A trip to hospital & the slow progress of learning to be vulnerable

 “Once an Overfunctioner,………….”

Help wantedI’m not that comfortable asking for help. In fact I struggle to really know when it’s appropriate to ask for help. I realise that I have an overdeveloped sense of independent coping and tend to minimise various life challenges and carry on as if I’m not affected. This is not a new discovery for me. When I first came across Bowen theory some 25 years ago I realised that I was attuned to helping others but not good at being vulnerable in my relationships. I have been consciously practicing sharing my needs and stressors with those close to me over the years. My progress is sometimes slow.

Last week I was booked into hospital for an overnight stay to have some minor surgery. It was not a life threatening issue and I was told that recovery would be quite fast. Hence, in my typical fashion, I minimised the effect of the experience and independently took myself to the hospital. When there were no taxis at the rank, I caught a bus and admitted myself in isolation. I had organised for my work administrator to collect me the next day as I didn’t see the need to disrupt my husband or other family member’s working days. Once in my hospital bed, with preparations for surgery commencing, I reflected on the inklings of stress arising. The nurse commented that my blood pressure was a little high, alerting me that my perceived sense of calm independence was not the true story according to my physiology. As I was wheeled up to the theatre area and greeted by the anaesthetist’s nurse I realised that this was bringing back the emotionally charged experience of my cancer surgery a few years earlier. I had underestimated the power of my memory system to evoke similar feelings of fragility and aloneness. At that moment I realised that my well-honed pattern of pseudo independent strength had once again been ruling the show and I resolved to ask my husband to come and be with me the following morning and take me home when I was all clear for discharge.

This pattern of being sensitive to others needs but under sensitive to my own has been shaped in my family relationships growing up. It is a common pattern that Bowen observed in his research and termed the “over and under functioning reciprocity”. It’s like a see-saw in relationships where one person steadies self through being strong and helpful and another by willingly being helped and advised. The downside in any relationship is the loss of mutuality of shared strength and weakness. One person assumes the stronger posture at the expense of another’s capacity to manage. My mother was a classic “overfunctioner” in her relationships and unwittingly helped train me to operate similarly; she would share her concerns for others but didn’t share any of her own feelings and personal experiences. In my teenage years we both talked about others needs but not our own. Even as she was dying of cancer in her 50s she didn’t know how to be vulnerable for fear of upsetting others; and conversely my father didn’t know how to respond with strong support. All families have variations of these functional postures where each person automatically adjusts what they express of themselves in response to their sensitivity to another. Examples are “the Panicker & the Soother”; “the Distancer & the Pursuer”; “the Problem Generator and Problem Solver”; “the Intense one and the Clown”. For me the posture of being strong and independent means that my stress goes underground and is not dealt with appropriately at the time. It also means that I don’t allow myself to fully experience the wonderful nurture of family and friends reaching out to support me in their own unique ways. For those close to me they are robbed of the space to develop their own empathic strength in our relationship.

I’m grateful that my recovery is going smoothly as predicted. I’m also pleased that I was able to at least let extended family members know about my surgery and I could appreciate the caring phone calls I received. It was soothing to draw from my husband’s strong presence and not leave the hospital as independently as I arrived; and it was just delightful to have a friend from my church community deliver a delicious meal to enjoy. I am resolved to do better at asking for and joyously receiving care; both for myself, for the benefit of the important people in my life and for the growth of our relationships.

Questions for reflection:

• Do I tend to assume a posture of strength or neediness in my important relationships?

• What is the effect of this on the relationship?

• When things were stressful in my family growing up did I tend to collapse/struggle and/or distance or did I step into the over responsible, fixing position? What can I recall was the way other family member’s responded?

• What aspect of myself do I need to consciously practice expressing in my relationships – my capacity to manage or my struggles?

Quotes from M Bowen (family Therapy in Clinical practice):

The “emotional process” is deep …It runs silently beneath the surface between people who have very close relationships.” P 66

“Overadequate refers to a functioning façade of strength that is greater than realistic. Inadequacy refers to a functioning façade of helplessness that is as unrealistic as the façade of strength is unrealistic in the other direction.” P 53

“One of the most important aspects of family dysfuction is an equal degree of overfunction in another part of the family system. It is factual that dysfunctioning and over functioning exist together.” P 155

“When the therapist (helper) allows him/herself to become a “healer” or “repairman,” the family (or individual) goes into dysfunction to wiat for the therapist to accomplish his/her work.” P 157-8


‘A trip to hospital & the slow progress of learning to be vulnerable’Jenny Brown