Change in psychotherapy.

I had a good one the other day. It’s good for the therapist when this sort of thing happens.

Goal setting or contracting for change in psychotherapy is big business. Much has been written about it over the years. One can attend entire workshops on how to set goals or make effective contracts with the client. In many different approaches this is considered a most important part of the therapy process. The client and therapist must both be clear and in agreement about what the contract for change is or the goals of therapy.

For example in Transactional Analysis it is called contracting. At the beginning of the session the client states what their contract for change is for that session. This is either accepted by the therapist or if not it is negotiated between the two until an acceptable contract is arrived at. An example of how this is done is shown in the diagram above. It shows seven different aspects of a contract that must be clarified in order to make an effective contract for change.

Sometimes clients change in response to therapy without any contract or therapy being done on the area of the change. The other day I was discussing with a client who can suffer episodes of depression and dissociation how she felt the therapy was progressing. I had seen her about 10 times. Initially I thought the therapy may not go so well or last very long. She began by talking in a very medical way about her difficulties such as about her serotonin and depression. It’s not that I disagree with it, it’s just not what I do when I treat depression. If she wants to do that then she needs to see a psychiatrist not a psychologist.

However she continued and kept making and attending appointments and then we had this discussion. As we talked about how her therapy was going at one point she stated:

“I feel like I have got my hope back and also my diet is much better than it has been before”.

Neither of these had ever been raised by her nor discussed in any of the sessions. I had no idea she even thought of these as possible contracts for change. Indeed she may not have been aware she wanted those until they happened. For example she may not have been aware that she had lost hope. 

These are called spontaneous changes and as has been described sometimes occur in therapy. I have always felt these are a good sign. The Child ego state is sitting by watching the therapy proceed, starts to feel a bit better about self so these spontaneous changes occur.

Also in this instance we have two things that are completely unrelated - hope and diet. If it had been something like hope and trust or hope and closeness then that is a bit more understandable. She was of average weight and neither fat nor thin, it was just her eating habits had changed spontaneously such that she was eating healthier. This indicates the kind of random nature of such changes and that she had never raised either of these in therapy before.

It’s good for the therapist when this sort of thing happens.

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Drug harm assessed - Part 2

Here is another interesting graph from the same article I referred to in the previous post. 4-MTA is an ecstasy like drug.

This can be seen in more detail here.

Here is a quote from them in the discussion: 

Our findings raise questions about the validity of the current Misuse of Drugs Act classification, despite the fact that it is nominally based on an assessment of risk to users and society. The discrepancies between our findings and current classifications are especially striking in relation to psychedelic-type drugs. 

(i.e. ecstasy, LSD & 4-MTA)

We saw no clear distinction between socially acceptable and illicit substances. The fact that the two most widely used legal drugs lie in the upper half of the ranking of harm is surely important information that should be taken into account in public debate on illegal drug use. 

(i.e. alcohol & tobacco)

Discussions based on a formal assessment of harm rather than on prejudice and assumptions might help society to engage in a more rational debate about the relative risks and harms of drugs.

(end quote - I added the information in parentheses)

This is based on the UK system of drug classification. Class A drugs are the meanest and nastiest with Class C drugs being the most benign. The Australian system would be very similar. They also note that 3 class A drugs are clearly in the bottom half of the list with ecstasy being third from the bottom. This is a glaring anomaly that defies logic. To understand why this anomaly exists all you have to do is read my book!

Tobacco would usually be higher but shows up lower as a consequence of how harm is defined in this research. For physical harm they use three criteria

Intravenous use - tobacco gets a zero

Acute use harm - tobacco is low here as well

Chronic use harm - tobacco scores very high.

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Drug harm assessed

I came a cross and interesting diagram today on the internet.

 In my book to be published soon on counselling alcohol and drug users I talk about the dangers of various drugs and this diagram is consistent with what I hypothesize. This is a good thing as what I have said is a bit controversial. Not overly so but some people may have trouble with it.

 I talk about why some drugs are illegal and others are legal concluding that governments make such legislative decisions based on a complex array of factors. One small part is the dangers of drugs but they portray to their constituents that this is the main reason.

 If it was the paramount reason then alcohol and tobacco would quickly be made illegal and cannabis, ecstasy and LSD would be made legal. These three are the safest of the drugs currently doing the rounds.

In the diagram above the closer the drug is to the top right hand corner the worse it is and the closer it is to the bottom left hand corner the better it is. So you can see this does provide some support for my contention in the book. They add in the concept of dependence which makes it a little bit different from what I am saying but it generally agrees with my proposal.

 If I should come in for some criticism then it will be good to have references that back me up. This chart comes from some serious research reported in the Lancet, which is a reputable journal. So it would be nice to have the article.

 Anyways I clicked on the link and it took me to the journal article abstract which I read and it sounded good. Then I discovered to get the whole article I had to pay $31.50. Yes $31.50 for a single journal article! That seemed like a lot to me and I wondered if anyone actually will pay that much for one journal article. Did I need it that badly to spend $31.50?

Feeling a bit despondent I googled the title of the article and the second link I clicked on gave a PDf of the full article which I have now downloaded. The exact article in full! I now have the article and will cite it should that become necessary. Just goes to show you that it pays to look around on the internet!

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Further consideration of the OC

The obsessive compulsive’s primary way of dealing with life is by thinking. As a young child the OC decided that to survive in the world one must think. It was chosen as the way to deal with things and solve problems. The opposite to this is the hysteric personality type who has decided to deal with the world by feeling, the young child decided that this is the way to deal with the world and to solve problems. Hence, to put it somewhat unkindly the hysteric is an ‘airhead’ who can’t think and the OC is ‘dead from the neck down’ who cannot feel.

Sometimes the hysteric and OC will marry each other because they are attracted by the other having the thing which they feel complements them and provides the thing they do not have. Needless to say they can end up in counselling at some point.

As with all personality types the goal is not to change the OC personality into something else. Firstly, what would it be to changed it into? Everybody has a personality and it must be of a particular type. It is impossible to not have a personality type. There is no such thing as the ‘normal’ personality type - which is probably a very good thing. Instead there are the following personality types:

Paranoid
Schizoid
Schizotypal
Antisocial
Borderline
Histrionic
Narcissistic
Avoidant
Dependent
Obsessive/compulsive

As you can see there is no ‘normal’ personality type defined.


Is it possible to have the normal personality type?


The goal is to modify how the personality type is expressed such that it is used in life to help the person rather than to cause them difficulties. For example the person piloting the plane of which I am a passenger I want to be an OC. The surgeon about to cut into me on the operating table I want to be of an obsessive compulsive personality type. As you can see there are occupations where it is a positive to be able to think, be very precise and orderly. On the other hand the hysteric can be a good people person because they can be outgoing, and the ‘life of the party’. They can work well in public relations or other occupations like sales.

OC and indecisiveness
Of course if not managed well then there can be a downside to each of the personality types. For example one feature of some OCs is indecisiveness where the thinking results in problems rather than having a positive outcome. The cause of this indecisiveness provides a good illustration of the decision making process. The decision making process is diagrammed below as a four part process.


The decision making process



The person initially receives information via the Adult ego state. Next they internally listen to what the Parent and Child ego states have to say about the information and then the Adult makes a decision based on these three pieces of information. For example the person may be deciding on whether to take a new job.

1. The Adult gets all the information like the job description, level of pay, place of work and so forth.
2.The Parent then makes its assessments about the job. It may think, is it a good job such as helping people by being a counsellor or a not so good job like becoming a tree logger that destroys the forrest.
3. Next the Child has its input. It may think that it likes the tree logging job because it pays much more and you get to be outside a lot rather than sitting in an office all day.
4. The Adult then assesses these three pieces of information and makes its decision.

In good decision making this process is meant to happen. With the OC it can fall down in two ways. Firstly the OC can overwhelm self by over researching. In part 1 of the process they simply get a mass of information. Due to their insecurity they think the more information they have the better informed decision they can make. What actually happens is they get swamped by a tsunami of information. For example in deciding which new car to buy the OC can get lost in all the technical information of the various models. As the saying goes, “They loose sight of the forrest for the trees”. They loose sight of the overall picture and find it hard to make a decision.


FC mud therapy for the OC?


The second way the OC can be indecisive involves the third part of the process. Due to their inability to access feelings and remain only with thinking they can loose contact with the Child ego state. If the choices are reasonably equal then the Free Child has the answer. The Free Child knows what is the right decision for the person. Those who are out of touch with the Free Child, like the OC can be, find it hard to make a decision because they lack the Free Child input.


OC and family relationships
I recall counseling a couple where the wife was an OC. She had strong needs for cleanliness and also strong contamination fears. The husband liked to garden but was never allowed to use any pesticides or chemicals in the garden. If he ever entered the kitchen or prepared any food he would be watched very closely. She tried to not make it obvious but he knew he was being closely watched on everything he did in the kitchen. She was very scared of possible contaminations by not cleaning correctly and ‘improper’ food preparation.

However the outcome of this was that his domestic life was significantly effected. He did not want her to feel anxious which meant he had to behave in very specific ways in his own home. This is an aspect of the OC that often does not get much consideration. The family dynamics aspect of treating the OC. The OC can end up with a very controlling presence in the family and home and those living there will have to adjust in some way. That can either be a sympathetic response where they become controlled in the home or there can be an angry response to the restraints where little consideration is given to the OCs fears.

This is a very real and difficult situation which can lead to marital and family breakdown where there are no winners. The OC has real and at times strong anxieties about what are usually mundane things in the home. On the other hand it is not fair for the various family members to have to live in a home that can be highly restrictive and indeed tense. When working with the OC, at times it is wise to meet with the other family members to find out the family situation and how they cope with it.



Obsessions and compulsions as a defense mechanism
Whenever I meet a client who tells me how they are constantly on the go, always doing things and never seems to have any spare time the first thing I think is, “What are they hiding from”. One way to avoid painful feelings or memories is to distract self. If one has a very full and busy life that can be a technique for distraction. Another way to do it is to have obsessive thinking. One way to keep painful feelings out of the conscious is to repress them with obsessive thinking. There is no space left for them to come up into the conscious.

The counselling approach here is clear and is often needed with the OC. Ask the client,
“If you stopped obsessing what would happen?”
“If you had to sit still and not do any thing what would happen?”

Most report some kind of feeling would come up which they are trying to avoid. With most OC client’s the therapist is wanting them to start feeling and expressing their emotions. If they achieve this then they tend to start to relax more and the obsessions and compulsions lessen.

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Counselling the Obsessive Compulsive personality type

OC & attachment
This article address some common issues that one comes across in working the OC. Firstly, generally speaking the OC does not have difficulty establishing attachments and this is a good asset as it allows the therapeutic relationship to develop in a normal way. Personality types that tend to have attachment difficulties are the narcissist, schizoid, borderline, avoidant an on occasion the antisocial personality. An ability to develop attachments is a definite plus when it comes to counselling the OC personality type.

OC & the Free Child
The other positive in counselling the OC is the Free Child ego state is overly constrained. The OC needs to let go, lighten up, become more carefree and irresponsible at times. This is a nice thing to have happen which assists the counseling process. One of the main problems in counselling the anti social personality type is they have to give up some FC. Their Free Child is not constrained enough and they are too hedonistic. Giving this up is not naturally good thing to do. They have to give up some of their fun FC whereas the OC has to bring more FC fun into their life.

As a consequence of these two points the obsessive/compulsive personality type is often quite amenable to counselling and can make some quite significant changes in how they think, feel and behave.


Free Child




Behavioral contracting with the OC
To bring out the FC counselling can work at a behavioral level where the OC has homework to do FC activities. Fairly simple and straight forward. Homework is given and if it is carried through (which it usually is as OCs tend to be responsible) one then works through the feelings and reactions the person had when the homework is carried out. One of the keys here is guilt free fun.

If the individual reports that some of the homework was fun the counsellor must make sure it is guilt free fun. That is whilst doing the activity they did not feel guilty about it for whatever reason. Guilty fun does not count as fun. Always make sure the client gets to articulate what is fun for them and the counselor must not project their fun onto the client. The OC may be susceptible to this as they can be quite out of touch with their FC and basically have no idea. Indeed they may need to experiment with a variety of ways in order to find out what is right for them.

In working with the OC one can do the old psychotherapy trick of using the pathology to get to the cure. Many OCs like to make charts, lists and spreadsheets. The therapist can use this by setting homework exercises that involve such charts and lists. For example

Make a list of ways of having fun - no less than 5 and no more than 10 items to be included.
Make a spreadsheet listing when they were FC and when they were not during each day of the week. Listing the activity they were doing when they were being FC and the activity they were doing when not in FC.
Make a chart of when they were responsible for others and when they were responsibility free. Again this is to be done for the week on a daily basis.


For the responsible, life can seem like hard work and not much fun.




Such homework taps into the natural style of the OC (such a list making) and uses it to their advantage. However one needs to be careful doing this and only continue with it if it succeeds. It must only be used as long as the OC does not get lost in the charting and listing and actually does get to the fun without too much difficulty.

Of course the purpose of the exercise is for the OC to become aware of how they would like to have some FC fun and to get an understanding of how much time they spend being responsible and avoid experiencing FC. This must the translate into them actually experimenting with the FC in the ways they have come up with. If it does not translate in that way then give up on such homework as that only supports the pathology.

Once the list of potential FC behaviour has been identified then, as just mentioned, the OC needs to go and do the behaviour and report back in the next session how that went, what they felt about it all and so forth. Of course the list of possible options is enormous. From listening to music, getting a massage, bush walking, craft activities, meeting friends, dinner, movie and so forth.

Once identified the the OC makes homework contracts to do the behaviour. Again one can use the pathology to get to the cure. Invite them to plan doing the FC in a detailed and systematic way. If it is to meet with friends at a coffee shop. They will have to make a list of the friends, list the phone numbers and then record who has been contacted and who has not and so forth. Setting the time of meeting, the place, making the booking and so forth. A perfect task for the OC. Indeed the OC can be a good administrator because they are organized like this, as long as they do not get too lost in the detail such that little in the end gets achieved. The therapist needs to make sure the FC activity does actually occur and it feels like fun for the person. If this does not happen then the therapist would not go about setting homework exercises in this way.


Be perfect



As I mentioned before this approach uses the natural talent of the OC (organizational ability) to achieve the cure. It also does one other thing that is another old psychotherapy trick. It’s called playing with the neurosis. This can be a powerful therapeutic approach but it is also more risky. In making such homework contracts it can expose the funny side of their neurotic behaviour. The client gets to see the funny side of his list making or orderliness which disempowers the neurosis. It defuses the potency of the compulsive behaving and obsessive thinking because they are seen in a humorous light. If the client can begin to look at his difficulties in a humorous way that is a significant therapeutic development. The danger with this, is the person can at times think you are making fun of them or not taking them seriously which of course would only damage the therapeutic relationship and the therapeutic goals.

The OC, FC & relational contact
In the FC contract setting one needs to note how much of it involves contact with others. How much of it involves relating to others. Listening to music, doing craft, bush walking and even playing with pets may not involve any contact with other humans. In the contracting process one is wanting at least some of the FC to involve relating to other humans, such as with the meeting friends or going to a movie with a friend and so forth. There is nothing wrong with FC activities that are solitary but if there are none or very few that involve relating to other humans then psychologically that is a problem.



Even if the FC activity does involve relating to others one is also wanting to make an assessment about the depth of relating. Again if one meets with friends for a drink and the conversation is only ever light discussion that is not OK if it is all or most of the time. One is looking for FC to FC contact with others that has of some emotional depth. That can involve active ‘deep’ discussion about feelings and so forth or it may be two people simply sitting close together not saying much as they watch television. One is wanting the client to report some kind of significant FC contact with others in some of the FC to FC contact. Again this is only expected to be some of the time. Finally the most obvious example of intimate FC contact is in a sexual relationship. Sex is (or at least is meant to be) Free Child. The OC can make all sorts of lists and spreadsheets about their sexual activity, in all sorts of ways, which can also allow them to see the funny side of their behaviour.


FC with client and counsellor
What better way for the OC to experience some FC than in the relationship with the therapist. If there is a healthy amount of FC to FC transactions between the client and the counsellor that is a most desirable thing. There needs to be some good hearty laughter in most sessions. This applies with any client but especially with the OC client. Humor in the therapeutic relationship is productive and health promoting and it makes doing therapy more appealing for the therapist as well.



Script work with the OC
Above I have discussed the behavioral work that a therapist can do with the OC personality type. This is done inconjunction with script work. The OC basically has trouble accessing their Child ego state and spends too much of their time in the Parent and Adult. Most injunctions are going to reflect that state of affairs. So common injunctions for the OC are:
Don’t enjoy, Don’t get your needs met, Don’t be a child, Don’t feel.
The drivers are likely to be:
Be perfect, Be strong and Try hard for those OCs who get lost in the detail and don’t actually achieve much in the end.

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Structuring the therapeutic relationship with the Obsessive Compulsive personality type

When working with any client a therapist is always considering two factors

What you are doing with the client

and

How you are doing it

For instance with the OC client one is working on how to deal with the anxiety and ways by which they can perhaps give up their obsessions and/or compulsions. Maybe doing redecision work with injunctions like “Don’t be a child” and giving up control. This what the therapist does with the client but it does not consider how it is done. By this I mean the therapeutic relationship.


OCs can be very orderly with their food.



All clients will establish relationships with others in their lives that fit with their personality type and life script. As they go through life they will structure relationships that fit for their life script such that it is reinforced over an over again. This is what all people do including you and me.

Of course a client’s relationship with the therapist is no exception. The client will set out to establish the same quality of relationship with the therapist such that it reinforces their life script and their personality type. This is not what they do in therapy but how they do it.

The goal of course is for the therapist to structure the therapeutic relationship such that it does not reinforce the life script. How easy this is to do varies from personality type to personality type. With the narcissistic personality type it can be quite difficult. They have a sense of grandiosity and others are somewhat inconsequential. Their only consequence is to serve the immediate need of the narcissist.



The therapist is wanting to establish a relationship with this individual such that he is of some consequence to the client. That is not an easy thing to do. What can a therapist do such the he becomes emotionally important to the narcissist? How can he make the narcissist fall in love with him? A difficult task indeed.

However with the OC personality type this task is less difficult. Indeed of all the personality types it is one of the easier ones. The OC will endeavor to be in control in the relationship. This does not mean he will battle with the therapist for control of the relationship but he will strongly resist the therapist being in control of him. The therapist is wanting the OC to experience a sense of being out of control in the relationship with the therapist. He can be out of control because the therapist is in control and will make sure everything will be OK. That the OC will be alright when they let go of their self control in the therapeutic relationship. The OC may find this a very difficult thing to do but it is not a hard thing for the therapist to encourage, (unlike with the narcissist).

The OC is too uptight, needs to lighten up and let go of the control. Their Child ego state believes that if they can just get control of things then everything will be OK, they will be safe. So that’s what they try to do and hence you end up with perfectionism, orderliness, cleanliness and so on.


What the OC craves and fears at the same time


The solution is the opposite of that. The more they seek control the more rigid and uptight they become. If they let go and loose control then the uptightness disappears as does the need for order, perfection and so forth. Thus the therapist is wanting to establish a therapeutic relationship where the OC can experience a sense of being not in control. If that happens then what is being done is consistent with how it is being done.

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Magical thinking & the obsessive compulsive personality type

The person believes his thoughts, words or actions will in some way cause a specific outcome that defies the normal laws of cause and effect. For example a man believes that if he prays three time at night that will prevent his mother from dying. A woman believes that if she checks the doors three times at night then she will be safe.

Magical thinking may be part of ideas of reference or may reach delusional proportions when the individual maintains a firm conviction about the belief despite clear evidence to the contrary. Magical thinking is found normally in children and with the OC personality type.

Magical thinking is a battle between the grown up Adult ego state (A2) and the Adult ego state in the Child ego state (A1) sometimes known as the Little Professor ego state. The young child is born without an A2 ego state, all it has is its Child ego state.



Thus all the thinking it does is via the A1 or Little Professor ego state which means it will at times have quite illogical thoughts and come to quite bizarre conclusions and decisions. The Adult (A2) is not really fully formed until adolescence. Jean Piaget’s theory of cognitive development has shown this. For example it is not until the age of about 8 years that a child finally realizes that death is not reversible. Up to that time it thinks death is a reversible process. This clearly is magical thinking and thus would be seen as a function of the A1 ego state not the A2.

Most grownups eventually form a strong A2 ego state and thus go through life without odd thoughts and beliefs about the facts of the world. However we never loose the A1 ego state, it remains with us until the day we die. So all grownups have the ability to have child like magical thinking.

Superstition is a good example of this. We all know that touching wood will not make good luck befall on us, however we all touch the wood anyway, (just in case). The same for black cats and walking under ladders. Most of us do not believe it has any effect but we avoid walking under ladders, (just in case).

However the magical thinking we all have is sometimes not so banal. People can at times spend significant sums of money based on magical thinking. Some beauty treatments have no scientific basis for them but people will spend significant money on them because they believe them to work. Some skin treatments and mud packs are of this kind. Conspiracy theories may also involve magical thinking that is not logical. Some believe that Lady Diana of the UK was either killed by MI5 or the egyptian mafia rather than her simply dying in a motor vehicle accident. Magical thinking is particularly susceptible to the phenomena of group think.



In group think people start to believe the same illogical thing, because others around them believe the same thing which makes them more secure that their thinking must be true. When conspiracy theorists get together to discuss their theories, they find others have the same magical thinking which makes it more true in their minds. “The end is nigh” groups can also be of this kind, where a group of people have the same magical thinking. Because others around them believe the same that makes it more true in the mind of each individual. The phenomena of group think can particularly happen with magical thinking.

Every “The end is nigh” group has been wrong so far (but beware the next one may be true!). Often they have an elaborate belief system about why the end is nigh that is based on significant evidence which they can produce or explain how it works. The point being that significant thinking has been engaged in before the conclusion that the end is nigh is reached. It is not simply based on a whim or a hunch.



Magical thinking is be no means solely for the neurotic and the disturbed. We all can and do engage in magical thinking because we all have that ego state in our personality. Many normal good members of society can have significant areas in their life that are based on magical thinking.

However the OC personality type in particular uses magical thinking especially with compulsive behaviors and it shows how the A1 and A2 can coexist at the same time in the personality. A client recently reported to me an elaborate ritual on checking if a door was locked. He would check the door could not be opened by trying to turn the knob to open the door. He would then walk to the other side of the room, turn around, look at the knob walk back to it and try it again. He did this three times and then he felt satisfied it was locked.

He knew clearly in his Adult ego state how illogical this was which caused him even more distress. However if he did not do the ritual he knew he would feel considerable disquiet and would have this constant urge to finally complete the ritual. The magical thinking was that if the ritual was performed then he could be sure the door was locked. His A1 was stronger in the personality than the A2 with regards to this specific piece of behavior.


OC personality type - cleanliness, perfectionism, orderliness, control.



Obsessive thoughts may also involve magical thinking. A long term client recently attended an appointment in great distress. The local council that morning sprayed herbicide along the street outside her house to kill weeds on the side of the road. She was convinced that could have been contaminated by the poisonous spray before she had time to close all the windows and that she will become quite ill and possibly die.

The fact that the council has been doing this for the last 20 years and no one before had ever reported getting ill had little effect. The fact that there was no wind and the sprayers are very close to the ground had little effect to reduce her angst. The fact the government health standards make sure there is no way such herbicides sprayed the way they are would ever contaminate anyone also had little effect for her.

Her Adult (A2) acknowledged all these as true but still she felt great distress about being contaminated because there was still a possibility that it could have somehow (magically) occurred. The A1 thinking dominated the A2 in this instance and she thought about it obsessively over the next week. Such A1 based contamination fears are common in the OC personality type.


OC - pro ana


Obsessive/compulsive
I have to feel in control of life and myself so I will be orderly and perfectionistic
Drivers: Be perfect, Be strong
Injunctions: Don’t enjoy, Don’t get your needs met, Don’t be a child
Life position: I-U+
Strokes given out: Positive conditional

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Three causes of anxiety driven OCD

1. Obsessive thoughts and compulsive behaviors are used as a means for the defense mechanism of suppression. The feelings are layered under the thoughts and behaviors. The person is in essence distracted from their feelings and thus they are kept out of consciousness and hence do not have to be dealt with. Therapist asks or invites the client, “If you weren’t allowed to check the door 5 times what would happen” or “If you stopped thinking and went blank what would happen”. Usually some feelings would start to come up.



Solution deal with the feelings and then there is less need for the OCD in the first place.

2. Due to emotional abandonment and thus the development of the hurried child syndrome.

3. Parents were anxious as were the grand parents. We get modeling, possible natural temperament and the formation of the Don’t injunction. The “Don’t” message is given by scared parents. “Don’t do anything because it may lead to disaster”. The child may make the decision of “Don’t”. This person can often develop magical thinking which can result in the belief that if they do compulsive behaviors or obsessive thinking then that will some how ward off the evil and keep them safe.



The young child looks up at its parents and sees that they view the world as a dangerous and scary place and they may even be told that it is. They see their parents operate in a way that it is. They may be restricted from doing many normal things like going near steps, climbing trees, swimming in the ocean, roller skating, wandering off by itself.

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