Friday, December 23, 2011

The great road toll lie.

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.

Lady with car.

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


Child psychotherapy

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.

baby & bear

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 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

Letting go

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

Woman looking

Establish overall family structure - emeshed vs distancing family structure


Monday, December 19, 2011

Psychodynamics of the recreational drug user.

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.

Rec drug user diagram

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.

Hair girl
Too much?


Wednesday, December 14, 2011

Gender identity

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.

Gender identity

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?


Locus of control

Locus of control and personal responsibility

LOC Hout 1

LOC Hout 2


Friday, December 9, 2011

Interviewing the child - Part 2

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.

Brick carrier

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?”

Boy carrying 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!


Tuesday, December 6, 2011

Interviewing the child in the therapeutic setting

(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.

Poking toungue

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

social isolation

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.

C wants magic
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.


Monday, December 5, 2011

Oral stage of development

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.

Oral Stage 1

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!

Oral Stage 2

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


Thursday, December 1, 2011

Co Counselling

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.

Big hair

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:

Man in seaweed

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.

Cat leaping
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.