Sunday, July 29, 2012

Jay Haley on marriage counselling - part 2

This post follows a previous one (July 2, 2012) where I recited some of Jay Haley’s thoughts  on marriage counselling, here.

I have mentioned before how I like some of what he says. He is a family system therapist. My personal view is sometimes the family system is of central importance to a client presenting with some kind of symptom. On other occasions it is of little or no importance. On those occasions when it is, I tend to use the Haley model of systems theory. Or at least I keep it in the back of my mind when working with the couple or family members.
In my early training in couples therapy which was some time ago it was highlighted how the counsellor must be an impartial party and not to be seen as favoring one party over the other. I have tended to follow this over the years but have always felt a bit uncomfortable with it as it seems a bit limiting in what the therapist can do.

Couple argue

Jay Haley
A good therapist will avoid consistently being in a coalition. At times the therapist will side with the wife and at times with the husband. The art is to avoid consistent coalitions. One should join a spouse against another in a calculated way for a specific purpose. In certain situations the therapist may want to destabilize a marriage to produce change. Sometimes a marriage may be stable but miserable. An effective way to destabilize a marriage is to join one spouse against another and simply hold that position. It will tend to bring out emotions and action in the stable couple.
I like this idea as it allows for much more flexibility by the couples therapist. It is different than my original training in marital therapy that I mentioned above. Also it rests on another basic premise of Haley. He posits the following

Ciggie woman

Jay Haley
In couples therapy it is best for the therapist to consider whatever the partners do in relation to each other they also are doing in relation to the therapist. The therapist views the couples therapy as a triad where the therapist is an active party in the dynamics of what goes on between the couple.
A comment by the therapist is not merely a comment but also a coalition with one spouse in relation to the other or with the unit against a larger group.
This makes more sense to me. The therapist automatically enters the dynamics of the marital relationship. They cannot be uninvolved, instead it is inevitable and couples therapy is always a triad not a dyad. This clarifies for me what I kind of knew but have never articulated clearly. When doing couples counselling one sees this obviously happening. One is an involved party in the couples relationship.

indian woman

This however raises another interesting proposal as it provides the beginning of a relational therapy approach to couples counselling. The therapist becomes actively involved in the relationship with the couple and the relationship is used as the agent of change. The therapist is using his relationship with the husband and wife (and their marriage) as the means to facilitate change. 
In this relational approach to psychotherapy, it is the relationship to the client that is seen as the agent of change. This implies that as the client changes the relationship to the therapist, this forces the therapist to react to the changed relationship and this makes the therapist also have personal change.
Jay Haley states, “He usually finds his own marriage undergoes changes in response to his experience with couples.” Here we have Haley stating in 1976 a basic premise of the current ‘new’ relational approach that is currently very in vogue in world psychotherapeutic circles.

Eye shadow

Individual and couples therapy
Some therapists have a rule that if you see a person in individual therapy you must not at a latter time see that person and their spouse in couples therapy. This situation not uncommonly arises in counselling, where the partner wants to get involved. Some of the logic behind this rule is that you cannot be unbiased as the couples therapist, because you have a pre existing relationship with one party and not the other.
I have never had that problem or followed that rule. I am quite willing to see a couple where I have had a pre existing therapeutic relationship with one party and not the other. After thirty years of counselling I have come to learn that in marital disharmony there is always two sides to the story. 
What is being proposed here by Haley now makes more sense. In the situation described there is already a coalition formed between the therapist and the client previously seen in individual therapy. It is quite likely the spouse who appears later in counselling will experience such a coalition existing as does the pre existing client. Even before the first couples session has started the dynamics of the husband-wife-therapist triad is occurring. One simply uses the perceived coalitions for the couples gain.
This changes the therapeutic landscape quite considerably. Haley states that counselling one party in individual therapy and not the other will tend to build a coalition between the two with the other spouse being out side that coalition. Thus one can use this method to build coalitions with one spouse as well as reducing existing coalitions by seeing the other spouse in individual therapy.
In this way the distinction between individual therapy and couples therapy becomes meaningless. Individual therapy becomes one technique or one subset of the overall couples therapy.

Thursday, July 26, 2012

Book update

The first proofs are almost done.

Title page

Contents page


Saturday, July 21, 2012

Life script patterns



This chart shows some of the psychological meaning of physical disorders.


Friday, July 20, 2012

Life script classification

What is your life script?


Tuesday, July 17, 2012

Counselling and the emotion of love - Part 3

Love as a contact emotion
Love is considered one of the contact emotions with the other one being anger but it works in the opposite way. These two emotions are often, although not always, associated with contact between at least two people. Feelings like sadness and scare are not so much related to human contact.
One can feel scared about jumping off a high ledge into water, or one can feel sad about the death of one’s dog. These do not involve any interaction between two people like anger and love can. Obviously love is all about two people reacting to each other and it is an emotion that often results in two people feeling a psychological connection and indeed often spending time physically together. Anger is also about human contact where two people hit up against each other in some way. When two people are angry at each other they are in psychological contact which is also the same for love.


Love and attachment
Love and attachment are inextricably linked psychological processes. They result from each other and result in the development of each other. Love causes an increase in attachment and attachment can result in an increase in feelings of love. 
Attachment here is referring to human attachment as was originally described by John Bowlby. In the therapeutic relationship, attachment is seen to develop between client and therapist in the positive transference stage (and break down in the negative transference stage). The same applies for relationships in the non therapeutic setting. When a couple meet in a romantic sense they may develop feelings of love for each other, especially in the honeymoon stage of a relationship. When this happens the psychological attachment between them grows quickly, which can then lead to a deeper sense of love and so forth. By the end of the honeymoon period usually quite a deep level of psychological attachment has been established. This is under normal circumstances but does not happen so much with particular personalty types most notably the antisocial and the narcissistic.
The key feature of an attachment is the desire to maintain proximity. Once an attachment has been formed both parties will have a strong desire to maintain geographical proximity to the other. Also the degree of grief reaction to the loss of the ability to maintain proximity can also show the extent of the attachment. The deeper the grief at the loss of the other (through death or divorce) the stronger the attachment is/was.

Person alone

From this one can deduce that should a person have difficulty with the experience of love then their attachments will be weaker than one would normally expect. This relates back to the personality types of antisocial and narcissistic who do have difficulty with the feeling of love towards another. 
However it is not only limited to them. For example I talked in a previous post about that person who has difficulty letting go of their Adult thinking and Parent controls. They also will have more trouble with the feeling of love and thus the attachment process. This typically occurs more in males than in females. Then there is the person who has suffered a broken heart in the past and all the pain that can go along with that, and they may develop some level of commitment phobia. The past experience of loss frightens them because it was so painful and hence the Free Child will naturally be more hesitant to let love feelings develop again because it knows that results in attachment and therefore one is again vulnerable to the pain of a broken heart.
There has also been an evolutionary argument put forward for this relationship between love and attachment. In cave man days when a woman got pregnant she was putting herself in a life threatening situation for herself and the child, more so than she is in this day and age of westernized societies. 

tree people

The child (and woman) has a much better chance of surviving pregnancy, birth and the post pregnancy period if there are others around to help her. To assist her with obtaining food, warding of mammoths and sabre tooth tigers and looking after the child in general. If some kind of affectionate love feelings develop in the man to the woman then he will develop a form of attachment to her. If that happens then he will have a desire to maintain proximity to the mother (and child) and hence the child has a better chance of survival. It is harder for the male to simply get up and move away from the woman. Hence the process of 
love > attachment > desire to maintain proximity 
can be seen to have a direct evolutionary advantage. Whether all this is true or not is another matter but it is an interesting hypothesis.
Therapeutic model for working with love 
1. Assess how the client understands love  - Adult or Child
2.Can client master the process of falling in love. Are they able to decommission the Parent and Adult ego states and let the Free Child be uncontrolled.
3.Those who have difficulty experiencing love may be stroked deprived as they lack the human contact that it provides. This may be reduced by having more human contact through anger.
4.The ability of the client to form an attachment can be seen as related to their ability to experience love towards another. This can identify some of those who have attachment formation difficulties.

Friday, July 13, 2012

Counselling and the emotion of love - Part 2

Falling in love
As mentioned before anger and sadness are often a reaction to a discrete event and this is less so with love. It is sometimes said that one ‘falls in love’. In this sense it is not a reactive process to some event. The metaphor of ‘falling in love’ in itself is quite a descriptive one. People do not run into love, or climb into love, or drive their car into love, instead they fall into love. 
"Falling" is a passive process and in one sense is almost a submission to the inevitable. Some people who are seeking love, flounder at the stage of falling in love. They may not  be passive enough and they rush to find it, which means of course they never do. They are too desperate for love and one can only really find love when it falls into their arms by accident.
This is a very unnatural act for a human. It takes some strength to jump and let self fall.

As mentioned before to find love involves a surrender to it and a giving up to it. People do not naturally like the sensation of falling. If one is falling they will usually instinctively put their arms out and try to grab onto some thing so as to avoid the fall. Falling in love involves a trust that that one will not be hurt and hence they do not naturally reach out and stop the fall. Some find this very hard to do as they lack the trust and hence they find the falling, submission process hard to achieve.
There are other human functions that require the same psychological ability of letting oneself fall and to give up the usual controls people look for, and those are sleep and sex. Again humans have naturally observed this and hence we have the saying that people fall asleep. They have to give up the controls of the Parent and Adult as this diagram shows.

Falling in love ego states

All three human functions require the ability to allow self to be dominated by the Free Child ego state and to turn off the controls of the Parent and Adult ego states. For some it is very hard to let go of the controls and that can result in insomnia or for men it can be one cause of erectile dysfunction. The same applies for falling in love. One must let the Free Child aspect of self run free and not be overly controlled by the Parent and Adult.
This way of viewing the emotion of love allows the counsellor to get some further kind of framework about how to deal with the emotion when it is presented by a client. For example in the previous post Annalynn made the following comment:
“Coming up with a "Yes" answer is difficult. It's never a "Yes". It is always a "Maybe" or "I guess" or "I don't know". I have to ponder it, taking in to consideration how much the person cares and factoring in how many times I have been upset/hurt by them. "Yes" would mean that the person cares and will never hurt me. But everyone will at some point even if it is unintentional.” (end quote)
The therapist may deal with this by seeing that Annalynn needs to master the falling process again. Because of past experiences she is very reluctant to let go of the Parent and Adult and let her Free Child fall in love with someone again. She needs to relearn how to surrender in this way and submit to her need to experience love again.

Roller girl

This model also provides for some clear therapy exercises. The therapist could provide her with ways to experience being in Adult and letting go of it. Should could experience her Parent ego state and then feel what it is like to give it up piece by piece. It is likely these exercises would engender a sense of fear in her and when this point is arrived at the therapist can assist her in working though the fear. Also she needs to have some practice at experiencing her Free Child. Therapeutic interventions like this would allow Annalynn to restructure her personality such that she is more prepared to again enter the submission process of falling in love.
Therapeutic model for working with love 
1. Assess how the client understands love  - Adult or Child
2. Can client master the process of falling in love. Are they able to decommission the Parent and Adult ego states and let the Free Child be uncontrolled.

Wednesday, July 11, 2012

Counselling and the emotion of love - Part 1

The emotion of love is one that is presented reasonably often in the counselling setting. It is brought up reasonably frequently by clients and when it is what does the therapist do with it? How do they handle it or address it?
When a client presents emotions such as anger or sadness the therapist knows what to do. A great deal has been written on these and indeed some of it varies. For instance with anger in the CBT approach the therapist will encourage the client to think about their anger, isolating any thinking errors that may be involved and planning for any similar future situations that may arise and how the anger can be avoided. The cathartic approach may encourage the person to express their anger, along with vocalizing their angry thoughts. Once expressed the client is then encouraged to drop the anger.

Love story
Love story, we all want it.

Although the methods differ there are clear guidelines on what to do with anger when a client presents it. However what is a therapist meant to do (if anything) with the emotion of love when it is presented in the counselling room? It seems advantageous if the counsellor can have some kind of framework in his own mind by which to understand and deal with this emotion when presented by the client. The purpose of this post is to provide a beginning to this venture and this comes from my own experience as a counsellor and from various writings that inadvertently may address the emotion of love and its role in human psychology.
What is love?
Answering this question is an onerous task indeed and it is probably safe to say that it has never been fully and successfully done. Many people have written about love and indeed isolated aspects of it but it seems safe to say that it is impossible to define love, fully and completely in an Adult ego state fashion. However this does not mean that people do not know what love is. I would say that most people do.
Not uncommonly a therapist may ask the questions:
Are you in love with him/her?
You really did love him didn’t you?
Generally speaking most people can answer such questions with a degree of certainty. When asked such a question I have found that most can answer the question quite quickly and feel a degree of certainty in their answer whether that be yes or no. This seems at odds with the point previously made. If we cannot define love in an Adult ego state way how can we be so certain when we are in love or not. The solution to this quandary lies in the ego states.

The kiss
The Kiss. The modern day Rodin?

The person who can answer the question is one who has good contact with their Free Child ego state. When they answer the question it is the Free Child that speaks. However ask them to explain what love is and they can’t, as no one can. Thus we have the odd situation mentioned before where the Adult ego state cannot explain what love is but the Free Child knows if it has it or not.
The person who finds it difficult to answer the two questions posed above is one who has poor access to the Child ego state aspect of their personality, especially the Free Child. That is why when asked, the one’s who respond reasonably quickly are the ones who generally know. Those who take a bit of time tend to be those who go into their Adult ego state looking for the answer and of course the Adult cannot answer it. The Adult ego state does not know, instead it is the Free Child that knows.

Are you in love question

The highly intellectual person or the one who tends to think rather than feel will of course have problems with the question. Those who tend to shy away from or are scared of their feelings will have difficulty understanding their own feelings of love. It is the Child ego state feeling part of us that knows and experiences feelings of love not the Adult ego state.
Emotions and the Adult
What I am proposing is a situation that is different to the other emotions, at least on some occasions. Anger and sadness can be more understood by the Adult ego state. These emotions are often a reaction to an event. If one is criticized or if one is cut off in the traffic by another car and one has a feeling reaction the Adult can be more sure that it is anger. If one finds his dog has died then the Adult can be more sure that sadness is being felt as that is how people usually respond to such a situation.
This is less so with the feeling of love. There is not a discrete event that it can be seen as a response to. It tends to develop over time. Indeed it can develop over a number of years. This makes it harder for the Adult ego state to understand.
In relation to this there can a be a different time factor involved in love. When someone is insulted they may have an angry reaction. If afforded the opportunity to talk about it to the person directly or to someone else, allowed to show some of their angry feelings and verbalize them then eventually the anger subsides and goes away for ever. 

Weight lift 2
Anger is easier to understand than love

In counselling this would be seen as working through the anger. The feeling is time limited and finite. It comes and it goes. This is clear for the Adult ego state to understand. Of course the same does not happen with love. Its duration is often much longer and it is far less finite. One does not work through love feelings one simply learns to live with them. This less finite feature of love that makes it less discrete and less explicit than some of the other emotions and hence makes it more difficult for the Adult to understand. The point at hand is the feeling or experience of love is less clear and distinct than some other emotions like anger and sadness. This makes it harder for the Adult ego state to comprehend and it has to be left more to the Child ego state to comprehend it.
The first therapeutic task when love is presented in the counselling room is for the counsellor to make some kind of assessment as to how the client comprehends it. Those who have difficulty comprehending it may be because they are too intellectual on the topic. It is safer for them to be in their Adult ego state and they feel less safe in their Child ego state. If the client can answer the question
Are you in love with him/her?
reasonably easily and with some certainty, then the counselor knows that person has at least reasonable contact with their Free Child ego state and are comfortable trusting it in knowing the world especially in relation to the emotion of love.


Monday, July 2, 2012

Jay Haley on marriage counselling

The marital couple is not a dyad but actually a triad because it is defined in terms of the inclusion or exclusion of someone else. This view allows us to see different stages of marriages. In the early part of the marriage the husband and wife are differentiating from their parents. Then they produce children who become part of the marriage. At no point do the husband and wife form a distinct dyad.

Polarities picture

Marriages in distress are unstable entities that require an external person to intervene in the dyad to stabilize it, thus making it a triad. A child with a problem can have a stabilizing effect on the marital dyad thus making it a triad. Indeed the marriage counsellor can replace the child and be the stabilizing effect on the dyad of husband and wife. If this happens then the problem of the child ceases. The problem for the therapist is how to exit without the couple destabilizing again and therefore bringing the child in again and the problem returns. In this approach, in any couples counselling there are always at least three people involved in the cause of the marital disharmony.

Sunday, July 1, 2012

Cognitive dysfunction in the antisocial personality

Quote from
Journal of Social and Clinical Psychology, Vol. 25, No. 7, 2006, pp. 802-824
“For example, both a psychopathic and non–psychopathic individual (with an antisocial background) might focus their attention on stealing money from a security truck. Such a focus might include external cues (e.g., the location of the truck) and internal cues (e.g., the “rush” associated with the prospect of becoming rich). Suppose other cues exist that are not the current focus of attention, such as the presence of an undercover police officer and thoughts of getting caught and going to jail. According to the RMH, the psychopath’s cognitive vulnerability is characterized by difficulty attending to and processing external or internal non–dominant cues (i.e., cues that are not consistent with their current focus). Thus, in this example, whereas a non–psychopathic individual’s desire to steal money may be moderated by the presence of an undercover police officer or thoughts of going to jail, a psychopathic individual is less likely to process such cues and thus is more likely to attempt the theft.” (end quote)
The point of interest here is that the antisocial personality simply does not think about information that is contrary to what they want. For example the antisocial may think “I want money and can get money by stealing”. A plan is then devised to obtain such money.

Hair woman

Any information that makes the plan look bad or unworkable such as possibly getting caught, going to jail, being on the run, traumatizing other people and so forth is just not thought about. It is not denied because if asked about the possibility of the ‘bad’ things happening the antisocial would acknowledge that they exist. Instead they just do not think about them all that much. And it is this that can be seen as their cognitive dysfunction.
Indeed this could be seen as another type of thought disorder. It is not magical thinking, not grandiosity, nor over detailing and so forth. Instead it is simply not thinking about important information in decision making. Perhaps it could be called wishful thinking
In this instance one sees a kind of child like wishful thinking. The FC has a wish for money and makes a plan to get money but it does not think about those factors which make the plan a bad one. Perhaps the transactions below could highlight the process.

Antisocial thinking style

This could be seen as the type of decision making that a young child would use. They may have a wonderful idea to build a fort, catch rabbits or even fly a kite, but when looked at with a mature Adult ego state it is clear the plan will not succeed. The child has a kind of wishful thinking where the idea is attractive and that makes it achievable. A disordered type of thought takes place.
From the point of view of counselling the antisocial personality this can have some direct implications. Firstly the person can be made aware that they at times engage in this type of disordered thought. They are made aware of their propensity to do the transactions above when planning their crimes. Or even other non criminal activities like planning legitimate business activities, considering marriage or even planning a weekend away with friends.
If they are aware of it then it makes it harder for it to be effective. Of course it can still be over ridden but it makes it harder to do. In addition one could use other ways to make it harder to engage in this dysfunctional thinking. For example a friend or a counsellor can be used write down a list of the relevant factors to be considered. The other party not having similar cognitive problems can highlight the ‘bad’ points of doing what they plan to do. If it is written down in black and white in front of them it makes it that much harder for the Adult ego state to simply not think about.

Childlike thinking allows one to believe the unbelievable.

Regardless of whether they go on to do the crime such simple cognitive exercises could be seen to strengthen the effectiveness of the Adult ego state in the antisocial personality and provide him with a way in the future to consider his planning more effectively. In essence one is doing Adult ego state strengthening exercises as the Adult ego state could be seen to be flawed in this way. There are many other Adult strengthening exercises one could employ with the antisocial personality. However the topic at hand shows specifically the area of Adult ego state strengthening that needs to be done. That is, to counter the child like wishful thinking they can employ. Their propensity to simply not think about ‘bad’ points of their plan.
Indeed one can see how a parts party exercise could be used to highlight to the antisocial how their Child ego state wishful thinking may interfere in mature Adult ego state decision making.
One other point this quote allows us to consider is the idea of risk taking and anxiety.  This list comes from a good article on the antisocial personality except it has one glaring error, point number 2. One simply has to go into a prison and one will find many antisocials who are of a low IQ. Indeed that is one reason why they are in prison. Their low intelligence does not allow them to cover their tracks very well.

Eleven features of the antisocial

However the point about the lack of anxiety is well made and it is necessary for the counsellor to understand that they do not experience the world in the same way as the average citizen does in relation to the experience of anxiety. The quote cited above helps us in our understanding of this. The lack of seeing the bad points in a plan can provide us with one explanation for the lack of anxiety.
Most of us do not engage in high risk behaviour because we experience anxiety and that feels bad so we avoid the danger in the first place. Many people are scared of snakes to some degree and it is that scare or anxiety that keeps us a safe distance from them. The antisocial can engage in high risk behaviour because they don’t see the bad (risky) points of the activity and hence do not experience the anxiety which keeps them away from the danger.