Client change

This chart comes from a book that was published in 1978. A basic transactional analysis text at the time. It is one of those things you find in a book that you notice for some reason and kind of never forget. It always struck me as an interesting chart.

It’s great when you get a client who is in the first and second groups and they attribute their change to you the therapist.

One of the reasons I noticed it was that it is based on the assumption that everybody is help-able. That all clients can be helped. It assumes that all people can be helped as long as the therapist’s skill is high and there is enough time and energy put into the client. I have my doubts that this is true at least at times. Some clients at some points in time can not be helped. That can and often does change over time for the same person. For instance a person who is in the 5th 20% is likely, over time to move up the list and therefore become more capable of being helped. I would add a 6th category - at this point in time no change will occur no matter what the therapist does or the amount of energy put in.

Another feature is that it is based only on the client and the therapist characteristics. I would add in a third criteria and that is the psychological condition being presented. Some things are easier to treat than others regardless of the client’s motivation. It is easier to treat a tightwad than a spendthrift. The tightwad does not have enough Free Child and the spendthrift has too much Free Child. People naturally do not like giving up their FC. The antisocial personality is too hedonistic whereas the OC personality is not hedonistic enough therefore the antisocial generally is harder to treat.

Then of course value judgements also creep into what is considered abnormal. It was only 40 years ago that homosexuality was considered by mainstream psychology to be an abnormal psychological state. Some kinds of illicit drug use are considered abnormal behaviour whereas the reason why it is illicit is for political reasons not psychological reasons. Hence they are considered psychologically abnormal because of a political judgement not the natural state of the human psyche. In these types of conditions perhaps one needs to consider more than just the client and therapist qualities.

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The analysis of suicide notes

Approximately 30% of people who complete a suicide leave a note of some kind. They can provide valuable insight into the psychology of the person at the point of the suicide attempt.

It must be noted that I have never met any of the individuals discussed here. As such my comments are based solely on what was written in the suicide notes and some of the circumstances know around their deaths. In no way is there an attempt to provide rigourous understanding of the psychology of these people. With the limited information at hand that is impossible. Instead I have made a few comments about what has been said in the suicide notes and these are meant to be generic in nature.

Adolf Hitler

The Last Will 

As I did not consider that I could take responsibility, during the years of struggle, of contracting a marriage, I have now decided, before the closing of my earthly career, to take as my wife that girl who, after many years of faithful friendship, entered, of her own free will, the practically besieged town in order to share her destiny with me. At her own desire she goes as my wife with me into death. It will compensate us for what we both lost through my work in the service of my people. 

What I possess belongs - in so far as it has any value - to the Party. Should this no longer exist, to the State; should the State also be destroyed, no further decision of mine is necessary. 

My pictures, in the collections which I have bought in the course of years, have never been collected for private purposes, but only for the extension of a gallery in my home town of Linz on Donau. 

It is my most sincere wish that this bequest may be duly executed. 

I nominate as my Executor my most faithful Party comrade, Martin Bormann. He is given full legal authority to make all decisions. He is permitted to take out everything that has a sentimental value or is necessary for the maintenance of a modest simple life, for my brothers and sisters, also above all for the mother of my wife and my faithful co-workers who are well known to him, principally my old Secretaries Frau Winter etc. who have for many years aided me by their work. 

I myself and my wife - in order to escape the disgrace of deposition or capitulation - choose death. It is our wish to be burnt immediately on the spot where I have carried out the greatest part of my daily work in the course of a twelve years' service to my people. 

Given in Berlin, 29th April 1945, 4:00 a.m. 

Signed: A. Hitler 

Signed as witnesses: 

Dr. Joseph Goebbels 

Martin Bormann Colonel 

Nicholaus von Below 

My comments

This is interesting for a number of reasons. It illustrates that type of statement that is part suicide note and part last will and testament. These are typically like an unemotional business letter as compared to the next suicide note which is highly emotional.

This is not a good sign if one finds a loved ones suicide note that is business like it its style. Firstly it indicates the person still has well functioning cognition or thinking ability. If this is the case then they can employ that clear thinking in planning a suicide attempt in the same manner. Thus the suicide attempt is more likely to be being completed compared to the spontaneous and not well thought out suicide attempt.

Secondly it indicates this person has made the decision to end their life and it is just a matter of time until the planning is finalised and the attempt will occur. The ambivalence of “I want to die vs I don’t want to die” that most suicidal people have is not apparent. This person is clear they have made the decision to end their life.

This most often happens over an extended period of time. The individual, in this case Adolf Hitler, may have made a series of decisions over years where he slowly backed himself into a corner where the only way out, in his mind, was to end his own life. This is usually done initially at an unconscious level but can become much more conscious as the time draws closer. The person finds them self caught up in a situation created by them (and now all those around them) and can see no way of getting out of it. They suddenly realise they are on a fast moving train and can see now way of getting off. 

At the beginning they cannot see where all this is heading but as they proceed on it becomes more obvious. Other examples of this can be with financial ruin. The person makes a series of decisions over a long period of time where the likelihood of financial ruin becomes more likely. Eventually it happens and they take their own life.

Some do the same with a loss of reputation. The politician or high profile person engages in what is very unwise behaviour often of a sexual nature. Eventually they are exposed and their reputation is ruined. This is same reason why pedophiles are a high risk group for suicide attempts. They behave in a way over time which significantly increases the risk of being found out. When they finally are they feel they have no way to turn, their reputation is ruined and thus they make an attempt ion their life. 

The point here in the suicide note of Adolf Hitler is it reflects a business like approach to making a suicide attempt. This commonly results from a protracted set of decisions made by the person which slowly but surely backs them into a corner, such that they can only see one way out.

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KURT COBAIN (Nirvana)

To Boddah

Speaking from the tongue of an experienced simpleton who obviously would rather be an emasculated, infantile complain-ee. This note should be pretty easy to understand.

All the warnings from the punk rock 101 courses over the years, since my first introduction to the, shall we say, ethics involved with independence and the embracement of your community has proven to be very true. I haven't felt the excitement of listening to as well as creating music along with reading and writing for too many years now. I feel guity beyond words about these things.

For example when we're back stage and the lights go out and the manic roar of the crowds begins., it doesn't affect me the way in which it did for Freddie Mercury, who seemed to love, relish in the the love and adoration from the crowd which is something I totally admire and envy. The fact is, I can't fool you, any one of you. It simply isn't fair to you or me. The worst crime I can think of would be to rip people off by faking it and pretending as if I'm having 100% fun. Sometimes I feel as if I should have a punch-in time clock before I walk out on stage. I've tried everything within my power to appreciate it (and I do,God, believe me I do, but it's not enough). I appreciate the fact that I and we have affected and entertained a lot of people. It must be one of those narcissists who only appreciate things when they're gone. I'm too sensitive. I need to be slightly numb in order to regain the enthusiasms I once had as a child.

On our last 3 tours, I've had a much better appreciation for all the people I've known personally, and as fans of our music, but I still can't get over the frustration, the guilt and empathy I have for everyone. There's good in all of us and I think I simply love people too much, so much that it makes me feel too fucking sad. The sad little, sensitive, unappreciative, Pisces, Jesus man. Why don't you just enjoy it? I don't know!

I have a goddess of a wife who sweats ambition and empathy and a daughter who reminds me too much of what i used to be, full of love and joy, kissing every person she meets because everyone is good and will do her no harm. And that terrifies me to the point to where I can barely function. I can't stand the thought of Frances becoming the miserable, self-destructive, death rocker that I've become.

I have it good, very good, and I'm grateful, but since the age of seven, I've become hateful towards all humans in general. Only because it seems so easy for people to get along that have empathy. Only because I love and feel sorry for people too much I guess.

Thank you all from the pit of my burning, nauseous stomach for your letters and concern during the past years. I'm too much of an erratic, moody baby! I don't have the passion anymore, and so remember, it's better to burn out than to fade away.

Peace, love, empathy. Kurt Cobain.

Frances and Courtney, I'll be at your alter. Please keep going Courtney, for Frances. For her life, which will be so much happier without me.

I LOVE YOU, I LOVE YOU!

My comments

Unlike the previous suicide note one this is very emotional. It involves much more Child ego state compared to the Adult ego state of the previous one. This means that should a suicide attempt follow this one has less chance of being completed as there is less Adult ego state available for the planning and carrying out of the plans.

Overall it is quite a narcissistic statement. The first half is about him and at the end there is a comment to his loved ones. The comment about his daughter is that she reminds him of himself and when he talks of his wife he ends up talking about himself again. At the very end he almost apologizes for the pain he is about to inflict on his wife and daughter but does not actually do it.

This raises an interesting point about some suicidal people. At the point of a serious attempt they can be quite childlike and quite narcissist. Indeed this in itself can be a predictor of the risk of a suicide attempt. The narcissistic person is not capable of empathy and simply does not see the point of view or feelings of others. They do not get consideration which frees the person up more to act on the suicidal urges.

One of the protective factors for a suicidal person is understandig the effect that their death would have on loved ones around them. The more childlike and narcissistic the suicidal person is the less this remains a protective factor and often the person will think what he said in the second last sentence. That their death will actually be a positive for the loved ones around him.

This note is also reflective of a person who has made the “Don’t exist’ or suicide decision in childhood. It shows no signs of being an attempt to manipulate anyone and clearly this is not a spontaneous decision but is the result of circumstances that have developed over some time. As those circumstances evolve the early suicide decision starts to become operational and his suicidality increases.

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SID VICIOUS (Sex pistols)

Sid Vicious was accused of the murder of his girlfriend Nancy Spungen

A pathologist who examined his body said the star's tolerance to the drug had been weakened by his period behind bars. That, and the potency of the heroin, had killed him.

Meanwhile, Anne Beverley (his mother) discovered what appeared to be a suicide note in the pocket of her son's jeans. Written some days earlier, Vicious told his mother he wanted to be reunited with 'his' Nancy.

The discovery of the letter led some friends to speculate that Nancy's death had been a suicide pact that had gone wrong, and Spungen had administered the fatal knife wound herself.

In fact, ten days after her death, Vicious had attempted to slash his wrists, and just a few months earlier the couple had told a British music magazine of their plans to take their own lives.

Note: We had a death pact, and I have to keep my half of the bargain. Please bury me next to my baby in my leather jacket, jeans and motorcycle boots. Goodbye. 

My comments

This suicide note raises some different features than the other two notes. Firstly it demonstrates the very short suicide note that is only a few lines long. This reflects a lack of desire to make some long statement about why or what is to be done upon ones death. It is simple, straight to the point, explaining why and giving instructions about what is to be done after death.

A complete lack of any emotion or remorse at the pain inflicted on others or the pain they were feeling at the time. This may be because at that time he was in quite a narcissistic frame of mind and unable to contemplate the effects of his actions on loved ones. However that may not be so. Some suicidal people report the futility of leaving a note. What can you say to make loved ones feel a bit better? What you say may just make them feel worse. One could argue that because he was very brief and gave a few instructions he has done a better thing for his loved ones than the highly emotive note shown above.

The note is clear in illustrating an intent to die and raises the whole area of suicide pacts. This is where relationships and suicide get mixed up. Many couples have a special connection with some activity, or place or belief. It may be a special activity they do each wedding anniversary once a year. Or a special place they go to on holiday each year. These things give them a commonality, a kind of special connection and is seen by both as important in their relationship. Sometimes the special thing is a belief or view about something. If we have two people who are potentially suicidal that special connection can be about suiciding together. Hence we end up with the suicide pact.

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Psychology of the promise.

How can one go past Wikipedia for a definition -  A promise is a commitment by someone to do or not do something

Examples

My friend promised me she would be there for my birthday.

My friend promised to do as I say.

My stepfather promised not to be cruel to me

The child promises to behave when the relatives visit

The child promises not to tease his sister

After some research on the topic of the ‘promise’ one finds a variety of things written. It has been looked at extensively from a philosophical point of view by people such as Immanual Kant. It is also discussed in terms of religion, contact law, oaths and political promises. Psychologists such as Kohlberg have looked at promises in terms of the development of morality in the child.

One however finds a scarcity of information on the nature of promises, their role and effect on human relationships. It has been noted that breaking a promise can effect relationships because it can erode trust in the relationship. However let’s look at the dynamics of promise making in relationships.

It seems safe to say that promise making is a coercive procedure which highlights the notion that promise making is a bi-directional process. It is this that one rarely sees discussed in the literature. Writings on the concept of the promise invariably focus on the promiser only.

Breaking a promise?

For the purposes of this presentation the following terminology will be used:

Promisee - the person requesting the promise be made

Promiser - the person making the promise

The making of a promise is a two step process. The promisee requests that a promise is made and the promiser agrees to make the promise. As I said before it is the promisee who is rarely examined in discussions on promises. 

If one looks at the psychology of the promisee, what does requesting another person make a promise do to the dynamics of the relationship between the two parties. As mentioned before promise making is a coercive procedure. A promise puts pressure on the promiser to do something that he does not really want to do. If the promiser already wanted to do it there would be no need for a promise to be made in the first place.

Thus we have the first insight into the psychodynamics of promise making. The promisee is endeavoring to coerce the promiser. This immediately puts the promisee into the powerful position in the relationship and the promiser into the child position. The promisee becomes the judge who will assess if the promiser has lived up to their promise.

This raises the question - “What’s in it for the promisee to ask for a promise?”. At times it could be because the promisee is making a power play in the relationship by seeking to adopt the powerful position in this way.

Indeed in one sense it does not even matter if the promiser agrees to make the promise. As I said before promise making is a two step process:

1. The promise is requested by the promisee
2. The promiser agrees to the request and makes the promise

What happens if the promiser does not agree?

As soon as a request is made the dynamics of the relationship is effected in the way described above even if the promiser does not agree to the promise. If they do not agree what does that say about them, usually something not so good. Thus they are evaluated anyway even if there is no promise agreed to.

As soon as the promisee requests a promise they automatically are falling into the powerful position to some degree. They are putting the promiser into a position where they are under assessment where their performance will be judged. The promisee on the other hand is under no such evaluation. Clearly the dynamics of the relationship changes as soon as a promise is requested.

What happens on the promiser’s side of the relationship. As said before a promise is a coercive process. The promiser is agreeing to do something that at least in part they do not want to do. Nobody likes being coerced so at some level all promisers will resent the process. The Rebellious Child ego state will be activated to some degree in the promiser as soon as the promisee request a promise to be made.

A promise could then be seen to come from the Conforming Child ego state of the promiser as the diagram shows.

It is quite likely the promiser will feel they are under assessment because they are and thus they will experience themselves to be conforming to some degree. The danger with this is most humans who are in Conforming Child ego state will sooner or later switch to their RC. This will be done overtly or covertly and possibly outside the person’s awareness. One is not wanting a lot of these transactions to enter into their relationship with the other. The Parent to Child transactions as shown in the diagram can quickly undermine the quality of the relationship.

Inherent in all promise transactions is a punishment of some kind. If the promiser breaks the promise the promisee inflicts some kind of punishment on the other. That can be obvious such as a parent smacking a child or it can be more subtle such as with the use of guilt or shame. If the promiser breaks a promise then they may feel guilty or feel they are an untrustworthy person. They know at least that the promisee will think similar about them. This is a dynamic that is introduced into the relationship when a promise is agreed to. Of course one also needs to be careful with this as it can also undermine the quality of the relationship.

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Characteristics of resilience

A capacity for close relationships

The ability to be proactive and get things done

Having positive expectations

Valuing one’s own independence and autonomy

Being an effective problem solver

The ability to enjoy laughter and respond to humor even is tragic circumstances

To experience lower levels of anxiety in situations outside their control

The ability to remain optimistic

“Resilience is the ability to adapt when faced with tragedy, trauma, adversity, hardship and continuous significant life stressors.”

Rees, R. ‘Resilience of people with traumatic brian injury and their carers’.  InPsych (The bulletin of the Australian Psychological Society) April, 2012.

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Patterns of loving

Psychologists have identified six differing types of love or patterns of loving that can occur in human relationships. This questionaire allows one to identify the types of love they experience in relationship with a partner.







The six types are
Storge
Agape
Manic
Pragma
Ludus
Eros

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Book comments part 2

This second set of comments come from my Facebook page on the book - Working with suicidal individuals.

Comment 4

The teenager presents a special set of circumstances when it comes to assessing suicide risk. They are one of the more difficult groups to make an accurate assessment of their current level of suicidality. People kill themselves for a variety of reasons. With the truly suicidal person their primary intent is to kill self but there are others who will end their life where that is not their primary intention. Due to their still immature thinking style and lack of life experience the teenager presents a special case in suicidology in that they are less predictable than the mature adult.

Comment 5

My personal circumstances illustrate how teenagers are a special case when assessing their suicidality. The truly suicidal person is the one who has made the “Don’t exist” suicide decision in early life. I have not made that decision. In my life script, suicide is not an option. In my adulthood there have been times when life circumstances have been very bad. Not often but there have been times. In those times the ‘solution’ of suicide has never even entered my mind. It is simply not part of my life script and hence is not considered by me when times are tough.

As I say in the book in my late teenage years I attempted suicide twice. I could have died in those instances if things had not worked out as they did. Thus we would have had a teenager who died by suicide but who has not made the suicide decision. The mindset of the teenager allows for that to happen whereas with the adult it is much less likely to happen.

Comment 6

In the psychological sense the truly suicidal person is one who has made the suicide decision in childhood. When this happens the person decides that suicide is a viable option or possible solution to problems and this decision then sits dormant in the psyche. If life events should develop where the person finds them self in bad circumstances then the decision becomes activated and the person starts to consider suicide as a solution to their problems. These problems could be financial collapse, marital problems, loss of reputation and so forth.

Whilst not all people suicide because of making such a decision this represents a significant group and they are quite a high risk group. Determining if a person has made such a decision is not a difficult task and I show a variety of ways this can be done in the book. It does not take long nor is it dangerous or particularly painful and it can be done in groups. This could be used to screen significant numbers of people especially those in areas where suicide is more likely such as in combat zones or other very stressful circumstances. High stress is another time when the suicide decision could become activated.

Comment 7

Whilst the truly suicidal person has made a suicide decision in childhood there is another by which the child can develop a suicidal aspect of their personality. In the Child ego state the person makes the decision that at some point suicide will be a viable solution to their problems. This decision once made remains dormant in the Child ego state. 

Of course as the youngster grows its Parent ego state also develops. The Parent ego state develops by modeling parents and introjecting them into their Parent ego state. If mother or father are suicidal then the youngster will model on that and it will become part of their Parent ego state. If the parents talk about suicide, the youngster sees them engaging in suicidal behaviour or at times the youngster may be the one who calls the ambulance or resuscitates the parent in some way. When these types of things happen the youngster will introject the suicidality into their own Parent ego state and thus become potentially suicidal at some time later in their life. Just as the early decision remain dormant in the Child ego state the suicidal introject (model) remains dormant in the Parent ego state until circumstances arise in adulthood and these aspects of the personality become operational.

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New link

The new link for the next book can be found here.



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