Suicidality and normal adjustment - Part 2.

 KYLady says

“This is an interesting post - the topic relates indirectly to my research. Behavior is influenced more by perceived risk as compared to actual (statistical) risk. Perceived risk can change day to day depending on events and conditions one is aware of. When risk becomes normal, people become more carefree about hazards they are exposed to. Normalized risk is a huge factor contributing to accidents on the job.” (end quote)

This is an interesting comment and adds to the concept of the normally adjusted suicidal person. It could be argued that a person can change actual risk to perceived risk simply by making the awareness of the danger unconscious. When that is the case the person will continue to act on their primary suicidal motivations even if they are not consciously aware of the behaviour they are using to express those motivations. Indeed this would put them at even greater risk of a completed suicide because of that lack of awareness.

If there is something that is clearly dangerous such as driving cars at very high speed and the person does not perceive it as dangerous they could have done that by making that information unconscious. They have employed some kind of defence mechanism to rationalize the risk away. This then makes the person at more risk of a completed “suicide” in the way I am talking about suicide in part 1.

A good example of this can be found in a case study in my book - Working with drug and alcohol users.

“A 37 year old woman recalls her thinking and feeling as she ignored harm minimization information.

"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 pain 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)

This shows a number of defence mechanisms being used to make the danger unconscious. Or making the actual risk and perceived risk different.

Another quote from my book:

“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 defense 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 defense of minimization. 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 minimize the importance of sharing needles.

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

These five ways shows how she can perceive the risk to be less as the awareness of the danger becomes unconscious and she can continue to engage in the ‘suicidal’ behaviour which expresses one of the motivations in her personality.

Generally speaking people will not consistently behave in a particular way unless it reflects a basic part of their psyche or some primary motivation they have. They just will not do it for any length of time. If a person is not suicidal they will not do high risk behaviour even if the level of risk is unconscious. The unconscious will be reflected in repetitive behaviour just as the conscious will be.

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Theory of contracts - Part 3.

In the previous post on contracts KYLady makes some good comments about lying to self, others and breaking them.

Thanx for that as it allows me to clarify what I mean by lying to self. In one sense people lie to themselves regularly and indeed one could say it is the role of the counsellor to ‘expose’ these lies in some way. Any time one packages off part of their thinking, feeling or behaving to the unconscious you could say they are lying to self. They are pretending to self that they are one way when they are in fact another. Every projection is a lie to self as is every denial that we all have.

For example, I was working with a woman recently and she expressed much sadness about being sent to boarding school as a child. Within just a few minutes it became obvious to me (as an outside observer) she also had considerable anger at her mother for doing such a thing. She was completely unaware of this and she had used the defence mechanism of denial. To be angry at her mother was unacceptable to her so she moved it into her unconscious and then could pretend to herself that she was not angry. 

For some of us our own inner angry child is unacceptable. To deal with this we place it in the unconscious and then can pretend it does not exist.

I suppose one could call this a lie, and one of my jobs as the counsellor is to expose the lie and bring it into her conscious which I did. I had to say it on 4 different occasion before she acknowledged what I was saying. Finally she did let in what I saying and then expressed some surprise that she felt such anger.

However this is not really what I am talking about when it comes to contracts. I often suggest homework contracts to the client at the end of the session. When they make them I will often ask, “Do you think there is any chance you will do it” and people generally can answer that question quite readily and easily. Sometimes they say yes with certainty and other times they will say no. If they say no then I suggest they forget the contract. This is what I am really talking about when it comes to lying to self.

If you know you are not going to do it or there is quite a probability you wont then don’t make the contract in the first place. What I am communicating to the client is - Contracts are not promises or statements from you to me. If you know you wont do it then don’t make it and most people quickly see that is a senseless task, as indeed it is. I not only do this with homework contracts but will do it with every contract including a no suicide contract. If a person will not make a no suicide contract that does not mean they are necessarily a current suicide risk.

In this sense the process of contracting is changed. Consider the contract, 

“I will tell my husband I am angry he wont keep to the budget each week”.  

Bill Holloway makes this point about contracts:

My preference is that the client elaborates the objective to include behavioral confirmation that the objective had been reached. A simple question by the therapist is often useful, “How will you know and how will I know that you have achieved the change you desire and intend?” (end quote)

Others would agree with him as this is not an uncommon thing to do with contracts. The client and counsellor define what behaviors will show the contract has been completed. This works on the basis that the client may or may not carry out the contract and effort is expended in the contracting to establish if they have or have not. For example the wife may say, “I will sit down with him after dinner on Wednesday and tell him about my angry feelings”. After Wednesday the client and the counsellor will know if she carried out the contract or not.

The contracting I am suggesting here is that even before the contract is made the client has established they are going to complete it so there is no need to ask the question suggested by Holloway. The ambivalence or reluctance to complete the contract is dealt with before the contract is made rather than setting the contract and then seeing if it is completed or not. 

If a contact is a statement the individual makes to self then this alternative approach has to be the case. They will not make a contract in the first place if they do not intend to complete it.

Finally KYLady:

If you break promises to self all the time I would suggest  you don’t make them. If you break most of them what is the point. If you stop making them, after some time you may find a new attitude developing in yourself about this.

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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.

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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.

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