Wednesday, September 30, 2009

The process of individuation**

Integral to a child’s breakdown of its attachment to mother is its own individuation. As it reduces its attachment it then develops an understanding of itself as an individual. It slowly moves out to the individual self. If it does not individuate successfully then it can never successfully separate from the initial attachment figure.

The top diagram is the situation for the new born. It has no sense or very little sense of its individuation or its self as an individual. Over time this begins to happen and slowly the child develops a sense of individuation as it separates from its attachment to mother. This is shown in the second diagram. As the child separates it has to individuate and the more it individuates the more it can separate.

To define who am I - individuate - I have to also define who I am not.

When I worked in a prison there was one guard in particular whom I became quite good friends with. When there was a ‘lock down’ as thus there was not much to do we would sometimes have heated argument.

One of the arguments that I would present to him, to which he would vigourously debate against, was that society needed its prisons and prisoners. They had a positive effect on society and that if ever there were no prisoners or law breakers then society would eventually collapse in on itself. This could happen because the society would loose its sense of identity.

Prisoners allow us to define what we are not. “Those people in prison are prisoners and we are not like them”. It allows us to get a sense of “Them and Us”. By doing that we then begin to get a sense of who and what “Us” is and thus we get a sense of our group identity in that way. Prisoners allows us to maintain our group identity.


Indeed then we have wars. One sometimes hears the phrase, “The war on crime”. When ever a society in engaged in some kind of war it allows it to define what we are not - we are not the enemy. Thus we get a sense of who we are, we get more of a sense of what “Us” is. If we didn’t have this then perhaps the group’s identity would fade and that is one thing humans do not like at all! This could be argued as one of the psychological bases of war.

At an individual level we find the same psychological mechanism at work. We hear a lot about the child’s separation from the parent. After it forms an attachment to mother it then sets about breaking that down by separating from the parent. It actually does two things. It separates and it individuates. As the young child separates it stops using mothers identity and must begin establishing it’s own and thus becomes its own individual. So how does it do that?

At birth an infant is all Free Child and has no identity of its own. It has no individuation. The separation and individuation is seen to occur at three crucial stages of development. 2 years of age, 4 years of age and adolescence. It is at these three ages when it develops its own identity.

These three stages are know as the negativistic stages. That is, at these ages many of the children are found to be negativistic, antagonistic and rebellious against the parents. Why would they be like that? One reason is that they are defining what they are not, they are establishing who the enemy is, which is most often the parents. This of course is when the RC or Rebellious Child ego state is extensively used by the child and teenager.

The teenager finds out what he is not which partially allows him to define who he is. If he is also allowed to experiment with different things then he also finds out the things that he actually likes himself. If he is allowed to do things then this allows him to develop his views and beliefs on this and that then he will complete the identity establishing process. He becomes individuated. Slowly he starts to shift from individuating by rebelling to individuating by the Free Child. If he is afforded the opportunity to define what he is not then he can start to define what he is.

Firstly the child sets about defining what it is not and then it can start to define what it is. If the parent makes the wrong responses then the child can get stuck in RC individuation and the FC individuation is hampered. Those wrong responses can be two fold

1. The parents do not allow the RC expression either by providing nothing for the teenager to rebel against. That is the parents are highly permissive with very few rules and boundaries for the child. Or they are simply overwhelmingly strict and authoritarian such that the teenager gives up trying to rebel at all.

2. The teenager is not allowed to try and experiment with a variety of activities and life styles. For instance I can remember being 18 years of age, unemployed and living in a house (if you could call it that) with three of my male friends. I lived for a year with virtually no money and it was a great experience even though at times I went hungry, was cold and tired. I learnt how to make a can of baked beans taste really good. Mind you that is not very hard when you are really hungry in the first place. I recall on the occasions that I would go home to my parents house and noticed how soft the carpet felt on my feet. I had never noticed that before. The house I lived in for a year had carpet in a few rooms but it was very thin and worn.

My parents could have intervened and provided the money for me to live in a much more luxurious accommodation but then my Free Child individuation would have been disrupted by them doing so.

Why do teenagers do this? Because they can. FC individuation.

The point being that I was afforded the opportunity for my Free Child to experience the world and life in ways that I had never done before. By doing such a thing I could then discover who I was as an individual. Of course this is just one example of the many hundreds of things that the teenager needs to be allowed to do so his Free Child can find out about life, who he is and what he thinks and feels as an individual.

Of course the antiscript stage of development occurs at this time as well for the teenager. Indeed this could be seen as an explanation of why the teenager deviates off the path of the life script into antiscript. He will try and do all sorts of things that his life script would not normally allow him to do. What is also highlighted here is that teenagers are sometimes see as being rebellious, that is doing RC individuation, when in fact they are not. Yes they rebel to get a sense of - I am not that - but this still does not allow them find who they are. To do that they have to try out and experiment with lots of alternative activities and life styles.

Many might see her as being rebellious by the way she presents herself. This may not be so. She may simply be trying different ways of looking and dressing so she can find out what she likes and what fits for her own sense of sense. Free Child individuation.


Monday, September 28, 2009

Should children go to funerals?

Over the years I have been asked this from time to time and it has always struck me as an odd question. My answer has always been, “Why the heck not”. Of course the parents of such a child are fearful that being at a funeral might somehow psychologically damage the child. That wont happen given that other circumstances are OK.

Obviously a child can only go to a funeral if the cultural rituals allow for it. I would also recommend that a child not go if there was the potential for some major calamity or highly emotional event. If someone was going to angrily attack another person there or if someone was going to throw them self in the grave and start tearing at their skin whilst screaming. Baring such unusual events I would recommend that they do go as the child could psychologically benefit from it.

There probably is one other thing to keep in mind. When a child and a parent are placed into a sudden unpredictable high stress event such as a car accident or a bomb goes off near by the first thing a child will do is to look at the parent and try and read them. As the event is highly unusual the child will not know how to react so they will look to the parent for ‘guidance’ in this way. Does mother get angry, collapse in shock, get calm and problem solving and so forth? The child will take the cues from how mother reacts and then react in its own way which most often (but not always) will be similar to mother’s reaction or some derivative of it depending on its own natural temperament. Either way it will be heavily influenced by mother’s emotional reaction to this unpredictable event.

If at a funeral mother is really, really going to loose it emotionally then it might be a good idea to have someone else looking after the child whilst there. There is nothing wrong, in fact it is psychologically good for a child to see mother cry at a funeral and even sob at a funeral if someone is nearby reassuring the child that mummy is OK. Which of course mummy is. Mummy will start sobbing and then mummy will stop sobbing and then life goes on. There is no way a child will be psychologically damaged by viewing such an event.

When my two sons were about 4 and 6 years old their grandfather (my father) died from an illness. At the chapel we had a viewing of him in his coffin and I took my children up to him and we said a few words and each touched him in turn. I never have understood what’s the big deal. People live and people die. When people die you say your goodbyes, you take time to grieve and life goes on.

In the previous post on preverbal thinking about death I talked with Kahless about different ways of knowing things in your Adult and Child ego states. This diagram sums it up. When a loved one dies we will know in our Adult ego state that the person is dead. We have an intellectual understanding of it.

This is quite different from the Child ego state feeling, knowing and believing the person is deceased. We all have a 4 year old inside us who will be there until the day we die. So we all have the ability to think and feel quite irrational things like a 4 year old can. Accepting that a loved is deceased can be one of those occasions where the Child in us will think in a prelogical way and not accept the death in some way.

Funerals in this way can be very helpful. If the cultural rituals allow it I always suggest that there be a viewing of the body where the bereaved go and stand close to the body and touch it. The touching part in particular will let the 4 year old inside of us get some comprehension that the person is dead and gone. Often this can be quite powerful psychologically. And of course there is no reason why children cannot do the same.


Sunday, September 27, 2009

Prelogical thinking about death

I had a client say something today that was just very clear. You don’t tend to get such clear statements of this. She was reciting a situation when she was seven years old. She lived in a house with her parents and siblings and her aunt also lived there. Her aunt had an accident and died suddenly. She stated (This is pretty much as she said it):

“My aunt died and my parents did not want to tell me. I over heard them talking and they said that they were going to tell me that she had gone away to the country. But this was not a shock to me because I thought that dead people could come back”.

Not only did the parents little scam of not telling the child the truth not work as they were overheard, but the child would not have been distressed anyway because of her undeveloped understanding of the concept of death due to her age.

The truth?

It is sometimes noted that about the age of 8 years a child can get what is sometimes called “8-year anxiety” where they develop a pronounced fear of death. As Piaget has shown prior to age 8 the child is egocentric with magical thinking that involves prelogical thought. As a result of this children under 8 often think that death is reversible or that the dead can still see, hear and feel. At about age 8 the child’s thinking matures enough to allow it to understand that death is not reversible and thus it can hit that stage of “8-year anxiety” when it realises what is going to happen one day when it dies and when mummy and daddy die. In essence the child has an ‘existential crisis’ and has to come to terms with its own mortality for the first time at the tender age of 8 years which must be fairly hard for the little ones to do.

This woman’s statement was just so clear of this psychological phenomena that I noted it down and it does highlight one of the possible causes of childhood and adolescent suicide. The person at the point of making the suicidal act does not truly comprehend the consequences of what they are doing. In fact what they believe is going to happen maybe quite a distortion of the truth, such that death is reversible.

This is one of the four particular suicidal groups and I have called it the naive suicide group. Of course all adults also have a Child ego state. That is there is a four or five year old in all of us that remains until the day we die. For some people it can be quite pronounced and thus as an adult they can actually feel, behave and think in quite a child like manner. Thus part of them can believe at the age of 30 that death is reversible because they have a strong immature part where the Child ego state is quite influential. Such a person’s Adult ego state would know the facts about death but they also have a child feeling or understanding about it as well that is contradictory to the Adult facts.

Teenagers are in that twilight zone between

strong adult thinking and child like prelogical thinking.

At times they will oscillate between the two.

This phenomena is also particularly evident for some suicidal teenagers which makes suicide risk prediction particularly difficult for this group. The teenager may not show many of the usual indicators of suicide risk, especially the presence of the suicidal decision, the “Don’t exist” injunction, but still be at quite a high risk because of the reason I am just discussing as was highlighted by the woman’s comment. In suicide risk assessment I always feel much less sure when working with a teenager than working with an adult.


Saturday, September 19, 2009

Characterological problems

There is a concept in psychotherapy known as characterological problems. Consider the human personality as such:

This shows that we all have a core character or our basic personality. Based on that we have a whole range of other thoughts, feelings and behaviours which are more peripheral and not so much a reflection of our basic character.

In Transactional Analysis it is said that in the first years of life we all develop a basic life position. We make a decision that either we are OK or Not OK and we also make a decision if others in the world are OK or Not OK. This will form part of our basic character.

As we go through life of course we will operate and behave and feel in a whole range of ways. However if one looks at one’s overall direction in life then one can define a theme. Everybody is on a particular life path and more often than not will end up at the end point of that path on the day they die. There are a number of ways of determining this life path with a few questions:

What will they write about you on your tombstone?

If you had to write a sweatshirt message on your T-shirt what would it be?

If you keep going the same way you are now what will you be like in 20 years?

You are on your death bed. Who is there and what are they saying?

The answer to these questions will start to indicate your character or as it is sometimes called your life script theme. Of course along the way you may do a whole number of things that seem not to be following that life script but over 10 or 20 years one will see that they are following that life script. And thus we have the difference between character and the more peripheral behaviours. Over time the peripheral behaviours will fulfil or demonstrate the character.

Some times clients present a problem that seems to be very resilient. It will be very resistant to change. At other times they present problems that are quite amenable to change. One explanation for the very resilient problems is that it is what is called a characterological problem. That is, the problem has strong links or ties to the persons basic character. Of course whilst peripheral behaviours can change relatively easily our character is much more stable and takes much longer to change. With character problems one has to change their character (in part) to change the problem. Hence the problem being very resistant to change.

Sexual orientation is part of our basic character, thus behaviours reflective of that will be very persistent

Consider the smoking of cigarettes. I smoked from about age 15 to 25 and have not smoked since. Originally I smoked from a rebellious position. I was told that I was not allowed to smoke cigarettes and should not smoke because it was bad for me, which meant of course that I did smoke. Over time as I grew I stopped smoking from the Rebellious Child ego state but kept smoking because it was a habit. I was smoking purely out of habit.

Eventually I gave up a few times by simply going cold turkey for a couple of weeks. This broke the nicotine addiction and it also broke the actual habit of smoking. Since that time I have not smoked again and have no desire or urge to smoke.

For others this is not the case and they will try many times and ways to stop smoking but all to no avail. When this happens one gets the sense of a very resilient piece of behaviour that is very resistant to change. Thus it may reflect a character problem. That is, the behaviour of smoking cigarettes is closely linked or tied to their sense of character.

The most obvious explanation for this is what is called the oral character. This person did not successfully complete the oral stage of development (0 to 18 months of age) and thus they remain fixated in part at that stage. Many people of an oral character fixation can smoke cigarettes because it is constantly stimulating the mouth or oral zone as it is called.

This person does not smoke cigarettes for the peripheral reasons of rebellion or habit. They are smoking because they have an oral character and thus to stop smoking permanently they have to alter their character, not just the piece of behaviour. Hence the act of smoking is a very resilient piece of behaviour. One forgets about contracts to stop smoking, nicotine patch's and so forth and works on the character through the transference relationship and the relational.

Interestingly these people can sometimes stop smoking but their problem is not to get off the drug but to stay off the drug. Because I don’t have such oral character issues the urge for me to smoke when I stopped was insignificant. For the oral character, when she stops smoking, she will have a persistent and strong desire to take up smoking again because the basic character remains as it is. Hence the smoking of cigarettes is a characterological problem in this case.

A good example of this is provided by fellow blogger, Kahless who makes the comment:

“I guess my smoking is a character problem. Funnily I have given up a number of times - gone cold turkey - but its the staying stopped that is the problem. I just constantly have a voice in my head saying, just have one, just have one, its no big deal! You can control it.

The longest time I stayed quit for was for a year; at age 30.”(end quote)


Sunday, September 13, 2009

Group therapy with children

In the previous post I mentioned how I originally trained in group therapy with children. Historically play therapy rooms have been set up with a whole array of apparatus that allows a child to express itself. For instance there can be drawing equipment, a sand tray, clay, paint, water play area and so forth.

The theory behind this is that the child through the use of such expressive opportunities will begin to display their internal conflicts or emotional distress. For instance with drawing the child can draw conflicts in the family or between its own internal ego states. This allows for the therapist to begin to understand what the child’s internal conflict and emotional state is like.

Some then hypothesise that as the child displays its angst through play that will allow it to express them and thus they will reduce. This is typical of the theory behind art therapy and some psychoanalytic perspectives. Alternatively those who follow more of the Carl Rogers approach see play as a means by which the child can express itself in the presence of a therapist. That therapist provides an environment that is safe, empathetic and unconditionally accepting of the child. It is the theorised that the child in such an environment will naturally begin to grow and develop towards health.

The woman whom I did my first two years of play therapy group training with was quite psychoanalytic in her perspective. The psychoanalytic, art therapy and Rogerian perspectives described above to me certainly hold merit. When running play therapy groups I use those approaches.

After I finished my training in play therapy I went out on my own and ran groups. Over time I noticed that they changed from the style of my original training. As I worked with children I found myself moving onto other techniques that seemed to have a result. This was not a cognitive process on my behalf but more of an intuitive process that just evolved over time

Three techniques that developed over time.

1. The approaches described above one could call quite passive approaches. The child is simply left to its own devices and would proceed and progress at its own pace with little direction from the therapist. That is indeed why Rogerian therapy is sometimes called non-directive therapy. Over time I found myself becoming more action oriented with the children which more suited my personality as a therapist. Instead of just letting a child express itself through drawing or clay I would be much more interactive in my questioning and comments with the child as he played. Asking what this and that was, requesting that they draw word bubbles for the people they were drawing, asking them to write what the various parts or people were thinking and feeling. Getting them to include pets and various other people and objects in the drawings or plasticine.

This allowed for more diagnosis and also I was getting the child to identify its internal conflicts and to basically do two chair. Offering them the opportunity to expressed the unexpressed feeling or thought or need.

2. Whilst the techniques being employed tended to be more action oriented so was the relational. The therapeutic relationship between the child and myself moved away from the passive “blank screen” therapist that one would find in the psychoanalytic and Rogerian approaches. When a child made some kind response to me directly I would seize upon it and use it to some therapeutic advantage.

For instance if an anxious child with a high Conforming Child ego state said or did something a bit rebellious to me I might highlight it and request that she do it again or some other derivative of it to me directly. Alternatively if there was another child in the group who expressed some defiance of me I might ask the conforming child to see if she could say the same thing to me. Once done she gets to experience the new behaviour and sees that my response back to her is not catastrophic or demeaning and so forth.

The relational contact between the child and the therapist became very interactive and goal oriented with myself manipulating it in various ways for various means. Over time this became a point of significant departure from how I was originally trained.

Again this was not a conscious goal of mine but it just evolved over time. As I became more adept and confident in working with children in the group therapy setting I think I just allowed my own natural personality to come out in that forum. This is certainly what I say to trainee therapists. Initially you begin as a technique based therapist. What you do with the client is based on what techniques you have learnt in your training. As one gets more confident then you the therapist as a person enters into your therapeutic style. One transforms from being a therapist named ‘Tony’ to being “Tony’ who happens to be a therapist. Hence the client will experience you as a person who also happens to be a therapist rather than the other way around.

3. Finally there was the development of romp play. By far the most common approach in play therapy with children is as I described before. A low key, meditative, self explorative type of approach. Over time I developed this thing called romp play which is a far more cathartic approach. It is high energy, boisterous, jumping, rough and tumble, very interactional type of play. From what I have seen of the literature this is quite unusual. Whilst some other approaches do have some cathartic methods they are nothing like the romp play described here.

Originally it evolved as a method for children to develop their own internal Parent ego state controls. It is structured such that the group proceeds with - romp play on, romp play off, romp play on, romp play off and so forth.

Romp play is high energy Free Child behaviour. Whilst that is all good and well the problem with high Free Child is people can end up getting hurt physically and emotionally. Unrestrained Free Child can be dangerous. One needs to develop a Parent ego state that can control it when necessary. In the group any child could put a stop to the romp play at any time by using a prearranged word and all the romp play would stop. Those children who found it hard to stop would be stopped by the therapist. This allowed the children to begin incorporating this into their own Parent ego state. They learnt how to be Free Child and how to contain it when necessary. They were learning the internal controls to do that by their own Parent ego state.

However I think there is more to romp play than just this, although it is hard for me to articulate what that actually is. I could just recite the theory and say that the Free Child is that natural part in all of us and thus when expressed we are being our natural selves in this way. One can assume that when such expression is achieved this will be therapeutic in itself. This is probably all true but there is something that nags in the back of my mind about this. There is something more to this romp type of play for children that I feel the theory is yet to enunciate. When children have an opportunity to do a very free type of play and relating there is some kind of therapeutic effect on them that I cannot yet describe.


Saturday, September 12, 2009

Parent - child couples therapy

I have noticed in recent years that the way I work with children in therapy on an individual (ie not group therapy) basis has changed quite considerably. I have never tried to articulate that change and hence I am sitting here now attempting to do precisely that.

Many years ago when I first completed my psychology degree I managed to meet up with another psychologist, who was a child psychologist. She was very experienced in the area and had a very well decked out play therapy room. I worked with her and the children in the play therapy for two years. I didn’t get paid but got the supervision and experience for those two years in exchange. That hands on training was invaluable and has served me very well over the years.

Since then I have seen children and their parents in my own therapy with them. When seeing a child on an individual basis for many years I would almost always want the parents to leave the room at some point often for most of the session. This allowed me to interact with the child without the parents there. Then commonly I would get the child to leave the room and then talk with the parents.

In recent years I have done that much less and now see the parent(s) with the child in the room all together. In essence I am doing a sort of couples therapy by getting them to interact with each other and then making my therapeutic interventions with them as they transact right in front of me.

Working at a transactional level.

When working with a couple, say hubby and the missus, at a transactional level I will keep in mind the transactional diagram that highlights the three main features of a functional relationship.

With a struggling couple I will see if they have a problem with their Parent ego state compatibility. That is, do they have big differences in their values and goals about life? This is a common reason for argumentative couples to enter therapy and the big three Parent values differences are - money, sex and children. Also do both parties display caring and kindness to the other party and do they engage in some Free Child to Free Child exchanges at times.

If I am doing couples therapy with a mother and a son, at a transactional level, what are the transactions that will define a functional relationship between those two people. What transactions will make for a workable relationship between them. I came up with the following three transactional diagrams.

First one is wanting to see some good Free Child to Free Child interaction between mother and son. This is essential in any relationship really but for the attachment process between mother and son to proceed and be maintained then this transaction is pivotal. With busy mothers and fathers these days this type of transacting often gets a low priority and can sometimes be seen as a bit of time wasting. However from a psychological point of view and in terms of building a functional and healthy parent-child couple it is crucial.

In some respects this is the most difficult of all transactions for a parent to do with a child because in one way it is antithetical to being a parent. Most parents don’t understand what this transaction actually means. If they are presented with this idea then they will usually say something like, “We can go to the movies together”, or “We can go camping together”. These are not Free Child to Free Child interactions, instead they are two people doing an activity together.

The FC to FC exchange is where a mother interacts with her son so that she personally gets something out of it. In this sense she is not being a parent because she is not doing it for the child's welfare or benefit but she is doing it for her own personal gain irrespective of the child. It is in essence an emotionally selfish act on the mother’s behalf. It is certainly not the act of her being a good parent in the usual sense of the word as she is using the child to get her own Free Child needs met.

When a mother suggests an activity that might be a Free Child transaction, one needs to ask a question. What’s in it for her? In the answer there must be some Free Child need of the mother that is getting satisfied. If there isn’t then it’s not an FC to FC transaction.

The advantage for the child is it sees mother getting her own Free Child needs met by interacting with the child. A most positive psychological experience for the child indeed.

In this picture, you can see from the mother’s face and body language that she is getting something personally out of it. A FC need in her is being met by the interaction with the child.

Consider this. You are hanging out with someone and you can see how much they enjoy you and your company what does that mean for you and about you? If you have a young child, to whom mother is the most important person in the world, and it sees the same in her what is that child going to conclude about itself, her and the relationship?

The problem with Free Child is you can’t fake it. If she does not get a Free Child need met from her son then she can’t pretend to for the child’s well being. Hence we have one of those dilemmas of human nature. One of the healthiest things mother can do for a child is have such Free Child interactions, but if she does not feel that way then that can be quite psychologically destructive to the child and she can’t pretend. If she tries to, as can often happen, then the situation ends up worse.

What is it like to be friends with someone who tells you they like you when in fact they don’t? Over time you pick up the inconsistency, end up confused and worse off than if they had been straight with you in the beginning. Of course a young child will feel the same if mother tells it, it is liked and wanted when in fact it isn’t. However the psychological damage is much greater for the child than if it just happens to be between two adult friends.

Obviously there needs to be Adult to Adult communication as well. This of course is effected by the age of the child and how rudimentary their Adult ego state is. By the time the child is say 8 or 9 some serious Adult communication should be occurring. However even with quite young children one would be wanting to see mother asking the child how it likes its eggs cooked, or what colour shirt it likes to wear and so forth. In most parent-child coupling this is under done. The mother or father have many more opportunities to ask an Adult question of the child rather than simply making the Adult decision for the child.

In such a functional couple the mother would also be displaying a good amount of Nurturing Parent and Controlling Parent to the child. And on the other hand one is wanting to see a lack of such transactions from the child to the mother

Again this varies on the age of the child, but you are not wanting to see any significant degree of the child parenting the parent. For instance one sometimes hears of a mother who will discuss (seek counsel) her marital problems with her son or daughter.

If this happens from a young age then it can be particularly psychologically devastating for the child. It can lead to some quite serious personality maladjustment.

Finally one is wanting to see a good level of Conforming Child and Rebellious Child responses from the son to the mother. This is often good information to pass onto a mother or father as most often parents will see a RC response from a son as all bad. Very few parents will seek counselling because their child does not display enough Rebellious Child ego state. Very few parents will seek counselling because their child displays too much Conforming Child ego state.

In some families there can be one child who protests or fights the system loudly and the other child is quiet. Not uncommonly it is the quiet child who is more psychologically damaged. So in this mother and son couples counselling if the mother can see the son’s RC as a positive thing (at times) and then she is more able to respond to it in a productive way.

Again on the other hand one is wanting to see a lack of CC and RC responses from the mother to the son. One would not want to see this happening much at all as the parent is then behaving in a child like manner in her parenting. For instance one sometimes hears a mother say, “Johnny bit me so I bit him back”. A child like response indeed from mother.

Child-parent couples therapy

In marital couples therapy both adults can speak for them selves and say what they are wanting. With a child and parent obviously the child is far less articulate so in one sense the therapist becomes the advocate for the child. The therapist needs to be able to ‘hear’ what the child is wanting from the relationship and then state it to mother in a way that will be heard by her. The therapist becomes in one way the child’s Adult ego state in the couples therapy.


Sunday, September 6, 2009

A therapist's attachment**

I ran a short workshop last week on attachment and attachment in the psychotherapeutic process. Some interesting comments came out of it as participants gave feedback and asked questions.

At one point we spoke about the longer term attachments that can happen in therapy. One of the participants had been reading this blog prior to the workshop and asked a question about pre-verbal issues and their treatment.

I was going to suggest we did a demonstration rebirth but decided against the idea! With pre-verbal issues one is usually dealing with the more psychotically damaged person quite often with characterological problems or what is sometimes known as personality disorders or a third degree impasse in Transactional Analysis terms.

Doing co-therapy with Mary Goulding

The question was asked about how one treats the pre-verbal client and my answer was with attachment in the transference relationship. And amongst other things it is through this the client learns how to self soothe. The only problem is that it takes time. I am not aware of an expedient way to treat such characterological problems.

The question was then asked, how long is that? Usually 1, 2 or 3 years but in my answer I noted that my longest client ever was about 11 years. A very paranoid man who saw me once a week for about 11 years. There were a few breaks in that time but not many and none of them were long breaks. This brought a flurry of comment and questions.

After I stopped seeing him finally, he left and that was that. Months later on christmas day there was a knock on my front door. I went to see who it was and it was him! He said hello and handed me a Christmas present. We had a discussion for about 10 - 15 minutes and he left.

The paranoid personality type

This left me a bit perturbed as he had come to my home uninvited. This man could be very paranoid and could have created all sorts of paranoid beliefs system about me in his head. However I just let it go, did not hear from him again and forgot about the whole thing. Then next christmas day there was a knock at my door and when I opened it there he was again! I got another gift, we talked for 15 minutes and he left. This has continued every christmas since.

This has been good for me because after 11 years I got to know him very well and of course I developed an attachment to him. Of course as a therapist I need to be very careful with this and so forth. But after 11 years I had developed an attachment and this once a year continuity I like because it is a continuity of our relationship.

Sometimes clients complain that the therapy relationship is a one sided attachment wise which I agree with and then they complain that the only reason I see them is because they pay me and that if they died I wouldn’t even go to their funeral. Well if the man under discussion died I would go to his funeral.

The complaining clients are correct however and I would not go to the funerals of most of my clients should they ever have one. However I can recall two that I have gone to. At one I was even asked by the husband to give a short eulogy, which I did. That was of a woman who I saw for five years most of it at three times per week. So it was an intense therapy relationship and yes I did develop an attachment to her and I was moved by her death and emotionally moved at her funeral.

Let me tell you, that is not an easy thing to do, to see a client three times a week! What the heck are you going to talk about! If I see her Monday and then again on Wednesday there is not a lot of time for something significant to happen. However we managed.

At the workshop I also mentioned that over the years a few clients had legally changed their surname to mine. This brought consternation from some of the workshop participants asking if that was professional and ethical. My response was what is wrong with it? I can’t stop them anyway but of course they wanted me to agree with it which I did.

This has not happened for a long time and was in the early 90s if I recall correctly. These people had read about the Schiffian school of Transactional Analysis where Jacqui Schiff’s clients would change their name and so it was a follow on from that.

I must say that regarding the attachment or therapeutic relationship from my point of view this did have an impact. To me it meant something special and I was indeed very glad for them. I have not seen or heard from them for a long time now which is a bit sad. So clearly I did have an attachment of some kind with them.


Wednesday, September 2, 2009

The psychology of the bitch **

I was shopping in the supermarket the other day as you do. Going up and down each of the aisles and there were two women coming the other way talking to each other. We crossed by a number of times as we went up and down each aisle.

They passed me quite slowly in the first aisle and I overheard what they were saying. I wasn’t going out of my way to eaves drop on them! They were just talking and it was quite close as we passed each other. They would have been in their 50s and they were talking about some other woman who obviously had small children.

Well! They were savaging her, they were tearing her to shreds. A full on character assassination it was. Firstly about how bitchy she could be. Which was a bit ironic as they were bitching about her bitchiness. Then when we crossed two aisles later they were still at her, about what a bad mother she was, how she never controlled her children, always let them run amok and so forth.

So I wondered about all that. What was all that about? Why did it happen?

I suppose one could see it as a display of anger or aggression. Of all the emotions, it would seem that anger is the one that it would most closely be aligned to. However it is the expression of aggression in a feminine way - that is verbally. I think one could say that the more masculine expression of aggression would be less verbal and more physical.

So one could say that bitching can be a form of feminized aggression. Thus explaining why women (and gay guys) tend to engage in it more than straight males do, or at least one could argue that.

However since musing on this topic I have had discussions with two female colleagues of mine. They came up with some ideas that as a male I had not understood or even considered. They said that for females sometimes bitching about someone allows for a connection to be made between the two discussants. To say such confidential thoughts and secrets to the other means that you are trusting them and taking the relationship to a deeper level sort of thing. A most interesting idea that as a male one does not tend to experience at all. In this way the psychology of bitching is about relationship formation and maintenance.

I would suggest that males are not so bitchy in these ways but males certainly can be competitive. Whilst that is about winning and beating the other it is not so much about putting the other person down or creating some sort of connection between two men.

There is one other point that I would like to mention. In the Transactional Analysis literature one comes across the concept of four life positions:

I’m OK, You’re OK - (I+U+)

I’m not OK, You’re OK - (I-U+)

I’m OK, You’re not OK - (I+U-)

I’m not OK, You’re not OK - (I-U-)

I have since developed the theory of life positions further and this can be found at Life Positions.

I think one could say that the bitch would be adopting the life position of

I’m OK, You’re not OK - (I+U-)

In the article I state that it is more accurate to conceptualise this life position as:

I’m not OK, but You’re worse (I-U--)

The person in this position does not feel OK about self (I’m not OK). They deal with this is by trying to prove to self that others are worse than them. If they can prove such a thing then they feel better about self. It would seem reasonable to hypothesise that at least for some, this is one of the psychological functions of bitching.

“If I can prove to myself that some one else is bad, not doing the right thing and so forth then I wont feel so bad about myself” is the thinking of the bitch.

Now this formulation provides for an interesting theoretical off shoot. This last psychological function of bitching could be seen as a defence mechanism as was conceived of by Freud. The goal of the defence mechanism is to fend off anxiety provoking threats to the person. The belief - I’m not OK - would be such an anxiety provoking threat that the person would seek to fend off using one of the defence mechanisms.

To my knowledge no such defence mechanism like bitching has been previously suggested. There is a defence mechanism called - self negation. In this case the person wards off anxiety by getting in first with self criticisms and derogatory remarks. This is done in the hope that others will refute such claims with comments like - “Oh you’re not silly at all”.

Bitching could be seen as a derivative of this. It is not self negation, but others negation. By negating others the focus of attention is taken off self and this fends off the anxiety about ones own self doubts. In addition by convincing self that others a very negative then one’s own negative characteristics are minimised. Again the anxiety provoking threat is fended off.

So perhaps we need to add to Freud’s list of defence mechanisms with - The bitch defence mechanism.