school, his exceptionally neurotic wife seemed to be jealous of his school activities. As soon as he settled down with his books, she would start talking to him about irrelevant unimportant things. When he complained she said that he acted as if the work were more important than she, that he never spent any time with her, and that he just didn’t love her any more. This generally led to a big argument between them; and by the time they calmed down it would be near midnight and his school work would be undone.

At my urging, this husband tried an entirely different approach. First of all, before he tackled any school work he spent a period of time being exceptionally nice to his wife, telling her that he loved her, and occasionally making sex advances to her. Second, he discussed his school activities with his wife; made an effort to get her interested in them, and to be as concerned as himself about them. He would tell her, especially, about his difficulties with this professor or that instructor, and ask her how she thought he should handle these situations. She soon began to respond very well to this approach.

We’re taught to be neurotic

Finally, he induced his wife to help him with his lessons. In this way. she became vitally interested in the work and began to feel that she was practically going through school with him. After a few weeks she was entirely co-operative and they were getting along much better. In addition, her own neuroticism became somewhat reduced. She no longer felt as inadequate as she previously had: began to conceive of herself as making a real contribution to her husband’s education and started to see herself as being in the same educational class.

This kind of plan can be worked with many neurotic individuals. To try to argue or bully them out of their disturbed behavior is useless and will frequently only make things worse. But if you attempt to discover why they act the way they do, and what can be done about getting them to act better, you have an excellent chance of helping them —and, of course, helping yourself at the same time.

No one, as far as we know, is born neurotic, although there may be some inherited factors that make it easier for one person to grow up to be disturbed while another person, living under even more harrowing circumstances, resists becoming equally troubled. In the main, however, we learn to become neurotic as a result of our upbringing. Neurosis, like syphilis and the measles, is a social ailment: we arc raised by other human beings and they literally teach us to become neurotic.

Parents tend to control children’s behavior today, not by beating or punishing them, but by explaining to them that certain of their acts are “wrong” or “bad” and that no one, especially their parents, will love them or approve of them if they continue to engage in these acts. In raising children in this manner. we wittingly or unwittingly teach them—or propagandize them—to accept several important propositions: (a) that they should be "good”; (b) that it is terrible if they are not "good”; (c) that they should try to win the love and approval of virtually everyone; and (d) that it is

horrible if they do not win the love and approval of even a single human being.

Once youngsters are well indoctrinated with these premises, and are then permitted to grow up without modifying them, they are virtually doomed to neurosis or psychosis. For they will then almost certainly spend the rest of their days trying to do the impossible: always be “good" and always win the love and approval of everyone. And since they inevitably will not succeed at these impossible tasks, they will assuredly acquire deep-seated feelings of inadequacy

and self-hatred, on the one hand, and of frustration and hostility on the other.

Many—perhaps most—people of our time refuse to face the neurotic issue squarely. They erroneously believe they can overcome the severe feelings of inadequacy with which they were raised by winning the approval of others. This is foolhardy. In the first place, feelings of inadequacy are directly related to the dire need for others’ approval; so that the more you think you need to be loved or liked by others, the greater feelings of worthlessness you will tend to have.

At bottom, you lack confidence in yourself precisely because you think it is most important that others approve of you, and you are afraid that they will not.

Second, attempting to bolster your self-esteem by winning the love of others is, at best, a hazardous means toward a questionable end. If nine people accept you fully, and you begin to feel confident because of their acceptance, you can never be sure how the tenth person will react. If you win the love of a father, wife, child or friend, you can

never be sure how long you will retain it. Self-esteem, therefore, that depends largely on what others think of you, rather than upon your acceptance of yourself, is an esteem built on shifting sands.

It is possible for a neurotic to get over his disturbances, and for you to help him to do so, for the simple reason that it invariably stems from these irrational unrealistic ideas — which are learned rather than inherited, and which (albeit with some difficulty) can be unlearned or changed. Neurotic symptoms, moreover, such as exaggerated and sustained feelings of anxiety, anger, tension, guilt and depression, are nothing but reactions to or effects of illogical thinking, and you can help a neurotic to overcome these symptoms by encouraging him to eliminate his errors and change his thinking.

The very first step toward helping an individual become less neurotic is for you clearly to recognize and fully accept the fact that he is neurotic. Most people who have close associations with disturbed individuals simply refuse to accept the fact that they are disturbed and continue to treat them as if they were welladjusted. Disaster inevitably ensues. For neurotics are nut well-adjusted. And if you treat them as if they are, as if they are able to live up to all kinds of behavior which a non-neurotic would be expected to live up to, they will quickly disappoint you, you will show your disappointment. and they will feel that they have failed—and hence tend to become more neurotic.

Once you have faced the fact that your parent, child, sibling, mate, friend or business associate is seriously neurotic, you must next understand what neurotics are. how they get the way they are, and how they can be helped to change. This requires study. You should be prepared to do a considerable amount of specialized reading and attend any lectures on the subject that are available.

The next step is to give them warmth

and support. Alas, they often do not seem to deserve it. Instead, they frequently go out of their way to bring on rejection and disapproval. What is more, when they are accepted they often view with suspicion almost any kindness shown them and test out their friends by ungrateful negative responses. Consequently, they need consistent unvarying love, and they need it for a considerable length of time before they begin to accept the fact that it is really being given.

This does not mean that one should shamelessly flatter disturbed people in an effort to build up their ego strength. On the contrary, they will quickly see behind this flattery in many instances and it will boomerang. Bring their good points to their attention; show them how they are truly effective at this or that, however inept they may be at something else.

Above all, encourage disturbed people to do the things they are afraid of and that they wrongly believe they cannot do successfully. Take an optimistic attitude toward their efforts, whatever the chances of failure may be. If they happen to fail at the first tries, show them that these are only preliminaries; that the next attempts may well succeed. Try to induce them to do things at which you are fairly certain they can succeed, then show them their successes prove that they can do still other things they fear to do.

Convince your neurotic relative or friend that all of us fail frequently and that to fail is only human. Show him that the only way human beings learn is by trial and error; that failure, therefore, is necessary, is a good thing—as long as we learn by it and thereby help ourselves to succeed in the future.

If necessary, help your neurotic associate to lower his level of aspiration, so that he doesn't attempt things beyond his capabilities. Encourage him to be daring—but realistic. Discourage his perfectionism or highly unrealistic expectations. Somehow induce him to see that though his success may be vitally important to him. it is in some ways

How to recognize a neurotic

All neurotics are eccentric, but not all eccentrics are neurotic. Here is a partial list of the most important symptoms that distinguish a neurotic from a so-called normal person:

Indecision, doubt and conflict: neurotics are afraid to make a decision or take responsibility for their acts.

Fear and anxiety: neurotics fear disapproval, and turn their fears into phobias like dread of walking in the streets—or being cooped up.

Guilt and self-blame: neurotics feel guilty about their desires, particularly sex drives, and berate themselves for acting on them.

Hostility and resentment: frustrated by their own behavior, neurotics retaliate with aggressive actions toward other people.

Ingratiation: to win favor, neurotics curry favor with others at the expense of their own self-respect. This symptom and the hostility symptom are sometimes directed at the same person.

Inefficiency and stupidity: even the most intelligent neurotics often work unsystematically with involved methods that bog them down.

Defensiveness: because they lie to themselves, neurotics have to set up a system of defences against facing unpleasant realities.

“Crackpotism” and bizarreness: depressed by reality, neurotics often create a world of their own and acquire crackpot ideas on how to live.

not that important to you. You know he can achieve it and will do everything possible to help him. But in case he doesn't succeed, you do not care; you love him and respect him just as much.

Suppose, for example, you are married to a neurotic who is afraid to meet people and who therefore wants to sit home every night, never having visitors in. The thing not to say is: "Now look here, Joe (or Mary). You know there’s nothing to be afraid of in meeting other people, and that you’re just a stupid neurotic in refusing to make friends. If you really loved me, you’d get over your silly notions and take me out regularly, or at least be delighted when 1 ask peo: pie in.’’

This kind of talk will invariably convince your mate that he is even more inadequate than he previously thought himself to be, that you just don’t understand him, and you are thinking only of yourself. It will, in other words, tend tu make him more disturbed.

Instead, you should realize that his not wanting to see people results from neurotic anxiety, from lack of self-confidence, and you should do everything possible to give him greater confidence in himself, to make him feel that he can get along with people. You should, perhaps gradually, try to introduce him to a few exceptionally nice people, preferably those whom you have warned about his problems and who will act warmly to him. Then you should show him that. jv\st as he can get along with these people, so can he get along with others.

Don’t be bullied

Suppose, however, your mate is still stubbornly neurotic about meeting people and insists that you stay in with him. Then you should say something like this: “I really understand. Joe. that you have great difficulty in meeting people right now, and I'm sure you'll get over it one of these days. But in the meantime, I’m just going crazy, being steadily cooped up like this. Maybe because of my own peculiarities, I have a real need for people now and then. I don’t mind your not wanting them, but 1 can't permit myself to be ruled by your feelings exclusively. Now suppose 1 stay home with you most of the time, but every once in a while go out by myself. Then, when you get over your tears ol people, which 1 am sure that you soon will, we can have a fine time going out together.”

Working along these lines, one can easily stand up for one's own rights in marriage or other relationships and yet comprehend the neuroses of others and not step too heavily on their toes. To let them, however, take complete advantage of you merely because they are neurotic is often to give them an incentive to prolong or intensify their disturbance; it gives them an excuse to remain a baby and get things their own way. Moreover, they tend to lose respect for you, and then lose more respect for themselves for being associated with such a weak, namby-pamby person as you.

Neurotics, moreover, don’t always want to get their own way. They frequently know they are not doing the correct thing and feel even worse when someone lets them get away with it. One of my clients, for example, enjoyed having a husband who let her walk all over him. no matter how unreasonable her demands were. But when he finally let her spend all their vacation money for a trip by herself, while he stayed home in the sweltering city, she loathed him for being so weak and, what's more, hated

herself for taking advantage of him.

Above all, don't permit neurotics to blackmail you emotionally. Frequently, as in the case of mothers who suddenly acquire heart conditions or severe indigestion just when their favorite sons are about to marry, they use sickness for this purpose. If you let them plead illness or acute unhappiness to get you to do things their way, they often become chronic sufferers and exploit you mercilessly. Don't submit to this kind of blackmail or let neurotics, who can be the world’s worst tyrannic martyrs, use

their emotional and physical disturbances to badger you. Be kind; but stand firm.

One central rule in dealing with neurotics is: do not criticizeNeurotics get the way they are largely by being overly criticized by their parents or early associates. Because they thus become over-sensitized, they can take virtually no further criticism. If you give such criticism, you will only be increasing rather than decreasing their feelings of worthlessness.

But restraint in criticizing a neurotic is

not enough by itself. You must add an active element: love. If you really convince a neurotic—or, for that matter, so-called normal—individual that you love him. see things from his frame of reference, if you are truly on his side, he will often do virtually anything for you—including, at times, surrender some of his neurotic behavior.

Let us be specific. Consider the problem of your spouse with whom, let us say, you want to have steady sex relations but who. because of his (or her) neurotic fear of "too frequent" sex ac-

tivity desires them only once or twice a month. If you use ridicule with this spouse, he balks all the more. If you plead with him, he says he would like to have sex relations more often, but just can’t feel comfortable when he does so. Impasse. The more you ridicule or plead, the more uncomfortable he feels, the more hostile against you he gets, the more his neurosis intensifies.

Try a different line. Be most understanding of his predicament and show him that you realize that he is fearful and is not merely trying to annoy you by his sex behavior. Try, if possible, to discover the basic cause for his fear of sex and to show him that even though he once may have had good reasons for it, these no longer apply. Stop making fun of his sex fears or superstitions; try rather to get behind them and undermine them with different, more logical attitudes.

Above all. love him. If you will consistently, wholeheartedly love a neurotic person even when he is inconveniencing you, he will begin to feel that at least one human being, has true respect for and confidence in him, and will begin to lose the feelings of inadequacy and hostility which underlie his neurosis. Second, he will come to feel that he has a partner, a true helper, and that therefore he has a better chance to overcome his fears and disturbances. Third, he will normally tend to love you in return; and, out of his love for you, will often begin quite spontaneously to do things for you that he would not think of doing for anyone else in the world — including. quite possibly, trying to overcome his neurotic fears that inconvenience you.

The next important point to note in trying to help a neurotic is that of doing something to relieve his guilt. At

bottom, virtually every neurotic is abnormally guilty—fearful that he is doing the wrong things and that others will therefore not like him. To relieve his guilt, you may employ two main procedures: be lenient, noncritical and permissive when he does guilt-provoking acts; and encourage him to conform to his own standards and generally do the things that will prevent him from becoming guilty.

Thus, if your son has unnecessarily harmed your neighbor’s child, you can legitimately show him that he has acted improperly, and that the remedy for his guilt is not for him to punish himself (or for you to punish him) but for him to resolve to be more than pleasant to this neighbor’s child in the future. Or if your neurotic wife is inordinately guilty because she has not been taking care of the house properly, you can show her that such guilt is easily quieted by being a model housekeeper in the present and future.

lie’s afraid of being wrong

Perhaps the biggest hurdle any neurotic has to overcome is that created by his irrational fears: his fears of being disapproved and rejected for doing the “wrong” things; and his fears of bodily harm or of death. Sometimes, you can reason with a neurotic, showing him how silly his fears are, and bring him to a rational viewpoint. In so doing, however, it is ineffective merely to tackle the fears themselves; rather, you must ferret out and attack the irrational ideologies that lie behind him.

To help a neurotic face the things he dreads, you may employ one of a number of effective techniques. You can serve as an excellent model yourself by

doing the thing he fears and proving to him that it is really not so fearful. Or you can go along with the neurotic and keep him company in doing something fearsome—for example, induce him to take a plane ride with you, to show him that it is not as bad as he thinks it is. Or, occasionally, you can trick a neurotic into doing some presumable awesome thing—such as getting him to take his first plane ride—by pretending that there is a railway tieup and that planes are the only practical means of transportation for the moment.

More frequently, you can often entice an individual into doing a feared thing by offering him some special incentive —for example, paying for his vacation trip if he will take a plane instead of a train or bus.

By fair means or foul, then, if you can somehow induce your neurotic associates to do and to keep doing almost anything of which they may be afraid, they will usually tend to lose their fears, and eventually even enjoy the previously abhorred thing.

One of the most efficacious ways of helping troubled people is to get them to be actively interested in people and things outside themselves. For neurotics, because of their extreme concern over being approved by others, usually are exceptionally self-centred and not really interested in others in their own right. People quickly note this and in turn are not interested in the neurotics. This leads the latter to hate themselves more, especially when they finally come to realize that they do not really care for anyone and become additionally guilty about their inability to love.

Can, then, virtually anyone help almost anyone else to overcome emotional quirks and upsets? No. not exactly. For

the would-be helper, aside from having good intentions and real patience, must himself be not too disturbed to begin with; and the same may be said of the would-be helped one. Individuals who are deeply disturbed should normally be seen by psychologists and psychiatrists, and those who would help them should obtain psychological consultation. Otherwise, serious harm may result.

This means, specifically, that you should not try to cure your friends or relatives who are exceptionally depressed, who think very little of themselves, who arc unusually agitated, or who arc behaving in a clearly bizarre manner. Such individuals may be overtly or underlyingly psychotic and be in immediate need of professional care (or even institutional care). By all means leave these deeply disturbed associates to those who are psychiatrically trained.

As long as you live in our society, you will inevitably meet seriously troubled people. As you do, remember this: that neurotics are neurotic; that they are not to blame for being troubled; that they became neurotic because they adopted irrational beliefs that lead to deep-seated feelings of inadequacy and hostility; and that they will become more disturbed if you look down upon them and make no allowances for their difficulties.

If you love a neurotic in a mature quiet manner, if you love him nondependently and with some degree of guardedness, you will be in a better position to help the one you love, and to maintain a healthier relationship for him and for you. ★

This is cm excerpt froni Dr. Ellis’ book. How to Live with a Neurotic at Work or at Home, to be published later by Ambassador Books.