Friday, April 2, 2010

Contracts and promises


I was talking with someone the other day about therapy and contracts and an interesting notion came up about contracts and promises.


All therapy has a contract of some kind. That is the client must have a contract. Some times it will be explicitly stated and at other times it may be ill-defined but it is still there. It is the goal the client has. If they did not have a goal then they wouldn’t be there in the first place, assuming they are not a coerced client of course.


I was asked if a contract was a promise. Most would be clear that a contract in the Transactional Analysis sense is not a promise of the client to the therapist. Not many would accept the contracts like:


I promise to use relaxation exercises when I have a panic attack.

I promise to be assertive with my mother this week.



However one does hear other words used such as assurance and commitment. “A contract is a commitment” one would find in the literature. According to my dictionary assurance and commitment are synonyms for a promise. Of course it is not the word that is important it is the psychological process that the word defines that is important.


A common treatment contracting process would usually be drawn as such


It is an Adult ego state process of the client



A promise would probably be drawn as such


As one can see it involves the Conforming Child ego state and not the Adult ego state and thus is quite a different psychological process.


Is there anything wrong with a contact being a promise or an assurance? It seems one needs to look at the psychology of the promise.


If a child is asked to promise to its parents to tidy its bedroom a number of things could happen. Promises work on the basis of guilt. The child knows that if it breaks its promise then the parents will feel distress of some kind such as disappointed, hurt, let down, betrayed and so forth. If the child lets them down then it knows they will feel distress and thus it may feel guilt about ‘hurting’ the parents.


The parents are using guilt to get the child to do something it does not want to do. If the child is highly compliant it will clean its room because the guilt is too much for it to deal with.


However when one is in Conforming Child it is usually not all that hard to switch to the Rebellious Child ego state. If the child is less compliant then that could easily happen as the child will realise at some level that it is being manipulated by the parents using guilt.


If the switch to Rebellious Child occurs then anger in the child will arise so the child will either

Not tidy its room at all and live through the guilt or their anger may become its predominant emotion instead of guilt.

Tidy its room and feel resentful

Tidy its room poorly as a passive expression of its anger against the parents.


If one changes the context from cleaning a room to making a therapeutic contract one can see the potential problems. If the client perceives the therapist to be asking him to make a promise type of contract then the outcomes described above are also likely to occur. Of course the therapist may not even be doing that and the client may still perceive the therapist to be requesting a promise and thus the outcomes would be the same regardless.


If the client goes into the Conforming Child ego state in their relationship with the therapist when asked to make promise contracts, it is so easy for them to switch into the Rebellious Child. Most will do this at some point so the therapist is wanting to avoid such a dynamic developing in the therapeutic alliance.


In addition in such circumstances the initial problem often gets lost. The young child may in fact want to have a tidy room but because he has been made to promise to make it tidy his initial want can be forgotten. The parents are pressuring him to either comply to or rebel against their conditions and thus he moves away from his own Free Child want. If such conflict with the parents continues for an extended period the child can eventually loose touch with his Free Child and ends up not knowing what he wants.


From a therapeutic point of view this gains considerable importance especially when one considers the no suicide contract. Indeed it is in this area of contracting where one in particular hears of the promise type of contracting. Of all the areas of contracting this is the one where promises are wanting to be avoided for the reasons cited above.


The desire for the promise is usually generated from the anxiety of the therapist who does not want their client to kill self. Understandable indeed, but to request a client to promise not to kill self for ‘x’ amount of time is a counter productive plan of action to take. One is not wanting a NSC to be made from the client’s Conforming Child ego state as happens when it is a promise.


Graffiti

8 comments:

  1. Yeah - i wondered how that would work.

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  2. Hello Camilynn,

    Thanks for the kind comment and I will have a look at the website

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  3. How what would work Roses?

    Happy easter

    Graffiti

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  4. OH! and BTW Camilynn I did a YouTube monologue on panic attacks. It can be found at

    http://www.youtube.com/user/agbw

    Cheers

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  5. What if a therapist had a requirement that in order for me to continue to be able to see them, I had to be back on my psychiatric meds and seeing a psychiatrist regularly?
    Would this be different than what you have described above?
    I am a bit confused because while it may have been a goal that I wanted to be better, it was not a goal of mine to be back on meds.

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  6. That is a good example Annalynn of a contract versus a promise.

    It depends on what you do with the therapists requirement in your own head. If you took the therapists requirement as a CP demand then you would very likely be in CC and promise to take them. That is not good as people can so easily switch to RC and the promise goes out the window one way or another.

    If you took it as an Adult ego state thing from the therapist then you could make a contract with yourself to take the meds and that contract may work.

    You say that you don’t want to take the meds. That means part of your Child ego state will resent taking them so that would need to be watched and managed

    Tony

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  7. Oh Annalynn, thank you so much for that comment.

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  8. Oh, no problem. :)

    It makes more sense now. As predicted, I ended up lying about taking the meds and the therapist never knew otherwise. Needless to say, that relationship wasn't very successful. Thanks for the explanation.

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