Tony White - Graffiti

Reporting suicide in the press.

2012-01-30T20:04:00.000+08:00

In the city where I live a high profile woman suicided two days ago. This has again re activated the debate about reporting it in the press. The danger of such reporting is a copy cat effect and you can get a spike of suicides when a high profile person’s suicide is reported. It does happen.

In this instance I think the press has done a good job of reporting. It has been done in a temperate manner. No reporting on the how of what she did or any sign of sensationalising it and so forth.

In my view there is a positive side to such reporting as well. It gets the topic out into the open and people do talk about it, when that happens it seems reasonable to assume that it could have the effect of reducing possible suicides. Unfortunately you don’t see any statistics of this of course. If people talk about their suicidality they are better off than if they do not. In my book I state that 75% of people do make some mention of their suicidal urges before a serious suicide attempt. It is a matter of hearing it which can be hard at times as it maybe mentioned obliquely.

This means there are 25% who make no mention of their suicidality prior to an attempt and as I note this is the highest risk group of all, which I call the DSR group. It seems logical to conclude that reporting suicides in the press could reduce the size of this group. But one will never know for sure because there is no way of recording this effect. If people are talking about suicides then it gives permission to others to do so as well.

Graffiti

Me the psychotherapist

2012-01-19T05:58:00.004+08:00

This may form part of the introduction of my book on counseling drug and alcohol users.

Professionally, the other major influences were Bob and Mary Goulding who taught me how to understand people. Not just how to observe people but how to listen with my eyes. How to stop listening to them talking and start observing them, then one can truly see who they are and what they want.

Another significant influence was the quintessential Gestaltist Jim Simkin who always left me marvelling at how he did what he did. Where he could take clients and how he took them there was craftsman like. The other person who did influence me was Michael Conant and his training in bioenergetics. How to understand the psyche of a person by looking at their body. How the bits fit together, the body holding patterns, where it bends and where it does not and how it moves. I have never been interested in practising body therapies but ‘body reading’ as they call it is a major part of bioenergetics which again taught me how to observe people.

Then of course there is the theory of transactional analysis of which cognitive behaviour therapy forms a significant part. This provides me with the nuts and bolts and practicalities of the counseling process. The behavioural things you do with the client.

Service

I was asked recently by a supervisee what approach do I use and I could not answer the question. I used to be able to answer that question and was a bit surprised that I felt I no longer could. I could no longer identify a approach that I would say defines me as a counselor or psychotherapist. Initially this concerned me as it seemed to be a retrograde step. I had gone from knowing who I was to not knowing who I was. Needless to say I subsequently pondered the question for some time.

I can state the practicalities of what I do with a client and I can cite the influences on myself as a counselor, as I have done above. Perhaps that means I am now eclectic in my approach. I have never liked the idea of being an eclectic counselor as it seems one is a collection of a lot of things but not really any of them. It seems to lack a substance.

Fainting woman and the dead mouse

As I thought about the question in the subsequent days, I wondered what had changed such that a question I once could answer, I no longer could. In my musing I calculated that I would have done between forty to fifty thousand hours of counseling in my thirty two years of working. It seems logical that if one does a task for that long then it stops being something that you do and becomes part of who you are. You have done the task so many times it becomes second nature, ‘in your bones’ and part of your character.

This idea then allowed me to answer the question. I am a person, Tony White and there are many parts or aspects of me, one being a counselor. When I go to work I am simply being me. This is what the client gets, me the person, with the counselor being part of me. I think I have shifted from being a counselor who happens to be named Tony, to being Tony who also happens to be a counselor. As you can imagine this answer left me feeling much more secure in who I am in my work.

Is this me or am I just doing it?

Graffiti

Therapeutic relationship with the teenager

2012-01-08T10:11:00.002+08:00

When counseling a teenager this is the therapeutic situation that I am wanting to set up with the various parties. This is the best case scenario and actually occurs in varying degrees.

1. In counselling the teenager one is wanting the parents or those people who are responsible for the teenager involved. Most often they are willing to be part of it but at times they refuse to do so or they may simply not be around all that much.

The age of the teenager is directly inverse to the importance of the parents in this process. If the teenager is fourteen years old the parents are central in the therapy process as shown by the diagram. If the teenager is nineteen then they are usually much less involved. However if there is an emeshed family structure then the parents remain pivotal to the process until the child can gain some kind of psychological separation.

2. The diagram is to scale in terms of the relationships of the three parties involved. I am wanting to establish myself off to the side of the relationship between parents and teenager but a bit closer to the teenager side.

3. In the teenagers mind I am wanting to establish myself as a benign confidant and advisor. I am not with the parents and at the same time I am not against the parents. This is at times a hard position to maintain. I try to sit off to the side of the teenager parent relationship in this way.

4. The more emotionally important I become for the teenager the better. I am wanting to be benign in the sense of not seen as an adversary by the teenager but if they can emotionally depend on the me this is a desirable situation.

5. I will actively interfere in the relationship between the parents and the teenager. Indeed I can use this to keep my position off to the side. For instance at times parents need to put limits and controls on the teenager. I will discuss with them how they do this and encourage it. This in one way is not fair to the parents as they take all the heat and it allows me to avoid conflict with the teenager and remain in the position I am in the diagram.

Graffiti

The “Are you still there?” session.

2012-01-06T16:07:00.002+08:00

It’s kind of nice when you get one of these and I have had one over the last two weeks. A 30 year old woman who I had not seen for three years. Prior to that I had seen her quite intensively for about two years. The time had come for her to deal with some childhood trauma which resulted in quite dysfunctional relationships with men. I would not call it a sex addiction but she did have some quite promiscuous periods. She did very well, got her life back on track and established quite a good relationship with an OK guy.

Then she stops coming and I hear nothing for three years. A few weeks back I get a phone call and she comes and sees me twice. She comes in and we greet, I catch up on all the developments with family, boy friend, work, social life and so forth. She talks about things that are troubling her and I keep waiting for the ’thing’ to come out and it never does. Nothing serious is being presented which leaves me asking myself why is she here?

She is getting on quite well with her partner but I can tell from how she is talking it is getting to the point where she wants a marriage type thing or that may be that. They are not arguing or anything and have talked about this type of thing but it is not moving that way and she is getting to the point where something may have to happen.

She is just checking out to see if I am still there, in case things turn bad and the relationships ends. Is he still there and is he still the same? - is what I think is behind this revisit. As a therapist it feels kind of nice when that happens.

Graffiti

The great road toll lie.

2011-12-23T17:17:00.001+08:00

I can’t take the BS anymore. It’s all over the radio, TV and newspapers. The endless harping on about the danger on our roads over the festive season. The massive amount of money that is being given to the police to police our roads and apparently keep us safe.

The police commissioner announces that over this christmas and new year season 16 people will die from car accidents. That amounts to one ten thousandth of one percent of the population of this state. It is a minute threat to us. Even if you add in all the injured people it is still going to be a very tiny number. There are far more serious dangers particularly from cancer and heart disease and diabetes that will kill and injure us, than motor vehicle accidents.

This amounts to a major mismanagement of public money by the government.

Graffiti

Child psychotherapy

2011-12-23T10:04:00.002+08:00

I was asked the other day what model do I use when I work with children and I could not answer the question. I originally trained for two years in a psychoanalytic approach to child psychotherapy but that was a long time ago and I have changed my approach considerably since that time.

Eventually in answer to the question I simply made a list of the things I would look for and do at least in the early stages of working with a child.

Usually via drawing I establish the emotional status of the child. I use the catharsis approach to feelings - identify the feeling, express the feeling and drop the feeling.

Again usually via drawing I establish the family structure as the child sees it. I ask the child to draw their family and then analyse aspects of the drawing to get an understanding of the child’s perception of the what they see as their family.

Establish the life script decisions the child has made:
Don’t
Don’t exist
Don’t be you (the sex you are)
Don’t be a child
Don’t grow up
Don’t make it (succeed)
Don’t be close
Don’t be important
Don’t belong
Don’t be well (sane)
Don’t think
Don’t feel
Don’t get your needs met
Don’t be separate

Establish the inborn temperament of the child
Rhythmicity - Regular or irregular
Approach/withdrawal - Positive or negative
Adaptability - Adaptive or non-adaptive
Intensity of reaction - Mild or intense
Quality of mood - Positive or negative
Activity level - Low or high

Attachment style between mother and child - it requires a couple of sessions with mother and child together to ascertain the attachment quality

Parenting strategies - interviews with the mother and father to discuss various parenting strategies to deal with difficult circumstances

Establish overall family structure - emeshed vs distancing family structure

Graffiti

Psychodynamics of the recreational drug user.

2011-12-19T08:44:00.001+08:00

The social drinker unlike the alcoholic has the ability to do these transactions. The Child ego state has the desire for more but the Adult ego state and the Parent ego state have the strength to curb the excesses of the Child.

The alcoholic or problem drug user does not have the strength in the Adult and Parent to restrict the Child ego state desire for more.

Too much?

Graffiti

Gender identity

2011-12-14T18:12:00.001+08:00

Gender identity - Am I male or am I female
Sexual orientation - Am I sexually or romantically attracted to the same sex or opposite sex.
Sex role - how do I practically display my gender identity and how do I relate to the opposite sex.

An interesting statement about cross dressing which seems to make sense. But the male cross dressers I have worked with by and large are not homosexual which does not make logical sense really. But it does indicate that gender identity and sexual orientation are two separate things.

Who am I?

Graffiti

Locus of control

2011-12-14T18:07:00.000+08:00

Locus of control and personal responsibility

Graffiti

Parent's responsible for children?

2011-12-11T08:52:00.003+08:00

KYLady says:

There’s never a dull moment in our house – we have twin daughters soon turning 16 years old. Fortunately, we learned a lot from raising their older sisters. I like your metaphor of walking the tightrope – that’s exactly what it’s like. Too far one way and we are tyrants, too far the other way and we’re accused of being uncaring. For sure, what works with one does not work with the other. I believe parents are responsible for their teens, but if they haven’t parented with clear expectations and firm guidelines in their childrens’ earlier years, it’s going to be a lot harder to influence them as they become more independent. Parenting teens is not easy, not even with good kids!
(end quote)

I would agree with your point that what happened in the parenting of the child effects what happens in the parenting of a teenager. Also that parenting styles with teenagers vary from one to another. This would also be true in childhood but I think it is more pronounced in adolescence.

I find your comment

I believe parents are responsible for their teens

an interesting one.

I know what you are saying but I don’t agree with it, sort of.

I don’t see myself or other parents as responsible for their teenagers. I provide a boundary for teenagers such that they are allowed to do A & B but not C & D. However I would not see myself as responsible for their actions nor their internal emotions. As I write this I am not too sure what I am saying.

I have a belief system in my head that I assume is communicated to my children that they are responsible for their behaviour and emotions and thoughts. I also know that when they are children they do not understand the world enough in order to survive or just operate successfully. That is where I come in and provide boundaries, make suggestions and make decisions for them.

I decide for them that eating a large block of chocolate all at once is a very bad idea and so I stop them but that does not make me responsible for them. All I am doing is controlling a piece of behaviour.

I retreat to my dictionary and discover that responsibility is defined as:

The state or fact of having control over someone

It appears that I am incorrect in my understanding of the term because I do have control over their eating of the chocolate. So according to this definition I am responsible for my children as KYLady originally proposed.

So what am I trying to say here?

As I think here I discover I have a belief and an expectation about my children. You are responsible for yourself and what happens to you in life. There are going to be plenty of times when I am not around and then you are responsible and even when I am around you are also still responsible for what you say and do, etc.

As I write this I am thinking, “OMG, I hope this is an OK thing!!”. I was not aware of this expectation I had of them until now.

Whilst I cannot recall myself saying such things often and openly I am sure this belief was communicated subliminally to them.

I will do all the appropriate things to control their behaviour, such as with the chocolate but at the same time there is this expectation or belief about responsibility that is communicated to them as well.

This is a little bit of a light globe turning on moment as I write this. I rarely if ever said the belief I had about responsibility to them instead it was an unstated expectation of them.

So back to KYLady’s comment about parents being responsible for their children. With the dictionary saying what it said I have to agree in one way but I disagree in another way.

Graffiti

Teenage supervision

2011-12-10T13:48:00.002+08:00

Its not a good week to be a parent in the city in which I live. Parents have come under considerable criticism by the police and parts of the press, most notably Jane Marwick in today’s daily newspaper.

As 14 - 16 year olds end the school year they go to holiday resorts and some of them get drunk and so forth. Whilst these are undoubtedly the minority they attract attention from the police and the press. The police in particular are scathing of parents who they say are not taking any responsibility as they put it and letting these teenagers run riot.

One thing the police do not say is how it should be done differently. At some point the teenager has to be left unsupervised. That is how a young person develops a sense of responsibility. If you are supervising them then they are not being responsible for them self and thus can never develop a sense of self responsibility. Sooner or later you have to let them go and do it on their own.

I have been counselling teenagers and their parents for 25 years and I am not aware of another way by which a teenager can become self responsible without being left unsupervised at some point. If Jane Marwick or the police have some idea on how to do that I would be very interested to hear it.

At what point do you let them be unsupervised and to what degree - there is no clear answer. It varies depending on the personality of the child and the relationship with the parents. It is a very difficult path for parents to walk as often it is trial and error and involves changing the plan of teenager management as you find what works and what does not.

At times parenting teenagers involves two bad choices and it is a matter of picking the less bad choice. A strong willed 15 year old who is reacting against parental supervision can simply get up and walk out of the house. You cannot stop them. You can call the police who can find them and bring them home but then they just walk out again. This can only happen a certain number of times before they end up on the streets. A horrible scenario for parents.

Such a teenager is demanding to be unsupervised and most teenagers do this in varying degrees. When I counsel such parents and teenagers the parents again have to walk a tightrope. You certainly don’t want them being on the streets so you have to give them more unsupervised periods than you may like. The parent has to pick the lesser of two bad choices in order to maintain a relationship with the child and some degree of control. If those criticising these parents have a better solution I would be very glad to hear it.

As the relationship transitions from parent/child to parent/teenager a quality of bargaining and negotiation enters into it. Almost all teenagers will do this to varying degrees. If the teenager is of a complaint nature then it may be minimal. If they are of a strong willed adversarial nature then it can be very pronounced. At times parents have to let teenagers do what they don’t want them to do in order for the longer term goals to be achieved.

At some point parents have to let teenagers be unsupervised if they are to grow into functional members of society who can self regulate. Those unsupervised times often involve undesirable behaviour, that is how the teenager learns what is desirable and undesirable.

Graffiti

Interviewing the child - Part 2

2011-12-09T07:10:00.003+08:00

In the previous post Kahless says

I have never drunk a cup of coffee in my life I dont have the inclination, though i do wonder if it is because as a kid, i distinctly remember my brother telling me i dont like coffee. powerful stuff eh!

This is exactly the next point I was going to make. In the previous post I referred to the idea of the leading question. One can also make a ‘leading statement’ as it could be called. Doing such a thing in interviewing a child can be positive or negative depending on the circumstances.

Children are more suggestible than adults because their Adult ego state is in a rudimentary form. As a result when an adult says something to a child it will accept it more freely than would an adult. The child cannot do the critical analysis or factual assessment of what is being said as effectively as an adult can.

Consider this clinical situation:

A child reports that it has a pet fish which it loved very much. The previous day the cat climbed up on the aquarium, managed to snare the fish and eat it.

The child psychotherapist then says: “Oh, that is sad for you”.

This is a leading statement as it defines reality for the child.

Loss of loved fish = sad feelings

However the child may not be feeling that at all. At that point the child may be feeling anger at the cat and not sadness at the loss.

This can be a bad thing as it may lead to confusion in the child. As the child is highly suggestible it will take on the ‘facts’ provided by the counsellor much more readily. After hearing the counsellor’s comment the child may think,

“I thought what I was feeling was anger but it must sadness as I was told it was”. This can result in the child becoming confused about what is anger and what is sadness. The leading statement has resulted in a problem. The counsellor at least initially needed to ask a question, rather than make a leading statement. For example, “What are you feeling about what happened to your fish?”

In another circumstance one may be counselling a child for anger management. The child who tends to be chronically angry. After some inquiry one discovers that the young boy has learnt that sad feelings are bad things and result in bad consequences. He may have been humiliated by his father when he cried at home. What he does is cover up his sad feelings with anger which is acceptable to his father. The problem is his sad feelings are never resolved and hence he ends up being chronically angry.

Thus the counsellor can make ‘suggestions’ to the child with leading comments such as, “People feel sad when their pet dies”. As they are more suggestible the child will take this comment on more so than an adult would. Such a statement gets planted deeper in the psyche of the youngster than the adult. In this case their suggestibility is being used for therapeutic advantage. (Of course one also makes sure there is not confusion about anger and sadness). The suggestion has affirmed that sad feelings exist, that the child does have sad feelings and that such feelings are appropriate at times

The key to such suggestions is for the counsellor to get the relationship with the child right first, get their timing right and deliver it in a way that will have the most impact.

Hence we get back to the comment by Kahless

I have never drunk a cup of coffee in my life I dont have the inclination, though i do wonder if it is because as a kid, i distinctly remember my brother telling me i dont like coffee. powerful stuff eh!
---------

It is possible this was a suggestion inadvertently given by her brother. The circumstances were right at the time when he made the suggestion and she took it on as a fact. When that happens it is powerful stuff indeed my pommy friend!

Graffiti

Interviewing the child in the therapeutic setting

2011-12-06T09:34:00.003+08:00

(This is a work in progress and will be added to over time).

The problem with interviewing children in counselling is that they are highly suggestible and they look to parents (big people) to define reality.

Because a child has a poorly formed Adult ego state it therefore becomes suggestible. If a child interacts with her brother then she will remember that interaction in her Adult ego state. If an adult person comes along and suggests or says things happened which did not happen then that child may take on what she was told happened rather than what actually happened. The less robust the Adult ego state the more likely this can happen.

This can range from the very serious where it is believed the child may have been assaulted by someone to the benign when its a feeling about a pet fish dying.

In interviewing a child there are times when the therapist is wanting to get the facts of what happened to a child or some event they were involved in. This is the hard to do because the child is suggestible. The interviewer needs to be cautious they get the information from the child rather than suggesting facts to the child which the child then takes on as facts and presents back to the interviewer.

To avoid suggestions the interviewer must do what is known in the legal profession as avoiding asking leading questions.

“And what did your brother do to you in the back shed?” is a leading question.

Besides asking the child for information it also says to the child
You were in the back shed
Someone was there with you
That person was your brother
He did something to you

The weaker the Adult ego state the more the child will take these on as facts that actually occurred. The child may not have been in the back shed for two years. It all of a sudden starts thinking

“I was not in the shed but he said I was so maybe I was and I don’t remember it right”.

The child has now become highly suggestible. Its already weak Adult ego state has become even weaker. It has accepted that in this interview what it recalls is probably inaccurate and the interviewer is in essence telling it what really happened.

This can be made even worse when the interviewer confronts an answer. The child may respond with some sort of comment about not being in the shed. The interviewer takes this as a repression of the event because it was traumatic or maybe as an attempt to protect the brother. He then questions the accuracy of the child in recalling where the event took place and the child’s belief in their recall of the facts is made even more fragile.

Did it really happen?

Thus in interviewing a child one at times must avoid asking leading questions. If one is wanting to get facts from a child leading questions must be avoided. One asks questions with no or very few assumptions in them. One could ask

Where did you play that day?
What were you playing?
Do you play that game by yourself or with other people?
Who have you ever played that game with?
Is it fun to play with him?

As you can see these questions head in the same direction as the question

“And what did your brother do to you in the back shed?”

But they are allowing the child to define when, where, who and what. I would also be asking these questions whilst having the child distracted by some activity such as drawing. This allows the child more ‘space’ and one can look for changes in the child’s drawing (Behaviour) as the questions are being asked.

Here I have given an example of a legal type of situation which child psychotherapists are sometimes required to do. Leading questions also can interfere in the therapeutic process in a more psychological way which will be discussed next.

Graffiti

Oral stage of development

2011-12-05T08:36:00.007+08:00

The oral stage fixation is often associated with the highly dependent person. That person who may have dependent relationships on others or develop a strong dependnecy on a drug of some kind.

These are some of the features of people who have an oral stage fixation.

The oral stage of development is broken into two parts. Initially there is the oral sucking stage which is followed by the oral biting stage, which breast feeding mothers can tell you about!

In the second digram the top two rows relate to the oral sucking stage and the bottom two rows relate to the oral biting stage

Oral sucking stage fixation

Pro-ana. Oral biting stage fixation

Graffiti

Co Counselling

2011-12-01T14:09:00.003+08:00

I was going through some old notes the other day and came across a mention of co counselling. I was always fascinated by the idea of co counselling but never actually did any myself.

I haven’t heard of co counselling even being mentioned for many years. I think it would have been in the early 1990’s when it was all the rage for about a year or two and then disappeared never to be heard of again. Funny how the counselling industry has fashions like that, which come and go.

Co counselling is about therapists getting therapy from other therapists. Therapists getting personal therapy is a good idea for two reasons. First it gives them an opportunity to work on their own issues and secondly a “training analysis” as it is sometimes called is a great way to learn therapy. The therapist as a client gets to see another therapist work not only by observing but also by being directly involved in the process. A great way indeed to learn the art of psychotherapy.

However co counselling has extra special interesting factors than just a therapist getting therapy from another therapist. Two therapists meet and decide they want some therapy and it goes like this:

Week 1.
Person A is therapist
Person B is client

Week 2.
Person A is client
Person B is therapist

Week 3.
Person A is therapist
Person B is client

Week 4.
Person A is client
Person B is therapist

and so on.

Each week they swap the roles of therapist and client. A most interesting proposal indeed. For instance what happens with the transference? It would provide a most interesting experiment on the nature of transference to see what did happen.

Social experiments involve risk. If you never take a risk what will you end up with?

Transference is where the client develops a strong attachment and feelings for the therapist. Often the feelings are not reality based. The client starts to put mother’s face onto the therapist and react to her/him in the same way she did 30 years ago to mother.

This happens because the therapist is in the power position with the client and the client starts this transferring process. Sometimes the transference feelings can be quite strong indeed. In co counselling the therapist and client switch roles each week.

What impact will that have on the transference process?
Will both develop a transference?
Will neither develop a transference?
If one or both parties develop some transference how can that be managed in the co counselling process?

Most interesting questions indeed.

It provides a quite different perspective from which to examine the whole therapeutic process.

Graffiti

Overdose

2011-11-29T19:38:00.002+08:00

It is an interesting process. I just stopped writing for two weeks. There was no decision to, I just did. The previous month I produced a lot of words for the book I am writing on counselling drug users. I just started writing again today.

It was similar to the first book. I treat my Free Child with great care which is a good thing really, therapeutic as well. I listen closely to it or more just follow its lead. I don’t push myself at all to write. I don’t have a schedule of writing. I need to be very careful of my rebellious side and not to engage it in this large writing project.

I must admit I do start to wonder a bit as a week goes by and nothing has been written. But I sit back and let the FC take charge. I suppose I am trusting it a bit more as I know it will come back to the keyboard when ready. That happened last time and is happening this time.

Yesterday I mentioned this to someone and they asked if I had writers block. I don’t think so but then I don’t really know what writers block is. I didn’t feel blocked. It is more a feeling of I am taking very close care of that part of me and trusting it will do its stuff when ready.

Heroin overdose

One hears this term quite a lot but it is in fact somewhat of a misnomer.

Part of chapter 2

Poly drug use.
Anyone in the drug counselling field will come across the term poly drug use. This is seen to be the contrary of mono drug use. In real terms there would be very few mono drug users on the planet. The vast majority of people are poly drug users. If one has a wine during dinner and a cup of coffee at the end then they are a poly drug user using both alcohol and the stimulant caffeine. However the term poly drug use usually refers the use of illicit drugs maybe with alcohol at the one time. The person ingests a combination of drugs in the one session.

Where poly drug use assumes most importance is when considering the possibly of drug over dose. The drug counsellor needs to be cognizant with the effects of possible combinations of drugs. Over dose from one single drug is much less common that over dose from multiple drug consumption. One study of drug related over dose, Hickman et al (2006) found only one drug present in just eleven percent of deaths with the average being more than three drugs detected. The most common drugs found in over dose were heroin, cocaine, benzodiazepines, alcohol and methadone. The least common were amphetamines, ecstacy and cannabis. (Also see Newcombe and Woods (2010), McKenna (2002) and Giroud et al (1997))

As a matter of course any drug counsellor will enquire as to what drugs the client is using. They should specifically ask if the person uses heroin, cocaine, benzodiazepines, alcohol and/or methadone and in what combinations in any one drug taking session. If there is a combination used then the counsellor would obviously inform the client of the potential for over dose and look at ways by which the client can reduce the risk of a fatal over dose, such as not using alone and so forth.
(end quote)

As you can see it would be more correctly named as a poly drug overdose as only 11% of fatal overdoses result from the ingestion of one drug. 89% result from a combination of drugs taken. So how can you say which one was the fatal one or played the most part in the death? So heroin overdoses are rarely just heroin over doses.

This comes from chapter 5

Research study
Kerr, D., Dietze, P., Kelly, A. and Jolley, D.
“Improved response by peers after witnessed heroin overdose in Melbourne”. Drug and Alcohol Review. 2009. 28, 327 - 330.

Heroin related over dose
Current IDU recruited at a needle and exchange programme (ie not recreational users)
61% had reported they over dosed after injecting heroin with the median being 3 times
84% reported witnessing an over dose with the median being 4.5 times

46% reported witnessing an overdose in the last 6 months

These figures show that these people are really living on the edge of self destruction. To go that close to death that often would strongly suggest some suicidal or self destructive urges play a part in what they do.

It should be noted that the subjects in this study would be the dependent drug users and not the recreational heroin users because of how they were recruited for the research.

Graffiti

Book award party

2011-11-27T09:36:00.002+08:00

Last week we had a party for the book award I recently received.

Here is a photograph of myself with the award certificate.

Note the Toblerone and the strawberrys!

Here is what the publisher had to say about the award.

The list of university and college libraries that stock the book contuinues to grow. I must admit that I am a bit surprised at the size of the list as the book is still not even one year old. I would have assumed that psychology, social work and psychotherapy degrees would have to plan more on what texts they would use for next year and so forth.

University of Waterloo (Canada)
University of Manitoba (Canada)
Saint Francis Xavier University (Canada)
University of Victoria (Canada)
Vancouver Island University (Canada)
Ryerson University (Canada)
Royal Roads University (Canada)
Simon Frasier University (Canada)
St. Clair College (Canada)
Universite de Montreal (Canada)
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Games children play

2011-11-22T19:45:00.002+08:00

For the love or money

This is an associated game of Stupid and is sometimes called the game of Spoilt Child. Here love and money get mixed up. The parents believe they can express their love to a child by giving it things. They may even end up saying to the child, “Of course I love you look at all the things I have given (done) for you”.

The parent is for what ever reason unable to express feelings of love or affection to the child. (Their parents may have done the same to them, they have a “Don’t show your feelings” injunction, they may have their own closeness issues, they may equate affection feelings with sexual feelings and that scares them, they may just be self centred and have little interest in giving affection to the child because they want it themselves, and so on).

So the parents give things instead showing love or affection. A prime example can be boarding school in some instances. “I have sent my daughter to a very expensive boarding school so she gets the best education”, (and by the way it also gets her out of the way so I can go and do all my things).

In this game, over time the child’s bedroom begins to start looking like a shop of “Toys-r-us”. The child gets a never ending series of toys and things with which it can play or be entertained by. Computers, computer games, bikes, flat screen TV, pets, DVD player, CD player, overseas holidays, swimming pool, and so on endlessly. (This is of course encouraged along the way by all the marketing which often portrays the line that if you buy this gift for your child then he/she will feel loved by you.)

The problem with this game is that it half ‘hits the spot’. And that can trick both parties’ Child ego states. They think they are being shown love when in fact they are not. All humans have a need for love. That need can only be fully met when:

It is shown to the person first hand (so not mother telling the child that father loves her)
Is face to face (so not via email or even the phone to some extent)
Has emotion involved
Has some form of physical contact.

If these conditions happen then the Free Child need of the person for love is met and satisfied. Indeed the child will feel loved by its mother or father if the love is expressed to the child in ways like this.

I sometimes hear clients say; “I know my father loved me, even though he never told me that”, or “I used to over hear my father tell others how much he loved me but he never actually told me”. Unfortunately these only half meet that Free Child need for love.

Societies will even formalise times when the Free Child need for love is meant to be met. In our country it is often birthdays, and the birthday gift is meant to be an expression of love for the other person. But the physical gift is only a symbol of that love and to the Free Child that does not mean much.

This is summed up well by Coleman & White (1988), “To clarify this point, consider the example of a parent and child playing a game of cards. We would invite such a parent to consider the following question : Are you playing cards with your child, or are you playing with your child and that just happens to be cards at the moment? Toys, games and play activities can provide an effective way of avoiding contact with a child. They can allow the parent and child to become side-tracked into the activity and avoid closeness, contact or openness with each other. Parents who provide children with expensive toys particularly need to consider how they play with their children.”(P13).

In the wall of trivia ‘things’ get in the way of the two parties actually getting close and having intimacy. The Free Child to Free Child transactions get blocked. Indeed in some marital counselling, the counselling can become a thing that gets in the way as well. It gives both parties a ‘thing’ to talk about other than themselves and their feelings for the other party.

A derivative of the game, “for the love or money” is the game of “Childhood obesity”. In this game love does not get mixed up with an expensive gift but instead love gets mixed up with food. The parent has the mistaken belief that it can express its love to a child by providing it with food and the child begins to take this on and when it feels full it feels loved. So it is provided with lots of food and it eats the food in its desire to feel loved. Again this only half “hits the spot”. For a brief while the Free Child need for love is met when it eats but it does not last because the need is not really getting met in the way I described above. (Note there are many other reasons as well for the over weight child).

The other derivative of the game, “for the love or money” is the game of “Higher, faster, longer”. In this instance love gets mixed up with achievement in the child’s mind. “If I can jump higher, swim faster or run longer then mum will love me”. “If I can win the gold medal then dad will finally notice me” The child believes that if it can achieve success in sport, business, education and so on then the parental love that it craves will finally be given. I would suggest that many high achievers are of this ilk. Again, it works for a little while, and the parents may in fact provide the contact with the child when it does achieve. The problem is there is always another race, there is always more that could be achieved. So the child never gets to the end and often high achievers are left with a hollow feeling as they look at their trophy cabinet, investment portfolio or degrees hanging on the wall.

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Drug use ambivalence

2011-11-18T13:58:00.002+08:00

Using the drug use ambivalence technique with those drug users who are in remission.

I have been using this technique now for some time. I have developed it over a number of years and kind of did not realise that until I spoke with my supervisee the other day and she raised some concerns.

It is a two chair exercise where the client sits in a chair and experiences that part of their personality - either the FC or AC.

I have used it recently with two women who had been clean for some time but they had both expressed some concern about relapse. They were fine doing the FC chair and gave the usual responses of why they do not want to use - their lives are better, healthier, save money and so forth.

When asked to go to the AC chair both expressed an instant strong fear reaction. One woman even stated,

“That bit does not exist..... if it does exist it is only very tiny”.

After a bit of discussion she stated that she did not want to acknowledge that it existed because then she might use again. Indeed we had spent a good deal of time in the previous weeks discussing the idea of relapse and she was quite open about it. She was fully aware in her Adult about her desire to use drugs again but to actually experience that part of self was an entirely different thing. Her statement about it not existing or only being very small was highly incongruent. This however does show the difference between her Adult being aware of her desire to use again and her first hand experience of that part of her personality that wants to use. Which supports the validity of this technique.

However this raises an interesting question, What was she actually scared of? Does the bigger fear reaction mean the more likelihood of relapse or the closer the person is to a relapse.

Or it may simply mean that the person is scared of relapse even if they are not at any great risk of doing so.

I do not know the answer to that question. However my supervisee expressed some concern at this technique. She reported that by asking the person to experience the part of self that wants to use drugs may in fact increase the likelihood of them doing so. Another interesting proposal and one that I do not agree with.

The fear reaction, along with the reluctance to ‘be’ that part, (with one person even denying its very existence) means that she had repressed that part of her personality. She had become unintegrated in that way. She had locked away this part of her personality and kept it hidden from her conscious.

Psychological theory states that the more you integrate parts of the personality the less trouble they will be. By keeping it unintegrated the more likelihood there is that she will relapse. By experiencing it and integrating it, the less problematic it remains in the personality.

Also with her being the AC part of self it allows me to relate to it directly. This is a most important thing to do. Whilst sitting in the AC chair I can dialogue directly with it. Thus we have the opportunity to develop some relational contact. It allows us the option of building up some kind of relationship. This is a very good thing as it allows the AC to stop feeling so isolated. It defuses it and people are always in better psychological shape when they feel they are in some kind of relational contact with others.

Any time I come across some kind of self destructive aspect in a client my first goal is to establish some kind of relational contact with it.

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Singapore workshop

2011-11-16T08:02:00.001+08:00

This is a picture of the group of counselling students I worked with recently. I ran a workshop on the theory and practice of group psychotherapy.

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Rackets and feelings

2011-11-05T18:42:00.001+08:00

This post is a work in progress and I will complete it at a later time. It is for the comments by KYLady and di345 who asked about feelings and rackets.

One of the problems with the concept of rackets is that it has had many differing definitions in the literature. Below are listed some of them.

So people use the term in different ways and mistakenly assume (often) that they are talking about the same thing when they are not. As you can imagine confusion results in such debates over feelings and rackets.

Also I have been remiss and excluded one of the more significant barriers to dropping a feeling. So the list has increase by the number of one.

Barriers to dropping a feeling

The racket value of the feeling
The strength of its connection to a script decision
Secondary gains associated with it.
Characterological basis of the feeling

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Self harm

2011-11-05T13:56:00.004+08:00

This was sent to me today by a self harmer who did this to her leg.

It catches the emotional core of the Borderline personality. A mixture of anger and fear.

She makes an interesting distinction between ‘playing” self harm and ‘punishing’ self harm. This is playing self harm where the cuts a quite superficial but with punishment self harm the cuts are significantly deeper. And it is the bleeding that has the most psychological significance.

In my book - Working with suicidal individuals - I propose 8 possible motivations for self harming:

1. Self harming as part of gang tattooing behaviour.
2. Self harming to make self feel real which can be found in those who dissociate.
3. Self harming to make self feel something.
4. Self harming used as a means of tension relief and to release pressure build up.
5. Self harming as a physical expression of emotional pain. Self harming is seen as providing concrete evidence of the pain.
6. Self harming as a means to self nurture. It allows the person to care for self as can be found in Munchausen Syndrome.
7. Self harming as a means to punish self and an expression of self hatred.
8. Self harming as a means to manipulate others or as a cry for help.

It would seem that reason number 7 is part of the motivation to self harm. As for seeing the blood and bleeding one would need to enquire as to what it means for the self harmer. It could be a variety of things such as found in reasons # 2, 3, 4, 5 or 6.

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What personality type are you?

2011-11-05T08:14:00.000+08:00

To view in larger size:
Click on picture > click on actions > click on view all sizes

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Book review - Part 2

2011-11-04T14:04:00.008+08:00

This comprehensive book review comes from the magazine of the Institute of Transactional Analysis which is a UK based association.

To view in larger size:
Click on picture > click on actions > click on view all sizes

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Book review

2011-11-03T13:35:00.002+08:00

From the newsletter of the International Transactional Analysis Association

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Drop a feeling

2011-11-01T07:59:00.004+08:00

Some people report experiencing feelings that they don’t want. In such circumstances the psychological process of dropping the feeling is required.

For small feelings

1. Child ego state experiences the feeling
2. Adult becomes aware of the feeling
3. Adult decision to drop feeling

For large feelings

1. Child ego state experiences the feeling
2. Adult becomes aware of the feeling
3. Child expresses feeling the number of times needed
4. Adult decision to drop feeling (May need two chair)

Barriers to dropping feeling

The racket value of the feeling
The strength of its connection to a script decision
Secondary gains associated with it.

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Life positions

2011-10-30T19:31:00.001+08:00

What is your life position?

I’m OK, You’re OK
I’m not OK, You’re OK
I’m OK, You’re not OK
I’m not OK, You’re not OK

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Book update - October.

2011-10-30T17:26:00.001+08:00

I am much happier now. As I enter the second half of the manuscript for my book on counselling drug users the last two weeks have been frustrating to say the least.

I have never had to produce documents of this size and for this purpose before so I did not know how I would do it. But I am discovering I am doing this second book the same way as I did the first. I am not a systematic writer at all. I have a general idea of what is going to be covered, after all I did have to produce a book proposal that included a statement of the titles of the chapters for the publisher.

Fortunately last time they allowed me to modify that a bit as I went along and I am doing the same again. I definitely do not have a very clear idea of what I am going to write. I make it up as I go along in the general areas that I have decided on.

I kind of start at chapter one and move through the chapters but often I am doing them out of order. It depends what comes to my mind on any particular day. I walk pretty well every day as exercise and often when I am walking I get the best ideas coming up. So when I get home it is straight onto the word processor and putting down the ideas, at least in note form.

I have a current supervisee who has to do this project that is basically a small thesis. About a month ago she made a contract in her supervision that she would do ‘x’ amount of words, ‘x’ number of days per week. When she made it I thought, there is no way this is going to work, but it has worked well and she is getting it all done. Obviously I projected onto her because there is no way I could write like that.

However back to me being happier today. In the past two weeks my thoughts have been jumping between three separate chapters all at once. Counselling the teenage drug user, the Transactional Analysis theory of addiction and self soothing and the drug user. A common feature of the problematic drug user is an inability to self soothe. This jumping around has left me feeling like I am not getting anywhere and hence the frustration.

Kahless

However today I concluded two of the three chapters, the teenage one and the theory of addiction one and that is why I am back to being a happy little chappy again. And I will be doing the self soothing one this week which is a little bit more focussed, well I hope it remains that way!

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The peace protester and projection.

2011-10-29T12:40:00.002+08:00

Projection is a natural thing that many, no all of us do from time to time. It has also been identified by Freud as a defence mechanism. A defence mechanism is a psychological process employed by a person to save them from anxiety and one could say to save their self image as a good person.

For example a peace protester may have significant aggressive impulses inside him. He is disturbed by these impulse so they cause him anxiety and they do not fit with his own self image of what a good person is.

As a consequence his unconscious takes over and solves his anxiety. It gets him to project his aggressive impulses outside onto someone else or perhaps some organisation. This allows him to avoid his anxiety and maintain a good self image because in his conscious mind he has no aggressive impulses. Due to his non aggressive sense of self he becomes a pacifist and goes on peace protests, (Also because he is unconsciously frightened of his own aggression).

He sees the government as being very aggressive at least in part because he has projected his aggressive impulses out onto it.

Hence we have

“The lady doth protest too much, methinks”.
William Shakespeare (Hamlet)

And the icing on the cake comes when he can go on a peace protest and express his aggression towards the police (who he has also projected his aggressive impulses onto). This aggression does not cause him anxiety because in his mind he is being aggressive in the quest to achieve peace.

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Boiled egg and peace protesters

2011-10-29T12:14:00.002+08:00

Have you ever had a boiled egg with toasted soldiers. I was raised on that sort of breakfast food and the soldiers dipped in the yoke is very yummy.

But my good friend calls them -

A boiled egg and peace protesters.

A good name I thought!

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Eros and thanatos

2011-10-29T09:33:00.004+08:00

INTRODUCTION
Any student of the psychotherapies would have heard the terms:
Eros and thanatos
Libido and mortido
Life instinct and the death instinct
If not, then they should have! Freud seized on this concept and it became central in his overall theory of human nature. In his book “The ego and the id” he discussed this theory of instincts at length.

Freud[1962] in his discussion of the two classes of instincts states that the first class is the sexual instincts or Eros. This is a "...self-preservative instinct,..."(P30). On the other hand there is the death instinct whose task it is to, "...lead organic life back into the inanimate state;..."(P30).
He is thus entering into the field of the philosophy of opposites. Human nature, life and the universe is unerringly a collection of opposites. The answer to the question, “Is it possible to have something that does not have an opposite?” begs unending cognition.

Hyams(1998) notes this in her article on dissociation. She says that the world is full of polarities - good/bad, inhaling/exhaling, high/low and so on. In addition there is yin/yang, protons/electrons, left/right, black/white, matter/anti-matter and so on endlessly. Does something exist that does not have an opposite? I am yet to think of one. As soon as one defines ‘x’, then ‘not x’ is also defined. However that is for the philosophers to conjugate over.

THEORY OF OPPOSITES
Freud’s theory of these two instincts is a theory of opposites. One problem with such theories is they can become static. One discusses what is a manifestation of Eros (the life instinct) and what is a manifestation of Thanatos (the death instinct).
Eros = love, procreation, win/win situations, peace and cooperation, god.
Thanatos = hate, murder, game playing, war, devil.
This provides us with a static taxonomy of this theory. It is possible to look at how they interact and Freud does this to a certain extent in ‘The ego and the id’. He talks about love and hate being able to change into one another and how eating is both simutaneously constructive (gives life to consumer) and destructive (destroys the consumed product).

It is this point, in my view, that gets lost and is never taken far enough by Freud. This theory of insticts gets caught up in a right/wrong or good/bad morality. His bipartite system has a moral basis which leads it into trouble. It follows on from the same moral view that has been held by many if not all religions throughout time.

Life, growth, creation is good vs death and destruction is bad. In religious terms we have good and evil and god and the devil. The church has for all time seen god as good and the devil as bad and we must behave and think in a way that allows to be with god and defeat the devil. The only true way to defeat the devil is to not define god. As soon as one defines god, one defines the devil at least in part - the devil = non-god. If you do not define god then the devil cannot exist. If it does not exist then it is ‘beaten’ in one sense.

MORAL BASIS OF PSYCHOTHERAPY
This god vs devil or eros vs thanatos are static models based on a moral principle as suggested before. Thus we have the very basis for the moral underpinnings of psychotherapy.
Thanatos vs Eros = games vs intimacy, aggression vs assertion, I’m not OK vs I’m OK, win/lose vs win/win, competition vs cooperation, script vs autonomy. Some now argue they do not hold to such a moral view, as Transactional Analysts they work with the client and hold no judgements as to what is right and wrong.

In my view - balderdash. How many books on TA describe how to increase game behaviour and decrease the capacity for intimacy. How many describe how to avoid intimacy and increase script bound thinking and feeling. Transactional analysis is based on (as are all psychotherapies) a set of moral judgements about what constitutes life & growth and what constitutes death and destruction. What constitutes health and what constitutes pathology is central to any psychotherapy.

EROS & THANATOS VIEWED DYNAMICALLY
Let us take the static model of Freud’s bipartite theory and look at it as a dynamic model. Once done we end up with a very different situation. This allows us to go beyond examining the two insticts and what they represent in thinking, feeling and behaving. Instead it leads us to 3 new questions:

1. Are Eros and Thanatos interacting or not?
2 When they do not interact what happens?
3 When they do intereact what happens?
These three questions lead us to yet another set of opposites - change vs inertia.

What would happen if all the poeple on earth suddenly came to their senses and were able to tap totally into their eros energy and avoid all their thanatos energy? Governments would stop spending trillons of dollars on building bombs and weaponery and put all that money into psychotherapy and medical science. With all the advances taking place eventually people would than be able to live good quality lives until, they were 150 years old. What would the planet be like then. Firstly, governments of the world would rapidly bring out one child policies and these would even more rapidly become ‘no child policies’ or ‘very few child policies’. We end up in a state of inertia - little change. If we could all tap into the good growth, creative energy of the universe we end up static, in a state of inertia. When the eros instinct over rides its opposite for too long this is where we end up. If the thanatos instinct over rides then we end up in a similar state. Everything is destroyed, nothing is created and we end up inert again.

As transactional analysts this means we must be aware that it is essential that we remain playing games at some level and remain script bound to some degree. If we became script free then we end up inert. Thus we have one answer to the question about what happens when eros and thanatos do not interact.

So what happens when they do interact. Consider this other example that occured in Australia recently. There were massive bush fires in the eastern states of Australia. We saw images of huge flames, dead animals and huge areas of burnt out forests, All the reports were of how much devastation had been caused, how much bush had been destroyed. Clearly thanatos had been at work and left massive destruction in its wake.

However this is incorrect. The bush had not been destroyed it had been changed. The pictures of huge blackened areas all left us with black, sorrowful feelings. These blackened areas should be a stimulus of great feelings of excitment, anticipation and joy, not of sorrow. Imagine the growth and creation of insects, rodents, vegetation that are now going to occur in these blackened areas. It will represent an expression of eros in its undiluted form, a thing which we all say is wonderful. If there had never been the thanatos of the fire then this eros could not have occured.

DEATH PHOBIA
We humans are a death phobic species. We will do almost anything to avoid the pain that acts based on the thanatos instinct can bring. We spend millions of dollars on fire fighters and fire fighting equipment to reduce the “destruction” (ie thanatos, ie change) to a minimum.

Consider human reaction to endangered species like the elephant or lion - the Kings of the wild. What do we do. We create breeding in captivity programs in zoos. We create reserves for them to live in. These are called wild life parks. A nice term to alleviate our guilt. Lets be realistic wild life parks are the same as breeding in captivity. These wildlife parks and zoos are simply museums. They allow us and our children to see species as how they once were. A useful endeavour. But lets not pretend they are existing as they used to. Such parks and zoos allow us to observe the history of such species, not the now.

So why do not we just let all the elephants and lions die out. Let that symbol of evil and thanatos - the poacher - do his work and kill off all the remaining ones. Why do we not get it over and done with instead of stringing out the pain and trying to pretend that these species still exist. Why do not we accept that lions are extinct, its just that we do have some in a museum that we can go and look at from time to time?.

I do not have an answer. Perhaps it is a sign of some form of collective human guilt. Perhaps it is because we have accepted a static model of eros and thanatos or god and the devil. If we look at the same model dynamically then we see that with the extinction of the lion that opens up change and some form of species will be allowed to grow, develop or even be created that could never have happened with the presence of the lions. The poachers work allows eros (god) and thanatos (devil) to interact thus we do not remain in inertia but move into a change phase.

PSYCHOTHERAPY AND THE DYNAMIC MODEL
How does this translate into psychotherapy and transactional analysis. All psychotherapies have some sort of statement on what is health and what is not. The majority spend a great deal of time defining such things. For instance in TA we have script and autonomy. Large amounts of time and energy have been spent on defining and diagnosing what are script thoughts, feelings and behaviours and what are not. Then just as much time is spent on how to treat or facilitate change of such thoughts and feelings.

How would people react to suggestions that:
“A divorce is to be as celebrated as much as a marriage”
“Game playing is essential to normal human growth and development”
“The srcipt free individual will wither and die over time”

This is what the dynamic model of eros and thanatos or the life and death instincts proposes. Up to date psychotherapies have been taken from the church or the (moral) static dichotomy of good and bad and the god and the devil.

CONCLUSION
It seems erronous to view humans as having the two drives of eros and thanatos. Instead we have:

interaction/unbalance/change or stagnation/balance/homeostasis.

It is more reasoned to view these two drives as either interacting or not. If they are not dynamically involved then we have stagnation and non-life. If they are interacting then we have life.

REFERENCES
Freud, S. (1962). The ego and the id. New York: W.W. Norton.
Hyams, H. (1998) Dissociation: Definition, Diagnosis, Manifestations, and Therapy, with Special Reference to Cults/Sects. Transactional Analysis Journal. 28(3), 234 - 243.

Who am I?

2011-10-24T08:03:00.001+08:00

Thoughtful
Sweet
Insecure
Shy

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Resilience

2011-10-23T09:42:00.002+08:00

Sometimes I do requests. (I agreed to a brief one)

Resilience is a word as we know that is used in common everyday language. It also refers to a specific psychological concept. One definition I found was:

The ability to maintain or regain mental health despite experiencing adversity.

How some people can with stand adversity without developing negative physical or mental health outcomes. Desensitisation is one part of resilience but it includes much more. For example the ability to self soothe. A person who can self soothe is going to be more resilient than the person who can not.

The concept of resilience is of particular importance in the training of military personnel. Part of their training is to desensitise them so they become more resilient. To do that they must be abused or assaulted in some form which is how they will naturally desensitise.

But desensitisation is a tricky little sucker because you have to do it in the right amount. Look at this graph

As desensitisation increases so does resilience but a point is reached at the top of the graph where further desensitisation results in a drop in resilience. When you have too much desensitisation for too long, one ends up with PTSD which we know can happen to combat veterans. They fail to resensitize on the return home.

On the other side is being hypersensitized when one has not desensitised enough and thus the resilience is down again. In the previous post this is where I would put many Australian children because they are overly protected from things like the Gaddafi death video.

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Developing resilience in children

2011-10-22T18:01:00.003+08:00

Since the images and video of the death of Col. Gadaffi have been out so have all the moaners and groaners in Australia.

Its not necessary to show the video
Its not newsworthy to show images of a dead and dying Gadaffi
We need regulation on this (The last thing we need in Australia is more regulations!)

And then finally someone plays the trump card of all cards and says:

“What about the children?”

Meaning that what if the children see such pictures?

and I think, yes what indeed about the children.

Let children be confronted with problem situations.

I know one way to get the moaners and groaners, moaning and groaning and getting the regulators sharpening their pencils and salivating at the prospect of making even more regulations.

When children see the video of Gadaffi being killed then as a psychologist I can say that they will be a bit more, wait for it.....

desensitised to violence!!

OMG (x10)!!

I can now hear those electric pencil sharpeners whizzing and whirring at a frantic pace now.

That is an interesting phrase

Children desensitising to violence.

I’ll tell you what I will do. I will say the same thing but with different words.

By watching that video of Gadaffi dying children will have an opportunity to develop their psychological resilience.

Now that sounds much better. Not desensitising to violence but developing resilience!

Desensitizing to violence and developing resilience are the same thing.

Now all the huffers and puffers will be chortling that developing resilience is a very good thing and we want our children to develop their resilience and become resilient. That is a very good sounding thing indeed they will pronounce.

A central part of a child developing psychological resilience is to desensitise to repugnant images such as people being killed. Not to become a cold, hard machine but to desensitise to violence at a healthy level.

If you don’t regularly desensitise then one becomes hypersensitized. If we completely sanitise a child’s world then it can never develop resilience to the unsanitary. If we remove all repugnant images, from the severe to the mild, from children then they are going to become hypersensitized to them. And I am afraid to say that in Australia we have done precisely that. In Australia we are a group of hypersensitized wooses when it comes to images and videos of the demise of Mr Gadaffi.

I have said this before here.

Australians are nation of neurotic necrophobics. By sanitising our lives of seeing death on TV and so forth we have become hypersensitized to it and now have a national phobia about seeing dead people.

You have to let children see such things or they wont desensitise to them and will become hypersensitized to them. I am not suggesting you sit children down in front of a TV to watch violence for an hour or so but be realistic about what they see in day to day activity on the TV, the internet, newspapers and so forth.

Then yes you deal with it a clear and effective way. If I was watching TV with my young children and the Gadaffi death video came on this is a summation of the dialogue that would happen. It would probably be longer than this but this gives the general idea.

Developing resilience

Children: What’s happening there daddy?

Father: That man is a called Mr Gadaffi and he is hurt.

C: Who is he?

F: He is the president of a country that is near the pyramids like you drew pictures of at school

C: What are those people doing?

F: They are probably going to kill Mr Gadaffi because he has been a bad man. He hurt lots and lots of people and those people are angry at him. Its called revenge, like when your sister hits you and then you want to hit her back.

C: Why are they all shouting?

F: Because they are very excited and angry at catching him hiding. That red stuff on his head is blood.

C: How did he get that?

F: He has probably been shot with a gun. When people get shot blood comes out. If you get shot in the leg, or bum (to which there are snickers and giggles because daddy said a rude word) or head blood comes out. It looks a bit scary doesn’t it?

C: Yes it is a bit scary.

F: Oh well these things happen and if you treat people nice they are nice back to you.

Maybe more on feelings and thoughts about the thing and then that is about that. Problem solved and the children have had a chance to develop a bit of resilience. It is OK to say words to children like kill, shot in head and blood. It’s not going to traumatise them for life. More importantly its how the adult in the dialogue above does it in an open and clear way without a fear or horror about the whole thing. If the children see the father handle it in an OK way then the children will see it for what it is and have their questions answered as well.

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Strengthening the Adult ego state

2011-10-15T16:14:00.003+08:00

Today is Saturday and that means laundry washing day for me. Hey I am a regular kind of guy! As I embarked on this most OCD of all OCD tasks I discovered that my laundry powder had run out so I went to the supermarket to buy a new box of clothes washing laundry powder.

When I got there I was confronted with this wall of different types of laundry powder boxes all different shapes and sizes and colours all claiming different sorts of things. I thought

“S**t, all I want is a box of washing powder and I am going to have to make 30 decisions to end up with the one I want”.

Now I know what home work exercises to give my clients who are tormented with indecisiveness. To hone their decision making skills just go and buy some laundry powder.

So I started the process and decided on the size I want and the kind of money I want to spend. The rule of thumb with this kind of product in the supermarket is never buy the cheapest as the quality is crap. Also never buy the most expensive as they use the psychology that people will assume it is the best quality when it is no better than the average priced brand.

On a side note sometimes people ask me about how to pick a therapist, to which there is no easy answer but there is one thing I tell them not to do. Never pick the one with the biggest and most expensive advertisement. Now if one is choosing a plumber or an accountant it may be OK to pick the most expensive advert. But in choosing a therapist there is something not just right about the one with the most expensive advert. I can’t articulate why it’s just an intuitive conclusion. Having been in the counselling industry for 30 years, to me there is just something wrong with a therapist who presents self in the biggest advert.

However back to the topic at hand. I finally reached the point where I had decided on two possible items to buy. One was called Bam and the other was called Blast. That was my choice - Bam or Blast. Who thinks up these names? Some psychologist would have done a PHD on this. Someone would have received a doctorate for a study on the marketing psychology of laundry powder and concluded that names like Bam and Blast are the ones that would sell. Hey it worked on me!

OCD

Also as I pondered this decision one is confronted with a paradox. There are questions one muses over such as what does my life mean and who am I? And then I realise I am in a supermarket pondering on which product to buy - Bam or Blast!

So I made my decision and Blast it was. However there was still one decision to go. What scent do I want - lemon or frangipani? Do I want to smell like a lemon or smell like a flower when I wear my clothes? Last time I chose lemon because it seemed more manly to smell like a lemon as compared to a flower. But this time I chose frangipani because of late I have been developing my feminine side.

Today I have been walking around smelling like a flower. And after all that decision making I feel like I have to have a valium and have a lie down.

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Insomnia

2011-10-14T14:24:00.004+08:00

One could diagram the state of sleep as such:

The Parent and Adult ego states are decommissioned and one is left with the Free Child alone. That is why sometimes dreams are referred to as the windows to the soul. It is truly a way to see into the unconscious and the primal needs of the person.

With the two ego states decommissioned the FC is allowed to roam free and create what ever it wants which is what it does with dreams. It provides such a rich source of psychological material but many disagree on what it means and what is the best way to use it with clients. There are many, many different varieties of dream work.

To have good sleep the adult woman has to somehow psychologically get like the girl.

However getting into the state of sleep that is diagrammed above involves an interesting psychological process and this is why some have difficulty with insomnia. The way people talk about sleep states it fairly well. People are said to FALL asleep. People do not run into sleep or jump into sleep but they fall asleep.

People have to kind of surrender into sleep. It is a letting go process. To decommission the Parent and Adult and access pure FC involves the person giving into or surrendering to sleep, like letting self fall. Some have a lot of trouble doing this because it means they have to let go and trust. Letting go of the conscious and surrendering to the unconscious if frightening for some and hence they experience insomnia.

The same applies for the experience of love. People do not run into love or drive their car into love instead they FALL in love. To understand and experience this people have to do the same kind of surrender or submission that is required for the sleep state. Those who say they do not know what love is, can be because they are too frightened to do this letting go and falling process. Hence they can never experience the Free Child as it is shown in the diagram above and hence never have a true experiential understanding of love.

Finally sex also requires a similar psychological state, especially for the male. Some men who have difficulty obtaining or maintaining an erection, can be because they have difficulty with the same letting go process. If they cannot decommission the Adult and Parent ego states adequately enough that can lead to sexual difficulties as described.

The diagram shows a very child like state. When each of us are born we are psychologically like this. So in one way it is such a natural state to be in. However to release our control and indeed our very way of understanding and viewing the world is difficult for some. Also it seems safe to say that when people fall they quickly and instinctually reach out and try and grab onto something. To fall asleep one has to trust the fall process such that they do not instinctually grab onto their Parent or Adult ego state.

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The dream I had last nite

2011-10-12T08:38:00.001+08:00

I was outside in the street. I didn’t recognise where. I suddenly realised that I could fly and kind of just floated up in the air and I could fly around. (Flying has been a theme in many of my dreams over the years. I don’t know what it means but it’s probably important). Other people where there and saw me and tried to fly but they couldn’t.

That felt kind of good. Like a special feeling and I was enjoying the flying anyway. I was flying around and suddenly realised there were electric power lines nearby and I got frightened. I might touch them and die. I kept flying but was scared of the power lines and the dream ended. Maybe there is some danger in my life at the moment that interferes in my enjoyment of life.

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What the judge said

2011-10-05T11:55:00.001+08:00

Comment made by the British Medical Association judges on the high commendation awarded to the book - Working with suicidal individuals.

JKP report on award.

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Anti social personality

2011-10-02T08:33:00.001+08:00

Conduct disorder in children can lead onto the subsequent development of the anti social personality.

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BMA certificate

2011-09-28T19:30:00.000+08:00

British Medical Association Book awards certificate

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Dynamics of the marital relationship

2011-09-26T20:05:00.002+08:00

Someone asked me about how the relationship with their father early in life might have effected the relationship with males she has as an adult woman. She reports some difficulty in getting a relationship that seems to work.

In normal circumstances the relationship with parents provides us with the templates for subsequent relationships such as with a partner later in life. For instance if a girl has a close and loving relationship with father that sets the template for similar kinds of relationships in subsequent relationships with males.

However it is not that simple. There are other factors which will influence the final relationship outcome such as with a partner. For example the young girl watches how mother and father get on. She will unconsciously and automatically model that behaviour, but she may at the same time decide never to be mistreated by a man like mother was.

In such circumstances one may get two types of relationships for the woman as an adult. One where she is mistreated by the man who happens to be her partner, but she may have also have had a series of relationships where she mistreated the men in her life as a demonstration to herself of never being like mother in a relationship.

One of the key features in the selection of a marital partner is what is known as the early demand.

What was the thing I always wanted from father (mother) and never got?

It is usually something like time, affection, love, encouragement and so forth. The woman then sets about finding a man who will continue to not meet that need in her, like father never did. This may seem a little odd but it is just the way it is.

It is usually in our most intimate relationships where we tend to try and resolve our Free Child needs. Of course a marital partner can often be that. We often try and use our partner to finally resolve the issues we never resolved in childhood.

This can lead to circumstances where a much younger woman marries a much older man. When there is a big age difference it is likely that such a thing is happening and the woman is psychologically using the man for such reasons. The success of such a thing varies from situation to situation.

However these circumstances are much more frequent than many realise. Whilst in many relationships there may not be a big difference chronologically there can be psychologically. Thus in real terms the same psychological mechanisms are at work even though the chronological ages may be much closer.

In some, nay most relationships, the psychological status or strength is not the same. There tends to be one more psychologically stronger partner than the other. This indeed can change over time as well. In some relationships the psychological dominance varies considerably and thus one has the same circumstances as the much older male and much younger female. The same psychological mechanisms are at work.

The less dominant one tends to see the other as a dominant psychological parent and sets about trying to solve all the stuff that was never solved first time around with varying success.

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Melamary life script currency analysis

2011-09-26T08:24:00.002+08:00

Results

uniqueness
one and only +
feelings ++
power +++
reverse status
sex ++
beauty
pied paper
booze ++
food +
violence
money ++
words +
drugs +

Analysis

Games - Rapo, cops and robbers, psychiatry
Stage - anal
Lifestyle/occupation - politics, examiners, critics, the “boss”. police, doctors, psychologists
Therapist - Supervisor / supervisee disputes, industrial mediation
Personality - paranoid, anti social
Issues - Control, penis envy, dependency

Power is an interesting script currency and not an uncommon one. It is unfortunate in that the person tends to waste so much energy as they get caught in fights or disputes they do not need to and so much energy gets ‘wasted’ in this way. The person with the power script currency needs to ask self, “Do I need to be involved in this dispute”.

The young child has fight (compared to flight or freeze) as its primary response to parental control. Feeding, toileting and adolescence are especially crucial stages in this child’s development where parents need to be extra careful not to set up an adversarial relationship with the child in a battle for power and control. However it is not just these stages and it is all through the formative years that parents need to be careful with the ‘fight’ child.

Power is a double edged sword in relationships. If one feels they have the power position in the relationship that can lead to a sense of safety because one is in control of what happens. However it is also tiring as one IS always in control and thus can never be ‘looked after’ by the other. In therapy the client is invited to take the dependent role in the relationship with the therapist. They may find this very difficult to do but if achieved they may feel a great sense of relief at not having to be the one expending all the energy being in charge.

The therapist needs to make sure that the therapeutic relationship does not become just yet another battle field for a fight over control, for the client. This does happen as therapists are the ones in the power position in the therapeutic relationship and thus those with a power script currency issues will be attracted to the profession.

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The emeshed family

2011-09-25T17:34:00.001+08:00

A video on how the emeshed family structure can result in anxiety and panic attacks

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Book award part 2

2011-09-20T07:06:00.003+08:00

A summary of the BMA book award night can be found at the publishers website here.

I travelled there with a good colleague of mine and here are some photos of us.

And I finally was able to meet up with the Commissioning Editor of JKP who was also there to see the event.

And here is the woman who made all the announcements of the nominees and the winners.

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Book award

2011-09-18T18:07:00.003+08:00

This was the moment of truth. At the British Medical Association 2011 medical book of the year awards. There I was in London last week at the awards as my book had been given a high commendation and nominated for the award by the BMA.

There would have been at least a couple of hundred people there including publishers, authors and those in the medical profession.

A big screen was at the front of the auditorium. Each time a nominee was announced the book would be displayed on the screen for all to see. In my category of psychiatry you can see there was a total of 12 nominees with my book in the bottom right hand corner. Then they announced the winner and that book would be displayed up on the screen by itself, everyone clapped and so forth.

To see the BMA list of winners and losers for the night go to here.

There is one other thing that I have learn about book publishing. My next book is not going to have a title that starts with a “w”. Any list I have seen my book on it is always at the end as happened when the nominations were announced, as you can see. Even if they sort them by author it is still at the end.

My next book on drug counselling will have a title something like, “A compendium of drug counselling”. Even if it doesn’t get put under “a” it will get under “c” on any list.

Besides all that here is an updated list of the libraries my book is in and these are only the ones I know of. Also the book is still only 9 months old so it is good to see it get into so many university and college libraries in their degree programmes.

University of Waterloo (Canada)
Saint Francis Xavier University (Canada)
Simon Frasier University (Canada)
Mount Saint Vincent University (Canada)
Mount Royal University (Canada)
Wilfrid Laurier University (Canada)
Kwantlen Polytechnic University (Canada)
University of Lethbridge (Canada)
Concordia University (Canada)
University of Guelph (Canada)
Library and Archives Canada (Canada)
Maribor General Hospital Library (Slovenia)
Stellenbosch University Library (South Africa)
Mitt hogskolan library (Sweden)
Stockholm University (Sweden)
PJ Library (Norway)
University of Bergen (Norway)
Norges teknisk-naturvitenskapelige universitet (Norway)
University of Oslo (Norway)
University of Tromso (Norway)
University of the West of England (UK)
Derbyshire library (UK)
University of Plymouth (UK)
Manchester Metropolitian University (UK)
Lancaster University (UK)
University of Hull (UK)
University of East Anglia (UK)
University of Cambridge (UK)
Oxford University library (UK)
University of Exeter (UK)
Coventry City Council library (UK)
Bromley Library service (UK)
Cadbury Heath Library (UK)
Kingswood Library (UK)
Nottingham Central Library (UK)
Yate Library (UK)
British Library (UK)
Ebook library London (UK)
Hounslow Library (UK)
Barnet London Borough Library (UK)
National library of Scotland (Scotland)
Executive Counseling and Training Academy (Singapore)
Ngee Ann Polytechnic Library(Singapore)
Singapore Polytechnic Library (Singapore)
National University of Singapore (Singapore)
LaTrobe University (Aust)
Victoria University (Aust)
Queensland University of Technology (Aust)
Deakin University (Aust)
University of Western Australia (Aust)
University of Ballarat (Aust)
University of New England (Aust)
University of Western Sydney (Aust)
Charles Sturt University (Aust)
Curtin University (Aust)
Australian Catholic University (Aust)
University of Newcastle (Aust)
Bond University (Aust)
University of Melbourne (Aust)
James Cook University (Aust)
National Library of Australia (Aust)
University of California San Diego (USA)
Open Library. California State Library (USA)
Ithaca College (USA)
Marquette University Raynor Memorial Library (USA)
University of Massachusetts Amherst (USA)
Williams College Massachusetts (USA)
National Library of Medicine Maryland (USA)
Illinois State University (USA)
Loyola Marymount University California (USA)
University of Michigan (USA)
Central Michigan University (USA)
University of North Carolina Chapel Hill (USA)
University of Missouri-Columbia (USA)
Akron-Summit County Public Library, Ohio (USA)
University of California Merced (USA)
University of North Carolina Greensboro (USA)
Library of congress (USA)
University of California San Franisco (USA)
Mt. Hood Community College Library Oregon (USA)
National College of Natural Medicine Oregon (USA)
Oregon Health and Science University (USA)
Northeast WI Public Libraries (USA)
College of DuPage Illinois (USA)
Boston College (USA)
University of Chicago Illinois (USA)
University of North Texas (USA)
Laredo Public Library Texas (USA)
University of Texas-Pan American (USA)
University of Texas at Austin (USA)
Trinity College Dublin (Ireland)
Dublin Institute of Technology (Ireland)
University of Auckland Library (New Zealand)
Northtec library (New Zealand)
Auckland University of Technology (New Zealand)
Unitec Institute of Technology (New Zealand)
Eastern Institute of Technlogy (New Zealand)
University of Otago (New Zealand)
Rotorua District Library (New Zealand)
City University of Hong Kong (China)
National Cheng Kung University (Taiwan)

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Using drugs dangerously - part 2

2011-09-04T14:39:00.003+08:00

In the previous post I talked about people using drugs dangerously and gave an example.

KYLady made some good comments on the possible defence mechanisms used by the case example below. I find that I got similar ones to her and a few different which I have listed below

Below is a statement by a 37 year old doctor who shared needles on this occasion.

“Never in wildest dreams did I EVER IMAGINE that I would share needles. Some of the details around these circumstances I can’t recall. I spose it was so traumatic, having a medical background and a deep moral code around sharing fits it still seems unbelievable.

I would ask the people who had used the fit before me if they had HIV or hepatitis and I chose to believe their response of no. Truth has no place in this world, if it shows up then is gets distorted, ignored or disproven because truth and drugs cannot be in the same room. The thought of not being able to get the drugs into me as quickly as possible especially when watching the others getting relief from their angst was something I could not take. This anxiety/fear far outweighs the fear for my own health and life. It was like trying to resist the sound of a newborn baby crying when you’re breast feeding.

I would disassociate from reality, time and space changed. I would wash the fit out with alcohol or bleech the whole time repeating a mantra of please God please God. I would think who cares anyway, you’re fucked and life is fucked and you’re all fucked. Self loathing and the fear of not getting that rush would fuel me on.

Then the ritual of mixing up would begin and my mind would start bargaining “you’re not really going to do it” “you’ll stop before you whack it” but there is no stopping by this stage you’re like a robot and this thing has you in its grasp. I would cry as I found a vein, wishing I could stop, jacking it back, holding in the sobs so I didn’t shake too much, then pushing it down the relief flooding over like a lover holding you in their arms no more aghhh and once again I’m cleaver and funny, all worries dissolve, I am a sex goddess and philosopher, brave and complete, all fears drift away.” (end quote)

1. Firstly she describes how she would ask others if they were carrying the HIV or hepatitis C virus. She knew the answer of ‘no’ could be considered quite unreliable. To proceed she must have used some mechanism like repression or denial to push the knowledge of unreliability out of her conscious.

2. Next she describes how she could dissociate which would allow her to decommission her Adult ego state temporarily which would allow her to proceed. This may have also assisted her discounting the unreliability of her peers reporting they were virus free.

3. Then she talks about repeating the mantra, “please God please God”. This could be the defence mechanism of magical thinking where the Child ego state can feel safer because she has ‘prayed’ and this will some how magically make her safe.

4. Next she moves to an angry position with her comment, “I would think who cares anyway, you’re fucked and life is fucked and you’re all fucked.” This may be the defence of minimisation. If she can convince herself that everything is bad then one little bit more of badness is not going to make any difference. It would allow her to minimise the importance of sharing needles.

5. Finally she talks about how her mind would start bargaining which may be a kind of rationalisation. Convincing herself that her preparations for drug taking were not wrong because she will pull out at the last minute.

Humans are very good at lying to themselves

If she had not been able to employ these defence mechanisms then she would not have been able to trick her Adult ego state and then she probably would have not engaged in sharing needles on that occasion. So you can begin to see the importance of what I am presenting here.

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Using drugs dangerously

2011-09-03T17:11:00.004+08:00

In order to use drugs dangerously such as with injecting drug use one has decommission their Adult ego state whilst doing so. This can be done by using what are called defence mechanisms. Humans are very good at lying to themselves and defence mechanisms are one way they can do that.

If a person has the Adult ego state information that sharing injecting equipment is a most unwise thing to do then in order to do it that, the Adult needs to be tricked some how. The Child ego state in some way needs to temporarily trick the Adult. If it can not do this then the person will not share injecting equipment on that occassion.

Below is a statement by a 37 year old doctor who shared needles on this occasion.

“Never in wildest dreams did I EVER IMAGINE that I would share needles. Some of the details around these circumstances I can’t recall. I spose it was so traumatic, having a medical background and a deep moral code around sharing fits it still seems unbelievable.

I would ask the people who had used the fit before me if they had HIV or hepatitis and I chose to believe their response of no. Truth has no place in this world, if it shows up then is gets distorted, ignored or disproven because truth and drugs cannot be in the same room. The thought of not being able to get the drugs into me as quickly as possible especially when watching the others getting relief from their angst was something I could not take. This anxiety/fear far outweighs the fear for my own health and life. It was like trying to resist the sound of a newborn baby crying when you’re breast feeding.

I would disassociate from reality, time and space changed. I would wash the fit out with alcohol or bleech the whole time repeating a mantra of please God please God. I would think who cares anyway, you’re fucked and life is fucked and you’re all fucked. Self loathing and the fear of not getting that rush would fuel me on.

Then the ritual of mixing up would begin and my mind would start bargaining “you’re not really going to do it” “you’ll stop before you whack it” but there is no stopping by this stage you’re like a robot and this thing has you in its grasp. I would cry as I found a vein, wishing I could stop, jacking it back, holding in the sobs so I didn’t shake too much, then pushing it down the relief flooding over like a lover holding you in their arms no more aghhh and once again I’m cleaver and funny, all worries dissolve, I am a sex goddess and philosopher, brave and complete, all fears drift away.” (end quote)

Can you spot the defence mechanisms?
Or the ways her Child ego state temporarily tricks her Adult ego state.
I can count 4, possibly 5.

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Gender bias in drug use and impact

2011-09-03T15:47:00.000+08:00

One thing I have noticed over the years of studying drug use and drug counselling is the bias towards males. In any statistics you come across whether they be rates of use, rates of ODs, rates of viral infections invariably males will be higher. Not always but in the vast majority of cases males will be at the higher rates.

For example see these charts of illicit drug use in Australia. These are typical of the statistics one comes across over and over in terms of gender bias.

I have always wondered why this would be so.
Why should males very consistently be the ones to use more and use more dangerously and so on?

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Di life script currency analysis

2011-09-02T07:56:00.002+08:00

Results

One and Only ++
Feelings +
Power +
Sex ++
Beauty +
Booze ++
Food +++
Violence +
Words ++

Analysis

Food
Games - Obesity, anorexia, bulimia
Stage - Oral
Lifestyle/occupation - body builder, dietician, cook, calorie counting, mother
Illness - stomach problems, mouth ulcers, IBS,
Therapist - eating disorders, weight loss counselling, alcohol/drug/cigarette counselling
Personality - Schizoid, borderline, antisocial, narcissistic
Issues - can life and death, control, sexual avoidance issues.

As this is an oral issue stage the consequences can vary considerably. Some who have an oral stage fixation can have few difficulties at all and have a work life like Jamie Oliver. On the other hand there can be very real life and death issues. This can result from over eating, under eating or highly restrictive diets and exercise regimes that can be dangerous. Or drug issues like alcohol and cigarette addictions can all result from oral stage fixations.

In females there can be issues around sex. Sometimes (but not all ways) the anorexic woman is protecting herself from sex (and a sexual relationship) by making herself unattractive to males and trying to make herself prepubescent again. The overweight woman may be also trying to make herself unattractive to males so as to avoid sex.

Dependency in relationships can be problematic. The two extremes by either being overly dependent on others or never being dependent on others. Oral stage issues can respond well to therapy and can include working out the relationship dependency issues in the transference with the therapist.

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Annalynn life script currency analysis

2011-08-28T09:48:00.002+08:00

Results

Uniqueness ++
One & Only +++
Feelings +
Power +
Reverse Status +
Sex
Beauty
Pied Piper
Booze +
Food +
Violence
Money
Words ++
Drugs

Analysis

You are quite unique Annalynn as this is quite an unusual set of results that you provide. The main thing I can say about it is that it could be reflective of disordered attachment. I know you a little bit but not a lot so I will have to speak more generally.

Research shows that children who grow up in a monomatric family will tend to have singular attachments in adulthood. This could be seen to represent the script currency of one and only and uniqueness. Especially the quality of the exclusion of others. Children who grow up in more polymatric families will have a more diverse set of attachments in adulthood.

In terms of psychological games this could result in what are called exclusion games. These are played the best of all by teenage girls. Those who establish peer groups and then keep some others out of them. This is not saying that you do such things just that you would be hypersensitive to such behaviour.

Because of the singular attachment there could develop problems with loyalty, betrayal and so forth, including exclusion games as mentioned before.

Of course there is nothing wrong or unhealthy about having singular attachments. From a psychological point of view if the needs for human contact are met in one or two attachments then there is no problem. Others usually have more attachments to meet those needs but as long as the needs are being meet then there is not a psychological problem.

The main danger is you put all your eggs in one basket. If the primary attachment figure dies or moves away then you may be left bereft of other attachments.

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Kahless script currency analysis

2011-08-27T17:59:00.001+08:00

Results

One and only ++
Reverse status ++
Drugs ++
Booze ++

Analysis

Booze and drugs

Games: alcoholic, cops & robbers
Psychosexual stage: Oral
Lifestyle/occupation: Gourmet, wine taster, narc, temperance league, junkie
Illnesses: Gastrointestinal, oral problems
Therapist: Addiction counselling
Personality: Antisocial, schizoid, narcissistic
Issues: Can be more severe in terms of life threatening, despair rather than depression

Tends to result from pre-verbal quite early problems with the primary attachment figure. Primary attachment figures may be emotionally absent in some way.

May have a tendency to move to a position of non life if not obviously self destructive. Stroke deprivation can result when the individual enters periods of incapacitation (non life) which may last many months.

Possibility of openly self destructive behaviour with the use of alcohol and drugs but also by other means as well. Possible suicidal urges.

The sophistication of smoking Peter Styvestant thins.

Quite amenable to psychotherapy but needs to find a good attachment figure in a therapist. If achieved then considerable psychological gains can result but it takes time.

Needs to structure life such that social isolation does not result even though there maybe a constant pull to that position.

Graffiti

Linda life script currency analysis

2011-08-27T09:09:00.002+08:00

Results

Uniqueness +++
One and Only na
Tears and Feelings na
Sex +
Violence n/a
Pied Piper n/a
Drugs n/a
Booze n/a
Food +
Power na
Reverse Status ++
Words +++
Money ++
Beauty ++

Analysis

Words
Games: Psychiatry, Greenhouse
Psychosexual stage: Anal or possible oral
Lifestyle/occupation: Lawyer, politician, writer, journalist, orator, salesman, psychotherapist, debater
Illnesses: Elective mutism, migraines, neck/shoulder pain,
Therapist: Intellectual therapies are attractive
Personality: Obsessive compulsive, paranoid

Issues:
These people are sometimes said to be “Dead from the neck down”. They retreat to the safety of thinking and thus there can be a mind body split. Out of touch with their body and thus one can have eating disorders or various forms of self harming. Out of touch with what their body is saying and thus detached from part of the Free Child.

Retreat to intellectualisation so as to hide from feelings (at least some of the painful ones).

Need to access the Free Child in therapy. The Free Child has gone into hiding for some very good reason and accessing it will bring up those reasons which may be quite distressing.

Body therapies might be an idea to deal with the mind body split. Physical contact needed as there may also be a history of prolonged stroke deprivation.

If it is a reflection of oral stage issues there could be obvious suicidal or self destructive impulses or more subliminal self destuctive impulses displayed through such things as alcohol abuse, chronic cigarette smoking or severe eating problems.

Graffiti

Crocus life script currency analysis

2011-08-26T14:07:00.002+08:00

Results

Uniqueness ++
One & Only +
Feelings +
Power +++
Reverse Status
Sex +
Beauty +
Pied Piper
Booze ++
Food ++
Violence
Money ++
Words +
Drugs ++

Analysis

Power
Games: Cops & robbers, rapo
Psychosexual stage: Anal
Lifestyle/occupation: Politics, examiners, critics, the ‘boss’, police, doctors, psychotherapists
Therapist: Supervisor-supervisee disputes, industrial mediation
Personality: Paranoid, Antisocial
Issues: Control, penis envy, dependency.

Rapo is a power based game

The life script is lived out via power in relationships with others. This is what will become the issue in relationships and the means by which psychological games in relationships are played out.

In the winner’s life script the power is used for the benefit of self and others. In the loser life script, power will leave the individual with dysfunctional relationships and in an unhealthy state of mind.

The Adapted Child ego state will seek the power position in relationships and the Free Child will crave dependency in relationships. Therapeutic goal is to get to the dependency and have the client satisfy the craving for the powerless position in relationships.

Graffiti

Life script currency

2011-08-24T20:29:00.001+08:00

People can live out the same life script but using different currencies. The ‘thing’ you use to live out your life script can differ but there is still the same life script out come.

Eric Berne proposed three script outcomes

WINNER’S SCRIPT:

Someone who gets where he intends to go and has a good time doing it.

In a Winner’s script the strokes are positive - they are highly charged and the ending is pleasant.

Eric Berne describes a Winner as someone who accomplishes his declared purpose, and does so from an I’m OK You’re OK position.

NON-WINNER’S SCRIPT:

The non-winner’s script is Banal. It has no highs or lows, and is based on the philosophy of “at least....”.

This script includes both positive and negative strokes, and neither are of great intensity.

The profile of this type of script is - Work Hard. Play it Safe. Live life along the lines of the greatest majority. Put up with things. Aim for the middle of the road.

The formula is to avoid exciting situations or risky endeavours.

To avoid uncertainty, the people with this type of script will operate more from the Adult ego state and less from the creative Child ego state.

LOSER’S SCRIPT:

This can be a high energy script, and it can often end in tragedy.

Strokes in this script are often negative.

The ending of the losers script is predictable and usually unpleasant.

The disastrous outcome can range from less severe to most severe.

--------------------

Each of these can be lived out using different currencies. Below is a questionnaire to discover your script currency.

If you wish to complete I will show you what are the features of your script currency.

Graffiti

The suicidal process

2011-08-24T09:51:00.002+08:00

In my book I discuss the seven main types of suicide decisions these being

If you don’t change I will kill myself
If things get too bad I will kill myself
I will show you even if it kills me
I will get you to kill me
I will kill myself by accident
I will almost die (over and over) to get you to love me
I will kill myself to hurt you

I recently wrote an article on the suicide note left by Adolf Hitler, here.

In the press there is currently a lot being said about events in Libya and the fate of Muammar Qaddafi.

These types of leaders provide some good insight into the nature of the suicidal person and how the life script progresses to its final conclusion. High profile political and military leaders who manoeuvre themselves into a position where they have no way left to turn. The difference between these and others is their moves and decisions get highly publicised and are the content of detailed analysis by historians. So one can get a much more complete understanding of what they did to end up at the point of suicide.

All these people at some point must violate the rights of large numbers of people which usually also involves killing large numbers of people. Once done then it is fairly safe to say that he has made the early decision of

1. If things get too bad I will kill myself, or
2. I will get you to kill me

These individuals would know that as soon as they do that then their life is now under significant threat from those on the other side of the political fence. They would know this prior to ordering such killings. They would also know that politics is a very fickle thing and that political power can change quickly. Prior to ordering such mistreatment they would know these two things.

It seems safe to say that the situation these people voluntarily entered into indicates they are suicidal in some way. They are voluntarily behaving in such away that it is quite likely they will end up dead by either their own hand or by others and not be natural causes. They are voluntarily behaving in such a way that it is likely their life will be shortened which one could argue is a suicidal act.

With Hitler it was
If things get too bad I will kill myself

and he killed himself

With Saddam Hussein it was
I will get you to kill me

and he got the state to kill him.

With Muammar Qaddafi we will find out what happens. If things progress where his political power is finally gone completely then he is left in the position to carry out the final scene of his suicidal life script. It is very likely that he will die by his own hand or others and not of natural causes.

Each of us on this planet have our own field of influence. We live in a community of some kind whether that be one or two friends, a family, a small community or an entire nation. From a psychological point of view there is no difference between these people. The person who kills his wife in DV (where the death penalty exists) to the person who kills thousands in his own country.

Psychologically there is no difference they are simply constructing their life circumstances such that the early suicide decision can be carried out in the end. There is much hype surrounding powerful political leaders that one tends to forget they are just an individual. Once upon a time he was a little boy with his mother and father who did whatever they did and he made a suicide decision early in life. He then sets about constructing life circumstances such that his suicide life script is played out. That can involve one or two others or millions of others, but psychologically there is no difference between the two.

Graffiti

The three C's of relationship

2011-08-21T13:10:00.001+08:00

Two types of power struggles in relationships

1. Competing for the parent position in the relationship

2. Competing for the child position in relationships

The wall of trivia in relationships. The two parties talk about stuff, argue about stuff or do stuff. They can even go to counselling and talk about stuff. This allows them to get lost in trivia so they can avoid to intimate contact which many (all) of us find frightening.

Graffiti

Book update.

2011-08-16T20:23:00.001+08:00

With the negotiations completed and the contract signed I am in the process of writing the next book. Although the title is yet to be decided it is about counselling drug users.

The last book - Working with suicidal individuals - was meant to be 70,000 words and it ended up being 90,000 and I was asked to reduce it. I finally got it down to 87,000 words and it was accepted. This time however I have been asked to keep it to 70,000.

The first chapter I have almost completed is probably going to be chapter four and it is on Harm Reduction. This topic will be found in the vast majority of books on drug counselling. It is usually quite dry and has been said a hundred times before but you really do need to have it in there.

I thought it was going to be about 1,500 words but it ended up being 7,000 and I am really happy with it. I mean really! It has ended up with a really good structure, looks at the overall area and then has lots of new and applicable stuff on the area. Most of it I have never seen in the literature before.

It was one of those situations, that as you start writing you begin to find out that you knew all this stuff, you did not know you knew. It just kept coming out as I wrote along. Problem is one tenth of the book is taken up with this one chapter!

Other than this, as with the first book the initial stages are quite taxing and hard. I have the outline of the book and I keep thinking of things I have written or know of in the literature and frantically putting them in all sorts of folders on my computer. But it’s like at times you have to keep four different things in your head at the one time as you don’t want to miss any. This happened with the last book and should slow down a bit soon I hope as I get most of it together in the right places.

But all in all it is good to have a new project like this. It certainly has my interest and I am motivated to do it. As with the last one when I write I have to let my Free Child run wild at times and then get it all down and together in the right structure and format.

Free Child

Graffiti

The facts about drugs

2011-08-07T10:09:00.002+08:00

I have now been commissioned by my publisher to write a second book, this time on drug counselling. I am currently writing about how it is important for the drug counsellor to have the facts about drug use. Whilst this seems like a fairly simple and rudimentary task it is surprisingly difficult.

One reason for this is that drugs are inevitably a political issue and that means governments will present the facts on drugs in a way which suits their current political need. This extends to the official health information on drugs. Most commonly they tell the truth but they don’t tell the whole truth.

The following comes from a website of the Government of Western Australia - Drug and Alcohol Office.

It provides variety of information including the possible effects of various drugs. Below is what it presents as the list of the possible effects of cannabis. This list is what one usually finds in government presented facts on cannabis. It is presented in this order in the website.

loss of concentration
impaired balance
loss of inhibitions
reduced coordination
feeling of wellbeing
increased heart rate
reddened eyes
increased appetite
talkativeness
tunnel awareness - where a person focuses their awareness on one thing
confusion
restlessness
detachment from reality
excitement
hallucinations
anxiety
panic attacks
respiratory problems
mental health problems in those who are vulnerable
bronchitis
lung cancer
decreased concentration
decreased memory and learning abilities
dependence
interference with sexual drive and hormone production
mental health problems in those who are vulnerable

This list presents the effects of cannabis as a very undesirable thing. If this list was accurate who would ever spend their hard earned money to get such effects. Who would ever voluntarily engage in an illegal activity to get such effects. Yet one third of the entire adult population of Australia has done precisely that, engaged in the illegal activity of smoking marijuana. It cannot be as bad as this list suggests.

It does not present the true picture even though it does include all the facts. Yet they are presented in such a way to give a misleading picture and hence my point that drug counsellors can find it hard to get the true picture on the facts about drugs. This list has a political agenda behind it because drugs as I said before are always a political issue.

The reason why so many people have used marijuana is because of effect number five - feeling of wellbeing. The way it is stated and how it is hidden in the list gives a false picture of the effects.

If they were going to give a true picture of the effects of cannabis at the top of the list they would say - The vast majority of users will get the effect where the cannabis makes them feel really, really, really good. Clearly this is very different from it being included as the fifth effect and simply put as, a feeling of well being.

A government website could never be so candid because there would be an outcry from various groups saying such a statement encourages cannabis use. That may or may not be true. However the point at hand is this demonstrates how hard it is to get the true picture on the facts of drugs. Those engaged in drug counselling have to negotiate the various political agendas on both sides of the fence to get accurate information which obviously the drug counsellor must have.

Graffiti

Bereavement neurosis

2011-08-02T18:56:00.002+08:00

Good on the DSM-5. This book to be published in 2013 has defined a type of grief that is a mental disorder or perhaps could be called neurotic.

They have put a time limit on normal grief. Somewhat of a courageous thing to do and one that I have been advocating for some time. People who are grieving excessively after a year are considered to be neurotic or have a mental disorder as they say.

This could bring some criticism as it is not a politically correct thing to do. Bereavement counsellors tell us that people grieve in their own time and way. I agree with this to some extent but it is also a view promoted by grief counsellors that in my view has lead to massive over servicing of such clients in a billion dollar a year industry.

Some will see it as being too harsh on the bereaved. They will say to tell someone that their grieving should be somewhat complete after a year is a mean thing to do and not kind to a person who has suffered a great loss.

In my view, and this is supported by psychological research, after a year a significant amount of the grief should have passed. With a close loved one, one would expect there to be some more grief after that time but it will tend to be intermittent and not usually of a intense nature. It probably takes about 4 years for a person to fully psychologically readjust after the loss of a very close loved one. But the actual grief and crying should mostly be gone after 12 month period if the grief is allowed to proceed normally.

Some will argue that such a statement in the DSM-5 does not take into account cultural differences. I have also discussed this before. There are many wide and varied cultural differences in funerals and grief rituals. However underneath the rituals the same psychological processes apply no matter what culture one is from. The process cited in the paragraph above applies if you live in Australia, Egypt, Siberia, China or where ever. That same basic psychological process applies to all humans whilst the burial rituals do vary considerably between cultures. The actual burial or formal ceremony for the dead is only one very small part of any psychological grief response for the loved ones who remain.

The problem with bereavement is that it is so prone to secondary gains. A secondary gain is when a psychological problem starts to be used to the advantage of the sufferer. A woman who starts to be agoraphobic learns over time that this allows her to control her husband more. She cannot leave the house so she can ring him at any time to do tasks for her. A mother who develops depression may learn over time that her children start to feel sorry for her and visit more. These are what are known as secondary gains.

When you suffer the loss of a closed loved one what happens. People all of a sudden become kind and nurturing to you. They cook you casseroles, drop in to see how you are going and mow the front lawn for you. When you start to get over the grief that all stops and things go back to how they were before. For socially isolated and emotionally deprived people this can be very attractive and they will be reluctant to end the grief.

Finally it should be noted that the development of a secondary gain is an unconscious process developed by an individual who is struggling with life. If it is a conscious thought out plan it stops being a secondary gain and becomes manipulation.

Good on the DSM-5 for doing this and it may come in for some criticism when the book is published.

Graffiti

Will I win first prize?

2011-07-28T04:19:00.002+08:00

Email received 27.7.11

Dear Tony,

I am delighted to inform you that your book Working with Suicidal Individuals has been highly commended in the Psychiatry category of the 2011 BMA Medical Book Awards. This means that you are shortlisted to win first prize in this category, and are invited to the awards ceremony.

Congratulations!

The ceremony will take place on Wednesday 14th September at BMA House in London, starting at 5.30pm. Please let me know if you would like to attend, and I will register this with the event organizer, and send you more details. I appreciate that since you are in Australia, this may not prove possible, but our commissioning editor will be attending to collect your award if necessary.

With best wishes,

Jessica Kingsley Publishers - 24 years of independent publishing 1987-2011
116 Pentonville Road, London N1 9JB, UK
Tel: +44 (0) 20 7833 2307 Fax: +44 (0) 20 7837 2917

------------------------------------------

But guess what!
About a month ago I booked the flights to be in the UK from September 6th to 17th!
Is this divine intervention?
Or just plain divine?

I will have to make sure I cry at the right time and have a long list of thank you’s to say!

------------------------------------------

An article involving the psychological examination of three suicide notes - Adolf Hitler, Virginia Woolf and Sid Vicious of the Sex Pistols found here.

Order form for book can be found here.

------------------------------------------

The list of universities and colleges that now stock the book in their libraries for courses in psychology, counselling, social work and nursing continues to grow as well.

Maribor General Hospital Library (Slovenia)
Stellenbosch University Library (South Africa)
Mitt hogskolan library (Sweden)
Stockholm University (Sweden)
PJ Library (Norway)
University of Bergen (Norway)
Norges teknisk-naturvitenskapelige universitet (Norway)
University of Oslo (Norway)
University of Tromso (Norway)
University of the West of England (UK)
University of Plymouth (UK)
Manchester Metropolitian University (UK)
Lancaster University (UK)
University of Hull (UK)
University of East Anglia (UK)
University of Cambridge (UK)
Oxford University library (UK)
University of Exeter (UK)
Coventry City Council library (UK)
Bromley Library service (UK)
Cadbury Heath Library (UK)
Kingswood Library (UK)
Yate Library (UK)
British Library (UK)
Ebook library London (UK)
Hounslow Library (UK)
Barnet London Borough Library (UK)
National library of Scotland (Scotland)
Executive Counseling and Training Academy (Singapore)
Ngee Ann Polytechnic Library(Singapore)
Singapore Polytechnic Library (Singapore)
National University of Singapore (Singapore)
LaTrobe University (Aust)
Victoria University (Aust)
Queensland University of Technology (Aust)
Deakin University (Aust)
University of Western Australia (Aust)
University of Ballarat (Aust)
University of New England (Aust)
University of Western Sydney (Aust)
Charles Sturt University (Aust)
Curtin University (Aust)
Australian Catholic University (Aust)
University of Newcastle (Aust)
Bond University (Aust)
University of Melbourne (Aust)
James Cook University (Aust)
National Library of Australia (Aust)
University of California San Diego (USA)
Open Library. California State Library (USA)
Marquette University Raynor Memorial Library (USA)
University of Massachusetts Amherst (USA)
Williams College Massachusetts (USA)
National Library of Medicine Maryland (USA)
Illinois State University (USA)
Loyola Marymount University California (USA)
University of Michigan (USA)
Central Michigan University (USA)
University of North Carolina Chapel Hill (USA)
University of Missouri-Columbia (USA)
Akron-Summit County Public Library, Ohio (USA)
University of California Merced (USA)
University of North Carolina Greensboro (USA)
Library of congress (USA)
University of California San Franisco (USA)
Mt. Hood Community College Library Oregon (USA)
National College of Natural Medicine Oregon (USA)
Oregon Health and Science University (USA)
Northeast WI Public Libraries (USA)
College of DuPage Illinois (USA)
Boston College (USA)
University of Chicago Illinois (USA)
University of North Texas (USA)
Laredo Public Library Texas (USA)
University of Texas-Pan American (USA)
University of Texas at Austin (USA)
Trinity College Dublin (Ireland)
Dublin Institute of Technology (Ireland)
University of Auckland Library (New Zealand)
Auckland University of Technology (New Zealand)
Unitec Institute of Technology (New Zealand)
Eastern Institute of Technlogy (New Zealand)
University of Otago (New Zealand)
Rotorua District Library (New Zealand)
University of Waterloo (Canada)
Mount Royal University (Canada)
Wilfrid Laurier University (Canada)
University of Guelph (Canada)
Library and Archives Canada (Canada)
City University of Hong Kong (China)
National Cheng Kung University (Taiwan)

Graffiti

The contextual diagnosis of ego states

2011-07-25T18:46:00.003+08:00

Introduction
Eric Berne (1961) in his book Transactional Analysis in Psychotherapy outlines the four ways by which the diagnosis of ego states can occur

Behavioural diagnosis - This is the most common method used and involves the observation of a person behaviour, body language, voice, demeanours and so forth.

Social diagnosis - This involves observing the types of communications or transactions the person has with others. How others respond to him give some indication of the ego state in which he may be.

Historical diagnosis - This involves enquiring into the persons history. How they acted and responded in their past will give insight into how they are responding in the here and now.

Phenomenological diagnosis - This is the diagnosis of ego states by self examination. An awareness of ones feelings and current experience can be used to assist in the correct diagnosis of ego states.

The need for a contextual diagnosis
For many years psychologists have examined the role of context in human psychology. It is now a widely held belief that humans examined in the context in which they exist will give a much more comprehensive understanding of them.

Indeed context is integral to how we perceive the world, even down to the perception of simple basic objects. This is no better illustrated than with the Rubin vase. When presented with an ambiguous object (ie with no context) humans can fluctuate in what they are actually perceiving. See the Rubin vase below. Some people see a vase, others see two profiles and yet others fluctuate between the two.

Rubin vase

Add in some context and the perception of the figure becomes far more consistent. In the picture below some context has been added such as depth perception and other markings on the object. The vast majority of people will now see a vase rather than two profiles.

The Rubin vase illusion is important because it shows that perception is not solely determined by the image formed on the retina. Thus the very way we see the world is determined by the context of what we are looking at. This of course highlights the integral importance of context in how humans interact with the world.

At the macro end of the scale we have the discipline of social psychology. This whole approach to psychology is based on the assumption that to understand people one has to examine the context in which they live and operate. To view a person in their wider context allows one to gain a fuller comprehension of why they do what they do and indeed who they even are in the psychological sense.

The point at hand here is to demonstrate that from the micro to the marco of human functioning we see the importance and value of context. Thus it is proposed that to diagnose ego states accurately one needs to do a contextual diagnosis. Examples of how this diagnosis works are plentiful and easy to demonstrate.

Contextual diagnosis
A man says, “On July 5th, 2007 the alignment of the planets will create a magnetic field so large that there will be the biggest tides in half a century”. What ego state would be diagnosed?

If that man was of a dishevelled appearance, not shaven for 2 days and was
sitting on a park bench drinking out of a bottle in a brown paper bag what ego
state would be diagnosed?. Probably some kind of regressed Child ego state. If
that man was in an observatory wearing a white coat and carrying a clip board
what ego state would be diagnosed? Probably Adult ego state. The different
contexts for the same statement would tend to result in a different diagnosis.
The context in which the statement is made is central to the diagnosis of ego
states.

Thus one has the fifth way by which ego states can be diagnosed - The contextual diagnosis.

Ego state diagnosis on basis of body
language with very little context?

Possibly perplexed Adult ego state or maybe Adapted Child ego state in some slight discomfort or pain after playing a game.

Ego state diagnosis on basis of body language
within the context of his immediate milieu?

Eye strain with probable Free Child ego state sexual arousal.

References
Berne, E. 1961.
Transactional Analysis in Psychotherapy. Ballantine: New York

Graffiti

Amy Winehouse

2011-07-24T10:15:00.003+08:00

Rest In Peace Amy

A lot of people told you how they thought you should live your life but you did it your way. I wish you were still here and I admire you for living the life you did. And thanx for the really good music!

Graffiti

Ego states in the counselling process

2011-07-24T01:44:00.003+08:00

Three new articles have been uploaded. I would have done it here but Blogger cannot take Pdfs.

Number 1
The Child ego state in counselling

Paper 1 – Looking for the Child ego state in counselling
How Child is brought into the counselling session
1. Feelings
2. Contracts for taking the client out of their comfort zone.
3. Polarities.
Conclusion
Paper 2 – Psychological polarities
Paper 3 – Relational contact with the AC

Number 2
Parent ego state

The Parent ego state

Sameness in relationships

How modelling occurs

Group think

Number 3
Working with the Conforming Child, Rebellious Child and Free Child ego states

The highly conforming client

The highly rebellious client

Dealing with the difficult client – Free Child, Conforming Child & Rebellious Child

Pdf here.

Graffiti

Newspaper articles about adolescence

2011-07-22T17:51:00.003+08:00

Graffiti was recently interviewed for two newspaper articles on adolescence.

The first is about the positive aspects of teenage rebellion.

The second is about how to 'battle' or not with teenagers about such issues as drugs.

Graffiti

Adolescent stage of development

2011-07-20T17:23:00.002+08:00

In the previous post Anon makes the comment that people don’t need two decades to fully form but they could be fully formed by age 12 - 15. I had previously stated that in my view it takes about 2 decades to fully form.

I think we are both right depending on where you look. The less affluent societies will tend to ‘force’ the youth to grow up quicker whereas the more affluent allow them longer to fully form at least at a psychological level. Consider this diagram:

In Australia, the stage of adolescence has at least doubled in length of time over the past 40 years. It used to be 4 or 5 years and now is 10 to 15 years long. For a person to reach the psychological stage of adulthood they are often in their early 20s. That is for the adolescent stage psychological issues to have largely dissipated takes much longer now.

Why would this be so?

There are a number of possible reasons for this.

1. As a general rule the more educated a society is the longer adolescence will be. If one is receiving schooling then one is not working. If one is not working then one does not have economic independence which is a key feature in finishing adolescence - no longer being financially dependent on others, usually the parents.

2. Marriage is tending to occur later. One does not hear much about weddings occurring with 18 and 19 year olds as they did not so long ago. So in this way people do not have to be ‘grown up’ so early.

3. Related to this child birth is occurring later and numbers of children is reducing. This allows people to be more irresponsible in this sense, all they have to do is look after self and not a child.

4. As a society we tolerate this period called adolescence more so than in the past. In the city where I live every year there is a week or fortnight called ‘schoolies week’. This is where those who have just completed high school (17/18 year olds) go on vacation as soon as their last examinations end. On this vacation they drink too much alcohol, take drugs and engage in gratuitous sex. Whilst I am sure there are many who do not do such things, this is what is highlighted in the press year in and year out. In general it is tolerated by society and even viewed with amusement by some. I would imagine that there are many societies around the world who would not tolerate such things at all.

5. As some societies becomes more affluent they do not need the group of ‘adolescents’ to be working so as to maintain a functioning society. This allows for more navel gazing. As food and shelter become more certain people start to look at their psychological needs and adolescence is a prime example of where such navel gazing can occur.

6. Life span increases. Over that past 50 to 70 years the average life span has increased by about 20 years. So in this sense there is less of a need to hurry through the developmental stages. As people can now be adults for longer they can then proceed through adolescence at a slower rate. And there are more older people to maintain a functioning society so the young are not needed so much to be out there working for the society to survive.

Experts in the area of adolescent development have used the following phrases to describe teenagers in this stage of development:

Graffiti

Childhood mental health problems

2011-07-15T13:05:00.002+08:00

Most common mental health issues encountered in 6 to 12 year olds
Reported by school psychologists

Anxiety - 73.1%
Challenging behaviour - 71.8%
Family/parenting concerns - 65.4%
Peer relationships - 59%
Anger and conflict - 55.8%
Bullying - 41.7%
Self esteem - 38.5%
Child safety and protection - 31%
Depression - 21.1%
Trauma - 19.2%

Challenging behaviour = Autism spectrum disorder, ADHD, oppositional disorder, learning difficulties and conduct disorder

Ref: [Inpsych - Bulletin of the Australian Psychological Society, June 2011]

My work with children has mainly been in the private practice setting. Children are brought to me by their parents usually. The list cited above would be quite similar to how I would rate the children I have seen over the years.

One thing that has always interested me in my work with children, and what this data supports, is the low rate of depression as compared to the other mental health problems presented. I have found this surprising as I expected it to be higher. I expected anxiety to be as high as it is but I also expected depression to be the same. Which it is not. The rate of depression is much lower.

Why I expected this is because with adults and adolescents they tend to be about the same.

Adults in Australia (Department of health and ageing statistics)
10% anxiety at some point in adult life
20% depression (6% major depression)

One needs to be careful with such statistics as they can vary quite considerably depending on how one defines depression and anxiety. However, it seems safe to say that in adults there are similar amounts of depression compared to anxiety unlike in childhood. They are at similar rates whereas in childhood that is not the case with anxiety being much more prevalent than depression. According to the research above anxiety is three to four times more prevalent than depression in children seeking help from school psychologists.

This of courses raises the question as to why this would be so. I don’t know of any explanation that has been given to answer this question. So I thought I might do some hypothesising of my own.

Anxiety in childhood
It could be that diagnosing depression in children is harder than in adults. Thus the rates of depression are higher in children but are not recognised because the children do not present to school psychologists with that difficulty. I suppose this could be the case but it seems a bit dodgy to me as depression is not that hard to diagnose. Even if the child does not report the problem emotions found in depression the body language of a depressed child is not that hard to detect. It would also seem reasonable that a depressed child is just as likely to report unpleasant emotions as an anxious child. Why should there be any difference between those two?

It seems more reasonable to me that childhood by its very nature is more likely to produce reactions of anxiety rather than depression, whereas in adulthood this is not the case. It is simply a matter of when god made us, she stuffed up. The way humans reproduce the species is by giving birth to very small versions of adults that take almost two decades to fully mature.

As adults it is easy to forget just how vulnerable a child is. A child is like living in the land of the giants. Take a minute to lie face up on the floor, get someone to stand over you and remind yourself of how a child sees her relationships with adults.

One of my favourite TV shows in childhood - Land of the giants.

This could partly explain why anxiety is the highest of all mental health issues in childhood. A child’s life is on the line each day. Its actual physical existence is out of its control and is determined by those adults around her. Indeed a threatening state of affairs even if the child is treated well. Those around it can kill it at any time and of course children don’t understand about laws against murder and so forth until much later in life.

It has been postulated that you can roughly determine the difference in strength between two people by taking the fourth power of the ratio of their heights.
Ref: [S. Gould. 1977. Ever Since Darwin. New York: W.W. Norton Company.]

The height of the average female is twice that of the average two year old so she is (24 = 16) sixteen times stronger than the child (2 to the power of 4). A very large difference in power and strength I think one could say. It has been postulated that around that age of 10 - 12 years is the first time where a child could probably start to look after itself in terms of acquiring the food and shelter necessary to live. Up until that time the child’s physical well being in terms of food and shelter is dependent on the adults around it. Of course the child knows that the adults can withdraw that food and shelter should they choose to do so.

Despite these physical threats we also have all the psychological causes of anxiety. If a child is psychologically abandoned in some way, which many are to varying degrees, anxiety is a common reaction to such abandonment. Children are much more psychologically dependent on those around them than adults are and thus anxiety may be more prevalent in childhood as a result.

Every parent also has a Child ego state of their own. Sooner or later there are going to be situations where their own Child ego state needs are going to take priority over the needs of their biological child. A classic example is post natal depression. In this case the mother’s own Child ego state needs may be to sleep for extended periods of time in bed as a consequence of the depression. When she does this her biological children’s psychological needs are secondary and thus anxiety can result when the children experience this psychological abandonment.

Finally normal human development requires the child to master scary developmental tasks. Most obviously the separations from mother and father. Such as going to school, handling difficult circumstances without mother’s help, getting a job and just becoming psychologically independent is an anxiety producing process.

There we have it. This could explain to some degree why childhood is more of an anxiety producing stage of human development as compared to adulthood. It does not seem possible to develop an argument for why childhood would be a more depression producing stage of development. Indeed the level of depression in childhood in the first piece of research cited put it at 21%. The statistics from the Department of health and ageing put the level of depression in adulthood at 20%. They are the same. Whereas anxiety in children seeking help was around 70% and in adulthood put around 10% of adults in general.

Nothing like a bit of hypothesising on a Friday!

Graffiti

Book update - July

2011-07-11T13:45:00.002+08:00

Working with suicidal individuals is now 6 months old. There have been three articles on it in the latest edition of WAVE magazine by journalist Milena Stosic.

A new review of the book found here.

An interview with me about my personal journey in the area as well as other questions about the book found here.

An article involving the psychological examination of three suicide notes - Adolf Hitler, Virginia Woolf and Sid Vicious of the Sex Pistols found here.

Order form for book can be found here.

The list of universities and colleges that now stock the book in their libraries for courses in psychology, counselling, social work and nursing continues to grow as well.

Maribor General Hospital Library (Slovenia)
Stellenbosch University Library (South Africa)
Mitt hogskolan library (Sweden)
Stockholm University (Sweden)
PJ Library (Norway)
University of Bergen (Norway)
Norges teknisk-naturvitenskapelige universitet (Norway)
University of Oslo (Norway)
University of Tromso (Norway)
University of Cambridge (UK)
Oxford University library (UK)
University of Exeter (UK)
Coventry City Council library (UK)
Bromley Library service (UK)
Cadbury Heath Library (UK)
Kingswood Library (UK)
Yate Library (UK)
British Library (UK)
Ebook library London (UK)
Hounslow Library (UK)
Barnet London Borough Library (UK)
National library of Scotland (Scotland)
Executive Counseling and Training Academy (Singapore)
Ngee Ann Polytechnic Library(Singapore)
Singapore Polytechnic Library (Singapore)
National University of Singapore (Singapore)
LaTrobe University (Aust)
Victoria University (Aust)
Queensland University of Technology (Aust)
Deakin University (Aust)
University of Western Australia (Aust)
University of Ballarat (Aust)
University of New England (Aust)
University of Western Sydney (Aust)
Charles Sturt University (Aust)
Curtin University (Aust)
Australian Catholic University (Aust)
University of Newcastle (Aust)
Bond University (Aust)
University of Melbourne (Aust)
James Cook University (Aust)
National Library of Australia (Aust)
University of California San Diego (USA)
Open Library. California State Library (USA)
Marquette University Raynor Memorial Library (USA)
University of Massachusetts Amherst (USA)
Williams College Massachusetts (USA)
National Library of Medicine Maryland (USA)
Illinois State University (USA)
Loyola Marymount University California (USA)
University of Michigan (USA)
Central Michigan University (USA)
University of North Carolina Chapel Hill (USA)
University of Missouri-Columbia (USA)
Akron-Summit County Public Library, Ohio (USA)
University of California Merced (USA)
University of North Carolina Greensboro (USA)
Library of congress (USA)
University of California San Franisco (USA)
Mt. Hood Community College Library Oregon (USA)
National College of Natural Medicine Oregon (USA)
Oregon Health and Science University (USA)
Northeast WI Public Libraries (USA)
College of DuPage Illinois (USA)
Boston College (USA)
University of Chicago Illinois (USA)
University of North Texas (USA)
Laredo Public Library Texas (USA)
University of Texas-Pan American (USA)
University of Texas at Austin (USA)
Trinity College Dublin (Ireland)
Dublin Institute of Technology (Ireland)
University of Auckland Library (New Zealand)
Auckland University of Technology (New Zealand)
Unitec Institute of Technology (New Zealand)
Eastern Institute of Technlogy (New Zealand)
University of Otago (New Zealand)
Rotorua District Library (New Zealand)
University of Waterloo (Canada)
Mount Royal University (Canada)
Wilfrid Laurier University (Canada)
University of Guelph (Canada)
Library and Archives Canada (Canada)
City University of Hong Kong (China)

Graffiti

Anger and forgiveness in psychotherapy

2011-07-09T09:24:00.002+08:00

On occasion there is the need for some anger expression in therapy. A recent example brought this to the fore.

A woman in her 50s had a life time of being ignored by her mother. But to make matters worse her two sisters were often highlighted by her mother at times in front of her. In public the mother may talk about the exploits and successes of her two sisters but never of her. It seems safe to say that there was favouritism in this way.

The woman would at times recount such situations that had occurred many times in her life and often felt anger as she did remember. When this happened it was not long until she would mention that she did not believe that her mother did this on purpose. That she was probably unaware that she was even doing such a thing. And from what I was told I tended to agree with her. In addition her mother was now quite elderly and frail and the client would say that how could she be angry at such an elderly person. Her goal was simply to forgive her mother for the mistreatment that she had received over the years in the way described above. However this meant she was directly avoiding being angry. Unfortunately this kept reappearing, her anger at her mother kept resurfacing.

As a therapist I am all in favour of the idea of forgiveness. I think it is a very wise psychological goal to aim for. Forgiving ones parents for that they did or forgiving ones abuser for the abuse received is a wise psychological goal. However sometimes this is the situation:

At times in order to get from the hurt to the forgiveness you have to go through a period of anger. If it is only a minor transgression then one does not have to. If it was significant especially at a young age and especially when over a period of time then one cannot go straight from the hurt to the forgiveness. They have to go through a period of anger.

This is where a lot of people get stuck, in one of two ways. Firstly, as in the case cited above the person is uncomfortable with anger and finds it difficult to go through that stage. They try all kinds of ways to avoid it and the example above shows some of the rationalisations that people will come up with in order to do that. Secondly, the other individual does not avoid it but gets stuck in it. This is not an uncommon scenario to come across in therapy. Some one who is chronically angry at their abuser. Quite often they never see their abuser now or the abuser may even be dead. The client may be carrying around a sack of anger on their back towards some one who died years ago. What does that achieve, and more importantly who suffers from the sack of anger - certainly not the dead person.

Some find forgiving their abuser this hard to do.

If the person does successfully transverse the anger then they are well on their way to achieving a sense of forgiveness. Once done, their life in the here and now is more pleasant and they are capable of more staisfying relationships in their current world. Indeed their current relationships are much less likely to be damaged by such unresolved past events.

However the difficult part for the therapist is to judge how long the angry period is meant to last. This is not an easy thing to gauge. As is often the case in therapy it is usually best to leave it up to the client and they will tell you in one way or another. However this is not always the case. For instance it is highly likely that the client described above will be saying she is ready to pass the angry stage before she is.

Living in the here and now. Can't enjoy this if your head is stuck in the past.

But she may tell the therapist in another way. Over time one will notice that she spontaneously brings up the issue of anger at mother less and less. When this happens she is ready to begin the forgiveness work and the therapist starts that phase of therapy.

Graffiti

Marriage counselling and the rise of individualism.

2011-07-04T19:09:00.002+08:00

In Australia at the moment the number of people living single in a dwelling by them self is at a record high. There has never been a time when so many have lived single and not in a family unit or a group of some kind.

I have talked before about society, psychology and the rise of individualism.

I made mention that psychological theory over the past 150 years has promoted individualism as the psychologically healthy state. Since the contemplations of Freud, psychology has been very influential in directing governments to structure societies such that individualism thrives. To my mind this has gone too far and the individualism which psychological theory promotes has indeed become a neurotic condition itself.

This is no where better demonstrated than in marriage. The divorce rate in Australia hovers around the 50% mark and of those who don’t get divorced probably half of them would if they were not under pressure from religion, family and friends, financial pressure and so forth.

Anthropological studies show that as societies evolved originally you had to live in groups. People found that if you lived in a group your chances of survival were much better. This is no better demonstrated than in the basic family unit. When a male and a female produce a child, that child had a much better chance of survival if the mother and father stayed together.

Thus the psychology of these people one could postulate, was about the survival of the group rather than a focus on the ‘psychological survival’ of the individual. In addition to just survival people would have also discovered that if you lived in groups you could achieve things and create a much better lifestyle than if one simply existed on their own.

As societies mature and become more affluent then the basic survival needs become more predictable and guaranteed. People feel more secure about their basic survival. When this happens instead of feeling relief along comes Freud and the navel gazing starts. People start focussing on their own individual psychology and happiness. This now has progressed over generations of psychologists to the point where individualism is seen as the zenith to be achieved.

This change of focus from survival of the group to the pursuit of individual happiness is reflected of course in how therapists ply their trade, especially in marriage counselling. This quote comes from a psychology text book on marriage counselling that is used in universities and training institutes for psychologists.

If there was ever a need for a collectivist mindset for survival it is between comrades in a theatre of war.

“The client who, out of his own feeling of need, seeks marriage counselling obviously has some dissatisfactions with that relationship. Some of his needs are not being met, or for some reason his life pattern is not providing adequate satisfaction.”

Yikes!!!

out of his own feeling of need
some dissatisfactions with that relationship
some of his needs are not being met

Sometimes in couples counselling clients say to me, “This relationship is not meeting my needs.”

When I hear this I get a sort of flummoxed look on my face, and think:

Hello! Marriage is not a happy pill. Marriage is not this thing that is to meant make you feel better about yourself.

No wonder the divorce rate is what it is.

Individualism riding roughshod over the collective. And we are training our psychologists and marriage counsellors to espouse that very view to the public by putting such ideas in the very text books we use to train them.

My counselling of married couples has changed somewhat over the years. I was trained on those textbooks as well. My approach besides exposing the underlying dynamics of the relationship would promote behavioural negotiation between the couple such that both parties can get their needs met more comprehensively.

Now I do more along the lines of the acceptance of the other person for who they are. Not so much about getting my needs directly met by the other, more about accepting the other for who he/she is.

However I feel this is a superficial response to the shift away from individualism to a more collective approach in marriage counselling. I feel a more basic change is needed but I am not too sure what that is at the moment. It needs to involve more of a change in the philosophical outlook on marriage that can be woven into the therapeutic process.

Graffiti

Racket feelings

2011-07-03T20:27:00.001+08:00

Emotions are such an emotive topic. There are many and varied definitions about them and lots of alternate theories of emotion. In transactional Analysis the term racket has been used in many ways and some are listed here.

To see a larger version click on the picture.

Racket feelings are generally seen as pathological and hence it seems opportune to define what a healthy, here and now feeling is.

Also enclosed are different solutions to feelings. Again there is much conjecture on what is the psychologically healthy way to deal with feelings - express them, inhibit them or think them away.

Graffiti

Free Child communication in relationships

2011-07-02T12:30:00.005+08:00

As a marriage or couples counsellor a common problem one sees is about the Free Child in relationships. In terms of the perceived quality of a relationship or a relationship that is wanted by both parties then these types of transactions must occur at least some of the time.

To understand such a diagram just think of a relationship which you like and enjoy and have a desire to be involved in. It is highly likely you have just identified a relationship in your life that has a significant amount of Free Child transactions between you and the other party.

In the honeymoon stage of a relationship these types of transactions occur quite often. Of course a solid relationship involves much more than just FC to FC transactions but my point here is that if a relationship does not have such communication then it will tend to fall on hard times. If there is very little then the ‘end is nigh’ often.

As a marriage counsellor one often sees couples who present with this type of communication problem, few FC transactions. This often occurs because the Free Child of both parties have ‘left the building’ as they say. The sensitive part of the personality has retreated into hiding for some reason.

Elvis leaving the building

In particular there are two common scenarios where this happens and presents a very real and difficult situation for the couple. This is often presented in marriage counselling and guess what they both involve sex and drugs! Why you may ask, because both sex and drugs often involve a degree of Free Child if not lots of Free Child.

Sex
Level of libido of a couple. If the couple have these combinations then sex is not going to be so much of a problem or at least it is a very good start for the couple not having difficulties in their sexual relationship. Both parties are either:

Low & low
Medium & medium
High & high

If they are either

Low & medium
Medium & high

then there is the potential for some degree of problem. If they are

Low & high

then there is a very real possibility of difficulties.

Why is this so? Because the Free Child is going to be affected. If the male has a high libido and the female has a low libido (which is usually the combination) then they have a significant problem that could contribute to destroying the relationship.

He is going to be asking for sexual contact often (or at least feel the desire to ask often). She is going to want much less. If she says yes when she wants to say no, it wont be long before her FC starts to retreat into the distance. She is having intimate physical sexual contact when she does not want it and the FC is not going to tolerate that for very long at all.

If she says no when she wants to say no (which will be often due to the different levels of libido) then one problem is solved but another is created. Her FC will feel satisfied but his wont be. His FC will feel ‘ripped off’ in some way. If this is occasional it does not matter all that much. But if it is happening most days what will happen after 5, 10 or 15 years? His FC is going to have disappeared in a similar fashion long ago.

A very real and difficult problem for a couple.

Cooperation in the relational

Alcohol and drugs
The most common scenario is the male likes a drink or a smoke and the wife finds him unpleasant or repugnant when he is intoxicated. The wife may say things like:

“He is embarrassing when he has been drinking”
“He snores loudly when he has been drinking”
“It is bad for the kids to see him like that”
“He may drive while intoxicated”

and so forth

So she asks, demands, threatens that he does not drink or use drugs (or significantly reduces the use). If he obliges and stops then her FC needs are met but this creates another problem. His FC will feel ‘ripped off’ in some way. If he continues to drink then his FC needs are meet but her FC will retreat into the distance.

After this occurring for 10 years what is likely to happen? Either one or both FC ego states have disappeared out of the relationship and probably do not even want to come back.

A very real and difficult problem for a couple.

In both these instances there are no winners. No matter which solution you take both parties loose in the long run.

It is best if the couple do not allow it to become such a large issue in the relationship. That’s easy for a bystander to say when not directly involved in it. Also most couples do not realise it is becoming a big issue until it gets there. And as I have said before most couples actually get into couples counselling 6 to 12 months late when the small issues have evolved into the very communication style of the couple. It is best to get to the problem when it is still relationship dystonic not when it has evolved into a relationship syntonic problem.

Graffiti

Review - book update

2011-06-26T17:08:00.003+08:00

Working with suicidal individuals

How is this for a book review I found on the internet by an unknown person but who runs the website,

artgraffitipaintings.com

Tony White - Graffiti: Book update part 2
by Tony White
I was sad that it uses traditional models of ego states from the 1960s, rather than more modish and understandable ideas about ego states. Nonetheless, the way these are acclimatized and illustrated with many many casing examples works absolutely well, and certainly works for him as a set of maps to have in mind about both character and communication............ Whole Tony Caucasian's soft-cover "Working with suicidal individuals" is exciting, educational and written in an pliant to skim manner. It reminds me of the laws from my adolescence, "Excursion To The Center of The Ground" by Jules Verne. It captured my Emancipate Infant in the reading of it. Is there a well-advised b wealthier felicitations for a volume, above all an occupational paperback? In his unreserved to penetrate period, the originator elucidate that soul comportment is a deliberating of the construct of their character. This elucidation gives intense trace there is a palpable consequence between those who are suicidal and those who are not. The distinguishing character between the groups are decisions. Untimely decisions made in youth under adverse nurturing (ego governmental Kid) or decidedness modelled by parents or valuable others in a approach of introjection ( Progenitrix ego style). It is these initially decisions in the persona system that infer suicidal bearing. Thanks to this lyrics we certain suicidal urges are not something lurking in every compassionate.
Source: Tony White - Graffiti: Book update part 2

I wonder if it is actual lyrics to a song?

Graffiti

Book update

2011-06-25T15:25:00.002+08:00

A part from an interview I did on the book

Interview on the book - Working with suicidal individuals.

Question - Does your own suicide experience have something to do with your interest in this topic? And why did you decide to incorporate information about it in this book?

Answer - In answer to your question, probably. My own suicidal experiences in adolescence would have something to do with my interest in the topic but it’s not something I have ever consciously thought about. I have no desire to have some sort of crusade or campaign to stop adolescent suicide.

Working in the field of psychology one comes across suicidal people quite regularly. Whilst I probably have a personal interest in the topic, when working as a psychologist it is wise to be well informed on the topic of suicide anyway. Hence I have specialised in the area over my years of practice.

Since writing the book were I refer to my two suicide attempts as a teenager I have had colleagues tell me how brave I am to make such a public disclosure and they would never tell of theirs. I have been surprised at the number of colleagues who have made suicide attempts or been very close to acting on their suicidal urges at some point in their life.

I have experiences in my life that I would keep private but this is not one of them. I see no difficulty in disclosing such a thing. I have never had anyone tell me they look down on me for it or because I did that it should disqualify me from being a psychologist. I suppose some may think but there is not much I can do about that.

I think it provides me with a unique insight into the psyche of the suicidal adolescent and makes me more qualified to work with such young people. Which is what I have done and I have endeavoured to pass that insight onto others though the book.

----------------------

Latest review from a very experienced and ‘decorated’ social worker who has practised well over 30 years in a wide variety of mental health areas.

Tony White   Working with Suicidal Individuals
A Guide to Providing Understanding, Assessment and Support.

I have read Rosemary Napper and Dr. Jan Hennig's reviews of Tony's book and agree with all that they say.   I would however like to add a few comments of my own after recently finishing the book.

My approach was three-fold:
1. What don't I know
2. What is it like for those new to the subject
3. My opinion of the total work.

When I began my training in clinical TA Tony had just qualified as a TA clinician, and I remember being amused and fascinated by the way that he then proceeded to examine every facet of the theory from every last perspective.   Some 30 years later, having read this book, I rejoice that he has brought the same scrutiny and rigour to his subject.   His work is a valuable and much-needed text book or guide to this very dense and complicated field.   It is comprehensive yet easily digestible: essential qualities that are, unfortunately, all too rare in many similar works.    His aim: "to add to the field in the assessment, management and understanding of the suicidal person" has been admirably achieved.

One of the things that struck me as I read was how well the TA structure of personality and the system of transactions lend themselves to the whole field of suicidal individuals, and Tony defines and describes them so clearly in Chapter 3.

Secondly, reading Chapter 4 The Suicide Decision, really brought home to me the secret of Tony's success from my perspective: Eric Berne, the author of TA taught us: "If a seven-year-old can't understand it, don't say it !" Tony's description of the early decision uses clear, simple, understandable language and a step-by-step style, which totally facilitates the understanding and grasp of this complex subject.   In toto, we take a fascinating walk through the facts rather that drowning in facts, figures and technical language.   The same essential skills are demonstrated in Chapter 6 - Reactions to High Stress where the coverage is very clear and wonderfully complete - eg. self-harming techniques v. suicide - never too nit-picking and boring but systematically and interestingly described.   I rejoice.

Other aspects of the book that I find worthy of note are:

1. pp.119-124 (Suicide and prisoners)   I appreciate the care given to examining the prison population and the respect with which the author approached them.

2. The clarity of the many charts and diagrams eg, p.128 (the cycles of depression).

3. The emphasis given to the times of severity and recovery, which would be surprising and important for newcomers to the field. p.131 (Recovery from depression)

4. pp194-96 I was very proud of Tony's courage in using plain speaking, and his very empathic and humane approach to explaining and promoting understanding of the causes of pseudo suicide.   I see this as a tacit invitation to others to drop their prejudices and adopt a similar perspective.

5. pp211-12 working with suicidal ambivalence.   The considerable amount of detail with FC and AC which is so very necessary was excellent, and again so clear....;...it made me sing !!!

6. Suicide Time Lines Ch.13 - are not very often seen as important - good to see them here.   Tony gets another star for thoroughness !

7. Redecision Therapy Ch/15 - great to see this splendid technique described in such detail- the most thorough and effective that I have found, especially for this life and death issue.

Tony, Eric Berne would be proud of you.   This is a splendid book, perfect for newcomers as well as for those long in the field.   As I read I began to smile: you have taught us all to do the great detective work required for these people.   I hereby christen you the Poirot of Psychotherapy - a Detective Extraordinaire!!!

The book has now been out 6 months and can be found in many academic and university libraries. And these are only the ones that I have found.

Additions of note have been in Canada and some recent quite prestigious universities like:
University of California San Diego (USA)
University of Western Australia (Aust)
National University of Singapore (Singapore)

It seems a book based on the Transactional Analysis theory of suicide is being used in such university programmes as social work, nursing, medicine, psychology, psychotherapy and counselling.

University of Western Australia (Aust)
Victoria University (Aust)
Charles Sturt University (Aust)
Curtin University (Aust)
Australian Catholic University (Aust)
Bond University (Aust)
University of Melbourne (Aust)
James Cook University (Aust)
National Library of Australia (Aust)
Maribor General Hospital Library (Slovenia)
Stellenbosch University Library (South Africa)
Mitt hogskolan library (Sweden)
Stockholm University (Sweden)
PJ Library (Norway)
University of Cambridge (UK)
Oxford University library (UK)
Coventry City Council library (UK)
Bromley Library service (UK)
Cadbury Heath Library (UK)
Kingswood Library (UK)
Yate Library (UK)
British Library (UK)
Hounslow Library (UK)
Barnet London Borough Library (UK)
National library of Scotland (Scotland)
Executive Counseling and Training Academy (Singapore)
Ngee Ann Polytechnic Library(Singapore)
Singapore Polytechnic Library (Singapore)
National University of Singapore (Singapore)
University of California San Diego (USA)
Marquette University Raynor Memorial Library (USA)
University of Massachusetts Amherst (USA)
National Library of Medicine Maryland (USA)
Loyola Marymount University California (USA)
University of Michigan (USA)
University of North Carolina Chapel Hill (USA)
University of Missouri-Columbia (USA)
Akron-Summit County Public Library, Ohio (USA)
University of California Merced (USA)
University of North Carolina Greensboro (USA)
Library of congress (USA)
University of California San Franisco (USA)
Mt. Hood Community College Library Oregon (USA)
National College of Natural Medicine Oregon (USA)
Oregon Health and Science University (USA)
Northeast WI Public Libraries (USA)
College of DuPage Illinois (USA)
Boston College (USA)
University of Chicago Illinois (USA)
University of North Texas (USA)
Laredo Public Library Texas (USA)
University of Texas-Pan American (USA)
University of Texas at Austin (USA)
Trinity College Dublin (Ireland)
Dublin Institute of Technology (Ireland)
University of Auckland Library (New Zealand)
Auckland University of Technology (New Zealand)
Eastern Institute of Technlogy (New Zealand)
University of Otago (New Zealand)
Rotorua District Library (New Zealand)
University of Waterloo (Canada)
Wilfrid Laurier University (Canada)
University of Guelph (Canada)
Library and Archives Canada (Canada)
City University of Hong Kong (China)

Working with drug users

2011-06-22T19:55:00.002+08:00

The other day I was talking with someone about psychotherapy matters especially in relation to working with people who use drugs or perhaps teenagers who may engage in antisocial and risky acts. I then got up and drew this picture on the board.

This is how I would rate myself as a therapist on that continuum. Clearly up the permissive end especially when dealing with the clientele I just described. With that clientele it is quite easy to use ego states like Controlling Parent or Critical Parent and using Adult facts to support the Parental statements.

The person I was talking with was working in drug rehab. I made the statement that I never tell drug using clients not to use and this was of some surprise to him. Obviously he does make such statements to his clients. This I think makes me quite a permissive therapist at least with clients like this. I would rarely use Parent ego state statements with such clients. This however creates a dilemma.

The reason why I would never tell a drug user not to use or make statements about why drug use is bad is because you quickly loose the client. They will quickly slip into the Child ego state and either stop coming, attend sessions but don’t tell you what they have been taking or take more drugs because they have moved into a rebellious position against you.

On the other hand I am tacitly giving them permission to use drugs and thus supporting their drug use in that way. Through the transference the client will introject me to varying degrees into their Parent ego state. If I am not saying, “Don’t do drugs” then they are not introjecting that so their Parental tape of me is in one way supporting their drug use.

So it seems we have the good and the bad. Obviously I see it as more important not to ‘loose’ the client as I described before, versus providing a Parent tape that is clearly against drug use being introjected into their Parent ego state.

On a side note:

As I looked at the diagram I drew I realised that if I was to rate my parents in this way on how they dealt with me in childhood and adolescence I would put them in almost the exact same position.

Graffiti

Third order structure of the Parent ego state

2011-06-21T20:02:00.001+08:00

To see larger versions click on the picture > Click actions > Click all sizes.

Graffiti

The two ego state model

2011-06-21T19:44:00.002+08:00

Tony White
Transactional Analyst
June 21st, 2011.

Introduction
Ernst (1971) believes Eric Berne's most significant contribution to psychotherapy was the delineation he made between the Parent and Adult ego states. This, he says, allowed us to distinguish opinions from objectivity. This view is consistent with the general view that science has held up to date. However sat present, the social sciences are experiencing much confusion in certain areas. (Strauss and Hafez [1981], Morgan [1983], John [1984], Eysenk [1983]). It is this distinction between the Parent and Adult ego states that illustrates why the confusion exists.

Steiner (1971) defines the Adult ego state as essentially a computer, an impassionate organ of the personality, which gathers and processes data for the purpose of making predictions. The Adult gathers data through the senses, processes them according to a logical program, and makes predictions where necessary. The Parent ego state is essentially made up of behaviour copied from parents, or authority figures. It is taken as a whole, as perceived at an early age, without modification. A person in his Parent ego state, is merely playing back a tape of of early internalized parent figures. It is a repository of traditions and values.

The above definition of ego states implies that the Adult is not a collection of tapes, that it is not comprised of the incorporation of parent figure information. this paper contends that the above proposal, simply stated, is incorrect. When a child attends school he acquires information, this involves the incorporation of the teacher's instructions. Later on in high school, when the child has more knowledge, he may critically evaluate what he is being taught, yet he can only do this if he has previously incorporated, or learnt how to critically evaluate.

The acquisition of language and basic mathematical principles also involves the incorporation of tapes. The most obvious example is the rote learning of multiplication tables and the alphabet. Brunner (1964) agrees with this, stating that all the techniques of data processing are passed down from generation to generation, in each culture. Each child incorporates data processing methodology from his parents.

The Adult and the Adult in the Parent.
It now becomes apparent that the Adult ego state and the Adult in the Parent ego state are the same. Thus the two ego state model may be represented geometrically as in Figure 1b

Figure 1

For further elaboration, it is necessary to examine Stuntz's (1972) paper on the second order structure of the Parent ego state. He states that the Adult in the Parent (AP) "is an external program of how to use the computer (Adult)" (p. 60). It is the contention of this paper that the Adult in the Parent (AP) is the Adult, and that any division is unnecessary and leads only to confusion. Stuntz suggests that each time Adult processing is required that ego state must consult the Adult in the Parent. See Figure 2a and Figure 2b illustrates that the Adult ego state outside the Parent is redundant, doing only what it is told by the AP. Thus it is an unnecessary middelman that creates four process instead of two.

Figure 2

In Figures 1b and 2b, it is seen that the two ego state model places the Adult ego state inside the Parent ego state. This is meant to indicate that those internalized tapes, specifically referring to data processing and manipulation, are encompassed with in the A2. Those tapes not referring to data processing are encompassed within the P2 but outside the A2. Processing which is not based on taping, falls within the realm of the 'Little Professor' or A1.

The Adult as a computer
The Adult ego state is often described as being a computer, this metaphor illustrates the notion presented in Figure 2. Computers are programmed by computer programmers. A computer's computational ability is entirely dependent on the computer programmer's logic. (In this case the 'computer' is defined as that part of the whole system which the computer user communicates with - most commonly the keyboard and visual display unit. The computer will only process data according to the instructions from the 'tapes' or 'disks', to which it is connected. It is these tapes that contain the computer programmer's logic (that is, his opinions, assumptions and beliefs on correct data processing).

As an obvious example assume the computer user asks the computer, "What is 1 + 1?". As indicated in Figure 2a, the computer now asks the tapes, "How do I respond to the stimulus, 'What is 1 + 1?'". If the computer programmer believed the answer or response should be '3', then the computer will respond with '3'. It will see nothing wrong with this. The computer blindly and unquestioningly accepts anything that it is told from the tapes held in its head as does the Adult outside the Parent. The only function the computer (i.e. the keyboard and visual display unit) serves is to convert computer language into human language. If humans could 'talk' computer language, then they could talk directly to the magnetic tapes. Parent ego state tapes are stored in human language, which allows us to talk directly to them. We do not need a conversion process, therefore the Adult ego state outside the Parent serves no purpose.

Tony presenting the two ego state model in his TSTA examination in Hawaii, 1989

Assumptions of this presentation
Logically, this paper is written from the Adult in the Parent. It is based on beliefs, programming and information, that is different to those used by Berne, when he outlined the three ego state model. There does appear to be a definite informational difference. When Eric Berne first published his paper outlining three ego state theory, it was the mid 1950s, (Berne [1957]), at that time, there was little evidence to suggest that the great promise of science, was not true. Scientists and theoreticians generally believed that reality could be viewed free from parental programming. However, with the knowledge explosion over the past one and a half decades, it has become obviously apparent that the promise has not, and will not ever be fulfilled.

It is the assumption, belief and opinion of this writer that an Adult external of the Parent illustrates the great promise of science, and the Adult internal of the Parent illustrates why this promise has not been fulfilled. The basis of this belief is presented in the preceding pages.

The second assumption of this presentation is that it believes it is necessary to propose an ego state theory which considers the problems of contemporary social science. This is based on the belief that it offers something to the scientific community, both theoretically and therapeutically, that is not already offered by the three ego state model. The reasons for this assumption will become evident over the next four or five presentations. There are undoubtedly many more assumptions of this presentation, these will become more obvious as the concept of the two ego state is further discussed.

Originally presented in:
Tony White. 1984.
New Ways in Transactional Analysis. TA Books: Perth.

References
Berne, E. "Ego states in psychotherapy". The American Journal of Psychotherapy. 1957, 11, 293 - 309.

Brunner, J.S. "The course of cognitive growth". The American Psychologist. 1964, 24, 1 - 15.

Ernst, F.H. "The diagrammed Parent. Eric Berne's most significant contribution". Transactional Analysis Journal. 1971, 1, 49 - 58.

Eysenk, H.J. "Personality as a fundamental concept in scientific psychology". Australian Journal of Psychology. 1983, 35, 289 - 304.

John, I.D. "Science as a justification for psychology as a social institution". Australian Psychologist. 1984, 19, 29 - 37.

Morgan, A.H. "Editorial". Australian Psychologist. 1983, 18, 7 - 8.

Steiner, C. 1971. Games Alcoholics Play. Grove Press: New York.

Strauss, J.S. & Hafez, H. "Clinical questions and "Real' research". American Journal of Psychiatry. 1981, 138, 1592 - 1597.

Stuntz, E.C. "Second order structure of the Parent". Transactional Analysis Journal. 1972, 2, 59 - 61.

Two chair in the therapeutic process.

2011-06-18T19:58:00.003+08:00

In this procedure the client projects some aspect of their personality out onto an empty chair and then dialogues with it in some form or the therapist can dialogue with it in some form. This can add an extra dimension to the counselling process.

A good deal of the usual counselling process involves presenting something to the client that may be new and then waiting for the client to do something with it. In this way it can be seen as a passive process.

This diagram shows how the therapist can present a variety of new or different actions, communications or relationship styles to the client. Once done the therapist then remains inactive to see what the client does with them, if anything. It is hoped that the client will take them and then alter something within their personality thus leading to psychological change. However as far a the therapist is concerned it remains as a hope. The therapist simply has to wait and see.

Two chair techniques allow the therapist to be more active. It allows the therapist to actually directly delve into the personality of the client. To get right into the personality of the client and change things around by stimulating various parts, highlighting them to the client and so forth. It also allows the therapist to establish relational contact directly with various aspects of the client’s personality.

This diagram shows that with the client’s permission the therapist can move beyond the exterior of the client’s personality and delve into the actual personality of the client using therapy processes such as two chair.

An important aspect of two chair is that the person does not take the role of the other party. If a client puts his mother in the other chair and then moves to be in mother’s chair he is not role playing mother. In that chair he is being the projection of his introjected mother. It is part of his personality in the chair not his memory of mother. In psychodrama one can role play other parties. In the two chair being described one is being part of their own personality in the other chair and not playing a role.

Two chairs techniques are also regressive techniques. It encourages the client to regress into their Child ego state from many years ago. This is a good thing as it provides a relatively easy way to get the Child ego state into the therapy room which should happen in most sessions. Generally speaking the focus of therapy is approximately:

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Kronic and social engineering

2011-06-16T13:30:00.002+08:00

Having been involved in drug counselling for over 20 years it is interesting to see current developments in the drug known in Australia as Kronic. This is a synthetic cannabis or synthetic marijuana. This marijuana is not grown on trees but produced in laboratories.

As of June 17th, 2011 the government of Western Australia has made this synthetic marijuana illegal. The first state in Australia to do so. It will be interesting to see what impact this new legislation has on marijuana production and use in this state. Those in the organised crime industry may be now rubbing their hands together in glee and dollar signs showing up in their eyeballs.

As of June 17th the production of synthetic marijuana moves from legitimate businesses into organised crime in Western Australia. How much organised crime take it on remains to be seen. If one counsels drug users in rehab one inevitably also counsels some drug dealers and producers. One hears all sorts of things about the business of drug production and distribution.

For those producing marijuana naturally by growing it, the big problem they have is that it takes a fair bit of space for the plants to grow but more so it takes a long time for the plant to become productive. Often 6 to 12 months for a fully mature marijuana plant. Synthetically produced marijuana takes one day to produce and can be made in a small kitchen of a house.

One would assume that this will make it very appealing for those involved in the organised production of illegal synthetic marijuana. It will be interesting to see in the next 5 to 10 years how much synthetic marijuana replaces naturally grown marijuana in Western Australia. One would hope that our law makers are not just handing a new multi million dollar drug to organised crime. We will have to wait and see the implications of this new legislation.

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Larissa - anger case study and results

2011-06-09T08:21:00.001+08:00

I appreciate your posts on anger because it’s a huge problem issue for me. I’m not really sure how to answer these questions because my parents left when I was young (around two). They came to visit sometimes so I had parents, but they were more like guests and not really like parents. I think my parent ego state is based on my father’s parents (grandparents). So if there's anything I've said here that would help me deal with anger better, I'd love to hear it.

My Parent ego state and anger

When my grandfather was angry he would (Hit, withdraw and sulk, shout, swear, give a lecture, get sarcastic, eat, fight, get depressed and so on)

Say - nothing

Do – slam the door on the way out and leave for awhile

When my grandMother was angry she would:

Say – curse, call me bad names, scream, rant

Do – threaten to send me away, threaten to send my brothers away, threaten to hurt me, blame me for ruining her life

My Child ego state decisions about anger

When I was angry grandmother would

Say – I was ungrateful, call me names, scream at me

Do – whip me, blame me, hurt me

Feel – she hated me more than usual

When I saw grandmother or grandfather angry I would

Say - nothing

Do - hide

Feel - scared

What did your grandmother and grandfather say about expressing anger. (OK, not OK, good, bad, time & place, men & women, etc) I learned very young that it was not acceptable for me to be angry or even look angry in front of them…ever. I don't remember them ever saying anything about it.

As a teenager did you get rebellious and angry? If so how did you express it and how did the parent figures respond? As a teenager, I hated everything about living. I did a lot of drugs and drank. I was not good to myself and did dangerous things. Sometimes I ran away. I stayed away as much as possible. Sometimes my grandmother found my stash and she flushed it (or hell, maybe she really kept it for herself) and she'd tell me I was trash like my mother and a nutcase like my mother's father. Fortunately, I had a couple of really good teachers in high school who motivated me to stay out of trouble and encouraged me to escape home by finding work rather than laying drunk in the alleys. They saved my life.

Summation of early decisions = Anger is forbidden.

---------------

Results

This case study is a good example of how a person can acquire contradictory script messages about anger and its expression. As we can see Larissa made a Child ego state decision:

“Don’t feel anger”

or at least

Don’t express your anger”

This is held in the Child ego state. At the same time she would have introjected her grandmother’s anger expression into her Parent ego state. This is shown with the statements like:

When my grandMother was angry she would:

Say – curse, call me bad names, scream, rant

and

When I was angry grandmother would

Say – I was ungrateful, call me names, scream at me

Do – whip me, blame me, hurt me

Thus she has a strong model which shows that it is OK to feel angry and to express that anger in a forthright and demonstrative way. Thus Larissa has a contradiction in her personality in this way.

It is probably safe to say that the early decisions are more influential in the personality than the models, however at the same time the modelling of behaviour is recognised as a significant factor in personality development.

Logically there are 4 possibilities
1. Decision made with consistent modelling
2. Decision made with contradictory modelling
3. Decision made with no modelling
4. No decision made but with modelling of behaviour

Larrisa is possibility number 2 and this could lead to some outright
contradictory behaviour with anger at times. Or what is more likely is that the decision behaviour will by overt with the modelled behaviour being expressed in a more convert way. Indeed this may be the case with Larissa (however this is based on very minimal information)

She says:
As a teenager, I hated everything about living. I did a lot of drugs and drank. I was not good to myself and did dangerous things.

This could indicate that the permission to express anger has resulted in her expressing anger at herself. Which resulted in some self destructive behaviour. In relationships with others there maybe a suppression of the anger as the decision demands.

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Anger in my personality

2011-06-07T10:30:00.001+08:00

Anger work - How anger is structured in my personality

My Parent ego state and anger

When my father was angry he would (Hit, withdraw and sulk, shout, swear, give a lecture, get sarcastic, eat, fight, get depressed and so on)

Say -

Do -

When my Mother was angry she would:

Say -

Do -

My Child ego state decisions about anger

When I was angry mother (father) would

Say -

Do -

Feel -

When I saw mother (father) angry I would

Say -

Do -

Feel -

What did your mother and father say about expressing anger. (OK, not OK, good, bad, time & place, men & women, etc)

As a teenager did you get rebellious and angry? If so how did you express it and how did the parent figures respond?

Summation of early decisions =

Graffiti

Anger in the personality

2011-06-06T23:09:00.002+08:00

Two ways of incorporating personality factors about anger

Injunctions - early decisions by the child (Child ego state)
Parent communicates to the child in some form that it is not OK to feel and/or express anger. As the young child has no Adult or Parent ego state it accepts the message in its Little Professor ego state, (The Adult in the Child ego state (A1)). 1. The child hears the parental directive in its A1
2. The youngster also listens to its own feelings (provided by the C1) as a reaction to the directive .
3. The young child makes its early decision based on these two bits of information and stores that decision in the P1.

Modelling based Don’t be angry injunction (Parent ego state)
As the child grows it begins to store modelling in its Parent ego state in a very rudimentary form. These can never be fully expressed in a grown up way until the Parent ego state gains maturation in the teenage years. The young girl will model on mother and if mother has a strong aversion to expressing or feeling anger the daughter will model that and incorporate it into her own Parent ego state.

The more the Child ego state decisions are consistent with the Parent ego state modelling the stronger the influence in the personality. At times they will be consistent and at other times they can be direct opposites. Consider this example. Johnny gets angry and hits his sister on the head with a piece of wood. On seeing this mother approaches Johnny angrily. With a raised angry voice she smacks Johnny on the back side and tells him not to hit his sister.

Johnny thinks in his A1 ego state. I was angry, that made mother very frightening to me and I got hit so I decide, “Don’t feel angry”. (Child ego state)

At the same time Johnny models on mother’s anger and her expression of that anger by hitting. (Parent ego state)

Thus the Child decisions about anger and the Parent modelling about anger are contradictory.

Problems with feeling and expressing anger

Starting with the most serious psychopathology moving to the least.

1. Don’t be sane. This person does not even acknowledge that a event has occurred that one could feel about. One may have been put down or say ridiculed and the individual does not even recognise that the event has occurred. The Adult ego state is so dysfunctional the facts of the situation are not recognised or comprehended.

2. Don’t feel. This person recognises that an event has occurred but does not feel anything in response to it. Person gets their wallet stolen but has no feelings about it.

3. Don’t feel X, feel Y. Person acknowledges the event, has a feeling in response to the event but it is not the appropriate feeling. Instead of feeling angry at being unjustly criticised the person feels scared or embarrassed. Women will often feel scared instead of angry and men will often feel anger instead of scared.

4. Don’t express your feelings. This person acknowledges an event has occurred, feels the appropriate feeling about it, but does not express the feeling.

5. Feel X, but express Y. This person acknowledges an event has occurred, feels the appropriate feeling about it, expresses the feeling but it is the inappropriate feeling. The woman who feels angry and then cries, the man who feels sad but shows anger

(Ref: Treatment of character)

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Anger work in psychotherapy

2011-06-06T13:20:00.002+08:00

Preliminary notes

It is necessary to use anger work in a context in counselling. In some areas such as the bodywork approaches this is not done and anger work can be used just as an exercise in itself. It must be relevant to the contract at hand and have a clear role in assisting the client to achieve that contract.

For example a client could say, “I want to shout at my father because of the way he treated me the other day”. In order for a therapist to go along with such a contract he needs to be aware of what happened between the two people as the anger work could be just a part in the game. What is the client’s script messages about anger and its expression. The client may be chronically angry and to go ahead and do the anger work would be contraindicated.

Anger work is a regressive technique. That is it encourages the client to ‘regress’ into the Child ego state and out of the Adult and Parent ego states. This has obvious uses for the individual who is stuck in his Parent and Adult and excludes the Child ego state, which many people are who attend psychotherapy. On the other hand there are people who are too much in their Child ego state and exclude the Parent and Adult, clearly one would need to be careful in doing such anger work with these individuals. For example the chronically angry person, and the hysteric personality type.

Anger work also destabilises the personality. This is one of its great therapeutic advantages. A client’s script becomes set and solid over time after many, many rehearsals and reinforcements day after day. Anger work can be used to shake it up and loosen the concrete holding it together. Once loosened one can then restructure the script into another form that allows the individual to live a more emotionally liberated life. That is, less script bound and more autonomous.

The down side of this destabilisation is that what if the client is already destabilised such as can be the case with schizophrenia, dependent personality, borderline personality and the obsessive/compulsive personality. One would need to be cautious using anger work in such situations.

Another difficulty with anger work is that anger always has the potential to turn into physical violence. So if the client is impulsive and has a tendency to be explosive then one needs to be very careful with anger work particularly if the client is bigger than you.

These women need to do some anger work, for sure!

In all my years of counselling I have never had a client express their anger in a way which hurt me or any of my property. One can use “Stop” techniques if necessary. Another advantage of this is with the client who comes from a physically violent back ground. By doing anger work they get first hand experience that there can be anger without physical violence.

Anger expression can be self validating. If one feels they have been wronged, then the act of saying so , especially to the face of the other party says to the individual - “I am worthwhile”. So to say such things with the expression of anger can assist with the self esteem.

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Goals of therapy - practical

2011-06-05T20:26:00.002+08:00

Kahless says:

Well I look at where I am at the moment. I am in my early 40s. I exist in a state of not happy and not unhappy thanks to the medication propping me up. I am thankful to the anti depressants that I am not in that low point of nothingness that I felt earlier this year.
I don't know what I want not what I don't want. You suggest a don't get my needs met injunction, but I don't even know what my needs are. I am by most people's standards, successful. I don't have to worry about money and I have a successful career and am in stable relationship with a partner who cares deeply for me.
But I am not happy. I do not know what will make me happy.

--------------------------

Her comment raises three interesting points for me.
I will address the first one here and do the other two at a later time.

I saw a piece of research once that outlined the best predictors of the outcome of psychotherapy. Or the importance of things in psychotherapy. It isolated three aspects of it
1. the techniques employed
2. the relationship between client and therapist
3. the practicalities of one’s life at the time

The results were something like
1 = 20%
2 = 40%
3 = 40%

However you can’t quote me on this because I can’t find it so these may not be fully accurate. I recall looking at it and being a bit surprised about the practicalities of life being that influential, but after some consideration it does make sense. This includes things like having a decent income, having relationships in life that are reasonable, living circumstances are OK such as having a home that is reasonable, diet that is OK, having a social life and so forth.

The more one has of these the better the prognosis when the client enters therapy. This is a bit sobering because it is easy for therapists to get lost in their fancy therapies and fancy techniques and so forth. It notes that therapists should initially at least focus on such practicalities in the treatment plan. This may seem a bit basic, and it is, but it is most important at least at times.

Many years ago I recall working in drug rehab with this guy who had a long term heroin problem. He was a nice guy and we established quite a good working relationship over some time. I recall we used to laugh a lot together. At one point he came into quite some money. Of course I did not ask how he came across the dollars, I just noted that he did.

Since our first meeting I had noted that his top front teeth were not too good, being quite discoloured and somewhat decayed. He had never mentioned them as a problem. I was the one who brought it into therapy. I suggested that he use some of the money to have his teeth repaired, whitened and so forth. He responded that he did not care what his teeth were like and he was unconvinced by my suggestion. I persisted with the suggestion through a couple of sessions and he finally did seek out the appropriate dental work, had it done and it did look decidedly better. Whilst I did think it was a good idea, one reason I suggested the dental work in the first place was because if he did not spend the money on his teeth it is highly likely that it would go on drugs.

However the surprising thing was the therapeutic results that it caused. He said that after it was done he felt so much better about himself. He reported that when ever he looked into the mirror he saw a reflection of himself that he liked. He had not not even aware of how this had effected him for so long. That he had disliked the image of himself every time he looked at it almost everyday.

I have never forgotten that. I could have spent my time doing fancy relationship building and fancy techniques to assist him to express his anger at his mother and so forth, when one of the things which turned out to be significant in the therapy was getting his teeth fixed. Something that simple. One of the simple practicalities of life turned out to be a significant factor in his recovery.

And my point is?

When Kahless says:
“I don't have to worry about money and I have a successful career and am in stable relationship with a partner who cares deeply for me.”

I know this is a good prognostic sign should she ever decide to take up therapy with a male therapist

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Di - Transactional Analysis Sentence Completion Test results

2011-06-05T09:42:00.005+08:00

1. My favorite story or fairytale as a child was The Lion, the Witch and the Wardrobe
2. I like when people are happy
3. My mother always told me to smile
4. I always try to do the right thing
5. Most men are childish.
6. What bothers me more than anything is being alone.
7. If I could, I would lose weight.
8. When I was a child, I wanted people to listen to me.
9. My father always told me to work hard.
10. I think I have a right to feel anything.
11. If I get angry enough, I lose my temper.
12. I shouldn’t get upset.
13. Love wonderful
14. I can’t lose weight
15. I get depressed when I feel helpless
16 A mature adult is a person who does the right thing.
17. One of my most important rules is DON’T lose my temper
18 My parents always told me what to do
19. I failed to grow up
20 My biggest fear in life is someone close to my dieing
21 Someday I will be happy
22. The child in me is lost
23 Sometimes I think “if only I had a different family”
24 People like myself work hard.
25. I need others
26 Winners are people who get what they want
27 Marriage is forever
28 Death is inevitable
29 My role in my family was to be quiet
30 One thing I try to hide from others is my unhappiness
31 My dreams are usually about scary things
32 Most women are beautiful
33 I feel really guilty when I say no
34 When things get tough I run
35 When I was a child, my parents never were happy with me
36 Sex is great
37 When someone disagrees with me I argue
38 If I were an animal I would be a fish
39 The last thing I want to do is quit
40 What I really learned in school is how to get along with people
41 I want my children to be happy
42 God is everywhere
43 A part of me wants to run away
44 Why can’t people do what they say
45 The story of my life would be called Getting Closer

---------------------------

Di I have written these as I would write in my clinical notes if you were a client. Thus I have made no attempt to make them sound nice. If they feel too brutal or you just don’t want this stated here let me know and I will delete it.

16 A mature adult is a person who does the right thing.
3. My mother always told me to smile
4. I always try to do the right thing
29 My role in my family was to be quiet
30 One thing I try to hide from others is my unhappiness

Results - Possibly quite a high CC. Need to access FC probably through RC. If CC response is at a pathological level investigate possibility of some significant trauma in childhood. Therapist would need to avoid the CC response in the transference neurosis. Develop RC in the relational with the therapist.

11. If I get angry enough, I lose my temper.
12. I shouldn’t get upset.
17. One of my most important rules is DON’T lose my temper
37 When someone disagrees with me I argue

Ambivalence about anger. Has internalised message of “Don’t feel anger” but reports anger behaviour. Need to investigate what is ‘temper’ is and what does ‘argue’ mean. Could be significant misperceptions about the demonstration of anger.
Need for anger work

7. If I could, I would lose weight.
14. I can’t lose weight
15. I get depressed when I feel helpless
18 My parents always told me what to do

Sense of loss of control in the personality. With such a reduced level of the Adult ego state as exectutive in the personality could indicate significant maladjustment. With food being used as one of the vehicles to sense the loss of control could indicate oral stage fixation and pre verbal issues. If at a pathological level investigate the possibility of others imposing their will onto to her in a severe way. Again anger work could assist with this so as to gain as sense of control of the world and in relationships. Make sure to identify times when client senses a loss of control in the relationship with the therapist

22. The child in me is lost

Examine how much this is a part of the life script

34 When things get tough I run
43 A part of me wants to run away
39 The last thing I want to do is quit

Flight is the basic response increasing the possibility of prolonged abuse in childhood. Develop fight response possibly with anger work
No run contract in therapy

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Life script over the life span

2011-05-30T20:16:00.003+08:00

Kahless says

Our development goes back to childhood but we do evolve in adulthood. So the 'issues' (lack of va va vroom) in my forties is not something I remember feeling in my twenties. So I have 'evolved' for want of a better word. I am not sure I repressed my child ego state in my twenties.

Life script

0 - 6 years - life script formation

All children have to learn to trust, but are the parents trustworthy?

6 - 12 years - latency period. Crystallisation of the life script decisions made previously

12 - 20+ years - antiscript period where the life script is rejected to some degree. Emotional pain can be ignored or seen as a temporary aberration and thus counselling in a serious way may be avoided. Teens and twenty somethings can still think they can handle it and outside assistance is not necessary. If things don’t get better by the late 20s or early 30s they can’t cope anymore and seek counsel. For instance if there are panic attacks or depression this can be the case.

20+ - late 30s - Implementation of the practicalities necessary for conclusion of the life script to be lived out. A whole series of decisions over an extended time will be made to guarantee the life script comes to its final chapter. Financial decisions, relationship decisions, career decisions, where I live decisions, how I live decisions, how I recreate decisions, educational decisions and so forth.

Each of these women will construct the practicalities of their life such that their life script will be fulfilled.

40+/50+ years - The life script becomes clearer as the person ends up in the in the life circumstances that were decided on in the first 6 years of life.

In the period from 0 to late 30s years of age the actual outcome of the life script has not occurred and thus one could argue that in one sense the person is kind of script free. In that period the person is still collecting all the life experiences (reinforcing memories and feelings) and structuring the practicalities of their day to day living that are necessary for the final chapter of the life script to come to fruition.

Sometimes the teens, 20s and 30s can be quite good times that are at odds to the final life script outcome. But as one hits about 40 years of age the life script begins to show it self clearly. Both the healthy life scripts and unhealthy life scripts.

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Book update

2011-05-29T15:59:00.003+08:00

Tony White. 2011. Working with suicidal individuals. Jessica kingsley Publishers: London

Released 5 months ago

Get it at a library near you:

Maribor General Hospital Library (Slovenia)
Stellenbosch University Library (South Africa)
Mitt hogskolan library (Sweden)
Stockholm University (Sweden)
PJ Library (Norway)
University of Cambridge (UK)
Oxford University library (UK)
Coventry City Council library (UK)
Bromley Library service (UK)
Cadbury Heath Library (UK)
Kingswood Library (UK)
Yate Library (UK)
British Library (UK)
Hounslow Library (UK)
Executive Counseling and Training Academy (Singapore)
Ngee Ann Polytechnic Library(Singapore)
Singapore Polytechnic Library (Singapore)
Curtin University (Aust)
Australian Catholic University (Aust)
Bond University (Aust)
University of Melbourne (Aust)
James Cook University (Aust)
University of Massachusetts Amherst (USA)
National Library of Medicine Maryland (USA)
University of Michigan (USA)
University of North Carolina Chapel Hill (USA)
University of Missouri-Columbia (USA)
Akron-Summit County Public Library, Ohio (USA)
University of California Merced (USA)
University of North Carolina Greensboro (USA)
Library of congress (USA)
University of California San Franisco (USA)
Mt. Hood Community College Library Oregon (USA)
National College of Natural Medicine Oregon (USA)
Oregon Health and Science University (USA)
Northeast WI Public Libraries (USA)
College of DuPage Illinois (USA)
Boston College (USA)
University of Chicago Illinois (USA)
University of North Texas (USA)
Laredo Public Library Texas (USA)
University of Texas-Pan American (USA)
Trinity College Dublin (Ireland)
Dublin Institute of Technology (Ireland)
Auckland University of Technology (New Zealand)
Eastern Institute of Technlogy (New Zealand)
University of Otago (New Zealand)
Rotorua District Library (New Zealand)
Library and Archives Canada (Canada)
City University of Hong Kong (China)

Linda - Transactional Analysis Sentence Completion Test results

2011-05-28T17:34:00.002+08:00

Linda
47 years old
Female
30/12/1963

1. My favorite story or fairytale was The Magic Far Away Tree.
2. I like when people are happy
3. My mother always told me to be quiet.
4. I always try to be a better person
5. Most men are lovely
6. What bothers me more than anything is chaos.
7. If I could, I would (see answer to number 4)
8. When I was a child, I wanted to live in the Magic Far Away Tree.
9. My father always told me I was fat
10: I think I have a right to feel at ease
11: If I get angry enough, I might break something.
12: I shouldn't get too angry
13. Love is multi faceted
14. I can't organise myself
15. I get depressed when I can't organise things around me
16. A mature adult is a person who accepts who they are
17. One of my most important rule is "Don't worry too much"
18. My parents always told me to stop talking rubbish
19. I failed to work things out for ages.
20. My biggest fear in life is failure
21. Someday I will not worry
22. The child in me is always there in the background waiting
23. Sometimes I think "If only I was a more organised person things would be easier"
24. People like myself like peace and quiet
25. I need to think more clearly
26. Winners are people who think they are winners
27. Marriage is something I value greatly
28. Death should be as inconvenient as possible.
29. My role in my family was small
30. One thing I try to hide from others is my sense of chaos
31. My dreams are usually about escape and my own death
32. Most woman are annoying
33. I really feel guilty when people around me are not happy.
34. When things get tough I see them through
35. When I was a child, my parents never liked each other
36. Sex is unique
37. When someone disagrees with me I don't care
38. If I were an animal I would be a dog
39. The last thing I want to do is not give a shit about anything or anyone
40. What I really learned in school was that the pretty girls got the boys
41. I want my child to be confident about who he is as a person
42. God is something that others might think about
43. A part of me wants to skippy skip out the door and disappear for a while
44. Why can't people be more genuine
45. The story of my life would be called Linda's Twaddle because that is what it is.

Linda - Transactional Analysis Sentence Completion Test results

11: If I get angry enough, I might break something.
12: I shouldn't get too angry
3. My mother always told me to be quiet.
40. What I really learned in school was that the pretty girls got the boys
9. My father always told me I was fat

Result - Possible self destructive urges if anger is not externalised.

6. What bothers me more than anything is chaos.
14. I can't organise myself
15. I get depressed when I can't organise things around me
25. I need to think more clearly
30. One thing I try to hide from others is my sense of chaos
19. I failed to work things out for ages.

Result - Loss of Adult ego state control in the personality. Potential sign of significant maladaption.

33. I really feel guilty when people around me are not happy.
2. I like when people are happy
24. People like myself like peace and quiet

Result - Inability to handle conflict or other’s disquiet. Can be manipulated in relationships. Central factor to resolve in transference relationship.

Graffiti

Kahless - Transactional Analysis Sentence Completion Test results

2011-05-28T17:06:00.002+08:00

1. I can't remember reading books much as a kid, or what was read to me. My favourite story was based on what I watched on TV. I loved Dr Who and the Cybermen the best.

2. I like when people are nice to me.

3. My mother always told me to be good.

4. I always try to do my best.

5. Most men are selfish.

6. What bothers me more than anything is noise (at the moment.) Also people being late.

7. If I could I would quit work.

8. When I was a child, I , like Roses wanted to fly.

9. My father always told me not to make a fuss and also not to upset my mother.

10. I think I have a right to feel but I rather I didn't at times.

11. If I get angry enough I will tell you to fuck off out of my life.

12. I shouldn’t be so lazy.

13. As Snoopy once said "Love is, never having to say youre sorry."

14. I can’t feel any va va vroomm for life any more.

15. I get depressed when I think too much about life.

16. A mature adult is a person who takes responsibility for their own actions.

17. One of my most important rules is “Don’t make a fuss." (But I do break it if I am angry.)

18. My parents always told me that I should always try my best..

19. I failed to stick with things.

20. My biggest fear in life is being ignored.

21. Someday I will lose some weight!

22. The child in me is very sad at the moment.

23. Sometimes I think “if only ...
I am not an if only person.

24. People like myself are fools to themselves.

25. I need to lose the weight I have put on since quitting the smokes.

26. Winners are people who never give up.

27. Marriage is marriage!

28. Death is inevitable. The timing is choice.

29. My role in my family is to be happy go lucky.

30. One thing I try to hide from others is what is going on in my head.

31. My dreams are usually about (I cant remember my dreams)

32. Most woman are self conscious.

33. I really feel guilty when I think about my parents dying.

34. When things get tough I go into myself.

35. When I was a child, my parents never came and watched me in fencing competitions

36. Sex Female.

37. When someone disagrees with me I will listen to their reasoning.

38. If I were an animal I’d be a dog.

39. The last thing I want to do is to go out.

40. What I really learned in school is that children can be destructive.

41. I want my children to N/A

42. God is and will always be.

43. A part of me wants to ????? I am not good at knowing what I want.

44. Why can’t people just be straightforward and honest and fair?

45. The story of my life would be ordinary.

Kahless - Transactional Analysis Sentence Completion Test results

3. My mother always told me to be good.
4. I always try to do my best.
9. My father always told me not to make a fuss and also not to upset my mother.
12. I shouldn’t be so lazy.
14. I can’t feel any va va vroomm for life any more.

Results - Injunction: ‘Don’t get your needs met’. High Conforming Child ego state. Possible pull to non-life structured into personality.

14. I can’t feel any va va vroomm for life any more.
15. I get depressed when I think too much about life.
22. The child in me is very sad at the moment.

Results - Repression of Free Child ego state

17. One of my most important rules is “Don’t make a fuss." (But I do break it if I am angry.)
11. If I get angry enough I will tell you to fuck off out of my life.

Results - Internal release of the life script

5. Most men are selfish.
9. My father always told me not to make a fuss and also not to upset my mother.

Results - Need for a male psychotherapist

Graffiti

Roses - Transactional Analysis Sentence Completion results

2011-05-27T17:37:00.002+08:00

Name : roses
Age: Almost 49 years old
Sex: Female
Date: 17th May 2011

1. My favourite story or fairytale as a child was “Kimba the white lion”. We weren’t told stories so I first heard them via the telly.

2. I like when people are touchable: we can touch each other and it’s ok.

3. My mother always told me she loves me, that’s why she is saying this or doing this: whatever it was at the time.

4. I always try to not try – either do or don’t do.

5. Most men are male?

6. What bothers me more than anything is when I can’t and I want to.

7. If I could I would believe that I could do anything I wanted to do.

8. When I was a child, I wanted to fly.

9. My father always told me... I don’t think he told me anything. I think he just loved me.

10. I think I have a right to feel everything and anything all the time.

11. If I get angry enough I can and will hurt something... badly!

12. I shouldn’t... hurt anything.

13. Love is a lie.

14. I can’t touch everything. Some things are totally untouchable eg. Love, trust, truth...

15. I get depressed when that feeling happens... that feeling on the inside that makes me hurt so badly all over: my skin mainly.

16. A mature adult is a person who can control themselves regardless of how they’re feeling: regardless of what they want to do or be or say...

17. One of my most important rules is “Don’t be shy”.

18. My parents always told me that they love me.

19. I failed to listen to my parents.

20. My biggest fear in life is that I have, am or/and will hurt something beyond repair.

21. Someday I will die.

22. The child in me is always my friend.

23. Sometimes I think “if only I’d not been born”.

24. People like myself live.

25. I need to love.

26. Winners are people who keep going regardless of success or not.

27. Marriage is legal.

28. Death is good.

29. My role in my family is to love.

30. One thing I try to hide from others is me.

31. My dreams are usually about something that I want them to be about.

32. Most woman are female?

33. I really feel guilty when I do something I know goes against everything I’d like to think is good.

34. When things get tough I so severely get going! Like a dog protecting his/her bone or a bull at a red flag. LOVE IT, LOVE IT, LOVE IT!!!! Oh my goodness! BRING IT ON!!

35. When I was a child, my parents never hugged me.

36. Sex is lovely!

37. When someone disagrees with me I let them.

38. If I were an animal I’d be dangerous!

39. The last thing I want to do is to say that I love someone and not really love them.

40. What I really learned in school is that no one has the power to make me do what I don’t want to do. If I do something for them, it was only because I wanted to first.

41. I want my children to one day understand what it was that’s really important to them... not what ‘is’ important but what’s important just to them alone individually.

42. God is love.

43. A part of me wants to hug you.

44. Why can’t people be touched and it be ok?

45. The story of my life would be called ‘Wasn’t meant to be but happened anyway’.

Touch

Roses - Transactional Analysis Sentence Completion results

2. I like when people are touchable: we can touch each other and it’s ok.

14. I can’t touch everything. Some things are totally untouchable eg. Love, trust, truth...

44. Why can’t people be touched and it be ok?

43. A part of me wants to hug you.

35. When I was a child, my parents never hugged me.

Results - Somatic conversion of psychological structures

13. Love is a lie.

18. My parents always told me that they love me.

14. I can’t touch everything. Some things are totally untouchable eg. Love, trust, truth...

29. My role in my family is to love.

25. I need to love.

6. What bothers me more than anything is when I can’t and I want to.

Results - Ambivalence in relationships

23. Sometimes I think “if only I’d not been born”.

21. Someday I will die.

28. Death is good.

35. When I was a child, my parents never hugged me.

Results - Self destructive urges

Graffiti

TA sentence completion answer sheet

2011-05-21T19:33:00.002+08:00

Graffiti

Transactional Analysis sentence completion test

2011-05-16T20:56:00.003+08:00

To see larger versions click on picture > click on actions > Click on view all sizes

Graffiti

Psychoanatomy of the eyes

2011-05-15T17:55:00.002+08:00

Theory of bioenergetics

Eyes = fear, sadness, power & human contact.

Double function of the eyes - vision and contact
When two people’s eyes meet there is a sense of psychological contact with the quality of the contact varying depending on the look in the eyes. A hard look can be like a slap in the face and a soft look can be like a caress.

One can look into a person, through a person or over a person. Eye contact can be one of the most intimate forms of psychological contact between two people. There can be a sense of feeling or touching the inner essence of the other. That can be exciting, even erotic or it can be frightening and disturbing. It’s about psychological closeness and the eyes can be a reflection of the the person’s comfort or discomfort with that.

Eye contact is particularly important between parent and child. Without eye contact the child can feel a profound sense of being cut off or disconnected from the parent, especially before the child has the ability of speech. The parent communicates so much of their feeling about the child, to the child through the eyes. From loving, affectionate and accepting to angry, hateful and rejecting. And the eyes don’t lie. Words and to a lesser extent body language can be controlled and censored. It is very difficult, if not impossible to censor feelings reflected through the eyes. If you want to know what someone feels about you look into their eyes.

The quality of eye contact between mother and child has considerable effect on the psychology of the infant as well as the functioning of its eyes. If mother has feelings of love and warmth in her eyes the infant responds with a look of pleasure itself and the eyes become soft and relaxed. If the child sees anger and hate in mother’s eyes it will respond with shock and develop a wide eyed frozen with fear look in its eyes. If this becomes habitual and repetitive in the infant its eyes will be maintained in wide eyed shock look. Wide eyes enlarge the field of peripheral vision but reduce central vision and eye dysfunction can result that involves central vision. Myopia and the need for glasses at a young age

The eyes can be a good measure of ego strength. Those with a strong ego can look straight into the eyes of the other. Looking at the other can be an expression of assertion. The unassertive will tend not to do this. The eyes can be used to obtain power in relationships. Sometimes known as “staring the other down”. Dropping the eyes to the floor can be a sign of submission as is found in bowing in Japanese culture.

Whilst the eyes are connected with the psychology of fear, ego strength and power they are also intimately involved in crying and sadness. Crying is the expression of sadness. The inability to cry or the “Don’t show sadness” injunction is held bodily in the eyes and thus visual or eye problems can result over time.

The amount and range of feelings the eyes can express can be a measure of psychological health. In addition one cannot be considered psychologically healthy if they cannot make or sustain eye contact with another person

Psychosomatic dysfunction involving the eyes

The need for glasses at a young age - childhood to early adulthood. Can result from preverbal experiences of the child. Fear of mother’s expression in her eyes or unresolved preverbal sadness.

Myopia - commonly occurs between the ages of 10 - 14 and can sometimes be attributed to bodily changes and the need to psychologically deal with sexual maturity.

Astigmatism, cross eyed, cataracts, conjunctivitis, dry eyes, sore eyes, habitual closing of the eyes whilst in conversation, facial tics involving the eyes (hemifacial spasms).

Problems with human contact are reflected in eye problems. Very thick glasses or the rim of the glasses can be used as a barrier to eye contact which is used to keep the person feeling safe thus reflecting trust issues in relationships. That can be either, “I don’t trust you” or “You can’t trust me”.

The habitual unnecessary use of sunglasses is interesting behaviour. It can result in a complete lack of eye to eye contact. That can be to hide feelings of sadness and fear or a sign of considerable discomfort with human contact. It can also be a reflection of a desire to obtain power in relationships and is a sign of a poor ego strength.

“I don’t feel strong enough to let you see who I really am”.

If the sunglass wearer is communicating with others who are not wearing any kind of eye covering it can allow the person to feel a sense of power or control, “I can see you but you cannot see me”. Again reflective of a sense of impotence or powerlessness in the person covering their eyes with sunglasses.

Graffiti

Book update part 2

2011-05-11T19:14:00.003+08:00

Working with suicidal individuals.

There is no consistent way that I am aware of to find out which libraries the book is now in. But I have found it in some libraries which I have accidently stumbled across. Listed here:

University of Cambridge (UK)
Curtin University (Aust)
Australian Catholic University (Aust)
Boston College (USA)
City University of Hong Kong (China)
Executive Counseling and Training Academy (Singapore)
Oxford University library (UK)
Eastern Institute of Technlogy (New Zealand)
Oregon Health and Science University (USA)
James Cook University (Aust)
Dublin Institute of Technology (Ireland)
Library of congress (USA)
Trinity College Dublin (Ireland)
British Library
PJ Library (Norway)
Bromley Library service (UK)
University of Missouri-Columbia (USA)
Akron-Summit County Public Library, Ohio (USA)
University of California Merced (USA)

Also two comments from a discussion forum which commented on my book:

Andy Williams • bought a copy about three weeks ago - will be using it to deliver a training on risk assessment at the North East Regional TA Conference in November 2011 at York

Rosemary Napper • I reviewed it for the publisher - I thought in many ways it is an excellent book - and I have found supervisees find it very stabilising. I wonder if it has a role with family members too as its very accessible as well as grounding.

I was sad that it uses classical models of ego states from the 1960s, rather than more contemporary and coherent ideas about ego states. Nonetheless, the way these are used and illustrated with many many case examples works quite well, and clearly works for him as a set of maps to think about both personality and communication............

Reccomend!
And so glad to see a TA book published by a mainstream publisher!
We need more writers!

--------------------------------------

Serbian psychologist Natasa Djurica says:

Overall Tony White's book "Working with suicidal individuals" is interesting, instructive and written in an easy to read style. It reminds me of the book from my childhood, "Journey To The Center of The Earth" by Jules Verne. It captured my Free Child in the reading of it. Is there a better compliment for a book, especially an occupational book?

Why the book "Journey To The Center of The Earth"? Probably because Tony White's book was a journey to the centre of suicidality as a human behaviour. He was an excellent guide on this journey.

The book has a logical and systematic structure. It reassures those who think suicide is a danger that lurks behind every human stress, depression or tragedy. He shows this is not the case at all.

In his easy to understand style, the author explain that human behaviour is a reflection of the structure of their personality. This explanation gives strong evidence there is a clear distinction between those who are suicidal and those who are not. The distinguishing feature between the groups are decisions. Early decisions made in childhood under adverse parenting (ego state Child) or decision modelled by parents or significant others in a process of introjection ( Parent ego state). It is these early decisions in the personality structure that determine suicidal behaviour. Thanks to this book we know suicidal urges are not something lurking in every human.

For some readers this will be surprising. But there is much more.

The author then leaves readers with some questions:
* Most people are unaware of their suicide decision. How do we recognise when the decisions are there? The suicide decision can be activated during someone's life but they also can "sleep" in the personality for their whole life, why? If someone has those decision is there possibility to change them?

* From his long term practice and rich experience readers are given examples of those behaviours which seem suicidal but are actually not!? He also explains why some behaviours even the potentially lethal end are not suicidal!?

It is very interesting to see how writer leads us from this uncertain position. I can say I found the answers I need. At the end of the journey the reader is well informed about suicidal behaviour, and provided with lots off tools and ways for understanding, assessing, helping, and working with suicidal individuals.

-----------------

One interesting comment that I see here and have had two others say to me is about the grounding nature of the book. This certainly wasn't planned by me but it may reflect a change in my self over time about working with the suicidal.

Rosemary Napper says of the book - it is stablizing and grounding
Natasa Djurica says - it is reassuring about the danger of suicide

When I meet with a suicidal client these days I am much less alarmed and feel more confident in my dealings with them than I was as a younger psychotherapist. It is good to see that this perhaps is reflected in this book which I had no idea I was doing when I wrote it.

Tony

Book update

2011-05-10T17:36:00.003+08:00

Final fantasy 7

2011-05-09T19:46:00.004+08:00

The P1 ego state.

As mentioned in the previous post, Final fantasy 1, the fantasy stage of child development and the development of the P1 ego state are closely linked.

Reference
Pam Levin, 1974. Becoming the way we are. Berkeley: Transactional publications

She states that when people develop problems about this stage they can often have a scary, sinister and demonic quality about them. Children can report nightmares and can have a particular interest in magic.

Levin refers to this stage of development as the Supernatural Child lasting from 3 to 6 years of age. The stage of fantasy and magic and scary things. Witches, potions, spells, dragons, flying broomsticks are all part of this magical, devilish, scary and a bit of fun part of the personality which TA theory would say is the P1 part of the personality. We all know magicians fake it but there is still that part of us that likes to see some magic in action.

This part of the personality is engaged with things like the Harry Potter stories. It can also be found in Batman with characters like the Penguin, the Riddler and the Joker. They are presented as mischievous, irreverent and yet appealing characters.

---------------

Two other pieces of research state:

Bouldin, P.
An investigation of the fantasy predisposition and fantasy style of children with imaginary companions. The Journal of Genetic Psychology, 2006, 167(1), 17 - 29.

According to Piaget (1962) (Play, dreams, and imitation in childhood. New York: Norton.) fantasy play, daydreaming and dreaming all evolve from the same mental process.

Children who engage in extensive fantasy play tend to be more imaginative. Thus they have an imaginative predisposition.

Children with imaginary friends were more predisposed to engage in fantasy than those children who did not have such friends. (Mean age of children in study was 6 years old)

Children with imaginary friends:
1. Reported they daydreamed more often
2. Daydreamed when alone
3. Felt they could almost see and hear the contents of their daydreams in front of them.

These children are able to create vivid mental images and tend to use these in times of solitude. And more likely to play solitary games with a mythical theme. They are seen as having enriched fantasy lives and are seen as highly imaginative.

Heuvelman, L.R. & Graybill, D.
Assessment of children’s fantasies with the Make A Picture Story: Validity and norms. Journal of Personality Assessment, 1990, 55, 578 - 592.

The younger the child the more fanciful the fantasy

Behaviourally aggressive children tended to have more aggressive fantasies but it is also noted that normal children also make frequent use of violence and aggression in their fantasies. Thus caution must be taken when children display violent fantasises to assume this is a sign of potential aggressive behaviour problems.

Children rarely will have nude figures in their fantasies.

Children will generally have child figures in their fantasies and usually select those of the same sex as the child.

---------------------

The schizoid personality

The DSM notes of the schizoid personality, “Excessive daydreaming is often present”. Based on the research above one can begin to identify those children who have the potential to develop the schizoid personality. For instance those children with fantasy involving imaginary friends.

Once identified one can then adjust their parenting style to make sure the schizoid personality development remains within the normal range. Some key features of the schizoid structure are as such:

Core decision
The world is scary so withdraw from it (people) and don’t show any of your feelings

Other injunctions
Don’t show your feelings
Don’t be close
Don’t belong
Don’t get your needs met

Ego states
Commonly high in Conforming Child ego state as ‘rocking the boat’ will attract attention and make people focus on them which is scary. The “withdrawn Child ego state” best describes them. They have little desire for social interaction. Often good thinkers and so they can be high in Adult ego state. The quiet achiever is a common style for them and thus they make good employees. Low Free Child ego state as that involves the expression of feelings and can also attract attention. They can give the appearance of being cold or aloof.
They in particular find it difficult to express anger (and assertion which is a derivative of anger). So Rebellious Child ego state is not often used. This can make them appear indecisive and not clear in their goals. Often present is a lack of social skills.

The demon or lillith.
Other than schizoid personality problems, the P1 stage of development (3 - 6 years of age) can result in the formation of the demon or lillth part of the personality

Consider this quote from Eric Berne who wrote about the demon in his book, ‘What do you say after you say hello’.

He stated, “The demon is the jester in human existence and the joker in psychotherapy.... No matter how well the therapist plans his psychotherapy, the patient always has the upper hand. At the point when the therapist thinks he has the four aces, Jeder plays his joker, and the demon wins the pot. Then he skips merrily off, leaving the doctor to leaf through the deck trying to figure out what happened. Even if he is ready for it, there may be little he can do..... The demon first appears in the high chair, when Jeder scatters his food on the floor with a merry glint, waiting to see what his parents will do. If they make friends with it, it will go onto later mischief, and then perhaps into humorous fun and jokes. If they beat it down, it will lurk surly in the background, ready to leap out at an unguarded moment and scramble his life as it originally scrambled his food.” (Pp 122 - 123).

Berne, E. 1972. What Do You Say After You Say Hello? Bantam: New York.

A fixation at the P1 stage of development can result in this type of behaviour becoming prominent in the personality.

Graffiti

Final fantasy 6

2011-05-08T15:29:00.003+08:00

Up to this juncture I have maintained the following psychological functions fantasy can provide

Fantasy as a defence mechanism
Fantasy in the schizoid personality structure
Fantasy to alter mood - self soothing
Fantasy as a source of strokes - positive and negative
Fantasy and life script reinforcement

It would seem that there are others

Fantasy in the narcissistic personality structure
I have mentioned this before that one feature of the DSM-IV criteria of the narcissistic personality is:

“Preoccupation with fantasises of unlimited success, power, brilliance, beauty, or ideal love.”

Thus it can be stated that fantasy is used by some narcissistic people to maintain that personality structure.

Fantasy as a reflection of current events in a persons life
As with sleep dreams, day dreams can occur as a reaction to events in a person’s life. If one is entering a new relationship they may have fantasies about how it will go or things the two people may do together and so forth. If the person gets a new job they may fantasise various scenarios about what might happen. This also happens in sleep dreams sometimes. When it does this reflects the psychological importance the current event has to the person.

Fantasy as wish fulfilment
This also occurs in sleep dreams. The daydream may be about what the person wishes. A relationship, money, success, sporting ability, their team winning the grand final, finding a lost child, to be the dependent one in a relationship and so forth.

Thus we have some of the ways fantasy can be used by the fantisizer. There may be others that come to light subsequently but at the moment we have this:

Fantasy as a defence mechanism
Fantasy in the schizoid personality structure
Fantasy to alter mood - self soothing
Fantasy as a source of strokes - positive and negative
Fantasy and life script reinforcement
Fantasy in the narcissistic personality structure
Fantasy as a reflection of current events in a persons life
Fantasy as wish fulfilment

There is one other point that must be made. This does not relate to the function of fantasy but how fantasy can be used in therapy. This I mentioned in final fantasy 5. If one maintains that daydreams are expressions of the unconscious or they arise from the unconscious, one can use them therapeutically the same way one would use dream analysis with sleep dreams. It is a way of understanding the unconscious of the individual.

For example Kahless stated:

“I used to day-dream being a secret agent, or a fireman, or Lara Croft”(end quote).

A therapist may ask of her,
What are the qualities of Lara Croft that are important in the fantasy?
What does Lara Croft do in the fantasy?
What is her relationship to others in the fantasy?

Of course the answer to each of these questions if simply a reflection of the psyche of Kahless. As with sleep dream work they each are part of her in some way. The therapist seeks to find out what those are and then finds a way to use them therapeutically. For instance it may become apparent that Kahless is not owning the Lara Croft in her. Some of the qualities she sees in Lara Croft she has in her own personality but is in denial about them at the moment. One could then use two chair to facilitate her accepting that part of her personality. As I also said in final fantasy 5 it is the theme that the therapist is looking for. The character of Lara Croft is not important. It is what that character means to Kahless that is important. The theme of the character and the theme of what the character does.

Of particular note with this is sexual fantasies. Whilst fantasy of heroic deeds or of great wealth can be used to understand the psyche, sexual fantasises have the extra feature of involving very close, intense and intimate relating. They involve at least two people interacting in a very close and intimate way. Fantasy about winning the grand final or being dux of the school does not have the same feature. Thus sexual fantasises assume extra importance in this way.

In using sexual fantasises in this way one firstly takes the sex out of the equation.
Forget about the sex and how are these two people relating?
If they were relating with the same theme in a non sexual way, what would they be doing?

Thus the unconscious wants, fears and needs involving intimate relationships becomes more defined. What the person’s unconscious feels about self and others and their relating becomes clearer.

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