Friday, July 30, 2010

Carl Rogers and health

Harriet states: I also thought of Carl Rogers when I read this. What did he say? Something like every person's goal should be to be the person who they truly are.

Carl said a lot of things Harriet. In his original writing there is a lot on transference that includes taped dialogue from sessions he did with clients. They are very interesting to read as one gets a bit of insight into how he worked as a therapist. However most of this is forgotten and he is most widely known for his clarification of the three essential features of the therapist in relationship with the client.

Genuiness - Therapist is aware of his own feelings, thoughts and attitudes and these are not concealed from the client.

Empathy - Understanding the client’s experience from the client’s point of view.

Unconditional positive regard - Conveying to the client that they are worthwhile humans no matter what they do.

Home wrecker

This has had a profound effect on the practice of psychotherapy which is why he is regarded as one of the greats of the field. As usual it is the simplicity that makes for it being more profound.

It seems reasonable to conclude that he was not the first to think this up. People would have known long before Rogers time that being genuine and empathetic was good for a relationship especially a helping relationship and I am sure teachers long before Rogers would have told their students such a thing. However he articulated it well and was in the right place at the right time and thus he became known as he is.

However this does raise an interesting and debated point of view. His approach and philosophy rests on the assumption that, “Love will cure it”. That is if you place a person into an environment or relationship that is genuine, empathetic and has unconditional positive regard they will naturally get better.

If you place a person in a nurturing and positive environment then their natural urge to grow and develop will be activated and the person will grow and develop towards psychological health. In transactional analysis terms it would be said that the Free Child aspect of the personality is energised or cathected and this is where the desire to grow towards health results from.

There is another school of thought that says, “Love alone is not enough for cure”. Without a doubt a loving, positive environment is good for one’s psychological health, but there is also an Adapted Child part of the personality that propels the person to ill health (or to their life script).

This side of the debate say that pure positivity is not enough to counter the drive to psychological ill health. At some point in the treatment you have to deal with this and that means doing something with the client that is experienced as painful in some way. That may be a confrontation of some kind that the client does not want to hear, getting the client to face their mother or father who abused them and so forth.

Some form of painful treatment is applied and this raises much heated debate. There are a group who say a client should never be subjected to painful treatment techniques with a common example being ECT or some form of aversion therapy like happened in the movie Clockwork Orange. You could argue that Carl Rogers would have been of the view that you do not apply painful treatments.

Carl Rogers workshop (1965)

My father back row third from right

Carl Rogers front and centre.

Of course there are much less dramatic painful techniques than ECT or aversion therapy and I certainly use some of them myself. For instance some two chair techniques could be placed in this category and this fits with my personal philosophy. Unconditional positive regard, empathy and genuiness as most useful in allowing the client to grow towards health but they are not enough in most instances. The AC is an active part of the personality that ‘love’ alone cannot over ride. It needs at some point to be dealt with directly and that usually involves some kind of angst for the client. Keep it to a minimum for sure but it is needed at times.


Tuesday, July 27, 2010

The 'x' factor in therapy

I was reading a book on counselling the other day and it discussed the therapeutic alliance. These two guys had done a meta analysis of the literature on what are ‘important therapist attributes’ for the development of a strong therapeutic alliance. They came up with:

Therapist attributes - flexible, honest, respectful, trustworthy, warm, confident, interested and open.

This seems like a reasonable list and includes some of the things one would expect to find. But this is indeed an elusive and indefinable topic. The quality that allows a good therapeutic alliance to develop between client and therapist. I have discussed this before and talked about the ‘x’ factor.

This is usually mentioned in relation to singers and musicians. There is a quality that the very good ones have that the not so good ones do not have. What that is however is largely indefinable, but you know when it is there and when it is not. A bit of an odd situation really - you know when it is there but you can’t define it (easily).

The same applies for the the therapeutic relationship. Some therapists have a ‘presence’ where they can have that special connection with clients, but what that is, is hard to define.

The list above is good and accurate but it’s one dimensional. It is a list of things and this will not define the ‘x’ factor. One cannot produce a list of things to do that. Instead one has to talk in more general terms that are less concrete because the ‘x’ factor itself in not concrete.

Theoretically it is quite easy to explain, it can be called the Free Child. This is best explained by looking at the training of therapists.

When therapists begin their trade they learn lots of things like how to do therapy and how to be a therapist. They learn the basic techniques and the basic process to follow. As they master these they become a therapist which undoubtedly is a positive thing. However it is an adaption and thus forms part of the Adapted Child ego state. They learn to be a certain way and a kind of professional role or way to be. They adapt to what authority is teaching them. The down side of this is they loose a sense of who they are and how to be themselves in the therapy setting. They are moving away from their Free Child part of the personality and becoming something else - an adaption.

This is not conducive to forming a connection with the client. The client will feel a sense of connection when the therapist simply be’s who they are. When they be them self which theoretically is the Free Child.

When client’s see the highly trained therapist they get good therapy that is of much assistance but that extra bit is not there. They do not get to meet the therapist as a person.

Some therapists never move beyond this because either they don’t particularly want to or they are not prepared to take the personal risk in doing so. To put the Free Child out in any relationship is a risk including the therapeutic relationship.

To move beyond ‘just’ being a therapist the person has to kind of unlearn what they have just spent the last few ( or many) years learning. They have to unlearn being a therapist and learn again how to be them self as a person in the therapy setting. If they achieve this then the Free Child again becomes accessible to the client and thus a special sense of connection can again occur. In my view this is part of the ‘x’ factor in the therapy setting.

The therapist moves away from being a therapist and becomes a person who happens to do therapy in the relationship with the client. The person comes first and the therapist part comes second. They have already acquired the therapy skills and now they relate to the client and happen to use those skills when necessary.

If the therapist allows self simply to be who they are in the therapy relationship then in my view the client experiences an extra dimension to the therapeutic relationship.

Just being who we are is surprisingly difficult. Most in childhood loose that ability.

Allowing self to just be who you are sounds simple, but is not easy. Indeed I would say that most people loose this after childhood and never achieve it again in adulthood, let alone those who have it trained out of them as happens in the training of therapists.


Monday, July 26, 2010

Cannabis and self medication.

Four types of drug use are commonly cited.

Experimental use

Recreational use

Symptomatic use

Dependent use

Symptomatic use is when the person uses the licit or illicit drug so as to solve a problem or treat a painful symptom. They discover that by using a certain drug they feel better because it treats a symptom. For instance heroin is an opiate. It is a pain killer. What better way to deal with your pain than to ‘kill’ it.

A person may have grown up in an abusive home and as a consequence they suffer pervasive depression and anxiety through their life. One day they try heroin and discover that that it makes them feel better because it gets rid of their depression and anxiety. So they try it again and obtain the same result. Thus they become a regular user of heroin because it alleviates their pain. This is sometimes called self medication. That is the person uses the drug to self medicate so as to ‘treat’ the symptom.

There is one type of self medicating that I have noticed over the years. These people use marijuana to self medicate. I would not say that it is a large group but you do come across them from time to time. This has recently been highlighted for me because I am working with a man where this type of drug use is quite obvious.

Marijuana for some people is effective in dealing with adulthood ADD or ADHD. I can’t say if it is for children as most people don’t start using cannabis until well into their teens. These people report that when they stop using they start to display the classic symptoms of ADD. The lack of focus, disorganisation, hyperactivity, insomnia and so forth. When they use marijuana the symptoms can subside significantly.

As a result of this they develop a particular pattern of use. It is different from the recreational user where the goal is to get stoned and experience the euphoria of the marijuana. This persons use is very intermittent. The cannabis user to self medicate for ADD uses much more consistently throughout the day and day after day.

The first use often occurs early in the day and then there is semi regular use throughout the day. This person does not get really stoned because they are continually half stoned all the time. Being continually stoned becomes their normality and they can function better due to the reduction of ADD symptoms. This is quite a different pattern of use compared to the recreational cannabis user.

Now one would usually say that the solution is obvious. This person needs to go to a psychiatrist, have a correct diagnosis of ADD made and then prescribed the appropriate ADD medication. Unfortunately it is not that simple.

Some have even done this but found that medications like dexamphetamines are not as effective. From what I have heard reported, marijuana can be a very effective treatment for the ADD symptoms. Just because its illegal is not a reason to stop in many a users mind.

Secondly, this type of marijuana user must have good connections in the drug scene. They have established a consistent supply over a long period of time. Now one thing you do not want to do when working with a drug user is introduce them to yet another drug, whether it is legal or not. Especially a drug like dexamphetamine which is very saleable in the drug subculture and can be used to make some good money.

The solution to this type of cannabis user is a difficult one indeed. I have yet to find a good one really. Maybe some other management skills for their ADD symptoms could help and just learning to live with it.


Saturday, July 24, 2010

Client's asking difficult questions

I bought a book the other day on addictions counselling and it is quite good. Most Australian produced books on this topic stick with CBT and that’s it. This book does the CBT but also looks at the therapeutic alliance as they call it. They deal with the process between the client and therapist as well which is good to see.

In it they make a interesting comment which one finds from time to time. In discussing the client therapist relationship they look at what does a therapist say if a client asks the therapist if he/she is sexually attracted to them. They say the therapist should respond by neither confirming or disconfirming any sexual attraction to the client. Instead the therapist should ask why such a question is important to the client and explore the thoughts and feelings the client has about wanting to know and so forth.

They state that for the emotionally robust client this will permit a much deeper exploration of their reactions, hopes, fears and wants than if the therapist revealed their exact feelings. For the emotionally fragile client they say it would be too anxiety provoking for the therapist to answer directly.

This is a view held by some approaches that one sees from time to time. The problem is I don’t believe their reasoning behind not answering the question. It has too much of a flavour of a therapist ducking for cover by hiding in their theory. It is a very convenient response for the therapist that keeps them emotionally safe and allows them to slip side ways out of a difficult series of transactions.

Whilst one gets this question from time to time the more common one is when the client asks the therapist if he/she is angry at them. The approach cited above would do the same in this instance. They would not answer the question and seek to know why such a question is important for the client, explore feelings and so forth.

Regardless of your theory or beliefs about the therapeutic relationship the bottom line is one person has asked another person a direct question and the other person refuses to answer it. Most often the client will ask because they think they are picking up an ulterior transaction from the therapist. If this is the case then client is doing good open direct communication. If you sense something in a relationship then asking about it in an open and direct way is good communication.

So the client does this and then the therapist blocks it by not answering in a direct and open way. At the very least the therapist is modelling bad communication styles and saying, “Do as I say, not as I do”.

In addition to this I think the client’s question of are you attracted (or angry) to me, carries another question imbedded in it. The client is asking the therapist to be a human with the client in that instance. The client is asking for a simple piece of human to human communication. In response the therapist refuses and answers as a therapist. In my view this is disrespectful to the client.

The therapist not answering the question

Regardless of not respecting the client as a human in my view not answering the question is bad from a therapeutic point of view anyway. If you ask someone a question and they respond by giving you lots of words that does not answer the question what then happens in side you? It immediately builds up FC curiosity. If you ask a question and don’t get an answer the FC stills wants its question answered and now it also wants to know why you didn’t answer the question in the first place. That seems like a natural reaction if you don’t get a question answered.

After all the analysis and exploration the client is still going to wonder what the therapist feels about them. But now they know not to ask the question as they wont get an answer.

It makes it an issue when it doesn’t have to be. If you answer the question directly it defuses it and then the relationship can move forward. If you don’t answer the question it makes it an issue in the relationship that just complicates matters. If answered directly in a careful way no client is going to be damaged by it. Their intuitive Little Professor ego state knows the answer anyway.

Body language. Client’s watch the body language of the therapist very closely.

Theory smeary! Throw away all your theory and therapeutic explanations and asks self:

What does my FC feel towards this client at this time?

What’s in it for my FC not to answer the question?

This is what the client will be asking self after you refuse to answer the question. - What does the therapist’s FC feel about me and what’s in it for their FC to not answer my question?


Sunday, July 18, 2010

The process of projection in transference

I will answer your question with this post Roses.

The script imago diagram is one way of showing how transference occurs in relationships.

This diagram comes from here.

As the child grows it forms relationship prototypes or relationship templates. These are shows as the slots in the script imago diagram which are categorised into three types. As the child grows it establishes its relationship with mother and father. This will include all the good stuff and all the not so good stuff including the unmet needs of the child. These are usually formed in the first decade of life and become the templates for later relationships.

As the child grows into adulthood it will begin to establish relationships similar to those templates established in childhood. The person will unconsciously select people like mother and also project onto the person mother like qualities. Thus the same types of relationships will occur over and over in the persons life. The psychological process of projection is an integral part of this process.

There are three types of transference described here. Those people whom we see as more psychologically potent than we are the parental figures or transference figures in our life. We will tend to project these templates onto people in our current life who are also seen as more psychologically potent than we are. Therapy is a perfect setting for a client to see the therapist as a more psychologically potent figure (parent figure) and hence the parent figure slots are projected onto the therapist.

If the son went into therapy over time he would begin to see the therapist in the same light as his father’s haranguing. This is done by him using the psychological process of projection.

People can also develop counter transference or dependent figure templates for relationships. Often this is done by older siblings on younger siblings. This happens particularly if the parents use the older sibling as a live in baby sitter and structure the relationship so the older one takes on a parental role with the younger one. Thus the older sibling develops a strong prototype for such relationships. These people in adulthood can become therapists who spend their working life looking after others who are in the child like position in the relationship.

Thus we have counter transference and the therapist can project their archaic image onto the client and this is where problems may develop in the therapy. The younger child can also use the older sibling as another parent figure slot. Some times youngest children have very few (and even sometimes nil) dependent figure slots.

In adulthood they are unlikely to seek an occupation where they are the looking after parental one like a therapist or nurse. It just wont feel right and they will not be comfortable in that role. They will tend to be more child like and self centered and end up in relationships that have that quality.

A child like profession in adulthood

Finally we have sibling transference. If the siblings or peers are allowed to interact as equals they can develop equal figure or sibling transference slots in their script imago. These are the templates they use in adulthood for equal power relationships. If a child was isolated for some reason then it may develop few and sometimes no slots for this type of transference. Children who are home schooled can have this difficulty or when parents for some reason do not allow the child to interact a lot with its peers. Only children can also do this.

In each case the process of projection is used by the person who projects the template onto the other. It can do this with the good qualities of the relationship and the not so good qualities. If the person had good quality and co-operative relationships with its siblings then these will be projected onto equal figures in adulthood. If it was encouraged to be very competitive with its peers by the parents then in adulthood this will tend to show out in the equal relationships. The person will project this onto the other.

How the soldiers relate to each other will depend on the projection of the early relationships they had with their siblings

As we can see this is different from the defence mechanism of projection. In that instance the process of projection is used to hide from some part of our personality that we do not like. In transference the process of projection is used such that earlier templates for relationships can be employed in our current day life.


Saturday, July 17, 2010

Transference and projection

Roses asks, “Is projection a lot different to transference then?”

Many do say that transference involves a good deal of projection but that is not actually accurate in the technical theoretical sense.

Projection was originally hypothesised as a defence mechanism. Its goal is to allow the person to maintain a positive self image. It allows the person to view self in a positive light which we all want to do.

We all have Child ego state urges that our Parent ego state does not think is right, good or proper. If we consciously acknowledge these in our Adult ego state then we feel bad about ourselves. They usually involve things like sexual thoughts, greed, envy, revenge and even feelings which some see as bad such as anger.

A good example of this is the passive aggressive personality. A woman has angry and aggressive feelings in herself which her Parent ego state thinks is bad. To maintain a positive view of self she must push these feelings into her unconscious so she is not aware of them. She can use projection to do this and will start to see those around her as being angry and aggressive as the passive aggressive personality tends to do. They tend to feel poorly and unfairly treated by the angry others around her and tends to view self as righteous and decent.

Of course her unconscious anger does not go away so she will also express it in a passive way such as with sarcasm, bitchiness, slight ridicule and so forth. With the proficient passive aggressive person, after talking with them for a time you start to feel bad (and maybe even angry) and you kind of don’t know why. They are so good at hiding the expression of their anger you don’t even know it is happening. That is one of the tell tale signs of the passive aggressive personality you come away from then feeling bad about something and you can’t really figure out why.

However getting back to the point. The passive aggressive personality often uses the projection of their anger out onto others so as to defend their own self perception.

Transference involves “placing mother or father’s face onto the therapist or another person”. That does sound very projection like and often the person is quite unaware they are doing it which is also a feature of the defence mechanism of projection.

However in transference the wife’s projection of father’s face onto her husband is not to defend ones self perception. She is not doing it to keep some unwanted urge or feeling in her unconscious. Hence it is not a defence mechanism in the technical sense of the word. Thus one could argue that it is not projection which is a defence mechanism which is designed to keep something out of the conscious.

So what does one conclude? It seems to me that humans are capable of projecting out internal feelings, thoughts, urges and relationship prototypes and so forth onto others in the world. We are all capable of the psychological process of projection. However there are a variety of reasons why a person would employ the process of projection of which all humans are capable. Thus we have two aspects of projection.

1. The psychological projection process.

2. The psychological motive behind the projection.

If the motive is to keep some undesirable feeling in the unconscious then we have the defence mechanism of projection.

If the motive is to place a relationship template onto another person then we have transference projection.

In answer to your question Roses. In transference people will use the psychological projection process but for different motives than it is used in the defence mechanism of projection.


Thursday, July 15, 2010

Looking for the Child ego state in counselling **

In the counselling session one must at some point touch the Child ego state of the client. It needs to feel that there has been some contact with the therapist. If this does not happen the client will feel that not much is happening and drift away. Once the Child is touched or cathected then it can be worked with to change the thoughts and feelings associated with the current script.

Many, many ways of doing this have been devised by therapies over the years. For example; free association, hypnosis, redecision, dream work, two chair, psychodrama, art therapy, primal scream, flotation tanks, EFT, dance therapy, massage, rebirthing, EMDR, body work of various kinds and so on endlessly. Usually when a new psychotherapy technique hits town this is what it is. It is a new and undiscovered way for people to open up their Child. Hence it is usually seen as exciting and for some it becomes the panacea of all the ills in life. Over the years many a snake oil salesmen has used this need of people to have a new way to release the Child ego state and cashed in on it, at times very successfully.

I am not saying that new psychotherapy techniques are the equipment of charlatans. The more techniques the better as each of us will fit better with one way of opening up our Child ego state than with another. It is better to have the choice of ten medicines than to be restricted to only one choice of medicine.

How Child is brought into the counselling session

1. Feelings. The client can present their Child with the expression of feeling. The client may have had some event happen such as the death of a loved one, they got the sack, they are bullied at work, their spouse has threatened to leave and so on endlessly. By the pure act of talking about it the client starts to show feelings and hence the therapist is left sitting right in front of the Child ego state.

What does one then do? First allow the expression which is therapeutic in itself (usually) then look for how the feeling is used to support the script. The client who is emotional is in a unbalanced psychological state and thus they are more ready to be able to change their script than if they are balanced and stable emotionally. This is where the intellectual and cognitive therapies can get into trouble because they do not do this.

2. Contracts for taking the client out of their comfort zone.

This can be seen as putting the client on the left foot. Do not give people what they expect. If a client comes to therapy and gets exactly what they expected then the session would have been of limited use.

One looks for the major factors in the persons life that currently keep them in their script. It could be a particular job, a relationship, a recreational activity such as substance use or promiscuous behaviour, a particularly discounting peer group, dangerous behaviour of some kind.

Suggest some contract that puts the Child ego state under pressure and pushes the client a bit such as a home visit counselling session. Something that makes them take a risk. This is at times necessary. If it was easy to do the client would have done it already and would not need a therapist’s help. This is where the non-confrontative therapies can fall down and flounder. Unfortunately love or unconditional positive regard for the client or whatever you want to call it is not always enough. It is a great help but not enough on its own.

Sometimes you hear therapists say that the client must not get angry at you or they wont come back. Or if the client feels unhappy when they leave then they wont come back. I have found the opposite to be true. They are more likely to come back than if they stay in their comfort zones. Psychotherapy is not meant to be a happy pill.

3. Polarities.

Look for the polarities in the client which in one way is doing the same as number 2. Polarities allow the client to hide from self. We all have a personality that has certain features or characteristics. We have these because we have discovered that they work for us in the world. They allow us to get on in a way that allows our script to continue and get strokes. So in this way our personality characteristics are an adaptation and we tend to get stuck in them and avoid the opposite or polarity of those.

The therapist searches for the polarity and then urges the expression of it. This will to some extent be the expression of the Free Child. If a client is loud and brash find the quiet timid part and urge its expression. Look for the male and female components to the personality and urge the expression of the polarity. If the client is active look for their passive side and encourage its expression. Think of a couple of features of your personality and then be the opposite as this is what you are hiding from.


These are just three ways by which the Child ego state in the client can come into the therapy room and be met by the therapist. It has to happen one way or another. I would want it to happen at least once in each session I have with a client. If this does not happen the client will have sense of therapy not really getting any where and they drift off and understandably so.


Projection as a defence **

I was asked a question about projection today. I have put some of my response here.

Projection is what is called a defence of defence mechanism. It allows the person to psychologically defend them self against something. One thing that I have learnt over 20 years of psychotherapy is that humans are very good at lying to themselves. They are very good at hiding from themselves.

To really understand what a defence is in this sense it is advantageous to understand where the concept came from.

Freud postulated ‘projection’ in the late 1800s when he lived in Vienna, Europe.

In this diagram he suggested that a person at any one time has 5% of material in their conscious and 5% in their preconscious and the other 90% resides in their unconscious. When a person felt or thought something that was not acceptable to him he would place that thought or urge into the unconscious. For instance the married man who felt lust after his neighbour’s wife may find this quite unacceptable to him so he ‘placed’ such urges in his unconscious. Then he no longer has to worry about it (in the short term).

Remember that where Freud lived (Vienna) and when he lived (Late 1800s) sexual repression was at it highest perhaps in the history of modern mankind. Sex was completely taboo. So when people had sexual thoughts of some kind they would feel repulsed and disgusted as they had been trained since early childhood to think such things. So the unconscious allowed people to cope with such things (in the short term).

The problem was that the urge did not go away, It had just been shoved into the “too hard basket”, and in the longer term it would keep coming back. That is it would spontaneously arise from the unconscious into the conscious. This meant that in the longer term the person had to defend them self against that urge and hence the development of the defence mechanism.

In Transactional Analysis we have the ego state explanation of the dynamics of a defence such as projection. This is shown below:

This is sometimes referred to as the hydraulic theory of personality. The Child ego state has an urge. For example a married man my feel sexual attraction to another man at work. But he has a Parent ego state which believes that this is totally immoral and disgusting. So the ‘force’ from the Child and the Parent collide. There is an impasse as they say. This collision is like a wave hitting up against the rocks on the shoreline.

When two opposing forces collide there is always a result. In the human psyche it is a symptom of some kind.

The resultant collision provides the force or the energy for a symptom or defence mechanism to develop. For instance the symptom may be anxiety or depression or even something like homophobia. The man can also develop the defence of projection. In this instance instead of acknowledging the homosexual impulses in himself he will project them out onto others. So he will see other men as being homosexual or behaving in homosexual ways when in fact they are not.

So projection allows the man to trick himself or lie to himself. “I wont see my own Child homosexual desires, instead I will see others as being like that”. This allows him to feel relief that he is not homosexual but he must continually guard against other homosexual men because they seem to be everywhere. When in fact he is really guarding against his own unconscious (Child) homosexual impulses that keep arising into his own conscious. Thus his projection defends his positive view of himself.


Monday, July 12, 2010

Website update

There has been new additions to my website

Four new photographs

And six new blog compilations

The pre-verbal client

Rebirthing as a therapeutic technique

Trauma debriefing and trauma management

Self harm, sex addiction and dissociation

The psychology of sorry and revenge

The psychology of christmas


Saturday, July 10, 2010

Jealousy and narcissism **

I have mentioned before that sibling rivalry and jealousy are a normal part of child development. Indeed one could go even further and say that these feelings and the disruption they can cause in the family are an integral way by which the child resolves its primary narcissism.

Primary narcissism, as distinct from secondary narcissism, is the state of mind a child has from birth to 5 years of age. It perceives itself to be the centre of the universe, omnipotent and all valuable. The child believes it is more important than others, that it is special and that it should get favourable treatment.

This attitude is meant to decline as the child learns that it is not the centre of the universe and there are others on the planet that are of equal value and importance. Realising the importance of others reduces primary narcissism.

Most theorise that the narcissistic person has the life position of I’m OK, You’re not OK (I+U-). As a result they behave in a way where they view their own needs and self as more important than others. Others are therefore treated as being of less worth and value.

I have questioned this else where. I propose that the narcissist has the life position of I’m OK, You’re irrelevant (I+U?). If this is the case, others are not viewed as second class or of less value, instead their worth and needs are not even considered in the first place. The person has such a focus on self that they never actually get around to thinking about the other. Or the other is only considered in a superficial way.

This makes sense from a child development point of view. The young child in a state of primary narcissism is very self focussed. When they are dealing with others their focus is on how does this effect me. They are not yet capable in any substantive way of seeing it from the others perspective, thus displaying empathy.

Due to this high degree of self focus it does not even consider the question of, Are others OK or not?

Me, me, me

How does the child learn that others are relevant and are of importance. This is where the child’s jealousy and disquiet achieves importance. It is one of those things in life that just does not feel good but you have to go through it any ways. Its like going to the dentist. Nobody likes going because it feels bad but you have to go anyway.

If left to its own a child will not naturally evolve out of its narcissism. The child will learn that others are relevant when it is imposed on them and children don’t like that. It does not feel good and it means their here and now needs do not get met.

There is one piece of cake left and the younger brother has it because he has not had any cake yet. The older sister has already eaten her piece but she wants the last piece as well. The parent intervenes and gives the last piece to the brother much to the loud protestations of the sister. The brother ‘relevance’ and worth is imposed onto the psyche of the sister in this instance by the parents intervention. When this happens the sister’s primary narcissism reduces a little bit more. This feels unpleasant to her so she protests with anger and crying.

Hence we have the developmental importance of sibling jealousy, rivalry and envy. The pain the child feels with the jealousy and rivalry is what she remembers and thus she understands a little bit more that her brother is relevant in her psyche. If she did not feel the pain of the jealousy the process would flounder and she would never learn about the relevance of others and remain in the state of primary narcissism. As I mentioned before if a child is left to its own devices it will not naturally evolve out of its narcissism.

This not only happens with siblings or peers but also in the child’s relationship with mother and father. As the child grows mother begins to express her own Child ego state needs to the daughter. More and more the girl learns that mummy has needs and at times her needs are second and mummy’s needs are first. Again this happens because the mother imposes it onto the daughter and as any parent will tell you there can be loud and long protest when this happens. The mother forces her own ‘relevance’ onto the child to which the child feels ‘pain’ and then can get angry and so forth. The child is forced to recognise that others do exist in the world and they impinge on what it wants at times.

With sibling rivalry and jealousy most parents fail to see the developmental importance of these feelings as I have just described. They tend to simply react to the disquiet being expressed in such a ways that it ceases as expeditiously as possible. Their usual goal is to circumvent the rivalry or have it quickly resolved by some means. They fail to see that the children are using it in an endeavour to move through the developmental stage of primary narcissism. Hence they impede the child’s psychological development in this way.

When asked I usually highlight three things to parents in how they can assist the child to use its feelings of jealousy and rivalry to master this developmental stage.

1. Allow the child to experience the jealousy and rivalry feelings. To be aware of and experientially understand the feeling and that this shows that others do exist in the world and are relevant. Obviously this is presented to the child in a way that it can comprehend for its age.

2. Adult information is given to the child about what is happening

3. Role plays are a great way for a child (and indeed and adult) to learn the skill of empathy which is also needed to master narcissism.

These are not meant to stop at age 5 years but I would suggest carrying these on all the way through childhood and adolescence. Indeed there can be considerable feelings of rivalry and jealousy in adolescence which is a fairly narcissistic stage any way.


Friday, July 9, 2010

Rebirthing as a therapeutic technique **

In my early years of training in psychotherapy I went around the world learning about and looking at different types of counselling and psychotherapy. One of the places I went to was San Francisco in the USA and other places in southern California. At that time the human potential movement was rolling along like a freight train and I trained in various things such as Transactional Analysis, gestalt, bioenergetics and rebirthing.

The leaders of the rebirthing movement at that time were Leonard Orr and Sondra Ray. They said birth trauma was experienced by us all and this was the cause of many psychological problems. They devised a way of returning to the womb and redoing ones birth. One could either have a wet rebirth or a dry rebirth.

In a wet rebirth the client would be placed in a hot tub (spa) that was 98 degrees which is the same temperature as the womb apparently. The person was then surrounded by others who formed the womb, they would then simulate contractions and the person was born out of the hot tub, through the vaginal canal to the waiting mother. Nobody had any clothes on so as to get the skin on skin effect that happens during birth and in the womb.

Rebirths in the hot tub

This type of psychotherapy could not exist today. The professional organisations and the press would sexualise it and that would be the end of that. The rebirths that I saw were not erotic at all and were not a sexual experience. I never experienced a rebirth myself.

It is unfortunate how those watching for any aberration would sexualise such a therapeutic process as it can be a powerful technique that can help people in distress. This can not now happen. Any ways at that time I saw many varied styles of therapy which I am glad I did. I saw types and ways of human relating that went beyond the average. I suppose that is why it was called the "human potential movement".

Dry rebirths in group therapy

In our early therapy groups sometimes clients would do a dry rebirth. We debated whether the people would be naked during the rebirths and decided against it for the reasons cited above.

In the process the client would lie on the floor curled up often sucking their thumb. A few other group members would sit next to the person and form a womb around him. At the baby’s head there was an opening left and two or three other group members would lie side by side to form the vaginal canal through which the baby was going to pass. The ‘womb’ would then begin the contractions. I remember at one point someone found an audio tape that was a recording of the noises inside the womb. You could hear the mother’s heart beat, blood flowing and so forth. This was meant to be played to new-borns to help them go to sleep. This tape was played during the rebirth.

This is at a month long training experience at the Western Institute for Group and Family Therapy in southern California which I attended. You can just see the top of my head right at the back. This is what is known in the US as a hot tub. In Australia we call them spas. Some nights the workshop participants would see if they could break the record for the most people in the hot tub at one time which is what was happening here.

As the womb started contracting there was a midwife who would begin pushing the baby on their backside forcing the head to the opening towards the vagina. The group members were meant to resist the movement as happens in a normal birth and the baby is slowly forced out of the womb and into the vagina struggling as it goes. Eventually it would be born with the whole process taking about 10 to 15 minutes. When born the baby would sometimes have a prearranged mother to be there who would breast-feed usually for about 5 to 10 minutes. And then the rebirth was complete.

And my point is?

First, I think it is safe to say that this would not be considered a mainstream type of therapy and hence many will write it off as fringe and wacky. Maybe it is and maybe not, but what it gave me was a better understanding of people and their psychology. It allowed me to see people involved in unusal therapeutic techniques, how they reacted and responded. In my view it allowed me to gain a wider and more robust understanding of the human psyche.

In this profession I am surprised at how quickly people will discard a therapeutic approach as nonsense. To my mind they see the trees but forget to see the forrest. In one way it does not matter if the therapeutic technique is effective or not. To see people behave as they do in differing therapies as I said allows for a deeper understanding of the human psyche. I have found that anyway. Perhaps people are a bit too willing to cathect their Parent ego state when they see something new or different.

The other point that rebirthing techniques can highlight is Child ego state magical wishful thinking. As a therapist one needs to be careful of this. The rebirthing process described could be seen to imply that you can redo a birth, have it be a good experience and this somehow negates the bad experience of the first time around.

Psychotherapy can add new experiences but it can never take away the bad ones and one needs to be careful that the client does not start to believe this. If one was abused as a child then one has memories of that which can never be taken away or some how extinguished or removed. The Child ego state in us all would very much like that to happen. One needs to be careful that the client does not start to believe that can happen.

Some clients can start to think, “If I do rebirth then I am sort of starting again and this time I can make it right”. This cannot happen as one cannot start such a thing again. When we did our rebirths in group therapy we were doing something but we were not redoing a birth. What we did, seemed to give good results but it did not allow the client to start all over again. Each of us gets only one chance to do birth and childhood. When the time has past it is gone forever. We can add in new contrary experiences through therapy but that cannot extinguish the past.

The other area where this type of magical thinking can occur is with the transference relationship. The wishful thinking of the client can be, “Through the new relationshiip with the therapist I can erase the old origianl parent-child relationship and have a new one”. As I mentioned before such erasure cannot happen and at times it seems the therapist would need to check if the client is doing such magical thinking.