I like this guy. He has virtually no sense of self worth. I mean unusually so and self deprecating to the same degree as well. Presentation is depression and some history of suicidal ideation.
His natural temperament response to stress is flight - as in fight, flight or freeze. He has a GAF response to a degree that I have not seen before. GAF comes from the life positions and stands for “Get away from”. It means that he will have a tendency to get away from others in his life script and thus he is likely to end up alone or with very few social contacts.
In this instance there is actually no problem with this. He enjoys his own company and can spend long periods of time by himself in the country, which he does. That is not the problem. The problem is that he does not tell anyone anything about what he is thinking and feeling. He never has for as long as he can remember. When ever he has a distressing thought or feeling he withdraws and says nothing to anyone. The technical diagnosis for this is elective mutism.
This worked fine at first except that humans cannot keep doing that for too long and eventually they collapse in on self. They will start to either hit the alcohol, drugs, prescription medication, get depressed, develop anxiety and so forth. The Child ego state simply needs the human contact and communication when it is distressed about something. If it does not get it over an extended period of time it has a ‘nervous breakdown’ as they used to call it.
Human communication. Some try to live without
it for long periods but it never works in the long run
The problem for him (and thus me) is that it is completely and absolutely antithetical for him to talk to anyone about his inner thoughts and feelings. But he comes to see me for precisely that goal, to talk about his inner world and hence he ends up as a non-talker (sort of).
The first sessions were difficult because he said so little and there were often prolonged silences. I thought that he would simply decide that it was all too much and I would not see him again. However at the end of each appointment he has initiated the request for another appointment and there has been another change in the last few sessions.
For the first 45 minutes he is his usual muted self. Then as I am thinking of winding things up (a little early) he starts to talk and even initiate conversation. In the last few sessions he has even gone over time (and I have allowed it). I don’t think it is a game about getting more time but he is starting to not want the conversation to stop. And indeed that is what we are doing. We have done very little therapy in the usual sense of the word. We basically just have a conversation. Mostly about him and his life but we are by no means doing the usual therapy things like setting contracts and so forth.
Some seem to feel like they just don’t fit
in with the rest of the human race