Break out of character for me
Time keeps on going when
We got nothing else to give
We got nothing else to give
— Spoon, “Inside Out”


An infinite variety of patterns of interaction get “grafted” into the child’s personality in the context of the specific early childhood environment — the mother, the father, and the general family system — into which the infant is born. Every infant is born into a set of cultural norms, patterns of interaction, familial do’s and don’t’s, as well as implicit and explicit needs and desires. These factors become expectations that combine with our inborn temperament to form the basis for the song-and-dance routines that we learn at an early age. These routines become the basic blueprint for the patterns of interaction we will develop to care for our key caregiver. We call these patterns GRAFTS and the acronym describes — in a very basic broad stroke — some of the habits that can become part of our caregiving conditioning.

Following are examples of adaptive behaviors that become “grafted” onto a child’s style of interaction with the world. In adulthood, the grafted behavior continues to be used by the individual to induce a “positive” emotional and behavioral response in others — especially significant others — thus reducing the individual’s anxiety:

Good — that is, being “good” In the way the child thinks his caregiver wants him to be a “good.”  If this technique worked with his mother, the individual will try to be “good” in the same way with everyone. This user’s hope is that the “good” behavior will be “good enough” to fix the caretaker so that she can respond to him in desired ways.

Right — The child is driven to be “right” because he thinks that his mother will get better and love him the way he needs only when he does things exactly the way she wants. Sometimes this can mutate into being “strong” or “competent,” both of which are ways of being “right.”

Absent — The child believes that, by staying out of his mother’s way, she will feel better, making her more able and willing to love him. This technique is often used by the child of a depressed mother who can’t be “cheered up,” but may also be deployed by the child of a preoccupied parent who seems unwilling to be bothered with the child’s problems. Though seemingly counterintuitive at first, this is actually the “beneath-the-radar” strategy employed by the “audience” who makes his mother feel better by listening to her without bringing up his own needs. (Generally, a certain degree of non-engagement, i.e., “absence,” is necessary for any of the song-and-dance routines to be “successful.”)

Funny — The child deliberately assumes the role of entertainer or clown, hoping to make the caregiver laugh. When he identifies the routine that works, e.g., acting silly, singing, dancing, joking — he re-deploys that type of performance anytime he thinks the caregiver “needs it.”

Tense — In this technique, the child lives in a constant but unconscious state of heightened anxiety. Driven to “caretake” his caregiver, he is constantly “walking on eggshells” but is not allowed to call attention to his unease — not even to himself. This is a set-up for becoming the family scapegoat or the “identified patient, i.e., the one member of the family whom the others identify as “the problem,” thus providing a target for unacknowledged family dysfunction or conflict.

Smart — In families in which intelligence is valued, children become precocious “mini-adults” so that the caregiver’s regard is secured, causing the caregiver to bestow more attention on the child. This often results in the child’s denying to himself not just his feelings, but also the freedom to explore his areas of interest. The result is that as he matures, he uses intellectualization to block awareness of his emotions.

These are general descriptions of some of the techniques used to gratify our primary caregivers. To reiterate, however, the purpose of being a compulsive performer or audience isn’t just being good and doing the right thing: song-and-dance routines are designed to reduce the individual’s anxiety by fixing his caregiver so that his own environment feels more stable and secure.

Larry Discovers his GRAFTS

When Larry came into therapy, he unraveled a life-story of uncommon complexity. Over the course of his therapeutic process, he became familiar with irrelationship, GRAFTS and song-and-dance routines. In a moment of energetic identification and self-discovery, he wrote the following summary of his newly developed insight into his life, seen through the GRAFTS perspective.

“I’ve lived a life of GRAFTS. I just didn’t know it. I never ever thought of myself as a people pleaser. Never. A performer? I just did what I did without thinking. It was automatic and part of my relationships with bosses, friends, everyone.

 I was so good at what I did that nobody ever messed with me, and if their appreciation wasn’t what I thought it ought to be, then, bang!  I was out the door and on to another job! I never had trouble finding a new job because I was well known in my field for very strong job performance. But until I read about GRAFTS, I never realized my getting and holding a job really began when I was like four, or even two years old.

Good? I was a Good boy, all right: I always gave the Right answers to my mom — but also knew when to be Absent — I knew when it was smart to stay out of her way. No problem!

And what a performer I was!  A really silly kid when the occasion called for it! Funny yes, but uptight at the same time — especially in the house — everywhere actually. I was Tense — all the time!

And the clincher, boy was I Smart! Smart enough to know how to work the whole system — the entire GRAFTS formula! Who knew? I was just trying to take care of things — or else. And yet, hard as I worked at holding things together, I felt all alone in the world.

Anyhow, I was a bank “turnaround” expert: give me a job in a bank in trouble and keep the rules off me, and I — the fixit-expert — worked my GRAFTS magic. I worked like a machine. Except the time I was working in a big bank holding company where I got too close to discovering how totally rigged it was — all the way to the top. I had enough bravado to let them know how much I knew without exactly pointing any fingers. And they got rid of me, all right; but while they owned the bank, I owned the staff — the staff were loyal to me!  Anyway, that’s what I told myself. Well that illusion lasted for the six months they gave me to get things squared away and get out. But what a kicker! My song-and-dance routine literally saved them not just from going under, but from going to prison! I’d saved their necks, and they thanked me by firing me.

“I’ll fix them,” I thought to myself, drowning in self-pity and, oddly, also a weird kind of remorse. But what was really starting to get to me was I was starting to see that, no matter how hard I danced my GRAFTS routine, I was getting nothing back for it — no help, no sympathy, nothing! I was still totally alone!

When you’re stuck in GRAFTS, getting hung out to dry this way is intolerable — you need for those who hurt you to be punished. That feeling of rage, of total betrayal and isolation — that’s what GRAFTS earned for me. Finally, a few years later, the chairman and the president of that holding company were fired. I was ecstatic.

“Go for it, Larry!”Mark

I remember once seeing a desk plaque on a bank officer’s credenza that read “Forgive and Remember.” I Loved that. “That’s me,” I thought. “You’ll see!”  And before long, I was back out in it again. I formed an Investment Bank in New York.  I got three Wall Street heavies on the board and bought a Savings and Loan Association that was in trouble in North Carolina. In the end, those Southerners got us Yankees: they took the S&L away from the company after I had caught two of my directors buying shares with insider information. I figured out what was going on by putting two and two together from some stuff I learned in a meeting with the Chairman of the biggest S&L in Jersey. When my two guys got busted, my company ended up smeared with a lot of the dirt that came out.  Well, I dealt with this by just letting them have the company and I walked away, liquidating whatever remaining interest I had two years later. 

One problem with performing GRAFTS all the time is it makes everyone else look like slackers. And believe me, I was enough of an opportunist — or just foolish enough — to rub it in everywhere I went. 

Anyway, the same thing had happened again: I got kicked out by my board, who I blamed for doing nothing to go after the guys that were fouling the nest.  Instead, they funneled the blame onto me for everything that went wrong, while giving me no credit for what everything I’d done to make the company go.

 Funny thing is, the same thing happened with my marriage: my wife blamed me for everything that was wrong with our marriage and gave me no credit for anything I thought I’d done to keep things together. You name it. My whole life — personal and professional — had been built by making other people happy using my GRAFTS routine. I never, never saw that the whole thing was a performance I’d created to try to get people to like me — and, when that failed, to get them to leave me alone in my hurt, anger and self-pity. 

 I heard on the radio the other day something like “don’t do what you should do; do what you want to do.” Gee, I thought, that’d sure be nice.” But I was a one-trick-pony, trapped in my song-and-dance, endlessly trying to please people who couldn’t be pleased. In fact, the people I tried hardest to “please” were the same ones who sucked up my “caretaking” and then took the money and ran.

Now I can see that this was exactly how it was in my childhood. I spent all my time and energy trying to please two people — my parents — who just couldn’t be bothered. But my GRAFTS routine gave them the perfect “out” so that they could excuse themselves from taking care of me. Only I wasn’t a professional colleague: I was their child!

Larry’s story shows just how deeply GRAFTS become embedded in our behavior, and yet we remain totally unaware of them. We become like a character on stage who has forgotten that we are in a role. And in this way, we become our song-and-dance routines. We create our routines, not because of who we really are, but because we figure out early in life that the people taking care of us respond positively to them. As psychoanalyst and pediatrician Donald Winnicott (1965) put it, we unwittingly create a “false self,” burying our underdeveloped “true self” deep within us to keep it safe. We persuade ourselves that our caregiver had more interest in the false self than in the fragile true one (or, from a relationally psychoanalytic perspective, the true ones). This relieves our terror of being left alone in the world with no one to take care of us. But the device works only temporarily, so we repeat the routine the next time we feel unsafe.  Before long we’re resorting to it habitually like an addict reaches for his drug. And like that drug, each use of the routine gives us just a little less relief. Still, the “improvement” in the caregiver’s mood or behavior is like a “fix” for both parent and child, thus reinforcing the cycle. We essentially become conditioned by conditional love in place of being liberated by unconditional love. Over time, these mechanisms come to shape how we relate to everyone.

Though varied, the song-and-dance strategies share another characteristic: once chosen, they are used uncritically as survival techniques that make the user unable to respond spontaneously and flexibly to life’s variables. Instead, the user comes to depend on the same technique as an overall life-management strategy. Winnicott (1965) suggests that “the development of a self may involve a sophisticated game of hide and seek in which it is a joy to be hidden but a disaster not to be found” (p. 186). GRAFTS is just such a game. In irrelationship terms, an undeveloped or underdeveloped “self” is deprived of choice and ability to meet life spontaneously.  In whatever GRAFTS choice we make, we, like Larry, become, locked in a state in which every new situation is a crisis that must be managed with our song-and-dance routine.


Winnicott, D. W. (1965). The maturational process and the facilitating environment. New York: International Universities Press.

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