Wednesday, 11 February 2009
Thought management - Part 3
Fantasy or day dreams as a means of thought substitution or thought management.
A great deal, particularly in the psychoanalytic literature has been written about fantasy and it is indeed included in the list of defence mechanisms. However there is also many ‘normal’ types of fantasy as well.
Comment made:
“When I had a more agile body, then I would be athletic like lara croft...As I get older, well tonight I spent the drive home from work enacting out a plane crash. Trying to understand what I would feel, think etc. Whiled away the time. I hate driving; so boring.” (end quote)

Home wrecker!
Here we have a description of two types of fantasies. Firstly the heroic or the megalomaniacal fantasy. This includes heroic fantasies like Lara Croft and other fantasies of great achievement, heroic displays, attaining world peace, great wealth or power and so on. It only becomes a problem when it is over used and thus one gets a Walter Mitty situation where the fantasy is used as a means to compensate for a flagging self esteem. But I think it is safe to say that many have this type of fantasy and it is not indicative of any sort of problem
Also described is the stimulation type fantasy in this instance to deal with boredom. The sexual fantasy would also fit into this type of thought management. One picks a situation that is highly stimulating for them and then fantasises about that as a thought management technique
Another type of fantasy is the masochistic fantasy. I am reminded of one fellow who I treated for a long time who would have very such vivid fantasies. He would fantasise himself being hit, beaten up, stabbed, burned and so on. Very vivid and quite elaborate fantasies which he often had as he was in bed going to sleep. These disturbed him quite a lot as he did not know what they meant. He also felt quite embarrassed about them, however they also gave him a sense of relief and solace and hence he continued to do it. He tended to do it when he was feeling particularly bad about himself and he just felt he deserved it so it is the right thing to fantasy. I tended to view it as a kind of self harm that was all in fantasy. I would also suggest that it is not a particularly good sign and may be indicative of quite significant maladjustment.

Then one can have fantasy on a much more personal level often involving personal relationships. These can be either realistic or imaginary fantasies. About how things are or about how one would wish them to be.
Thought management and one size fits all.
Comment made:
“I debated for a while whether or not to comment on this at all because it makes me feel sad and defeated that 'normal' solutions do not work for me. Not only do they not work, but they were quite destructive. Thought stopping and 'changing the channel' and all of that sort of thing only fed my dissociation and helped me find new ways to keep it propped up a little longer. That fact that therapists were unwittingly helping me to do it also fed my belief that my thoughts and feelings were not okay and were something to be gotten rid of at any cost. . Unfortunately, when the walls finally began to crumble, it was a terrible shock to say the very least. And now that I know what I know, I think all those techniques that were applied to my secret 'habit' of forgetting made it so that full-blown flashbacks were the final recourse of a most desperate unconscious. I really think therapists should try to find out if there is existing trauma and dissociation before they get too carried away with helping people find ways to escape themselves.”(end quote)

This is an interesting comment indeed. One sees thought management and thought substitution mentioned a lot in the literature. It is one of the key parts of a widely accepted approach. I can not recall ever seeing a comment made about the contraindications of thought management. Statements made about how thought management for some can in fact detrimental. Again there is a belief that in counselling one size fits all when it never does. So this is a most pertinent point and when it is contraindicated obviously has to turn to Plan B. That is not hard for me to do as I can simply change to some kind of regressive technique. However those who use the CBT model solely would not tend to do such a thing and thus they may struggle to find a Plan B. An interesting area that needs to be elucidated by defining when thought substitution is contraindicated.
Thought management and going with what the client presents:
Comment made:
“Tony suggested that a good way to deal with your internal critic and to stop harassing yourself is to have a sexual fantasy....I eased back into traffic and felt myself getting very anxious and panicky and starting to want to cry.
But I remembered Tony’s advice to have a sexual fantasy. A-ha, I thought, this is a good time for that. So I started thinking about Brad Pitt, he was the first one to come to mind, but then I realized that I would never let Brad Pitt see me naked, so this wouldn’t work. George Clooney? Same problem. How about someone older? Clint Eastwood? Ugh - he’s sexy, but he’s my father’s age. Adam Sandler would have worked, but he reminds me too much of someone I know in real life. Bruce Willis? Bruce might work, let me think about this. Bruce is older than me, but he has an amazing body and I don’t think he would appreciate my flabby middle aged body especially after he’s had Demi Moore. I’m thinking and thinking, and I got to the train station, but never started the fantasy. My anxiety did go away due to all of this deliberation about who should be in my fantasy. I mean, I wanted my fantasy to be romantic and sexual, not to have a guy be grossed out by me and run away screaming.” (end quote)

A good example about letting people find their own thought management techniques rather than imposing one on them. There was no actual fantasising done and yet the anxiety was avoided due to changing from the usual thoughts. As mentioned this example involved thinking about the construction of the fantasy rather than having the fantasy itself.
If this was in a counselling setting I probably would say nothing and see if the actual fantasy was used next time. Or did the individual again think about the construction of the fantasy rather than having the actual fantasy. It should be noted that the actual person for the fantasy was never selected, they are all ruled out for some reason. So the next time there is still no one for the actual fantasy to occur.
But of course that does not matter. All that matters is this person has discovered a way to avoid anxiety by using thought management. So I would suggest that in the future this person use fantasy construction rather than having the actual fantasy. We know she can make that work.

The other interesting point about this is how the internal critic was used for the fantasy construction. There is quite a lot of Critical Parent ego state used in it. The stated goal is to use fantasy to avoid the internal critic and thus the resultant anxiety. As I keep banging on about, in counselling it is always better to work with the pathology than to fight against it. No one ever wins wars weather they be between nations or between different parts of an individual’s personality.
So my suggestion in counselling would be in the future to use the internal critic (Pathology) in the fantasy construction to avoid the internal critic generating anxiety in the person. Working with the pathology. Both the person’s eros and thanatos are satisfied in the same single act. That is far more likely to be successful than trying to get eros to triumph over thanatos. Lillith never looses a fight in the long run.
Graffiti
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Friday, 06 February 2009
Thought management - Part 2
Hello Harriet,
You state
What ever works?
Exactly right. In fact what a therapist should do is ask the client for their solution first, such as with "When you are having anxious thoughts what do you think you could do". If a person says they could sing the ABC song then the therapist is better going with that and refine how it is used rather than imposing their own one onto the client.
Indeed you provide a good example of the point I was making in the previous post with the ABC song. I assume the ABC song is that song children sing when they learn the alphabet. I can hear it in my head as I write this now. You came up with a Child ego state solution, but most importantly an archaic Child ego state solution. It is ingrained into your personality. It was part of your Child ego state long before you even entered therapy.

Solution to anxiety learnt in childhood.
Harriet you state, “Stop thought was one of the first techniques I learned when I was in therapy for anxiety and phobias. It took me a long time to get it to work, I really had to practice. I know some people in my group gave up and said it didn't work, but the key for me was practice.” (end quote)
So we could say that practice is the process of getting it ingrained into the personality. If one takes one of the therapist’s thought management techniques then they have to go through this practice phase. Instead I could get you to do a Child ego state interview (similar to the parent interview) and have found the solution there.

There's always a solution
If there is one there then the practice phase is much shorter or maybe none at all. The ABC song is deeply imbedded in your personality as it has been there for years and was ‘implanted’ when you were a child and thus when the whole personality was forming. So it comes from the foundations of the personality and is thus likely to be much more potent than one that comes from today.
Another example of this that one hears from time to time in therapy circles is the statement to deal with a client's big internal critic. If you are harassing self then the therapist might say, “Stop harassing self and have a sexual fantasy”. Again a very Child ego state solution as sex is a very Child ego state function. Far more potent than thinking about cool lakes, serene sunsets, or gentle breezes.

Maybe a more male oriented solution, I don’t know, but a good example of a very Child distraction solution. Even with this it is much better if the client comes up with the solution than the therapist. However the therapist can assist the client to come up with such a solution by doing a Parent ego state or Child ego state interview.
Graffiti
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Thursday, 05 February 2009
Thought management
Thought management exercises are useful when a person is troubled by ongoing or recurring distressing thoughts. There is a range of thought management techniques.
Distraction: using pleasant thoughts can help take attention away from unpleasant thoughts.
Mindfulness techniques to redirect attention from negative thinking.
Thought replacement or coping statements. Develop a set of statements that will counteract worrying thoughts (e.g., "This is difficult but I have been through it before and have got through it okay", "Hang in there, this will not last much longer"). Substitute one of the reassuring or coping statements for the troubling thought.
Thought stopping: The person states the word “Stop!” in response to troubling thoughts.

These are most useful when the individual has problems that are not too ‘deep’. They can be quite effective and useful for the person who has trouble with a big internal critic and so forth. For those where there is more serious maladjustment such as with the personality disorders or character problems then such thought management is much less useful. Someone who hates and loathes self is not going to be able to change that attitude around by altering specific thoughts they have. This requires the use of other treatment methods as well.
However such strategies do have their use but one can add to those above with other thought management methods. For instance regressive techniques of thought management can be used.
Rather than creating new thought patterns as described above one can often find that they already have such alternative thinking styles. Some of these can already be ingrained in the personality and thus will tend to be much more impactful than learning a new thought style from scratch.

One can use regressive techniques to almost “hunt” around on the personality. One way of doing this is with the parent interview technique.
So it is better if you already have someone there
1. Identify who is in your Parent ego state tapes
2. Do a parent interview to elicit what they think, feel, do and say. One is accessing the Parent, Adult and Child ego states of mother and father.

The parent interview allows the client to define and experience mother's and father's own Parent, Adult and Child ego states.
Quite often there already are some good messages in those that the person is unaware of. Some times in counselling so much focus is on the damage that the parents may have done that there can be other ‘good’ stuff that is forgotten or pushed to the side. If some is there and can be found then they can be quite impactful as they are already deeply ingrained in the personality. They have been there since childhood.
If there is none then one better way to create new thinking styles is to make editions to the Parent ego state. The thought management techniques cited above are primarily an Adult ego state function. To have them ‘implanted’ in the Parent or Child ego state is going to make them much more potent.

How does a young child get Parent ego state tapes? It simply surveys its environment and copies other parental type figures around them. It then behaves, thinks and feels like that person. It copies them and practices being like that. If this persists then it will become part of their Parent ego state.
This happens at times naturally in the therapy setting. Clients will report things such as, “The other day I was dealing with my mother and I found myself saying things like you (the therapist) would say”. This means the client has introjected the therapist partly into their Parent ego state. So taking on new thoughts and behaviours via introjection is going to be much more powerful than by simple Adult ego state based thought management techniques.
In addition to this. In doing a more overall approach to thought management one needs to address the client’s reinforcing memories and script based fantasies.
Graffiti
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Sunday, 01 February 2009
Depression - despair monologue
Despair is commonly misdiagnosed as depression which leads to incorrect treatment such as with anti depressants.
If you want to see the proper version of this go to my Face Book.
You tube are Mother f**kers
Graffiti
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Monday, 26 January 2009
OZ day arsonists
Today is a Monday holiday!!
WooHoo!!
Oh yes and it is Australia day as well.
The day we were colonised by our British ancestors. So the aborigines call it invasion day and want the holiday changed.

I have just been to a local recreation area to do some exercise and buy some supplies and there was every type of water craft known to mankind in use. Every one is having - fun. fun. fun!!!
I have never seen so many flags, cricket bats, Aussie tattoos, BBQs, eskies full of beer in one place at one time. This is a day to enjoy for many in Oz.

A bit hot as well today so we could have that old tradition of setting a bush fire or two. Each summer we Australians do that you know and the old arsonists crank up their lighters and head bush to start a blaze or two. Been a few good ones this summer already.
OK I will start banging on, what I usually bang on about!
Psychologically fire is most interesting because of its extreme destructiveness. If your house gets flooded it probably will survive, or if it gets caught in the wind of a cyclone then it probably will survive to some degree, or if there is an earthquake it may survive to some degree. But if you get a good fire going in the house then it is nitey night, sayonara and toodle-oo. Of all the elements fire is the one that will destroy more so than say wind or water.
So if a person destroys something with fire it is seen as the expression of an intense desire to destroy. Rage and all that sort of thing. We all know this and so when we see out of control fire it is attention grabbing and stimulating in that way. Hence we have the psychological basis of the arsonist or the pyromaniac.

As Freud would have said the pyromaniac lights the fire, then get sexually aroused and this is the nature of the true pyromaniac. Now we know he was a bit obsessed with sex but he was also a very good observer of human nature, so lets change what he said just a little bit.
When the pyromaniac lights a fire he gets physical arousal in his body. In some people that state of arousal will get sexualised and for others it will not. However they are all placed in a state of heightened physical arousal. Hence we have the addiction of the pyromaniac or the serial arsonist.
It is like the self harmer who is so continually numb or psychologically anethesitized that they cannot take it anymore. So they go and cut self in order to get some feeling (ie physical arousal). The serial arsonist can be the same. They get such arousal from lighting the fire, hiding and watching the destructiveness of the fire that the ever present numbness goes a way for a time. Problem is it comes back and thus the strong urge to do the same again.
The other reason why the career of an pyromaniac can be a short one is they have to hang around. It’s no use lighting the fire and then running away because you don’t get the same physical arousal which is the whole purpose of the exercise in the first place. So they lurk around and are often identified and caught. In some instances they will get so excited they will need to urinate which is very symbolic in itself.

There may at times be considerable advance preparation of the fire setting which of course adds to the tension build up and feeling. Then as the fire happens and the person watches there is the release of tension and a sense of normality appears for a period of time. The same can happen for others like the kleptomaniac. First the numbness, then the tension build up followed by the release and then a sense of normality or realness for a period of time.

I knew a serial arsonist once when I worked in a prison. He was brought to me because one day he trashed his cell and I mean he trashed his cell. Every possible thing that could be smashed, broken or ripped up was. I went and had a look at it and it was a demolition site.
So as the psych I am supposed to fix him up which really meant monitor him and act as a release valve so the next time he would only trash his cell a little bit rather than do a complete demolition job. So I got to know him quite well. Some other inmates had been picking on him for some time and finally he just exploded and wrecked his cell.
I found him to be nice man and we had many good conversations. But he looked like he had just come in from the jungle. One day I said to him that he looked like the “Wild man from Borneo”, which he found most entertaining and indeed would refer to himself as that from time to time.

Often prisoners will try and intimidate and threaten you so as to gain the upper hand in the relationship. He never did any of this with me and was pleasant and indeed polite to me most of the time. But he also had a rage deep inside him. If the rage button got pushed, out it would come and that was the time not to be around. Interestingly he never had any convictions for assault so it seemed he could direct his rage at property and with the use of fire. Which is good in a round about sort of a way. He would be out by now. Wonder if he has joined this years fire lighting season.
Graffiti
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