Sunday, December 19, 2010

The hysteric and obsessive-compulsive personalities

Histrionic

This personality type is more common in women and with males it is more common amongst the homosexual community

A very Child ego state personality type. The Child is dramatic, reactive and intense and thus the relationships are usually not easy going. (Sometimes referred to as a ‘small dose person’). Initially it seems that they are having Free Child reactions to situations but the reactions are exaggerated and overly-dramatic so that it is more correctly diagnosed as being Adapted Child ego state.

Their feelings can have a lack of authenticity and can change rapidly. Quickly develop love and then it switches to someone else. Be very sad about loss of goldfish and then ten minutes later be jovial about something. Pyrotechnics and you need to cut off the top of the feelings chart. They need to have considered and controlled feeling expression. Thinking and feeling often do not go together, which is another treatment goal. To learn to think while they are feeling.

Adult and Parent are often minimal and thus they tend to be quite symbiotic and require someone else’s Parent and Adult ego states to function in life.

Symbiosis diagram
Symbiosis

Obviously treatment will involve the development of the Adult and Parent ego states and breaking down current symbioses which means you are effecting others who may not like the change. The hysteric can often marry the O/C or paranoid. They are quite impressionable and may be quite suggestible in relationships

They often sexualise transactions and play the game of Rapo (flirtation) and thus can have poor boundaries which shows up the lack of Adult and Parent ego states. They can quickly develop romantic fantasy and have sexual attraction to the other which of course male therapists need to be careful about and manage well.

Historically the girl may have had a romanticised, sexualised quality of relationship with father. This does not mean sexual abuse at all. They will report a special quality of connection between daughter and father. This can lead to later problems in their relationships with partners as no man in her mind can ever match up to father and her reluctance to break the attachment to father. Focus of treatment is this historical relationship.

Amy W 2

Their actual sexual relationship can cover the whole range from promiscuity and highly sexually responsive, to naive and sexually unresponsive, to apparently normal sexual behaviour. This can also change over time in the one relationship. Initially it can be highly sexually charged but then she can become sexually unresponsive as in her mind the historical relationship with father interferes.

The also somatisize feelings which also shows the strong Child ego state responses to the environment. This gets caught up with the hypnotic suggestibility.
. Their bodies will be very reflective of their emotional and psychological status so it is useful diagnostically in this way.

They can be diagnosed as hypochrondrical as they can seek medical intervention for their somatic complaints which can be common. This is probably an inaccurate diagnosis because it is not a preoccupation and fear of having some serious disease. Their psychology simply gets reflected in their body and they are not lying or trying to rort the system (at least initially). They do feel the pain its just that it does not have a physical basis which can lead those medically examining her to suspect she has ulterior motives. Hence we end up with more dramatic conditions like hysterical conversion such as hysterical paralysis.

Shusi woman

Often there is an abrupt onset of the physical condition that may be relate time wise to a particular traumatic event by the person. Argument and so forth. It is seen to have two psychological causes

Primary gain - by somatisizing the pain of say an argument it allows the person to keep the internal conflict out of their awareness. They get distracted to the physical condition and the psychological problem can be forgotten.
Secondary gain - It can allow the person to avoid the noxious activity. The soldier who gets hysterical paralysis or the woman whose husband has said he is going to leave her feels her can’t whilst she is physically infirmed.

Hysterics can often end up in counselling for the reasons just described (frustrated medical professionals refer them) and some therapies are also a great place for venting emotions loudly which may appeal. Often the hysteric can use the defence mechanism of denial steadfastly. It is always someone else causing her the problem. So in this way they lack considerable introspection whilst initially may seeming to be quite introspective.

Attachment style weak and difficult to form due to self centeredness

Fire monkey

Obsessive compulsive


Magical thinking is prominent in the personality structure. Scare and anxiety based difficulty so they feel unsafe. I can make myself feels safe if I just - wash my hands, switch the lights three times, check the windows and so on. This activity will make me safe.

This can take one of two forms
The person is aware of the irrationality and thus aware of the magical thinking

Magical thinking

Or the person seeks to convince self that there is a factual basis for their behaviour and thus one gets Child contamination of the Adult.
“I read in a magazine that there is this new bacteria that means you have to wash your hands 10 times.”
“there are lots of robberies in this area so it pays to check the window's many times a night”.

Contamination

Thus one looks for the original source of the anxiety. Possible hurried child, C > NP but no NP back. Either C or A back or nothing back emotionally. This often is a major focus of treatment helping the C2 to feel safe.

Hurried child dynamic

Obsessive thinking may simply be a cover for or distraction from feelings. “I you were not allowed to think what would happen” and it is usually that uncomfortable feelings would come up.

Layering process

thinking
------------
feelings


Get the feelings to come up and have them dealt with. That is cry (or scare) and get acceptance and the NP back. Get anger expressed with no terrible thing happening usually the expectation of violence or pain to child. Also possible shame feelings due to anal phase problems, sexually based, encropesis or enuresis or used as a parenting style.

Modelling of obsessional behaviour.

They tend to be dependable, neat, dutiful, inhibited which is all Parent and Conforming Child ego state. They lack Free Child which needs to be increased. Even contracts to have fun obsessionally and compulsively. Have a special meal or movie every second Wednesday night at 7pm.

Redecison work to be a child and enjoy and get needs met.

Relational patterns
The obsessions and compulsions can significantly impair ones everyday life, such as with cleanliness. This means that those others also living in the house have their lives effected as well. The O/C can thus ‘make’ others do the right thing (e.g. be clean) with Controlling Parent if the Parent ego state is strong. Or they can control from the Child ego state by being terrified of things (e.g. lack of cleanliness) and others will respond from their Rescuing Parent ego state. This can destroy relationships if too severe.

Beer hats

Often Adult ego state is well functioning and they use it to be perfectionistic and in the service of refining the obsessions and compulsions. Although decision making can be poor because the Adult can think of all the possible permutations and consequences of every option and thus can’t make a decision in the end. The get bogged down in too much information.

The Conforming Child ego state can also be high as they can be reliable, responsible, hardworking, dutiful, always punctual and so on. In this way they can make good employees as long as they do not waste too much time and energy with their obsessions and perfectionism.

Graffiti

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