#119 – Terry Real: Breaking the cycle of shame, anger, and depression

KEYPOINTS

• 01

  Terry Real became a family therapist to understand his father's violence

  Real grew up poor in Camden, New Jersey, the 'scapegoat child' of a depressed, abusive father. He says he started his career at about age four, because he needed to make sense of his father so he wouldn't repeat him. At about 28 or 29, after years of gently pushing past his father's defences, he finally heard his father's story.

• 02

  Trauma is passed down

  Real's father lost his mother at nine during the Depression. His own father, whom he called a 'passive loser', lost his candy store, and in a fit of depression tried to gas himself and his two sons in the family car. Real's father, then 11, kicked out a window, grabbed his younger brother and got out. He says that was the last real contact he had with his father. Afterwards he despised vulnerability in himself and in others.

• 03

  Relationships move through harmony, disharmony and repair

  Real borrows this model from Ed Tronick's infant-observation research. Closeness, rupture and a return to closeness is the basic rhythm of healthy relationships. Everyone is shaped by their parents' imperfections, which form what Real calls the adaptive child. What matters is whether ruptures are followed by repair and accountability, or just more injury.

• 04

  Shame is about who you are; guilt is about what you did

  Children who are neglected or mistreated take on shame and feel bad about themselves. Real says it is actually 'compassionate' for a child to blame himself, because a random, scary world is harder to accept than 'I'm bad.' Guilt, feeling bad about a behaviour, is healthy. He wants men going from inflated entitlement to deflated shame to land in the middle: accountable but not worthless.

• 05

  Grandiosity and shame are two sides of the same coin

  Real describes a 'one-up/one-down' seesaw. Men in this culture tend to lead from overt grandiosity, with shame hidden underneath. The central move of traditional masculinity, he argues, is turning shame into grandiosity and helplessness into attack. Real, now 69, says that whereas he swung up and down as a teenager, these days he rarely goes one-up or one-down.

• 06

  Male depression is often covert

  When his book 'I Don't Want to Talk About It' first came out in the late 1990s, depression was seen as a women's disease, diagnosed two to four times more often in women. Men hide it because being overwhelmed by feelings feels unmanly, and families and doctors collude: he cites studies suggesting family physicians miss depression in about 70% of cases. The defences are what show: radical isolation, anger, sexual acting out and self-medication with alcohol or drugs.

• 07

  Real self-esteem can't be earned

  He describes three forms of false self-esteem: performance-based (what I can do), other-based (being loved or admired) and attribute-based (looks, wealth). He says the California self-esteem drive was misguided. True self-esteem is 'spiritual, ontological': you have worth because you exist, not more or less than anyone else, and nothing you do adds to it or subtracts from it.

• 08

  Narcissism is too little self-love, not too much

  Narcissus was an addict to his reflection. Grandiosity covers an inner emptiness, which is why it needs constant feeding.

• 09

  Patriarchy hurts both men and women

  Real, who has practised feminist family therapy for about 40 years, cites Carol Gilligan's 'In a Different Voice': girls at 13 or 14 fall prey to 'the tyranny of the nice and kind' and lose their voice. Patriarchy, he says, rests on despising vulnerability and on the delusion of dominance. He argues that relational growth, for both sexes, is the next step for feminism.

• 10

  Relational skills are a technology you can learn

  Real's model, Relational Life Therapy, treats relating as a skill set, like learning to ski in your forties, play the piano or speak French. It takes about as long if you're diligent. The adaptation that protected you as a child, such as thick walls against an intrusive mother, can get you into trouble at 45 with an emotional spouse.