When hope gets in the way

Photo by Fotoholica Press/LightRocket via Getty

Hope is usually seen as a positive agent of change that spares us from pain. But it can also undermine healing and growth

by Santiago Delboy is a psychodynamic psychotherapist in private practice and adjunct clinical faculty at the Chicago Center for Psychoanalysis. His writing has appeared in the journals Psychoanalytic DialoguesPsychoanalytic Inquiry and Revista de la Sociedad Peruana de Psicoanálisis. He lives in Chicago.

The word ‘hope’ seems to hold an unambiguous quality in our vocabulary, imbued with a kind of purity that makes it unquestionably good. From old sayings to modern slogans, we are encouraged to develop and sustain a sense of hope. As a psychotherapist, I believe there is good reason for this. I have repeatedly witnessed the overwhelming burden of hopelessness and the centrality of hope in healing and growth. This is particularly true for people who experienced chronic childhood trauma, including emotional abuse or neglect, which undermines their ability to imagine that a different future is possible.

But I also believe that hope is a complex concept that deserves a more nuanced understanding. For example, hope may be considered both an antidote to helplessness and a source of helplessness. As the psychiatrist Harold Searles observed, we tend to consider hope our ‘last repository of … innate goodness as human beings’. It can be challenging, he suggests, to accept that our hopes can indeed be permeated with ambivalence and conflict.

Even though hope is seen as curative and a critical agent of change in a clinical setting, are there times when persistently holding on to hope – consciously or not – can get in the way? If hope is oriented towards the future and can make the present more bearable, what is the role of our past in the experience, function and meaning we give to hope? More specifically, when our emotional wounds were created by old relationships, how do they shape the conscious and unconscious hopes we hold for new ones? I would like to explore these issues through Alex, a composite fictional patient who represents some of the experiences people bring to therapy. The clinical process I describe is influenced by my own approach and illustrates how psychotherapy can help.

Alex entered the waiting room 15 minutes early for our first appointment. He started talking as soon as he sat down, without pause or hesitation, telling me about his background and why he came to see me. He was articulate and charming, yet something felt rehearsed and guarded. Were his words and his demeanour an attempt to prevent a silent crack through which pain could filter? A successful professional, Alex was worried about how unmotivated and stuck he felt lately, and how anxious and irritable he was in his close relationships. Before he left, he asked me, with a tremulous voice: ‘Am I depressed?’

Alex worked hard to be a good patient. He was eager to talk, astute in his observations, and open to hearing mine. Thanks to prior rounds of therapy, he could articulate some of the struggles he had endured as a child.

‘I know about my family issues,’ he said a few times, as if to convey: ‘So let’s move on.’ I continued to wonder what he was protecting behind that veil of self-awareness. His apparent desire to leave the past behind may have conveyed fears of opening old wounds, anticipation of being disappointed by me, or wishes to protect something he may not want to surrender.

At first, Alex approached our work like other new relationships. A coat of confidence and engagement covered a wall of ambivalence and mistrust. As we scratched the surface, I learned that he grew up fearful of his distant, critical and fragile father, whose expectations felt as unclear as impossible to satisfy. He kept a few fond memories of his mother, whom he experienced as occasionally tender and warm, but mostly depressed and emotionally absent.

It is hard to underestimate the impact of these experiences on Alex’s sense of hope. As Erik Erikson suggested, our primal sense of hope and doom springs from the dialectic between trust and mistrust during the earliest stage of human development. Conscious and unconscious hope and hopelessness coexist, not always peacefully, throughout our lifetime.

Alex managed to recruit the same cast of characters to rehearse the lines for a role he knew too well

This paradox appeared in Alex’s vivid childhood memory of hiding under the bed when his father seemed angry. It was a heartbreaking image, which found its way a number of times into our conversations. Each time, I felt a deep sense of desolation. I imagined a scared little boy in the darkness, his face against the cold floor, learning to identify every footstep while secretly hoping to be found by his mother. ‘I always had to come out on my own, my mom never looked for me,’ he said the first time I saw him cry…



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