"Help is the Sunny Side of Control" - Anne Lamott
Writer Anne Lamott wrote in Almost Everything: Notes on Hope that “help is the sunny side of control.”
And there's plenty to learn from that in our personal relationships. How sometimes we nudge, cajole, and even take the wheel for others—not out of altruism, but to quell our own fear, anxiety, or sense of unworthiness. But I think those of us in a helping profession should build a regular practice of holding it up to the light to look for where it's showing up in our work.
And before you decide this is a problem other clinicians have, consider how control dressed as help has affected the patients who show up in our offices.
The 12-year-old whose mom took her to Weight Watchers, now 40 and bone-tired of providers who recommend weight loss before ordering diagnostic tests, all those years of training landing on her the same as an aunt who "just cares about your health!"
The person with a substance use disorder coerced into treatment they weren't ready for, shamed into compliance, when nobody ever asked what hurt so badly, and how the drug diluted it. Or used to, at least.
The invisible chronic illness rewritten as anxiety, as somatization, because those are things we know how to treat. Unable to admit, sometimes not even to ourselves, that this enigmatic cluster of symptoms might be something. It's just not something we understand. And we have nothing to offer it.
The restrictive eating disorder treated with an antipsychotic for "anxiety," when inducing weight gain was the point all along.
And pf course, conversion therapy. Queerness approached like a tumor. Something to be cut out of the psyche and sent to pathology.
In our personal relationships, the urge to take over is usually about controlling the outcome.
Sometimes that's benign. I take the spoon from my toddler before a half cup of muffin mix coats every surface in the kitchen.
Sometimes it isn't. Coercive control degrades self-efficacy so slowly that after years of daily pinpricks, there's nothing left but a shell that complies. Not a soul that can be present with us in joy, in grief, in all the ordinary hours in between.
The benign version in my work looks like good pattern recognition. Catching hypomania at the first spark, treating it before it becomes a wildfire.
The malignant version undermines a person's humanity and calls the result stability, when what we're looking at is a dissociated stillness. And it holds up a mirror to everything we can't tolerate in ourselves, personally and as a society.
Help is the sunny side of control.
It doesn't have to be. Not if we're courageous enough to reckon with the unpleasant thing in us, instead of passing it to someone else like a candy whose bitterness has been coated in sugar to hide what's inside.
Once a week. Go through your panel, your treatment plans, your case formulations - and look for it. You’ll probably find it tucked in somewhere, in a very well-intended and evidence-based wrapper.
