Pathological Accommodation

Last month at our Tampa Bay Psychoanalytic Society, Inc meeting, I found myself literally jolted by a concept. Many of our speakers have left indelible ideas and memories within me, but this notion explored on a November Saturday morning struck me as profound and clear and pervasive. Dr. Shelley Doctors elucidated the psychological process called "pathological accommodation," in which a person, likely from infancy onward, learns essentially to erase him- or herself in order to have a relationship with an important other. In other words, a child grows up knowing that in order to maintain a relationship with a caregiver, he or she must deny longings, feelings, and opinions that reside authentically within: "I will accommodate to you, my mother, so that I can have a relationship with you and thereby survive, but I do so at the cost of my very self and its development. I will do this because to be rejected by you, I fear, will be the very end of me. So, this is my choice, the lesser of two evils, between having no self and having nothing at all."


The Impact of Pathological Accommodation

It was not the idea of pathological accommodation per se that rocked me, but rather, the developmental course that this may take in one's life. Authors Brandchaft, Doctors, and Sorter1 describe these possible trajectories:

The child may attempt to preserve and protect this core of individualized vitality at the expense of object ties by determined non-conformism or rebellion. That is a path of isolation and ultimate estrangement. Alternatively, the child may abandon or fatally compromise his central strivings in order to maintain indispensable ties. That is the path of submission. Or the child may oscillate
between these two . . . Depression becomes the dominant affect in a person whom such a conflict has become chronic and internalized. It signals the loss of hope where no synthesis can be found between intimate connectedness with important others and the pursuit of a program of individualized selfhood. (p. 56)

It is deep within this quandary where I see many precious people. Those who disconnect relationally may do so because they have come to the conclusion that the price tag surrounding personal connections, especially intimate ones, is simply too high: it requires a submission of self-ness, authentic personhood. Those who remain in unhappy intimate situations may do so because they have concluded that it is better to have a relationship that is smothering and controlling (or abusive), than to disconnect from it and risk alienation or worse. And the third group: those who cannot be at peace in isolation or stultifying relationship. These try one approach until the pain of their current dynamic overwhelms them and then they flee---either into nonconformity in a brave attempt to find and hold onto their own voice, or into a painful intimacy in an attempt to feel less alien, less disconnected from.

Perhaps as you read about this process, you might identify with it, if only to some degree; perhaps you have noticed themes in your life not altogether different than the process of pathological accommodation. Coming to a point in life where you dare to believe that you can indeed have relationships that are mutual and reciprocal, that do not require a forfeiture of self, is not only a life-changing moment, but a life-giving one.

Steve Graham, PhD

1. Brandchaft, B., Doctors, S., & Sorter, D. (2010), Toward an Emancipatory Psychoanalysis: Brandchaft's Intersubjective Vision. London: Routledge.