Good Morning, Monster: A Therapist Shares Five Heroic Stories of Emotional Recovery

“One thing I learned from Laura’s case was that a psychologist cannot judge. Everyone is judgmental to some degree; it’s how we humans sort and assess situations.”

Dr. Gildiner recognizes that Laura Wilkes is defensive of her father (despite his abuse of her). This defense is frustrating to her because she—being an objective outsider—can recognize the way Laura’s father’s behavior has been harmful and is inexcusable. However, to challenge Laura’s perception at this juncture, Gildiner realizes, would not work to change Laura’s view of her father and would not be helpful to Laura’s progression. Instead, Laura must slowly arrive at this perception in her own time.

“I had to dial it back and focus on seeking psychological truth, not the literal truth. We really had no way of knowing the truth.”

Gildiner stresses that much of what is important about exploring the past has less to do with factual events but with the patient’s interpretations of them. What happened is less important than how the event affected the patient and how it creates patterns or behaviors that shape the patient’s future. At times, Gildiner is frustrated when facts about Laura’s past cannot be objectively known, but then reminds herself that this is not the goal of their conversations.

“I had no idea that Laura had been behaving this way. One of the pitfalls of therapy is that all information is filtered through the patient, who can be an unreliable narrator. If the patient reports that things are going well, that’s only one perspective.”

Gildiner is surprised to learn that Laura has been rageful when interacting with her boyfriend. Yet her words here stress the limits of therapy—the therapist always operates with the patient’s subjective viewpoint. It is Gildiner’s job, in many instances, to help the patient shift their paradigms so as to shift their behaviors.

“Attachment disorder doesn’t just affect the relationship with the mother; it affects all social, emotional, and cognitive development. If the child doesn’t experience attachment, that child can’t move forward to step two—trusting and emotionally attach to others and, eventually, sexually attaching to others. In other words, you can’t grow emotionally if you didn’t have infant attachment.”

Peter’s inability to engage with another sexually is the result of his mother’s neglect. Although she viewed locking him away as keeping him physically safe, the emotional effect of this behavior prevented Peter from reaching important developmental stages when he was quite young. Because he never learned such attachment as a child, Peter does not have the tools to do so as an adult.

“I regarded [Peter’s mother] as someone whose maternal instinct was seriously compromised. But as a therapist, I knew it wouldn’t be helpful to say that to Peter. He’d need to come to the realization himself, and at a time when he could accept it. If you point out a ‘truth,’ for want of a better word, to patients before they’re able to hear or admit it, they lose trust in the therapist; their defenses take over, and they improve only superficially. Overinterpreting to the client is the sign of a new or insecure therapist. A therapist can lead patients to the door of understanding, but they shouldn’t drag them. Their patients will enter when they’re ready.”

As with Laura, Dr. Gildiner recognizes that Peter defends his mother’s behavior, despite the way in which that behavior has harmed him. She understands, however, that it is important that Peter come to view his mother’s behavior differently on his own in order to have a meaningful and lasting shift about his view of her. This process is slow one, but Dr. Gildiner stresses the importance of the patient doing the “work” for themselves.

“Slowly, Peter’s mother stopped insulting him and telling him to get a different job and to marry a Chinese girl. She never turned into an affectionate mother, but she did learn, through behavior modification, what she wasn’t allowed to do if she wanted to sustain contact with her son. She didn’t want to be alone. She wanted to give Peter food and shelter, and if he refused to take it, she was bereft. That was what she thought her job was as a mother.”

When Peter is able to establish boundaries with his mother, their interactions improve. Peter is able to assert himself in a way so that his mother does not continue to harm him. Gildiner points out, without excusing her behavior, the way in which Peter’s mother’s actions were motivated by what she believed to be good mothering. This is an example of Gildiner showing compassion for all involved in a situation and avoiding blame and judgment when tracing the causes of harm.

“The second thing [that happened when Danny was forced into the residential school] was that, shockingly, his long hair was shorn. To this day, many Indigenous people regard their hair as a physical extension of their spiritual being. In many tribes, people cut their hair when there is a death in the family. Others believe that hair is connected to the nervous system and is needed to process information from society, similar to a cat’s whiskers. Danny’s tribe believed that cutting your hair is a way of humiliating yourself for a wrong you’ve perpetrated, or public humiliation for a presumed wrong. Danny had no idea what crime he’d committed.”

The residential schools sought to assimilate Indigenous peoples into white society by force. This was done in a way that conveyed to children like Danny the “wrongness” of their culture and belief systems. Importantly, though Danny goes on to lose many aspects of his Cree culture—such as the language—as an adult he keeps the cultural practice of wearing his hair long. Later, Gildiner will take this as a cue that Danny should reconnect with his cultural identity.

“Most white people enter therapy in order to gain better control of their lives, or as one healer put it, ‘to stickhandle through life.’ Indigenous healing is instead about connecting with the spirit world in a meaningful way and achieving harmony. Whereas traditional psychotherapy is based on a man-against-nature paradigm, Indigenous healing focuses on man harmonizing with nature.”

Identifying and understanding the differences in Western therapy and Indigenous healing becomes central to Gildiner’s ability to help Danny. Though he is initially reluctant to both types of treatment, with time, both prove instrumental in his healing.

“I’ve made many mistakes as a therapist, but I didn’t think that suggesting Danny go home, however sad it turned out to be, had been one of them. Danny had to confront what had happened to his family, just as he had to confront his own issues. He’d avoided his father, and avoidance never helps anyone get well.”

Throughout the book, Gildiner reflects on her skills as a therapist, acknowledging when she makes an incorrect decision in advising a patient. Here, she stands by her insistence to Danny that he visit his father and brother. Gildiner asserts that this confrontation of Danny’s past is necessary. The differing views she and Danny have of the situation remind readers that therapists, like their patients, are human and must work within their own limitations.

“I started clapping. I had lost all my objectivity. In most cases, a therapist has to present an unemotional front. But since our therapy was effectively finished, I wanted to be more than a Freudian therapist for Danny. He needed an advocate, someone who was on his side but who asked for nothing back—someone who longed for his well-being. People who’ve experienced severe trauma are numb until they meet a compassionate witness. When they believe that individual is for read and can be trusted, they can turn into a ‘real’ person and dare to attach.”

With time, Gildiner’s role in Danny’s life (and, arguably in the lives of the other four patients) evolves from that of a therapist to that of a friend. Gildiner is careful to maintain this boundary early in the patient’s therapy. However, when she feels she has developed a foundation of trust between herself and her patient, she decides to share her support of Danny in a way that a friend would.

“I thought […] back to my [own] childhood. My father mostly raised me. From the age of four to thirteen I worked with him in our drugstore and delivered medication. I saw many dire situations: poverty, prostitution, people dying alone, battered women, forms of mental illness. Yet, as my father pointed out, it wasn’t my job to be there for each client on the route […] If I were to dwell on one needy person, if I were to be swayed by emotion, I wouldn’t get the job done.”

Gildiner explains that one of the skills necessary to be an effective psychologist was instilled in her at a young age: As she engages with her patients, she must learn to detach from their situations and approach them objectively. Though she feels compassion and empathy for her patients, if she were to let this overtake her, she would not be able to effectively counsel them. This reveals the way in which effective therapy is an important balancing act.

“Anyone who contemplates suicide has to decide to be or not to be. Yet, at some level, don’t we all have to make that same decision? There are times when we’ve had to decide or change or remain the same. Will we be slaves to safe, mundane routines or break out and remake our lives the way we imagine them to be? Real change may entail risk, pain, probably anxiety, and hard work, but it’s a way ‘to be’ versus not being.”

Though Alana’s life experience is both extraordinary and seemingly insurmountable, Gildiner emphasizes that making life changes is something that is not unique to those who have experienced trauma. Taking action to improve one’s life can be difficult for anyone and Gildiner aims to emphasize the way there are certain aspects of the human condition—fear, hurt, and other obstacles—that are universal.

“Sometimes a therapist has to ask herself why she’s pushing a patient in a certain direction. I’d wanted Alana to pursue a career commensurate with her talents, but I soon realized that I wanted this more than she did. I could hear my parents’ voices saying that I should never underestimate myself and that I needed a career; it was an important goal to them and, ultimately, to me. In other words, I’d been projecting my needs onto Alana. I’d been slightly fooled by her humor, her calm deportment, her frequent élan. I was now learning how wounded she really was. I decided to proceed more slowly.”

As Gildiner mentions elsewhere, it is important that the therapist separates themself from the patients. At times, Gildiner loses sight of this and must take a step back to reevaluate her treatment. Importantly, this moment in Alana’s therapy comes before Gildiner knows of her multiple personalities. Arguably, Gildiner may have operated differently, had she been privy to Alana’s other selves earlier in her treatment.

“Children who are given adult responsibilities when they’re too young to handle them are forever after worried about properly fulfilling their responsibilities; they never seem to accept that they were too young to manage the task but instead internalize their failure to accomplish it.”

Here, Gildiner points out a similarity in both Laura and Alana’s assessment of herself. Because both were thrust into a caregiving position at an unreasonably young age, they continue to enact this caregiving role into adulthood. Gildiner clarifies, too, the way such patients are set up for failure by the nature of being put into such an impossible role and given an insurmountable task. Yet, both Alana and Laura initially fail to see the task as at fault, blaming themselves instead.

“Psychologists have to learn from experience, and I certainly learned from my mistakes in this case. From then on I would tell my clinical psychology students about the cases in which the suicide attempt occurred just when the patient was apparently getting better. Not only does improvement require the ripping down of old defenses, which is stressful, but patients who have weak egos and who’ve been neglected also often have no idea how to ask for help when in crisis. They don’t believe they deserve extra care, so their despair goes under the radar.”

Gildiner is surprised when Alana attempts suicide, as it comes at a time when Alana seems to have experienced so much growth. Here, Gildiner reexamines the event and is able to identify not only why Alana was vulnerable to suicide at this point but also how her missing such warning signs was logical. Alana’s situation is a complicated one that poses many challenges for therapy to occur effectively.

“Alana found meaning in her life. She had to look after Gretchen, and she told herself that every day. Her suffering had a purpose. It was for the betterment of someone else. She pushed away all thoughts of suicide and escape for the sake of her sister. No matter how tired she was, she never laid down her sword.”

As Gildiner examines Alana’s past, she is amazed that, as a child, Alana only once tried to escape her situation through attempted death by suicide. Instead, the role of a protector of her sister led Alana to believe that her own survival was necessary. This attribute is one Gildiner cites in her assertion that Alana is a hero, as addressed in the book’s central theme.

“[Madeline] said she had to get better because so many people were counting on her. ‘It’s interesting that your first concern is to others instead of to yourself,’ I said. ‘Most people would say, ‘Doctor, I can’t live like this. My life is torture.’”

Madeline emphasizes the way that her phobia concerning flying is harming her business. She feels a responsibility to address this not necessarily for her own health and well-being, but because the income—and therefore, the well-being—of her employees is at stake. Later, she and Gildiner will uncover her fear of abandonment, which may be at work here as Madeline is focused on maintaining her employees’ happiness.

“Parents who instill a solid work ethic in their children are certainly doing them a favor, but this was different. Charlotte’s cruel perfectionism didn’t foster a healthy work ethic; instead, it promoted workaholic behavior. And workaholism is another compulsion—you work because you feel anxious when you’re not working. Some psychologists see it as an addiction, and certainly our modern culture has glorified it.”

Madeline’s anxiety is something that she may attempt to cope with by working. Her successful career should give her a sense of accomplishment and fulfillment, but Madeline will later admit that instead she feels undeserving of her success. Her hard work does not result in a rewarding payoff. Indeed, Madeline surrounds herself with other “workaholics,” many of whom she criticizes, unable to see the similarities to herself.

“‘So you feel you don’t deserve to have things go well. Underneath, you feel you’re a monster and that you deserve to have the plane carrying your best workers and your antiques crash.’

Madeline looked confused for a moment. ‘Yup. This whole business is built by a monster who’s a phony.’”

Uncovering the true issue that Madeline struggles with—her sense of self-worth—helps both she and Gildiner to ultimately address the effects of this struggle: Madeline’s unwillingness to travel by plane and unwillingness to allow her staff to do so either. The flying, then, is merely a substitute for the true problem. It is not until Madeline can address these deeper issues that she can begin to feel comfortable flying.

“I’ve found in therapy that it’s impossible to predict why some people will admit to, or be willing to explore, a very antisocial or uncivilized act, but will refuse to acknowledge that they’ve committed a relatively trivial social transgression.”

Here, Gildiner references the way that Madeline—despite outward evidence—is unwilling to discuss the possibility that she too, like her mother, obsessively plucks or tears out her eyebrows. Importantly, Gildiner has learned that it is most effective not to push the patient into discussing a topic if the patient is unwilling to do so at that time. This quote further underscores that way that though behaviors and patterns may appear objectively illogical to one on the outside, to the person doing them they serve a purpose, despite the pain the patient may endure because of the act.

“True narcissists, like Charlotte, never think they’re wrong. When they react by lashing out, they’re convinced that they’re simply defending themselves against some nefarious provocation from someone trying to harm them. When they feel threatened, they go into overdrive and retaliate quickly. Narcissism can be described as a trigger-happy defense.”

Gildiner points this out in response to Charlotte’s berating Madeline after she (Charlotte) is late picking Madeline up from a sports practice. Despite being completely responsible and entirely the one at fault, Charlotte shifts the blame entirely off of herself. Gildiner points out that it is the narcissism within Charlotte that is at work here.

“It’s interesting to consider the class differences in this child abandonment situation. Only the financially needy are considered in danger. If the police officers had gone to a housing project and found children who’d been left alone for six weeks, they would have either located the parents or moved the kids into foster care. The police who came to Madeline’s mansion must somehow assumed that moneyed people have moral authority—that if they left their daughter alone, they knew what they were doing. After all, they were ‘responsible’ adults.”

This quote shows that a false perception about child abuse and neglect is often present in American society. That this behavior—and other psychological issues, such as mental illness—can and does cross social and economic lines is what Gildiner seeks to emphasize. For someone looking in on Madeline’s life from the outside, it may have appeared to be fulfilling and idyllic. In reality, this is far from the truth.

“‘I never saw it […] I married my mother.’

I had alluded to this similarity before, but clearly it hadn’t sunk in. Sometimes patients have to see and hear things from many angles, many times, before their unconscious will release it to their conscious minds. That’s one of the reasons why therapy can take a long time.”

Madeline finally recognizes the parallel, abusive behavior between both her mother and her ex-husband, Joey. Though this was easily noticeable by Gildiner, in keeping with the theme of The Power of Self-Discovery, this parallel is only meaningful when Madeline is fully able to understand it for herself. Understanding this, too, helps Madeline recognize that she is not a monster, as she has been taught by her mother, but someone who desires love and is deserving of it.