Three discreet, contrasting mindsets evident within psychotherapy and society are entitlement, empowerment and cooperation. Taking a compassionate, non-judgmental approach, it is worth clarifying each of these mindsets and their implicit values and their relevance to psychotherapy work in the interests of helping patients appreciate and enhance their contribution to the therapeutic relationship with the overall aim of getting the most out of their sessions.
The entitlement mindset has become an increasing, normalised presence in Western culture, and as such is very often unnoticed by individuals who adopt this approach to life. It is a demeanour and set of dependent behaviours that embodies the message ‘the world owes me something more’, and as such can create powerful dynamics marked by tension and frustration in relationship with others. Individuals in therapy who hold this orientation to psychotherapy work, whether subtle or crude, commonly position themselves in a self-defeating, dependent attitude that is socially manipulative but ultimately disempowering to them, even though it in essence is an attempt to gain power. It is an orientation to life that says ‘I deserve to be given special treatment because….’. Justifications for special treament are a means of asserting demands by appearing to have unique qualities, experience or needs; to being helpless or disadvantaged; to being aggressive and hostile until demands are met; to finding fault; to being ‘top dog’ even to the extent of playing ‘underdog’ and vice versa. The goal here is to elicit a response in the recipient: sympathy, admiration, guilt, shame, fear or obligation, for example, thus positioning her into better serving the entitled person’s needs rather than taking responsibility and meeting his own needs.
Self-entitled people thus typically relate to others as objects of utility rather than respecting the other’s true status as a human being. The self-defeating nature of this position is that any love received via manipulating others into loving us or being loyal to us is always empty and devoid of any real affirming value or genuine security, thus reinforcing deep fears and insecurities the entitled person is so desperate to overcome.
Eliciting feelings of obligation in others
Samuel was a doctor, who used a variety of means in relationship to meet his entitlement needs for special treatment. He described a long list of examples of high status people with whom he associated, and how he used his job, religious identity (even though he did not practice his religion) and ethnicity to gain advantage; accusing anyone who resisted him of indulging their “white privilege” of being “xenophobic” or “racist” or “lacking empathy”. When his girlfriend became pregnant he took advantage of her status to make demands upon services using her vulnerability and his job title as an excuse to criticise and abuse staff. When the child was born it became a bargaining chip to elicit sympathy and guilt that allowed Samuel to evade his commitments, obligations and agreements with his employer and others, including his psychotherapist. Samuel’s manipulative behaviours stemmed from his sense of entitlement and need for special conditions that others were expected to supply. The rules applied only when they suited him. This attitude to life lost him friends and eventually his partner, all of whom he continued to blame for his plight in life, with the therapist becoming a target as soon as Samuel’s unreasonable expectations were not met. Samuel abandoned therapy as a final attempt to punish his therapist for failing to accommodate his demands.
In therapy patients with strong entitlement mindsets present in apparently contradictory ways: as top dog or underdog. Both positions, however, attempt to gain control over the other by manipulation. Such patients initially tend to elicit particular feelings in the therapist that suggest the creation of intial emotional openness followed by withdrawal; objection and flattery, with the corresponding passive-aggressive message ‘you’re special, you’re garbage’. These are the crude tools of reward and punishment. This message of ‘come close, stay away’ is experienced as an emotional pushing and pulling that the person uses in the service of rewarding and punishing the other into compliance. In terms of presentation, such patients tend to be more self-absorbed or take a more passive role with the expectation that the therapist will do anything to accommodate complaints and demands, or provide motivation for change or meet each expectation; the therapist being blamed when he or she inevitably fails to provide this external energy supply, to be ‘good enough’ or to read the patient’s mind.
The therapist who falls into the trap set by this form of child-parent transference-dependence often ends up frustrated, angry, disempowered, confused or drained by assuming the role of a symbolic parent who, naturally, can never satisfy the child’s expectations of perfection and thus must be punished for his or her failure to be perfect. And so entitlement can be seen as a means of recreating the stuck record of a struggle from the patient’s unsatisfying childhood relationships that he or she attempts unwittingly to recreate in order to meet his or her childhood needs.
Some signs of an entitlement mindset in therapy that I have observed over the decades include:
- the patient is experienced as wavering between open and withdrawn, close and distant, often with no explanation
- the outward appearance of deference or timidness, but with an implicit lack of generosity, gratitude, genuine respect or courtesy
- the outward appearance of superiority, control, indignation, condescension
- the spectrum of passive-aggression
- the needs and feelings of and agreements made with others are easily disregarded or usurped by expectations and demands for special treatment
- relating to the therapist as an object, without needs or feelings
- ‘the self-centred child’ role: the expectation of special consideration, or that others should orbit around the needs of the entitled person by virtue of their status or justification
- destructive envy, rage, anger or abandonment when entitlement needs aren’t met or when disappointment is experienced
- often there are issues around money e.g. complaints about fees, claiming to have little money whilst evidence emerges to the contrary; using therapy fees as leverage; gambling, or financial exploitation
- ignoring communications when expectations aren’t met
- contrariness and defensiveness
- finding fault and back-biting
- grudging dependency and denial
- lack of full engagement, resistance to experimenting or exploring in sessions
- deceit, deception or lack of honesty in the relationship
The entitlement mindset is the expression of some degree of individual narcissism; narcissism being a potentiality and regressive childhood trait in all of us. It is essentially a position that holds the expectation that others, as surrogate parent figures, are there to confirm the specialness and meet the needs of the child. And when adopted without insight or awareness, entitlement is invariably marked by passive-aggression and the destructive influence that this necessarily has in relationships, particularly when the self-entitled person is challenged or when intrinsic demands for external supply are not met and the ‘giver’ is then punished for his or her failures to provide. Implicit in this are, of course, unrealistic expectations based on an adult assuming the role of a child, and an intolerance of the experience of disappointment, sometimes with extremes of emotional response to it, for example by indulging in self-pity, feeling devastated or suicidal, or acting out destructive rage, often in hidden and passive forms against the source of disappointment.
People who adopt an entitlement position (and it may be subtle, crude, transient or more permanent) tend to see the world as being there to provide them with what they are owed or can win rather than what they might earn. Rather than being criticised or condemned for this, in therapy entitlement must be seen as an inherently dependant, regressive role in life, whereby the person continues to disempower herself relative to external forces whilst convincing herself otherwise. This self-defeating stance can be worked with in therapy – assuming the patient to be amenable to the work – when discussed openly and honestly in the patient’s best interests. However, in reality patients will often vigorously defend against challenges to this position due to the inherent feeling of vulnerability and very inflexible mindset driving it.
At the pathological end of the spectrum is, of course, narcissism as clinically-defined, which is in essence a form of childhood-based self-loathing and inner emptiness that seeks compensatory balance in self-aggrandisement and self-entitlement. In this form, the self-fulfilling nature and vicious circularity of narcissism tends to mean that narcissistic persons either don’t seek out or don’t maintain any genuine or lasting committment to psychotherapy work. Those who have more openly dependent attachment styles can do the reverse, staying in therapy for years where enough supply is provided and/ or there is sufficient room for destructive behaviours to be accommodated or acted out in secret. Neither of these is, in my opinion, a healthy approach or solution, and indulging it in therapy without examining its function with the patient is disempowering to them. Instead, developing personal authenticity, candid discussion, resolving old conflicts and recognising childhood needs in their proper context is the more empowering route to take in the therapeutic process.
Often our mindset is revealed in our relationship to money:
Fees for therapy were a continual issue for Karen, who begrudged paying for her personal development, seen in her complaining, cancelling sessions at short-notice and expecting not to have to pay cancellation fees, delaying sessions, paying fees late, claiming poverty and being misleading about her finances, or asking to pay in ways that weren’t available. Her sullenness in sessions became apparent as an expression of an underlying belief that her therapist should – if he genuinely cared – accommodate her expectations out of sympathy, and provide her with free help, even though free psychotherapy was available via the NHS. Instead of coming to terms with her choice of private therapy and therapist and the contract she had agreed as part of the work; and recognising the value of that work, Karen created a conflict between her sense of entitlement to both money and help; a conflict acted out in her mistrust and resentment toward the therapist that only ate up much of the value of the work her therapist attempted to offer her. The irony was that, by adhering to an entitlement mindset and being unwilling to recognise it as a deep childhood need for parental support, Karen ran the risk of wasting both her money and any help that was being offered to her, due to the fact that, as an adult, she was obliged to pay for that help.
By contrast the empowerment mindset is one in which the individual seeks to rely upon his or her abilities, genuine hard work, talents and development of skills in order to better meet his or her needs both materially and emotionally. It is a position of independence and self-reliance that says ‘the world owes me nothing and I must make my own destiny’. People who take an attitude of empowerment tend to want to learn, grow, do their fair share of the work, pay their own way and may be uncomfortable with others doing for them what they are able to do for themselves.
In therapy, patients interested in self-empowerment tend to view the therapist as an ally who is there to help them discover their own potential to heal, recover and overcome obstacles. As such, therapeutic work tends to be more active and dynamic than passive or stuck, and patients in an empowerment mindset willingly engage in what is required, facing discomforts in the service of personal development and growth.
However, taken to extremes, the empowerment mindset is also capable of being an expression of narcissism when it isn’t properly grounded in the foundational reality that we are all, at some level and at one stage or another, also dependent: dependent upon others for help, for support, for feedback that can help us illuminate our blindspots. Failure to recognise that the world cannot function purely by self-reliant behaviours can result in self-aggrandisement, isolation and the illusion that ‘I can do everything myself’.
Our political views often espouse our values and mindset:
Alan’s political views framed the individual as being entirely responsible for himself. He continually bragged about how hard-working he was, complaining about ‘benefit scroungers’, ‘asylum seekers’ and ‘freeloaders’, when it later became apparent that he had inherited a substantial amount of wealth and a family business that had then allowed him to secure a steady income generated by his property and employees, affording him an ‘independent’ lifestyle. Having never experienced poverty or its hardships, he had little sympathy or understanding for the plight of the poor, sick, infirm or disabled, believing that everyone was capable of generating wealth from nothing if they were intelligent, ambitious, self-reliant and worked hard enough.
The cooperative mindset reaches a balance between a realistic awareness of the interplay between dependence and independence; between reliance on others and self-reliance; vulnerability and strength; between giving and receiving. Where the entitlement mindset is one that expects to be spoon-fed by others or the centre of attention, and the empowerment mindset feeds only itself, the cooperative mindset recognises the value in our feeding ourselves and one another. This is a position of realistic adaptation to the world of others whereby our strengths and weaknesses can be appreciated and balanced in genuine relationship, where give-and-take and the courtesy and respect for one another that makes this interplay possible, keeps us alive as social beings who can use our individual powers for the simultaneous benefit of both self and other.
In psychotherapy, the cooperative position tends to bear the greatest fruit in terms of therapeutic gains once it is cultivated. Instead of being the topdog or the underdog we remain equals engaged in a fair exchange of mutual respect and goodwill. Patients who approach therapy as a cooperative venture tend to be those who are more willing to be open to, and to come to terms with, both their vulnerabilities and their strengths, finding appreciation, gratitude and generosity in the process of self-discovery and relationship.
We are all capable of adopting these orientations. And in the psychotherapy relationship there is room for all of them whilst the patient possesses some willingness to self-reflect, explore and be open to experiment and challenge. Indeed, most people will manifest each of these positions at some point in any therapy of normal duration, very often exemplified in their relationship to and handling of money (e.g. therapy fees and how these are managed or broached), time-keeping, communications and social interactions, all of which reveal something of our willingness to give and take both in relation to others and ourselves.
The key point is whether patients find themselves either stuck in or drifting in and out of self-defeating ways of being without a greater awareness of the choices they make by adopting such attitudes. One task for the psychotherapist is to assist patients in recognising where they are in themselves and in the relationship, and the kinds of choices and responses they make that get them there. Problems tend to arise when patients have a particularly entrenched adherence to ways of being that not only do not serve them or their relationships, but that they are unwilling to examine in the service of their own healing, recovery or development as people.
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