Sunday, October 31, 2010

Impasse theory

Some one asked about impasse theory so I have included this.

Part 1

Taken from Mellor, K in "Skills in Transactional Analysis Counselling & Psychotherapy" (ed) C. Lister-Ford. 2002. Sage.

Three impasses

Three impasse statement
This views impasses developmentally. The type 3 impasse develops in the very young child, the type 2 in a less young child and the type 1 impasse in late childhood.

Part 2

In psychotherapy this is what is known as an impasse

Ego states symptoms

An impasse is a clash between two different parts of the personality. They having opposing goals and wants and can be drawn as a collision between the Parent and the Child ego states.

For example a woman may be insulted by someone at work. As a result one part of her (the Child) wants to express her anger and displeasure at the other person for being insulting. As she is just about to do so she hears this voice in the back of her head saying, “Good girls don’t get angry” & “Girls who get angry are bitchy”. Just the type of thing she was told as she grew up in childhood. These voices may be seen as representing the Parent ego state.

Child & fire
My imaginary friend did it.

So we have an intrapsychic collision inside the woman. Her Free Child wants to show anger and her Parent ego state wants her to be polite and pretty and not show anger. She is at an impasse in her own mind. Over time when there have been a number of similar impasses then a symptom will develop out of this. One can say that the collision between the two forces in the psyche provides the energy or basis for symptom development. A common symptom to develop out of such an impasse is depression. Some people who chronically hold in their anger can develop depression over time.

Historically there have been seen to be two solutions to an impasse. It occurs when one ego state dominates over the other it is opposing. If the Child finally gets up the strength and courage and defies the Parent and the woman expresses her anger then the impasse is broken, at least in that situation. If she repeatedly does that then it becomes habitual and she could at that point be said to be ‘cured’ of her problem.

pulling cats tail

This is what the majority of psychotherapists will attempt to do with the client. For the Child to break the impasse. This is what the vast majority of their therapy theories will define a psychological health

On the other hand the Parent may dominate or ‘win’ in the situation and the woman holds in her anger and does not show it to her colleague. If this happens then the impasse is broken by the Parent belief. Often when I do this in therapy, such as in couples counselling or when a client’s expectations are too high. I will produce what is the greatest single line in movie history. That excellent movie -As good as it gets.

Jack Nickolson2

Jack Nicholson walks into the full waiting room of his psychiatrist’s office, looks around at all the people and says, “What if this is as good as it gets?”. So I sometimes use that line and say to the client, “Perhaps this is as good as it gets”. If taken on, then the Parent breaks the impasse and the client’s Free Child need is not met.

There is however a possible third solution to an impasse. (This must be credited to my psychologist trainee, Nadja). The client accepts the Parent position of the impasse and then the FC want is redefined. I have discussed some of this before in a number of postings.

Gun in girl mouth
Undecided. At the point of impasse

I once talked about a supervision question where I was asked about a client who was a teenage girl who had lymphodema. Her FC want was to have thin legs. The Parent stated that she can’t have that because she had lymphodema. I then supervised that her therapist call her elephant lady or lympodema lady (rhetorically of course). Accept the Parent part of the impasse and then it is redefined in a humorous way and thus the impasse is broken. Or when I work with clients and I get them to love their panic attacks or make friends with their depression. The Parent part of the impasse is accepted and then one ‘loves’ it. The impasse is broken and the FC want is redefined.

Sleeping with the enemy is a great appraoch to take when dealing with your neurosis.


Wednesday, October 27, 2010

Discipline and strokes - Part 2.

As was mentioned in Part 1 of this topic, discipline involves the exchange of negative strokes from the parent to child. Discipline is in part always involves a negative stroke of some kind. A common way of disciplining involves using the Critical Parent ego state.

Functional ego states

This ego state is expressed when the discipliner is telling off, criticising and putting down others. This is sometimes used in the discipline of children but lets use a workplace example here.

The problem with CP discipline is that it works. If a boss tells his secretary that she is doing a bad job and is not working up to expectations in a CP kind of way then it is quite likely that her work performance will increase very rapidly. Quickly she will put in a better workplace performance.

So it would seem that in the workplace at least the CP type of discipline is the way to go to produce a productive organisation. If a parent wants a child to change its behaviour quickly then CP discipline does work. However this is not the case in the longer term and consider the graph below.

CP & Performance

Line A is what happens with CP discipline. Initially there is a rapid increase in performance followed by a slow reduction in performance. Why would this be so? Here is the CP discipline transaction.

CP discipline transaction

1. The CP discipline is given
2. The person responds from CC and complies to what is demanded. Work performance increases.

Whilst this may seem good the problem is the background relationship is harmed.

3. At the same time as conforming the FC also feels anger and resentment at the criticism and being treated with little respect.
4. When the FC feels this and the person is being conforming it is highly likely that at some point the person being disciplined will switch ego states from CC to RC and respond back.

When this happens the boss may have won the battle but he has lost the war. The employee will fight back in some form and express the anger or resentment. That may come as open defiance or more subtle and even unconscious undermining of the boss and the organisation.

If you surround yourself with people who resent you and dislike you, they are not going to go out of their way to help you or assist you if they can get away with it. Thus the organisation starts to flounder.


Line B. The other way to increase performance is with the boss using Adult and Nurturing Parent to deal with the under functioning employee. This is usually seen as the ‘counselling’ type of management. However this style does have its draw backs.

As you can see from the graph the increase in performance is much slower. Also it takes more time, effort and money than a quick short telling off. And there is no guarantee of a significant increase in the performance level in the long run. Some people simply do not have the natural abilities required or they just don’t have the belief in self or the motivation.

However with those who do respond to the A & NP approach then you are going to have a person who feels better about self and feels respected by the boss. If you surround your self with people who like you and feel respected by you then they are going to go out of their way to assist you and they will be keen to help and make the organisation function well.

police and wookie

Child rearing and discipline is the same. If a mother uses a Critical Parent type of discipline then the relationship with the child is damaged. The child will feel worse about itself and angry and resentful to the parent. More problems are created than the original discipline attempted to solve even though there is an initial quick positive change in behaviour.

Disciplining a child with out belittling it of course results in the relationship and attachment increasing in its psychological quality. CP discipline may get quicker short term results but the war has been lost.

In addition with parents and children one must make the distinction between loving and liking. As I have mentioned before here, loving and liking are two different psychological processes. All children love their parents, in that children are biologically programmed to develop and attachment to the parent but there are some children who don’t like their parents. The different discipline styles will in particular effect the liking aspect of what we are discussing. NP & A discipline will result in a child loving mother and liking mother. CP discipline will result in a child loving mother but not liking mother.


Sunday, October 24, 2010

Book update

They have now finalized the book cover and they say it will go to print in two weeks.

Book cover

I like it. Whoever designed it I think did a good job. .

Not an easy topic to do a good book cover for. But I think he/she has achieved it


Thursday, October 21, 2010

Strokes and discipline

From a child development workshop

Strokes and attachment are intimately related (of course). The quality, strength and psychological health of an attachment between mother and child is directly influenced by the types of strokes that are exchanged between them. As we know there are 4 types of strokes
Positive unconditional
Positive conditional
Negative conditional
Negative unconditional

Attachment and strokes

If mother (and to a lesser extent the child) is giving positive strokes to a child then the quality and strength of the attachment between them will increase as is shown in the diagram. When there is an exchange of negative strokes then the quality and health of the attachment decreases. Thus the quality of the attachment is directly influenced by the nature of the stroking patterns between mother and child.

When there is no exchange of strokes from mother to child there is a plateau effect initially as is shown in the diagram. The longer the period of no strokes continues then there is a decrease in the quality of attachment at an exponential rate. Initially it is nil, then slow and then fast as is shown in the graph.

When a parent disciplines a child it is giving the child a negative stroke. Discipline causes a child pain. If the transaction does not cause pain then it is not discipline but something else. As discipline is a negative stroke that means it will subtract from the quality and psychological health of the attachment with the child.


If in the past there has been a lot of positive strokes then the attachment quality will be high up on the graph. Thus the negative strokes from the discipline has minimal impact on the relationship quality between mother and child. If the attachment quality is already low on the graph then the discipline has a more devastating effect on the relationship.

Most parents who present with discipline problems with their children have an attachment quality that is already low on the graph. One sees endless books on the disciplining of children which discuss the different types and styles and the pros and cons of both. When I work with parents on discipline I am mostly looking at what they are doing when they are not disciplining the child. The most important part in disciplining a child is what you are doing when you are not disciplining it!

This may seem a little odd and parents at times find this hard to accept and will try to bring it back to how to discipline the child and see the non disciplining periods as inconsequential. However I would assert that if the attachment between mother and child is high up on the graph then discipline problems will be negligible or quite transitory.

Tough kid

Other points.
One negative strokes is five times more powerful than one positive stroke. If a parent gives one negative stroke to get the graph back to where it was prior to that the parent has to give five positive strokes.

This however is just a general rule of thumb. The negative relationship effects of negative stroking vary greatly depending on the type of negative stroke (discipline) given. However negative strokes are more powerful than positive strokes as described above.


Main types of discipline

1. Physical - Hit the child, bite child, pinch child, pulling hair.

2. Behavioural - Loss of privileges. This is the consequences of behaviour
approach. “If you don’t clean your room then no TV tonight”, “If you don’t get
home by 12 midnight then you are grounded”.

3. Emotional -
Anger at the child. All people have a natural aversion to anger because the
consequences of anger are never pleasant and can even be physically threatening.
“If you don’t get ready for school mummy will get angry”.
Withdrawal of love. Very powerful in changing behaviour. “If you draw on the
walls mummy wont love you any more”. Or the parent who gives the silent
treatment or the cold shoulder to the child who misbehaves.
Abandonment fear. Also a very powerful discipline technique. “If you don’t stop crying I will get a policeman to come and take you away”. Or the parent who simply walks away from a misbehaving child.
Shame. The cinderella of the destructive emotions. “You should be ashamed of
wetting your bed”. “I am going to tell your friends how horrible you are for
drawing on the walls.” A powerful form of discipline indeed


Monday, October 18, 2010

Therapists’ marital problems

Evan makes a good comment on the previous post about therapists working through their own transference with their spouse.

“I guess the therapist is the best possible person to help their spouse work through this transference”

I thought I would make a comment about this and thus I make another short vignette. I like that word vignette. It sounds like something you would find in a recipe book.

Question - How do therapist’s handle their own marital problems?

Answer - Just about the same as everyone else does.

Alf Garnet

Yes therapists are humans like clients and thus they have life scripts like clients do. Some have winners scripts, some non-winners scripts and some loser scripts.

There is a belief sometimes that a therapist would not have relationship problems because they are so well informed about relationships and human functioning. How can the expert in communication have his/her own communication problems?

This highlights an interesting point about psychotherapy. The difference between information and psychological change. Just because someone is informed does not mean they will act on that information. This is especially true in the human psyche.

clown & fag

When a client (or therapist) understands the games they play, this does not mean they will stop playing them. These are two quite distinct psychological tasks.

Becoming informed about about ones self defeating behaviours (psychological games) is a relatively easy Adult ego state exercise. Changing ones self defeating behaviours is a much more difficult Child ego state task. (If it was easy there would be no need to have therapists in the first place!).

Most therapists would be more informed about human communication than the average punter, so they have an advantage with their Adult ego state knowledge. But that is quickly equalised when it comes to implementing that knowledge with Child ego state life script change. In this way therapists are no different than your average punter.

Bubble blower

There is also (sometimes) a view that a therapist who has marital problems and a divorce cannot be expected to do productive marital therapy with clients.

“If you can’t get your own house into order how can you be expected to get a client’s house in order” is the view.

This is also a fallacious view. Simply put the skills required to do productive marital counselling with clients are very different to the skills required to keep ones own marriage in order. They are quite different psychological tasks.

However back to the original point at hand. Therapists have their life scripts and they will live them out like most others in the world. They also would, as a group, be more informed about human communication and relationships and thus this could be seen to assist them to sort out marital problems as they arise. But the bottom line is a life script is a life script. It is a awesome psychological force that is difficult to rework.

smoking teen

Some do alter their life script in varying degrees and some do not. Therapists and clients would be no different in this respect.


Saturday, October 16, 2010

Significant others

Zbig makes a good comment in the previous post about what would my wife (or my significant others, as they say in the psychotherapy business) think and feel if they read the post about my client who seems to be developing a strong transference to me that may be romanticised.

This is a good comment because it articulates a very real problem for those in the psychotherapy profession. Over the years I have seen this issue raise itself with a whole variety of therapists many times and it is indeed a difficult circumstance for them and their significant others to deal with.

The kiss

Sometimes clients develop strong feelings towards their therapists, sometimes positive, sometimes negative, sometimes sexualised and sometimes not. How is the spouse of the therapist meant to deal with this? A difficult question indeed and a very real one.

Is it reasonable for the spouse to feel jealous, threatened, excluded and so forth?
If they feel those things is it reasonable for the spouse to express their concerns to the therapist who is just doing his or her job.?
If they are express how is the therapist meant to respond to the spouse?

As you can see a veritable minefield of potential relationship ruptures (as they are fashionably referred to these days in the psychotherapy business).

However I need to place this in context. The psychology behind the positive transference is by no means exclusive to the counselling relationship. It happens in all areas of life and human relationships.

Lost in space

For instance in the work place. Take something a tad monotonous like the banking industry. There maybe a man who is respected in the banking industry, seen as talented in his field and has some power in the industry. As he goes about his business he will come across various women who know of his reputation. As they get to know each other positive transference feelings will develop in some instances and sometimes they will be strong transference feelings from the less powerful woman to the more powerful man.

This is no different to the psychology of the transference in the therapy setting. Obviously it is not appropriate for the client and therapist to have a relationship but for two people who work in the same industry like banking they can easily have a relationship and many indeed do. But as I said before the psychology behind the relationship is no different than the client therapist relationship. However the point at hand is positive transference feelings from one person to another are not exclusive to the therapy relationship.

Soliders looking

However in therapy the feelings can get quite strong in quite a short space of time. Indeed the therapist and therapy setting are a perfect green house for such feelings to grow. Thus the questions cited above have special relevance to therapists and their significant others.


Friday, October 15, 2010

It happens sometimes

I have seen a twenty something woman about 4 times. About the end of the second session I could see it in the way she looked at me. A strong positive transference is developing, maybe even very strong. She reports the sessions have been most fruitful for her and is keen to attend further sessions.

But it is the way she looks at me right into my face and eyes. I find it a little bit disconcerting as she can kind of stare at me for a little time. Not an excessively long period of time but it is a little longer than would usually be the case.

Body dismorphia

Why do I feel a little perturbed by it? At the moment I am “The best thing since sliced bread”, in her mind so I am supposed to feel good about that aren’t I?. But it is the swiftness of the emotional development, it could have a romantic quality to it and they could be quite intense emotions.

I have dealt with such clients in the past but I suppose I am yet to find out how such intense emotions are going to be displayed by her. If she is an acting out type of person then it is going to be some hard work at times. Some clear boundary setting is going to be required along with some clear confrontations. I suppose I am not looking forward to the possibility of that. However from how she has behaved so far, acting out is not one of her traits.

woman with knife

As I have mentioned before an intense positive transference sooner or later turns around to an intense negative transference. As I write I feel I am perhaps hyper vigilant with her at this time due to the strength of the emotions she is feeling towards me.

Maybe also it is the fact that she really looks into my face and eyes. Maybe I am finding that a kind of ‘closeness’ which I am not currently comfortable with. I get a sense of too much too soon sort of thing.

Cat leaping
In dealing with her I kind of feel like this at times


Sunday, October 3, 2010

Why are some drugs legal and others not?

I bought a new book the other day on addictions counselling. It is quite good and has some useful information in it. It is the usual sort of thing reflecting mainstream thinking on the topic at the moment. In chapter two it makes a statement that one would not uncommonly find in such a document.

“Contrary to popular belief, most people who use substances do so in ways that cause them relatively little harm”
(end quote).

Why would this be so? Not that it causes relatively little harm but that it would be contrary to popular belief. Why would the wider community have a contrary belief to this?

There are a number of reasons for this which in part answer the question which is the title of this paper. The Australian Psychological Society (APS) has done a position paper on substance use. Now the guys that put these position papers together hard nosed MFs, who eat, sleep and s**t science. You can be sure they know the area very well, they are relatively free of any political pressure so you are going to get a pretty good statement about the science of the area under investigation.

To quote them:

“In Australian history, laws regarding the legality or illegality of certain drugs have been politically driven, and had little to do with the level of use or possible harms that the substances themselves might cause.” (p3)

girl whistle blower

This creates a problem for government because they say to the public that they are making some drugs illegal because they are dangerous to people’s health. They profess that it is a health issue and what they are doing is for the good of the public. Unfortunately this is not so. They are doing it at least in part for their own political well-being not for the good of the public.

To sell this to the public they then have to set about demonising illegal drugs. They have to exaggerate the dangers thus trying to convince the public that they are acting for their well-being and not for their own political survival.

Thus they demonise illegal drugs in all sorts of ways and hence one ends up with the contrary belief in the wider community that I mentioned earlier. The general public believe illegal drugs are much more dangerous than they actually are and the government has made them illegal to protect us.

Kermit man

From a pure lethality point of view consider this chart below. This was put together by two psychologists who work at Liverpool University in the UK. They looked at the official causes of death through the 1990s and then calculated the risk of death per 100,000 people. They came up with a chart that shows which things are risky for us and which things are less risky for us. Included in it are various drugs.

Very high risk
Tobacco, methadone, injecting drug use, BASE jumping, grand prix racing, cancer, heart disease, space travel

Quite high risk
Heroin, Morphine, barbiturates, alcohol, hang gliding, parachuting, motorbike racing, sudden infant death, working in mining, asbestos poisoning, strokes, prostrate cancer, shaking of babies, off shore oil work

Medium risk
Solvents, benzodiazepines, motor sports, water sports canoeing, diabetes, skin cancer, influenza, suicide, giving birth, helicopter travel, liposuction, working in farming, being in police custody, working in construction

Quite low risk
Ecstasy, MDMA, speed, cocaine, contraception pill, GBH, fighting sports, snow sports soccer & rugby, Asthma, AIDS. meningitis, cervical cancer, food poisoning, air travel, being murdered, chocking on food, electrocution, drowning, passive smoking, factory work

Very low risk
LSD, magic mushrooms, viagra, fair ground rides, swimming, riding sports, food allergies, syphilis, malaria, appendicitis, pedestrian crossings, clothes catching fire, falling out of bed, vaccination, abortion, storms, terrorism

Extremely low risk
Marijuana, cannabis resin, indoor sports, playgrounds, peanut allergy, measles, insect stings, copulation, starvation, dogs, lightening, nuclear radiation, police shootings

Negligible risk
Caffeine, nitrous oxide, ketamine, computer games, masturbation, small pox, leprosy, sharks, cats, meteorites, executions, volcanoes

Woman and gun

If the government was acting purely for the health of the community it would change the laws on which drugs were illegal. It would make tobacco and alcohol illegal and make marijuana, LSD and ecstacy legal. There is as much chance of dying from ecstacy as there is from choking to death on your dinner or being blown up in a plane by a terrorist. In addition as far as drugs go marijuana is the safest drug you are going to get.

Then some will argue that marijuana may not kill you but it can make you go crazy with a cannabis induced psychosis. Unfortunately as time rolls on the science has simply not backed up this hypothesis. Yes it is very unwise for a person with a propensity for psychotic symptoms to use marijuana and the vast majority of marijuana users will suffer no mental health problems at all. Hence back to the original quote from my newly purchased addictions counselling book and the APS position paper.

Is a government going to make such legislative changes with illegal drugs? I don’t think so. If they did they wouldn’t be in government for very long which is why they have to exaggerate the dangers of illegal drugs and thus mislead the public in this way. Pretend to act for the good of the public when they are actually acting for their own political survival.

However despite all the politics this does raise some interesting questions for the drug counsellor and indeed parents of children who may use drugs. Does a drug counsellor (or parent) use scare tactics with the client (child).

Black eye mask

One way to try and stop a person using drugs is to make such a thing very scary for them. Get them to believe that drugs are much more dangerous than they actually are so they get scared and don’t use. Commonly known as scare tactics.

To do this you have to lie to them even if only lying by omission. Is it OK and therapeutic for a counsellor to lie to a client? Most would argue no. To my mind you have to tell the drug user the truth even when you don’t like what the truth is.

If you tell them that marijuana can make people go crazy the first thing they will do is make their own observations. With the vast majority of marijuana users they will think - “Well I have smoked marijuana and I haven’t gone crazy”. Then they will look around at all their marijuana using friends and see that none of them have not gone crazy as well. After making these observations what is the drug user going to think - “My counsellor is lying to me”, as indeed he is.

As a result trust is broken, the therapeutic relationship is damaged and the counselling suffers, at times significantly. Besides this most drug users have heard it all before anyway. Their parents, teachers, the police, the press, the government and drug counsellors have all exaggerated the dangers of drugs to them many times before. So if you, the current drug counsellor comes along and tells the user the truth and the WHOLE truth they are going to be surprised and maybe even shocked by such a transaction from you. Thus the therapeutic relationship is placed on a much more robust footing and the drug counselling is more likely to be successful.

Drinking games
If you lie to the teenager can you expect them to tell you all of what they are doing?

In particular they are more likely to be truthful with you about what they are doing and why they are doing it. Can you really expect a client to be truthful with you, the counsellor, when you are lying to them in the first place. If you lie to them you have to expect them to lie back to you.


Friday, October 1, 2010

Temper tantrum (editted)

A temper tantrum is an uncontrolled expression of anger or tension. It can include arms and legs thrashing about, arching of the back, crying, screaming, stamping feet, throwing self onto the floor.

4 common reasons for temper tantrums
1] Tension outlet. The child becomes like a pressure cooker and it does not have a more sophisticated way of releasing that tension.

2] Manipulation or intimidation to get something or assume the powerful position in the relationship with mother. This can be particularly so if the child has a tendency to throw a temper tantrum in public, like in a supermarket.

3] Temper tantrums are dramatic displays of emotion especially when done in public view. So they can represent the precursors for the development of the ‘drama queen’ personality types such as the hysteric, narcissistic or borderline personality types.

Amy W
Tantrums? Not this good girl.

4] The child is learning about anger and assertion. Temper tantrums can be a crude expression of these feelings. Most people as the grow learn about their feelings of anger, how to manage them and how to express them in a socially acceptable way. The first thing a child must learn is to focus its anger at the source of frustration or the stimuli of the anger. This is shown in the two diagrams below.

Temper tantrum anger

The first shows temper tantrum anger. It is directionless and thus goes in all directions including being directed at self. The child angrily lashes out and will hit those around himself as well as himself. When working with the child one seeks to get the child to identify the source of its frustration. Who or what lead to the angry response? It maybe mummy saying “No”, a sibling getting the last piece of cake, having to go to school, not being able to tie its shoe laces and so forth.

One needs to assist the child to achieve the cognitive task of understanding what caused its frustration. Once done the child can learn to direct its anger at the source as the diagram shows. Then to show the anger at that ‘thing’ in a socially acceptable way.

Directional anger

Responses parents can have to children who are engaging in a tantrum:
The primary problem with a temper tantrum is the lack of control by the child such that they can physically hurt self. If a child is in a hysterical state the parent needs to assess if it’s in danger of hurting self. If it is, then the parent must adopt the first strategy of restraining the child. If the child is not in any danger of hurting self then the parents can adopt strategy 1 or 2. If there is more thinking ability in the child then parents can adopt strategies 3, 4 & 5. The response can also be sequential. Do 1 & 2 first and when the child calms one can do options 3, 4 or 5.

Gun girl
Directing anger

1. Hold or restrain the child physically. Dabbing a wet cloth on the face can also defuse the anger
2. Ignore it. If possible it is best to give the behaviour as little attention (strokes) as possible
3. Distract the child
4. Isolate the child (Time out)
5. Compromise.

Tantrums in adulthood
Sometimes people never properly learn how to have directional anger and thus can have tantrum like anger as they grow into adolescence and adulthood. As I mentioned before this can happen in the emotionally labile and acting out type of personalities such as the hysteric, borderline, narcissistic and maybe the anti social personality type as well.

The problem is with an adult having a tantrum is the circumstances are very different. Compare the young child to a fully grown man who is six foot tall, solidly built having a temper tantrum. The potential danger increases significantly and this could explain some types of domestic violence. However the problems do not end there a fully grown adult also has far more ability to plan and is much more capable of using weapons. So the tantrums can be much more physically violent.

This may explain those situations one hears about from time to time when a disgruntled individual walks into a place where many others are and simply starts shooting people and eventually ends up killing self. We hear of teenagers going into high schools doing such things. These situations do have the directionless expression of anger quality that one finds in a tantrum and thus could be an adult display of a temper tantrum.