Tony White

Solutions to problems or high stress.

There is an exercise sometimes used in psychotherapy. It begins with a few questions. What was one of the lowest points in your life and what did you think, feel and do? When things had gone really, really bad for you how did you react? What was your way of solving the problem or dealing with these very adverse circumstances?

It is generally acknowledged that the more a person is under stress the more they will revert to their childhood solutions to problems. The more stress a person is put under then the more they will regress, as it is known. This means they move from the Parent and Adult ego state into the Child ego state as is shown in the diagram below


Regression



So when life was going really badly for you what did you think?
One way of defining this is to finish the sentence, “It just goes to show you that....” Finish that sentence and you will know some of what you thought as a young child.

What did you think about yourself, others and life? This will be what you also thought and decided when you were a young child because you are in a regressed state.


This child is at the point of making decisions on how to think, feel and act.



What did you feel? This will be your racket feeling, or your most familiar feeling. If it is sadness then one will tend to be prone to depression and is more likely to conclude that they are wrong and others are right. If it is anger then one will tend to see others as doing wrong to them and that others are not OK. Or such a person can conclude that both others and self are not OK.


Racket feeling is?




What did you do?
Sometimes these are divided into 3 different solutions.

Fight - physically hit out (DV), verbally hit out, fight for your rights, put in a complaint, sue somebody. In childhood the child who will hit something or shouted in their defence or broke something to try and hurt the other person. “I’m going to hurt you” is the childlike fight response.

In adulthood we call this justice which is really just revenge but we don’t usually like to acknowledge that when of course feeling vengeful is a normal human emotion. So when under great stress this person will tend to hit out at others physically or verbally or legally. In childhood the child may voice disapproval at mother and father or seek to angrily get change in some way in the home. If mother and father are fighting the child may actually intervene in some way.

Flight - This can include things like using alcohol, drugs or prescription medication. All these are a way of getting away from the problem, as a way of solving it. Or the person who quits their job and simply goes elsewhere. So one can simply geographically relocate to move away from the problem and thus it is solved in their mind. In childhood the youngster may do running away from home behaviour or the child goes and hides under their bed as a response to stress in the home. This child does not seek to change the conditions at home or express their disapproval instead they move away from the problem and wait for it to subside. They want to ‘slide under the radar’.

Freeze - In the olden days it would be said that the person has had a nervous breakdown. In essence the person collapses in on self and goes into a state or incapacitation. They fall to the ground and go into the foetal position. These days people go on stress leave, or they may seek hospitalisation, some can have panic attacks and agoraphobia which are both incapacitating conditions. In childhood the child just stands there and simply does not know how to respond. In the extreme they can loose bowel or bladder control. Where as fight is primarily an angry response, freeze is mainly an anxiety response.



So as adults regress more and more as the stress increases they will respond more and more in a childlike way. They will think the same as they did as a child and feel the same way as well. They will also be more prone to pick the behavioural solution that they used as a young child as well.

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At a assessing suicide risk workshop I ran last week I did this exercise with the participants and asked them the question, “If a person considers or attempts suicide then what response is that - Fight, flight or freeze?”



I will answer it soon.


Graffiti

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Madeleiine, Kahless and KazzaB make good comments.

Some saw suicide as a flight response which to me makes sense. One solves a problem by getting away from it and suicide does indeed do that. I also think there is a fight response in there. Suicide is a murderous act. It is an aggressive act. The line between suicide and murder is a fine one indeed. Psychologically they are quite similar processes. Both persons are prepared to step over the line of destructive thought and put it into action. That is a big step to take.

Research shows that those on death row have a higher rate of suicidal urges than the general population. So perhaps those are not able or capable of killing self, so they act in a certain way and then that gets the state to do it for them.

Interestingly enough in the early histories of suicidal individuals it is not uncommon to hear of running away from home behaviour which is a flight response. Most often if a child says they are going to run away from home when asked where it is going to run to it has no answer. So in essence it is running away to oblivion.

The overall point of the exercise was to demonstrate that suicide was just one possible solution to a problem just like going on a bender is or beating the wife is. That is the person has made a decision for this to be one of their options to a problem. Such a person is said to have a Don't exist injunction or message. In assessing suicide risk this is the definitive point and one does this by doing one of the four methods of the Don't exist interview.

Graffiti

Speaking of name changes Kahless and my now graffiti less title.

I saw a show on TV a few weeks ago. It was about these parties or 'exhibitions' that they are having in Melbourne (Aussie) now. The trendy set will set up a party in an alley way or derelict building. They all stand around sipping champayne, with classy music and commenting in appreciation at the graffiti on the walls.

OMG! I thought and felt a sense of loss.

All that angst of youth, their sense alienation and their disestablishmentarianism has now been taken over and is lost.


Graffiti - powerful imagery that is now pedestrian.



It has gone beyond taking the graffiti art into the art galleries. The establishment has now moved to the graffiti in the streets.

Like when punk rockers with their dirty torn jeans saw them appearing in the expensive boutiques. Punk rock died at that moment.



Perhaps now the graffiti artist is at the point of death as well. Society has assimilated graffiti into the mainstream. Their meaning in society has gone for ever.

Tony

Francis Ford Coppola - Bipolar disorder

Kurt Cobain - Clinical depression



Winston Churchill - Bipolar disorder

Daniel Johns (Silverchair) - Anorexia

Kim Basinger - Panic disorder



Syd Barrett (Pink Floyd) - Schizophrenia

Issac Newton - Bipolar disorder

Charles Dickens - Clinical depression

Jim Carrey - Clinical depression

Karen Carpenter - Anorexia

Eric Clapton - Clinical depression



Ludwig van Beethoven - Bipolar disorder

Tennessee Williams - Clinical depression

Graffiti

Kahless said earlier today:

“Tony,
I hope you were humane with your slingshot.”

This is in reference to the statement that I made to Roses that I had recently made a slingshot to shoot the birds in the trees in my backyard.

In Australia Kahless we have a bird called the Magpie. Here is a picture of one:



These are very Australian birds, as Australian as meat pies and kangaroos. Many of them fly around my place and move from tree to tree and have their squawks and disagreements and so forth.

For some unexplainable reason in the last 3 weeks the local magpies have decided to run their therapy groups in the tree right above my back yard out door table and setting. This is where we often sit and socialise during the warmer months of the year. I have had the out door setting there for at least five years and never had any trouble before. But in the last 3 weeks they have decided to run their therapy groups right there.

It must be a Gestalt therapy group that they are having. How do I know it is a Gestalt therapy group? In Gestalt therapy often when the client gets stuck at the point of impasse the therapist will say, “Will you either shit or get off the pot”. When the client does either, then impasse has been broken.

Well obviously many of the magpie clients in this group are choosing the option, to “Shit”! The problem is that their shit falls right onto my outdoor setting. This causes me great distress and I feel like I want to turn the Magpies into something like this:



So what I did to get them to relocate their daily therapy groups was make a slingshot and shoot them a few times and then they would find somewhere else to meet.

Now I am an experienced slingshot aficionado. Consider this picture below of me shooting my slingshot:



I am in the white shirt at about age 10. That is a friend of mine on the left and that is my sister bending down to pick flowers. I am just about to shoot the top off an ants nest and then run for cover. I must add that I don’t know why my mother made me wear my pants up that high but she did and I look like a right regular dork! (If you want to see this picture in much more detail click on it and got to “All sizes” on my Flickr - a very typical Australian bush scene).

I have by and large been successful in this method of getting them to relocate their group meetings. They are about 10 meters high up so it is quite difficult to get a direct hit, not that I even wanted to do that. The vast majority of times the pellet will whiz by very close and the Magpie gets disturbed by this. At other times the pellet has ricocheted off a close branch and again the Magpie does not like this at all. After a little of this they will all fly off as they know something is wrong. I have probably had about 6 direct hits and the magpie flutters about briefly and then flies off.

They are now there much less frequently and indeed when I am spotted by them coming out the door often they just fly straight off. I have actually been surprised at how quick they have made the connection between me and “lets get the heck out of here!” So hopefully the problem has been solved as I certainly don’t want to cause the Magpies distress and I want a clean place to socialise during summer.

Graffiti

Most of the professional organisations of counsellors advise against dual relationships. This means that they advise that you only have a counsellor - client relationship with the client and no other contact or relationships.

In my view this is a major discount of the vast majority of counsellors and is throwing the baby out with the bath water. It is saying to the counsellor that we don’t think you are capable of handling any dual relationship problems so we will do it for you. To my mind that is treating the member counsellors with contempt and adopting a most supercilious attitude.


Most counsellors are not this and can manage at times quite complicated relationships.



As we know it is the relational or the therapeutic relationship between the therapist and the client that carries the most potent curative powers. So when a client sees a therapist most often that is for 1 hour per week. So the client gets to see the therapist and meet face to face with the therapist 1 out of 168 hours per week. That is not a lot of contact.

What has happened in the past in this part of the world is that some clients have taken on counsellor training with the counsellor who also happens to be a trainer. This allows the client to have much more contact with the therapist who is then in a training role.


Keeping the absolute 'single' relationship

Some of these clients who become trainees have no real interest in becoming a counsellor and of course I always get this out in the open so both parties are clear about it. So the client/trainee gets two benefits. First they are placing themselves in a training group that is therapeutic in itself. A good support group that is by an large positive stroking and encouraging of the person to grow and develop. Secondly they get much more face to face contact with the therapist and thus all the therapeutic flow on from that.

Of course some say that this dual relationship - client/therapist and trainer/ trainee - can lead to financial exploitation. Yes it can and I am sure that it has on occasion. But professional organisations want to get rid of it all just because of the actions a of a few. Thus many clients loose out in the ways I have just described.

However, with the development of the www we now have more occurrence of a new dual relationship - therapist/client and blog writer/blog reader(commenter). The client can have much more “contact” with the therapist via communication on the internet. They can read what their therapist is saying, maybe even comment on the blog, see photographs they take and place on the internet, read about their activities via facebook and twitter and all the other huge variety of things that can now be done via the internet.



This is the interesting part. What does the therapist do with this new dual ‘relationship’ with their client? They could do nothing or it could be used at times in some way should the circumstances be right? To my mind an area of much possible research and development.

I can only see one way that professional bodies can stop such dual relationships and that is by requiring the therapist simply not using the internet in these ways. Or they could take the view that their members are at least reasonable communicators and say, “we trust that you guys to have the expertise to deal with it”. I know that I do and can. I have already dealt with some problem situations that have arisen due to this new dual relationship. Like the client who complained to me that I write about others on my blog and not about him.

Graffiti

I am interested in what clients and trainees think and feel about accessing information about their therapist or supervisor on the www.

Of course this can be via weblogs, photoblogs, YouTube, google searches, websites, twitter, facebook, discussion forums, chat rooms and many many more.


Who's there?



Via these internet 'things' clients can access information about their therapist personally and professionally. They can do search google earth and see their actual home. They can also have online discussions with them. At times clients could be anonymous and talk with their therapist without the therapist knowing who they are.

Of course all of this also applies to trainers and their counsellor trainees.


Internet communication at times?



Some discussion of this has been done before on the blog Shrink Rap (See the link in my blogs I like list)

The following is stated in the comments section:

"April writes

I really like Tony Graffti, too. I love that his patients read his blog---but maybe that's because I wish I could read my shrink's.

Maybe it's not intimidation that prevents people from disclosing they found your blog---maybe they're using it as a reference, to see if you're the same person in 2 different settings.

Lee writes

My therapist wrote a book (a couple actually). I bought one of them and started reading it. Got bored, didn't really like it much. I haven't told him about that. It just seems weird. I just told him on Monday that I read the wikipedia article about him though. heh. It was right after he was bashing wikipedia.

one4theroad writes

i think if i found my therapist's blog, i wouldn't say anything to her just because i would be afraid that she would then start to censor herself, or feel like she should."
(end quote)



So if there is anyone out there who has a therapist or trainer. What do you think about this, what are your thoughts and feelings about seeing your therapists blog or website or having discussion with them in a discussion forum?



Any comment would be greatly appreciated.

Graffiti

Last Friday I was at a meeting. It was attended by therapists, trainers, workshop leaders and so forth. It is a bit of an odd community that one as within it people become therapists and clients to each other at various times. A therapist may ask another therapist who is a colleague if they could see them for counselling. So the relationships change in this way not irregularly.



At one point we were socialising, all standing around in small groups gas bagging to each other. I overheard this woman who was just behind me speaking in her small group and she said, “Tony is my therapist”.

This comment struck as a bit odd, which is indeed why I have remembered it I suppose. Firstly, I counselled this woman perhaps half a dozen times and it would be at least a year since I last saw her as a client. I did not think of this woman as being my client. So apparently I am her therapist and she is not my client. How can that be?


A matter of perception. Is he surfing waves or rapids?



Secondly, what about the statement:

“Tony is my therapist”

My reaction to that in this situation is that I am sort of like that bottle of medication that you keep forever in the medicine cabinet at home. You know you are very unlikely to need it but you keep it there just in case. Or perhaps it sounds like I am a hood ornament on her car or like that old photograph you keep in a draw somewhere at your home.

I had a another similar event recently. A client is going to have an operation which will keep her house bound for 6 weeks at least. She was expressing concern that she would not be able to see me should the need arise in that 6 week period. I said to her that that was not the case and that I could do a home consultation should she need it. She felt relief at this and said that she would probably not need it but she liked to know that it was there. Another instance of being that bottle of medicine that you never use. I am sort of being her therapist when I am not actually even there.



I always try and do at least one home consultation with clients. You get lots and lots of valuable information about the client by going into their home. You know the feeling when you have been e-mailing someone for ages and then you finally meet them face to face and they look and sound nothing liked you expected them to. Well the same applies for homes of people you have met many times and never seen their home before. The image of their home you have built up in your mind can be very different to the reality.

I just find it all a bit odd. How people can use their understanding of me as their therapist when they are not in session. Indeed in that woman’s case it was over a year that she had seen me as a client and I was still being used in that way. I wonder how long that can go on for and is it reflective of an attachment that has not been allowed to slowly die away?

In one way you could argue that there is a therapeutic relationship in existence but there is only one person in it - the client. That seems a bit odd to me.


It takes two to play ping pong. Maybe not?


Graffiti

Taken from Mellor, K in "Skills in Transactional Analysis Counselling & Psychotherapy" (ed) C. Lister-Ford. 2002. Sage.





This views impasses developmentally. The type 3 impasse develops in the very young child, the type 2 in a less young child and the type 1 impasse in late childhood.

Graffiti

In psychotherapy this is what is known as an impasse



An impasse is a clash between two different parts of the personality. They having opposing goals and wants and can be drawn as a collision between the Parent and the Child ego states.

For example a woman may be insulted by someone at work. As a result one part of her (the Child) wants to express her anger and displeasure at the other person for being insulting. As she is just about to do so she hears this voice in the back of her head saying, “Good girls don’t get angry” & “Girls who get angry are bitchy”. Just the type of thing she was told as she grew up in childhood. These voices may be seen as representing the Parent ego state.



So we have an intrapsychic collision inside the woman. Her Free Child wants to show anger and her Parent ego state wants her to be polite and pretty and not show anger. She is at an impasse in her own mind. Over time when there have been a number of similar impasses then a symptom will develop out of this. One can say that the collision between the two forces in the psyche provides the energy or basis for symptom development. A common symptom to develop out of such an impasse is depression. Some people who chronically hold in their anger can develop depression over time.

Historically there have been seen to be two solutions to an impasse. It occurs when one ego state dominates over the other it is opposing. If the Child finally gets up the strength and courage and defies the Parent and the woman expresses her anger then the impasse is broken, at least in that situation. If she repeatedly does that then it becomes habitual and she could at that point be said to be ‘cured’ of her problem.



This is what the majority of psychotherapists will attempt to do with the client. For the Child to break the impasse. This is what the vast majority of their therapy theories will define a psychological health

On the other hand the Parent may dominate or ‘win’ in the situation and the woman holds in her anger and does not show it to her colleague. If this happens then the impasse is broken by the Parent belief. Often when I do this in therapy, such as in couples counselling or when a client’s expectations are too high. I will produce what is the greatest single line in movie history. That excellent movie -As good as it gets.



Jack Nicholson walks into the full waiting room of his psychiatrist’s office, looks around at all the people and says, “What if this is as good as it gets?”. So I sometimes use that line and say to the client, “Perhaps this is as good as it gets”. If taken on, then the Parent breaks the impasse and the client’s Free Child need is not met.

There is however a possible third solution to an impasse. (This must be credited to my psychologist trainee, Nadja). The client accepts the Parent position of the impasse and then the FC want is redefined. I have discussed some of this before in a number of postings.


Undecided. At the impasse.

I once talked about a supervision question where I was asked about a client who was a teenage girl who had lymphodema. Her FC want was to have thin legs. The Parent stated that she can’t have that because she had lymphodema. I then supervised that her therapist call her elephant lady or lympodema lady (rhetorically of course). Accept the Parent part of the impasse and then it is redefined in a humorous way and thus the impasse is broken. Or when I work with clients and I get them to love their panic attacks or make friends with their depression. The Parent part of the impasse is accepted and then one ‘loves’ it. The impasse is broken and the FC want is redefined.

Graffiti

For KazzaB’s assignment

Laughter and fun. Well it is a fairly simple transaction and one which I certainly do in psychotherapy. There is often laughter in the counselling that I do.



Two people enjoying themselves and each other is what this diagram represents theoretically. In this instance it is the therapist and the client having FC to FC contact. So what impact does this have psychologically on both parties.

Well the first thing I think one can say is that it makes the counselling fun and enjoyable at least for some of the time. So the therapy becomes appealing. To my mind there is always a danger of therapy becoming too D&M (deep and meaningful). Obviously in therapy both parties are at times discussing serious and painful events and at times like this, there is much less laughter and humour. And it is good to get out of that sometimes with a bit of levity and it makes the situation light for the time being. Thus it also gives the counselling an appeal to the Child of the client.


Maybe this is why the footy is so popular - high FC

As we know it is the relationship between client and therapist that has a huge impact on the success or not of the counselling. FC to FC contact is a type of intimacy or contact and both parties will feel a sense of connection from such transactions. So this is a most important transaction or type of contact for the client and therapist to have in that it is true human to human contact. This of course builds the therapeutic alliance and thus the curative power of the transference is developed.

Indeed when the client and therapist are doing other therapeutic techniques, or contract setting, making a no suicide contract and so forth then they are actually involved in a wall of trivia situation.



The wall of trivia alienates the two people involved in the communication, it is a distraction. In terms of the therapeutic relationship this is a counter productive activity. It is seen as a distraction form the true human to human contact. So humorous contact between client and therapist dismantles the wall of trivia.

Secondly one notes in the literature many people talking about the natural human tendency to health and growth. If a client is placed in the right conditions then they will natural grow and develop psychologically. For instance Carl Rogers stated that if a client was placed in a setting of unconditional positive regard then they would naturally grow towards health. Abraham Maslow say that each one of us has a natural drive or urge to self actualisation. To achieve our full potential that is with in each of us. Then there was Freud who talked about the libido or life energy. He also said that each human has such a life force that propels them towards growth and creativity.


Creative energy in all of us.



Transactional Analysis has the same assumption of an innate life force in each of us. In theory terms that would be seen as a function of the Free Child. So if the therapist is encouraging the client into Free Child such as with laughter then he is inviting the client into that aspect of their psyche where the libido or life energy resides. Then according to the theory the client will slowly and surely grow towards psychological health.

Thirdly, one of the main difficulties in dealing with sad and depressed people is that they are low energy. They are ‘sodden’ or incapacitated as indeed are scared and frightened people. People are more likely to psychologically change when they are in a state of emotional disequilibrium or an unstable emotional state. Depressed people are not this. One way to get a person into an unstable emotional state is to invite them into anger. Anger is a mobile and vital emotion. The person is emotionally active and when anger is around often things happen or change. This is why anger is such a useful emotion in the psychotherapeutic process.


Anger often results in a change of some kind.



Like anger another active and vital emotion is ‘happy’ when a person is joyful, laughing, radiant, smiling and so forth. It is an ‘up’ rather than a ‘down’ emotion. Thus if there is humour in the counselling then the client is in this unstable emotional state rather than a more static or immobile emotion and hence psychological change and growth is more likely to occur. Or at least the therapist has a person sitting in front of them with whom they can much more easily work with to facilitate change.

Graffiti