Fears Around Commitment Colchester, Essex

Diagnosis: Mild depression (patient lives in Stratford St Mary, near Colchester)

"Malcolm" (not his real name), 48, is a successful mechanical engineer. He lives alone and rather 'loves' the 'challenge' of getting women to 'fall' for him. He has had many, many relationships, and seems to especially enjoy (gets a "kick out of") the 'conquest'.

However, things change rapidly when, some way into each relationship, the woman falls in love or wants a firmer commitment.

Malcolm never really connects with the women he sees. He goes from one woman to the next, insisting to himself that none of the women he meets can ever truly satisfy his needs. He dreams of finding the 'perfect woman', but each one eventually disappoints him; the closest Malcolm comes to intimate relationships is infatuation, with women whom he finds sexually enticing and exciting. Needless to say, these relationships seldom last long.

He says he loses interest and becomes "bored" easily, usually just after he has won their attention and affection. He has said that he can tell this because the woman starts to talk about them as a 'couple', holding hands and kissing him in public, which he perceives as the first signs of her becoming "'clingy'" or "'needy'".

He begins to feel, in his own words, "trapped", and looks for a way out, an "escape".

This is somewhat ironic, as Malcolm himself struggles with loneliness. He feels constantly "empty" and bored with life. Perceiving a 'hole' in his existence, Malcolm restlessly searches for THE woman who will fill that hole, and "fill me up". He remains hopeful that he will find his perfect girl.

Malcolm fails to countenance that what he is asking for in one person might be unrealistic. He characterises himself as someone who has always been alone and is destined to remain alone. The prospect of becoming a "miserable, lonely old man (just like my father)" terrifies him.

Malcolm's childhood, he remembers, was painfully lonely. His father was a head teacher at a well-known and rather austere private boarding school. A hard taskmaster to students, Malcolm's dad was even harder on Malcolm. Malcolm uses words like "cold" "inflexible" and "'emotionless'" to describe him.

Malcolm's father taught him to be distrustful of emotions, lest they render him weak. Academic achievement was the be all and end all, and emotional needs were neglected.

Malcolm's mother was also a teacher, and somewhat cool and aloof, deferring to her husband in most things. Neither parent met Malcolm's emotional needs. He grew up emotionally deprived, and continued to recreate this state of detachment from his emotions as an adult.

For many years, Malcolm was in a state of confusion. He realised that there was something wrong. His professional relationships and non-intimate relationships were in good shape. But he could never shake the pattern of becoming dissatisfied with his romantic and sexual associations, as soon as they became more serious.

The first thing Malcolm told me when he first came to see me was that he had been in therapy previously, but that all his previous therapists had not been able to 'fix' him. He'd begun with hope, but ultimately, they'd "failed" and "disappointed" him. He said that he'd never really connected with any of his therapists; he always found some 'fatal flaw' that, in his mind, justified him ending his therapy, often before it had really begun.

And, indeed, after just two sessions, he discovered that flaw in me. The evening after our second session, I received a lengthy email from Malcolm, detailing why my approach was never going to work, and insisting that I follow a different approach, which he outlined in great detail.

We discussed it at the next session, and discovered that Malcolm had always managed to find a reason, or some excuse, to avoid building a sense of trust with his therapists, all of whom he'd found warm and empathic. My hunch was that Malcolm needed to be confronted about these self-destructive patterns, and forcefully.

For Malcolm to escape his emotional deprivation lifetrap, he had to stop finding fault with the women he met, and begin to take responsibility for fighting his own discomfort about getting close to people. This included accepting their flaws, and their care and nurturance.

In therapy, I challenged Malcolm, over and over again, to 'chip away' at this lifetrap, whenever it asserted itself. It was important to show him that, although it was understandable that he was uncomfortable about getting close to anyone, in light of his experience of growing up (with emotionally-withholding parents), nevertheless when he insisted that "Elaine" wasn't beautiful enough, or "Sheree" wasn't intelligent enough, or "Karen" wasn't forceful enough for him (not their real names), I pushed Malcolm to see that he was falling into his lifetrap again, finding fault with others in order to avoid developing a sense of warmth and intimacy.

After the best part of a year of this empathic challenging, Malcolm has begun to see significant change. he is now living with Karen, and they are engaged.

A week or so ago, Malcolm sent me one of his long emails. He wrote:

"…I got a lot of insight into my childhood through therapy, but you took this further than the other therapists. They were empathic, and understanding, but you really pushed me to change. It was just so easy to fall back into my old familiar patterns, partly because I didn't know what else to do and partly because it felt safe.

"Your approach was different. I found myself looking forward to my weekly sessions. I realised that this was because I always came away with some new insight - a result of you gently challenging me.

"You never let me get away with anything, and I did try to pull the wool over both our eyes at times. You've showed me how to monitor this life trap, how to understand it and, most importantly, how to change it.

"I finally took some responsibility for making a relationship work. I didn't want my relationship with Karen to be just another failure, and I felt like this was it for me.

"Although I could see Karen wasn't perfect, I also knew we were good together, I decided that either I would have to connect with someone or resign myself to being alone forever."