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Saturday, 19 April 2008
Extractive identification - Part 2
It is interesting reading the comments here and having heard the comments about extractive identification at the workshop a week ago. There is some similarity.
One needs to distinguish between extractive identification and other processes like reflection and active listening with a client. They are quite different.
Things like reflective listening are a check out by the therapist. They may say such things as, “What I hear you saying is...” or “I understand your point as being....”. Or the therapist may simply reflect back to the client what they have heard them say or seen them do.
Reflection is a common therapeutic task.
On the other hand extractive identification is precisely that, identification on the part of the therapist. This makes it a more personal or intimate experience on behalf of the therapist. The therapist’s own Child ego state make a sort of connection with the client’s Child. The therapist thus has some form of emotive reaction about the client. The boundary between the therapist and client becomes a bit confused and thus the therapist can ‘feel the clients’ feelings, or the therapist ends up feeling the same way the client is.
So my client was at that time experiencing the devastation of the 7 year old who had felt completely abandoned. I as the therapist was to some extent experiencing those same feelings and thus I get my understanding of the client’s feelings in that way. This is what identification is, so it is much more than simple reflection or active listening.
In extractive identification there is more contact between client and therapist and then the therapist in essence states their own feeling reaction to the client and this is how they understand what the client is feeling. (This is the danger with identification as sometimes the therapist has a different feeling than the client is having but they think they are having the same one). So in this sense it is also not just a reflection. It is the therapist stating their own feelings.
Identification involves boundary fusion
This some will argue, is where the therapist steals from the client. When I told my client about what I saw as the devastating feelings of complete abandonment I had stopped the client from ever coming to their own realisation about that. I had stolen the opportunity for them to ever make a self discovery on that point, as soon as I said it. They are not permitted to do self realisation, instead the realisation is placed upon them by me. I had extracted the self experience from the client. I had stolen it from them.
Therapists at a conference on extractive identification
This has further implications for the relationship between client and therapist. In extractive identification I decide when the client was ready for the realisation. I do not leave it up to the client to decide for himself. In essence I am saying that I, the therapist, know what is best for the client and they do not.
This will then instantly generate a feeling of anxiety and a sense of insecurity in the client. What if I get the next one wrong?. By identifying I am going into the private and intimate world of the client and in extractive identification I am then going to expose that to the client and perhaps a whole group of people if it is group therapy. If ill timed, or my judgement is wrong then by doing such extractive identification I can insult or even assault the client with such an ‘extraction’. If I leave it up to the client to decide when he is ready for the realisation then this can never happen and the client will feel more secure in their relationship with the therapist.
I'm in their hands so I hope they know what they are doing.
Graffiti
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Friday, 18 April 2008
Extractive identification
I attended a workshop last week where the concept of extractive identification was discussed. This is a common process done by many psychotherapists. The therapist identifies with the client and then extracts that identification.
I did it today. A client reported that he lost his mother to cancer when he was seven years old. So we dealt with the various psychological ramifications of that. In the discussions however I discovered that after she died his father moved interstate for a time as he was so desperately ill with grief. Also he was placed in a house with good family friends and his brother and sister were moved to another family.
I then brought to his awareness that not only did he loose his mother, but that 7 year old boy also lost his father, two siblings, his home and bedroom and so forth all at once and that must have been quite devastating. His whole world of security had disappeared all at once.
This is an example of extractive identification. As a therapist my own Child ego state had identified with him and the pain I assumed he felt. Then I had ‘extracted’ that aspect of his experience by reporting it to him. In essence I had stolen from him. Extractive identification is literally theft form the client by the therapist.
Identification
By me reporting my identification to him I had made it impossible for him to ever achieve that by himself. I had stolen it from him for ever. The theft metaphor is an interesting one. Of course it rests on the assumption that if I report something to a client about their experience like I did above, then that results in less ‘gain’ to the client than if they achieved that awareness of their experience by them self. I think it is safe to say that many would agree that this assumption has some merit.
It has interesting implications for the therapeutic or transference relationship. It almost gives it an adversarial quality. The therapist can steal things from the client. Making prophetic and insightful type statements like I did may make me feel good but it is at the cost of the client having something stolen from them forever. The clients rights are violated when they have something stolen from them.
Can you steal their insights?
With the idea of the violation of the client’s rights and indeed in one form their ‘property’, then one immediately gets a stronger sense of boundary. What belongs to the client is more clearly defined when one considers extractive identification. In the medical field we hear about intrusive and nonintrusive medical procedures. Surgery to remove a persons appendix or gall stones is an intrusive medical procedure. It is intrusive because the doctor intrudes though the clients physical boundary (their skin, muscle and so forth). Of course nonintrusive medical procedures do not do this. Here they use other methods to treat the problem that do not involve intruding across the clients primary boundary of their skin.
Intrusive surgery?
With extractive identification one arrives at the same scenario. There can be both intrusive psychotherapeutic procedures and nonintrusive psychotherapeutic procedures. Extractive identification of course is an intrusive psychotherapeutic procedure. The therapist has sought to observe inside the client’s own psyche and then makes a comment about that observation to the client. Metaphorically the comment of the observation is the equivalent of the surgeon cutting into the patient’s skin with the scalpel.
So the client then has a sense of being intruded upon. “He’s reading my mind” maybe the kind of experience. Another good example of this would be hypnosis.
So in this way one can see extractive identification as not only theft from the client but also as an intrusion by the therapist into the private and intimate world of the client’s mind. This then begs two questions:
1. What are the psychological implications of this intrusion for the client (and therapist)
2. What is the fallout of this intrusion on the relational or the relationship between the client and the therapist.
Graffiti
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Wednesday, 16 April 2008
Naive suicide
This is a piece of dialogue that came from an ABC radio interview.
I have put in upper case the parts I wish to point out
Fifteen-year-old South Eastern suburbs Melbourne school girl Holly, talks about her suicide attempts.
HOLLY: When my parents, probably. They separated and that and just a lot of little failures with school, with friendships, that sort of thing. It just felt as though it was all like falling down on me and, yeah. I changed a few friendship group type things and, and school, I wasn't doing as well as I used to and so I had to try a lot harder but I figured I didn't have to do the work and so, yeah. It just all led to this.
LUISA SACCOTELLI: And then what happened? One day you thought .?
HOLLY: Well I basically thought, you know, nothing's going right. I'm just not good enough any more. Too many things. Too many bad things have happened, there's no point continuing. All that sort of thing that just went through my head and I'm like, yeah, WELL I MIGHT AS WELL GO DO IT. Yeah.
LUISA SACCOTELLI: And so did you then attempt suicide?
HOLLY: Em, yeah. Yeah, a few times.
LUISA SACCOTELLI: So do you think the fact that you failed - to use a terrible term - the fact that you failed meant that you really didn't want to?
HOLLY: I think deep down I knew I didn't want to LEAVE because I mean deep down I knew that I was something. Just on the outside I just... It felt as though I was failing too much. I just wasn't good enough and I'D NEVER ACTUALLY REALISED THE EXTENT OF WHAT I WAS DOING. I JUST DIDN'T SEE IT AS A SERIOUS THING.
--------------------------
Holly never actually uses the word suicide. Instead she talks about going and doing IT, or she talks about leaving. And her final comment clearly shows the misunderstanding that she has of what she was attempting to do. It simply had not been thought through and shows a naive child like understanding of attempting to take ones own life. It is quite possible that murderous teenagers are of the same state of mind.
When assessing suicide risk this is disconcerting. As mentioned in a previous post one can do a suicide decision interview and that is most informative, but with teenagers there is this extra component that may render the results of such an assessment inconclusive.
With teenagers one needs to have an extra interview and make a risk assessment based on that. Teenagers have less predictability than adults in this way.
Graffiti
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Tuesday, 15 April 2008
One child’s understanding of his death
I was working with a client today and did even some more integrative psychotherapy style! And yet again we arrived at a different point than we usually do. However the main point was not so much about this, as what he said about an event that happened a long time ago.
The client was an adult male who spoke of an event when he was 10 years old and very nearly drowned. He had never spoken of it before to anyone. So it had been his secret for many years.
We basically did some trauma debriefing as he now has similar feelings occurring at times today. With more of a style of attunement and making more contact with the Child of the client we went through the traumatic episode as one does in trauma debriefing.
At one point he can see the surface of the water above and he feels like he has absolutely no air left in his lungs. He recalls his legs being very tired as they kick so frantically to get him to the surface. He does not know if he is going to get there. Finally he does break the surface and he takes a huge gasp of air. After a brief time of getting his senses back he then slowly climbs onto a little jetty and lies there for an hour. It was probably 10 to 15 minutes as time distortions are quite common in traumatic episodes. He lies there with this horrible feeling in his body as those around do not even realise that he was so close to death. His friends had moved a bit away while all this was going on.
In going through the episode with him, I mentioned a number of times about the fear and scare that the 10 year old boy must of felt. The terror of not knowing if he was going to make it to the surface and drown. In making this comment a number of times there was a sense of missing a connection. Finally he stated that he was not sacred of drowning. He never felt that and it never went through his mind. He said that all he thought and knew was that he had to get to the surface and how tired his legs were. It never occurred to him that he would die, he just knew things were really, really bad that he could not get to the surface.
A few posts ago I wrote about teenage suicide and stated:
“This is some writing on teenage suicide. They understand what suicide is in their Adult ego state but not in their Child ego state. This highlights the idea of intellectual understanding versus knowing and believing in the Child.“
This man as a 10 year old child highlights how a child can perceive death differently to how an adult does. Death in that instance did not occur to him. The possibility of it was not contemplated. All he knew was that something was very wrong, but what that was, was never articulated in the 10 year olds mind. And in essence he never thought about it until he talked about it decades later with me today. At the time he was over loaded with the horrible feeling in his body and how no one ever asked him about it and how he always kept it to himself.
This is clear example of the added danger of child and adolescent suicide. They are more unpredictable than adults. They do not have to make a “Don’t exist” or the suicide decision for them to make a serious suicide attempt. With an adult you can assess them for such a suicide decision and then you can be more certain of their actions. With teenagers you can not be as sure, because they do not fully understand what death is or they simply do not think about the lethal consequences of their actions.
Like the drowning 10 year old he simply did not think about the death or dying bit. Other things were going on in his mind. Whereas for an adult the contemplation of their death would be the highest priority and certainly would have been considered repetitively after the event had occurred. This 10 year old boy never did that. This had lead me to make the inaccurate statements to him about how the 10 year old must have been terrified at dying and how therapy stumbled a bit at that point until he clarified what was going on for him. I assumed he would think like an adult would and he was not.
This to my mind is also one of the explanations of why kids kill. Why the young adult Martin Bryant shot dead 35 Australians at a tourist resort and why those two American boys did what they did at Columbine High school. They simply do not perceive or understand death the same way the average adult does. They kind of don’t even think about it and what it means. They are thinking about the guns and the planning and all the other stuff and never actually get to thinking about the death.
Graffiti
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Monday, 14 April 2008
The ‘real me’ therapy
Had quite an interesting counselling session today. Last week I was on a 5 day training workshop that was on integrative psychotherapy. Whilst the approach used at that workshop is different from the usual approach that I use, it is not dramatically different but there are some significant differences and obviously a number of subtle differences.
I saw a client today whom I have seen over a period of about 3 years. So we know each other well. I know her usual style and reactions to various interventions and she would know mine as well. Today she presented an issue that was just ripe for the approach that I had watched for the last 5 days. So I did the work with her from that integrative approach.
Interestingly enough her usual responses did not occur as often and she had quite a significant “a-ha” and a new insight into herself in terms of how she was scripted by her parents. This then left her quite perplexed. Her usual ‘path’ though the hour long session was different and in one way she ended up in a position that she had not had before.
Some argue that the different psychotherapies are not really all that different and are just doing the same thing in a slightly different way. But this today highlighted to me that different psychotherapy approaches will access different parts of the personality (or life script), in different ways and leave the client in a different place at the end of the session. She certainly made some quite important recollections that she had never cited to me before.
Life script injunction
Some time a go I a wrote a blog where I stated;
“As a psychotherapist, if you can do effective psychotherapy with a hangover then you know you have gotten there”.
Why? Because when one is hung over one’s Adult is far less effective and one is forced to do therapy from what is in their bones and ingrained in their personality. One reaches a point where their therapy approach fits in with their natural personality and thus when one is ‘doing therapy’ they are really just being them self.
So in adopting this new approach today I was thinking and processing a lot. When I made an intervention and the client responded, I then had to think what would the integrative psychotherapy approach do in these circumstances. So I had really adopted an integrative psychotherapy persona for this work. A persona in the sense that it was not the “real me” or the “in my bones” therapy style that I have developed over years.
Persona or the real me
Then near the end the following dialogue occurred:
Client: “You have that look on your face again.”
Me: “What look is that?”
Client: “You are looking at me like I am an insect.”
A most perceptive observation indeed as I had said nothing about what I was thinking. She had picked up that I was in a psychotherapy persona rather than being the usual me.
So I will continue to experiment using the stuff I observed over the past 5 days and at some point I suppose I will move out of this persona and the new bits I find useful will then form part of my ‘in the bones’ therapy style once again. The ‘real me’ with new bits.
Doing new things. Risky?
Graffiti
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Saturday, 12 April 2008
4 demons I have known
This includes four statements by four clients of mine in 1987. When I began to identify the personality structure of the demon I discovered that some people upon reading these statements could identify with them. Others simply did not. Some would say, “How do you know about that part?” So originally it was simply a way to make a diagnosis. However they also show important features of the demon and how it can interact with the therapist and the therapeutic process. Most often it is disruptive to the process of therapy. Most often therapists deal with its damage in a counter therapeutic fashion.
In addition to these statements by clients I wrote and article on the demon sub personality. Often when I re-read something that I wrote so many years ago I cringe. Unfortunately this one is no exception and I think “OMG how could I have said that, that is just so out dated or that is put very poorly”, and so forth. Oh well, such is life!
Eric Berne originally wrote about the demon in the book ‘What do you say after you say hello’.
He stated, “The demon is the jester in human existence and the joker in psychotherapy.... No matter how well the therapist plans his psychotherapy, the patient always has the upper hand. At the point when the therapist thinks he has the four aces, Jeder plays his joker, and the demon wins the pot. Then he skips merrily off, leaving the doctor to leaf through the deck trying to figure out what happened. Even if he is ready for it, there may be little he can do..... The demon first appears in the high chair, when Jeder scatters his food on the floor with a merry glint, waiting to see what his parents will do. If they make friends with it, it will go onto later mischief, and then perhaps into humorous fun and jokes. If they beat it down, it will lurk surly in the background, ready to leap out at an unguarded moment and scramble his life as it originally scrambled his food.” (Pp 122 - 123).
Not all clients have a demon part as is described in their personality. I have never sought to work out the numbers in the clients that I have seen but I would expect it to be a small minority of clients.
NUMBER 1
What does she look like
She is small and ugly in a demanding sort of way. She has her hair down over her eyes - peeping out from under and shaking it all over when she wants to hide or tease. The body is not significant, it is just small. The biggest bit is the head. She watches out from under her hair with a sneaky, teasing look and then shakes her hair over her face and backs off when she needs to.
Where does she hang out
She lives way down in the bottom in the pit of my stomach. Lying in wait to spring out at any time - and often I am not sure if she is going to or not. She sits right down in the bottomest corner on her knees by herself
What does she think, feel, do and want?
She reacts or just acts, rather than thinks about things, but how she chooses what and where to, I do not understand. I know she must think, but it seems more like she just is. She knows people are not to be trusted, and she proves it. She knows she hates being touched. She knows things without thinking. She just leaps out and I often do not know when it happens. I do not know the why of things, just what is.
What she feels
She hates to be called a ‘woman’, she reacts to that. When touched she feels burnt - the feelings are intense. This is a hard question - when thinking about what she feels I am confused or blank. I see a lot of screaming and screaming, jumping up and down and head shaking - a lot of triumphant laughter and glee. A feeling of enormous energy and strength of will. She feels intense hatred and a terror which results in screaming and screaming with head shaking. She feels triumphant and gleeful; “Ha, Ha”. She feels wary
What does she do and say?
This is the bit that is the problem - what she does or says. She lies quiet in the pit of my stomach, then leaps out and shatters the peace, and I can not control it. She screams and screams and jumps up and down shaking its head, until I feel like I will explode if I do not take notice. She’s unpredictable, sometimes when I expect her she lies still. I know she is there ever watchful and wary. And then later when I start to trust, believe and relax a little, she leaps out twice as bad. She says, “Watch out kid, you’ll go - he will get you - go on be a pain - he does not really care - listen to me - do not let him touch you - you do not need him - just get up and go”. She starts shaking her head when anyone gets near, just to keep them at a distance. Even when still, I know she’s just waiting for a chance to break something into pieces.
She repeats herself over and over - demanding but persuasive: “Come on just turn the wheel a little, just see what it is like to drive into the bridge, it will only take a slight turn of the wheel, and, Pow!. Go on, I dare you. Come on we don’t need anyone - go on, it will feel really good - its the only way - do it and see what happens - it wont take long”.
She is very hard to resist. She does this in many ways. All the time changing from peering out from underneath her hair, to jumping up and down with frenzied glee. “Keep him away, keep him away, you do not need him, do not touch me, he cannot help you, I will show you that”. It’s hard not to listen and believe. It has got away from me before. I know I have even started to go. I am not aware sometimes, I just turn-off and suddenly there is laughter and screaming. It is like it controls me.
I have to keep moving sometimes to keep her from taking over or exploding. I sometimes get lost and all I feel and hear is this screaming and shaking. She pushes me all the time. Gives me a shove - “go on”.
What does she want?
She wants to be left alone, not to be stroked or touched - to either survive or not on her own. She wants to be triumphant and have excitement. She wants people to keep away unless she can manage them, so they do not get anywhere near her. She is desperate to win. I don’t know why, its just an intense feeling of, “keep away and stay in front”.
What does she think about therapy and therapists?
Therapists are fair game and fun, until they are smart, and then their is trouble. They are something to pit your wits against, to win over, even if they ever know. She has a grudging respect when they are quick to spot her moves, and when they think fast and are smart. She reacts with glee, sometimes with triumph and has a fine old time. Other times, when he gets too near, she gets desperate and resorts to other stuff - either then or later. She then feels bad.
Therapy is a game - some stuff to do with the therapist, it is an intense way to sharpen you up. Sometimes it’s a threat now and she explodes with avengence just when I am starting to trust or believe. If things go wrong she is absolutely gleeful. She jumps up and down, and says, “Told you so kid, now what you going to do, huh?”. Physical type therapy, such as holding, she hates. Sometimes she lies quiet but at other times she forces me to keep moving. She leaps out sometimes and screams and screams until I feel as if I have been bashed.
What does she think about answering these questions?
She loves it and hates it. She loves talking about herself. But she did not like it at all when you gave her someone else’s information. That was a real insult. So she’s wary about how you are going to treat this. Because you can take it or leave it, she does not give a damn. But she likes the fact that she is recognised.
I think she does not like some of the things I have said because I get confused. I cannot spell or write legibly every now and again. And she wants to scribble over some bits.
She is most active when I have been vulnerable.
She wants you to know she does not want anything or need anything.
NUMBER 2
What does she look like and where does she hang out?
He is sitting on the floor in a largely bare room with no carpet or furniture. He has his legs crossed, arms crossed, and his jaw is very firmly clenched. He is bent slightly forward with his head pulled down in his shoulders. He emanates absolute defiance and rebellion, and scans the environment for any possible danger. People come and go in and out of the room. Most of them are insignificant, but occasionally one gets through his barrier and that is very dangerous.
What does he think, feel, do and want?
He is very, very angry, but it is very controlled. He wants to hurt others sometimes, but he would never do that physically. He likes watching others get hurt in movies like the ones about the Nazi’s. I also think he wants to love someone but he would never admit it. He feels cheated out of a safe childhood and he’s angry about that. He has a very hard, cold, conscienceless streak in him, that is of a mercenary nature. He thinks a great deal and prides himself on being able to see what’s below the surface of people. He knows that he is exceptionally bright but would never say it.
One the surface, none of this shows whatsoever. He is nice and caring, and fun. If you get on the wrong side of him, watch out, because in the end he will get you back. He would do this in a very subtle manner however, so even the person who he got back would not be consciously aware that he’s been got.
On the other side he is very fragile, scared and vulnerable. He wants caring so much, but it would take ages for him to ever let anyone do it. He puts himself down and thinks he is bad and should be destroyed at times.
What does she think about therapy and therapists?
Therapists are good to play with. He feels that many have all and nice intentions, but they are really not much chop. They can be seduced into thinking the right things, so they are never in control of the situation. The great majority of them are limited by their therapy because they have to follow the guidelines. This is a sign of weakness. He has been out-gunned and confronted a few times, and this he greatly respects. Someone who can outwit him and will stand up to him is greatly respected but this has occurred very rarely.
He likes the attention that he gets in groups, and he likes the opportunity to let out feeling. Most of the time however, the therapist is not good enough to give him what he really needs.
What does she think about answering these questions?
he likes answering these questions because he likes others to know how tough, uncaring and cunning he is. It’s funny, but he would never have done this without anonymity. Only to a very select few would he ever own up. The unfortunate thing about answering these questions is that he feels as though he has been dragged across the coals. There is a lot of pain in him and when he’s brought up some of this, the pain surfaces. He is worried that you will tell people who he is.
NUMBER 3
He is small and lives ina cave by himself. At the front of the cave is a shield with little slits in it that he can look out of and no-one can look in. He sees people out there, and sometimes wants to go out but he never would. He feels detached, and I call him “X”, the unknown quantity.
He feels at once very frightened and at the same time very angry. He feels a lot of hatred to himself, other people and sometimes his parents. A sense of helplessness seems to overwhelm him. He feels that he is bad and in fact is being punished.
He would like to lead a varied and adventurous life, but it seems as if life is not meant to be like that. It is dull and conservative. Now he is completely alone with memories of his own mistakes and the happiest part of his life is gone. In pursuing what he thought to be the right way to live he has wasted and thrown away his potential for living. In fact, he has sentenced himself to die. He just lacks the courage to carry it out.
He does not know what his own nature is and has no interest in being part of humanity. Yet because he is, he is still liable to human emotions and weaknesses which he finds hard to control but wants to ignore. Life has passed him by whilst he was playing and he now has nothing and can see nothing to alleviate this.
NUMBER 4
What does she look like?
She is tall, long limbed and attractive. He hair is shoulder length and it falls seductively across her left eye.
Where does she hang out?
In consciousness she is ina forrest filled with trees which have mostly lost their leaves. There are a few leaves hanging hopelessly to some branches. It is cold. She is cold; and moves quickly partly out of fear of what may be hiding there, partly to get warm to know she’s alive.
What does he think, feel, do and want?
She is constantly calculating, watching all movement, thinking what these movements might mean. She feels scared and ready to run and worries if she’ll go in the right direction to please you, so she’ll survive. She’d like to rest and relax and wants company.
What does she think about therapy and therapists?
Therapy is scary so it seems necessary to please, to get it right to survive like all scary things, yet this is the only chance, if I can hang on long enough so he’ll prove to be OK, then I can trust and change and know other ways.
Therapists may be out to trick you into something while you’re not looking. So she watches for a long time. Some therapists are safe.
What does she think about answering these questions?
She thinks she’ll be heard, but she’ll wait and see. She doesn’t want this to be edited, this is how it is. She wants her power in this and that extends further than that too.
Berne, E. 1972. What Do You Say After You Say Hello? Bantam: New York.
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Thursday, 10 April 2008
Global warming
I cooked myself some Kangaroo steaks for dinner tonite and I noticed this on the back of the packet. (No not the picture here but the quotation below!)
What about this guys contribution to global warming?
“Kangaroo‘s need less food than sheep or cattle, are better adapted to drought and are far less damaging to the fragile topsoil than their sharply-hooved sheep and cattle counterparts. Australia’s sheep and cattle produce huge amounts of methane, an important greenhouse gas, but kangaroos do not. Methane emissions from farm animals account for about 15% of Australia’s greenhouse production”.
Kangaroo for dinner
Graffiti
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Humor and human functioning
I have a friend who a few years ago was diagnosed with testicular cancer. As a result of this had one testicle removed and now is cancer free. A good friend of mine he is and he has this curious habit where from time to time he will tell testicle jokes.
If there a few of us at a pub and he spies a good looking woman on the other side of the room he may say something like:
“I would give my left nut for one night with that woman”
This is the sort of thing Aussie males say to each other when there are no women present and they have been too long in the boozer. I have always been interested in how he does that.
She seems to see the funny side of her dilemma
The other day I was supervising a trainee psychotherapist. She was reporting on a client of hers. A 16 year old girl who suffers from lymphodema. As a result of this she has fluid retention in her legs so that they are quite large and round. This of course has had a significant psychological effect on her self esteem. She may not be able to travel in a plane and feels unattractive to boys and so forth. The trainee was asking me for some counsel on how to deal with this client.
The first thing that popped into my mind was that she had legs like an elephant. So I said to my trainee, “She has big, fat, round legs so tell her she looks like elephant woman” This is a play on the title of that movie where a deformed man (John Merrick) looked like an elephant so he was called elephant man.
Well my trainee was aghast and chastized me for my callous and uncaring attitude. After surviving her scolding I managed to clarify myself. My point was, one option is to take the same solution that my testicle joke telling friend had discovered for himself. If you can have a humorous view of your problem - psychological or physical - then you have made a significant therapeutic achievement.
One thing that neuroses hate is being seen the funny side of. The neurosis will thrive in a climate where the sufferer gets down and depressed about it. Perfect conditions for the neurosis to grow and become stronger. Seeing the funny side of it disempowers the problem. Many a psychotherapist gets caught in this empowering of the problem because the therapy is always serious business and deep and meaningful and so forth.
If your clients seem to always look like this then don't give up your day job.
Of course if one wants to take this option with the client and tell her she looks like elephant woman one needs to be cautious. Of course I would not suggest you call her elephant woman straight up but would suggest that you search for a funny side to the lymphodema. The danger with this approach is that the client may feel like you are teasing her, or making fun of her and feel humiliated and shamed. If the therapist can avoid that happening then the client can progress significantly by seeing the funny side of their problem. Obsessions and eating disorders are great for this sort of approach.
Humour in the psychotherapeutic process can be a very healing thing. I know I laugh a lot with my clients. Some therapists don’t and as I said this can empower the problem which one is trying to overcome. Humour stimulates the Free Child. It’s hard to be neurotic and be in Free Child at the same time. Humour puts one in the here and now and it is hard to be there and be neurotic at the same time.
Free Child in the here and now
This does not mean you don’t take the problem seriously. All it means is that you can laugh about your imperfections from time to time.
Graffiti
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Wednesday, 09 April 2008
The demon
Eric Berne originally wrote about the demon in the book ‘What do you say after you say hello’.
He stated, “The demon is the jester in human existence and the joker in psychotherapy.... No matter how well the therapist plans his psychotherapy, the patient always has the upper hand. At the point when the therapist thinks he has the four aces, Jeder plays his joker, and the demon wins the pot. Then he skips merrily off, leaving the doctor to leaf through the deck trying to figure out what happened. Even if he is ready for it, there may be little he can do..... The demon first appears in the high chair, when Jeder scatters his food on the floor with a merry glint, waiting to see what his parents will do. If they make friends with it, it will go onto later mischief, and then perhaps into humorous fun and jokes. If they beat it down, it will lurk surly in the background, ready to leap out at an unguarded moment and scramble his life as it originally scrambled his food.” (Pp 122 - 123).
Dealing with a demon can feel like this to the therapist
Not all clients have a demon part as is described in their personality. I have never sought to work out the numbers in the clients that I have seen but I would expect it to be a small minority of clients.
Here is how one client describes the demon part of her:
She is small and ugly in a demanding sort of way. She has her hair down over her eyes - peeping out from under and shaking it all over when she wants to hide or tease. The body is not significant, it is just small. The biggest bit is the head. She watches out from under her hair with a sneaky, teasing look and then shakes her hair over her face and backs off when she needs to.
Demon?
She lives way down in the bottom in the pit of my stomach. Lying in wait to spring out at any time - and often I am not sure if she is going to or not. She sits right down in the bottomest corner on her knees by herself
She reacts or just acts, rather than thinks about things, but how she chooses what and where to, I do not understand. I know she must think, but it seems more like she just is. She knows people are not to be trusted, and she proves it. She knows she hates being touched. She knows things without thinking. She just leaps out and I often do not know when it happens. I do not know the why of things, just what is.
She hates to be called a ‘woman’, she reacts to that. When touched she feels burnt - the feelings are intense. This is a hard question - when thinking about what she feels I am confused or blank. I see a lot of screaming and screaming, jumping up and down and head shaking - a lot of triumphant laughter and glee. A feeling of enormous energy and strength of will. She feels intense hatred and a terror which results in screaming and screaming with head shaking. She feels triumphant and gleeful; “Ha, Ha”. She feels wary
More to come later on
Graffiti
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