Self harm

This was sent to me today by a self harmer who did this to her leg.



It catches the emotional core of the Borderline personality. A mixture of anger and fear.

She makes an interesting distinction between ‘playing” self harm and ‘punishing’ self harm. This is playing self harm where the cuts a quite superficial but with punishment self harm the cuts are significantly deeper. And it is the bleeding that has the most psychological significance.



In my book - Working with suicidal individuals - I propose 8 possible motivations for self harming:

1. Self harming as part of gang tattooing behaviour.
2. Self harming to make self feel real which can be found in those who dissociate.
3. Self harming to make self feel something.
4. Self harming used as a means of tension relief and to release pressure build up.
5. Self harming as a physical expression of emotional pain. Self harming is seen as providing concrete evidence of the pain.
6. Self harming as a means to self nurture. It allows the person to care for self as can be found in Munchausen Syndrome.
7. Self harming as a means to punish self and an expression of self hatred.
8. Self harming as a means to manipulate others or as a cry for help.

It would seem that reason number 7 is part of the motivation to self harm. As for seeing the blood and bleeding one would need to enquire as to what it means for the self harmer. It could be a variety of things such as found in reasons # 2, 3, 4, 5 or 6.

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Anger and forgiveness in psychotherapy

On occasion there is the need for some anger expression in therapy. A recent example brought this to the fore.

A woman in her 50s had a life time of being ignored by her mother. But to make matters worse her two sisters were often highlighted by her mother at times in front of her. In public the mother may talk about the exploits and successes of her two sisters but never of her. It seems safe to say that there was favouritism in this way.

The woman would at times recount such situations that had occurred many times in her life and often felt anger as she did remember. When this happened it was not long until she would mention that she did not believe that her mother did this on purpose. That she was probably unaware that she was even doing such a thing. And from what I was told I tended to agree with her. In addition her mother was now quite elderly and frail and the client would say that how could she be angry at such an elderly person. Her goal was simply to forgive her mother for the mistreatment that she had received over the years in the way described above. However this meant she was directly avoiding being angry. Unfortunately this kept reappearing, her anger at her mother kept resurfacing.

As a therapist I am all in favour of the idea of forgiveness. I think it is a very wise psychological goal to aim for. Forgiving ones parents for that they did or forgiving ones abuser for the abuse received is a wise psychological goal. However sometimes this is the situation:



At times in order to get from the hurt to the forgiveness you have to go through a period of anger. If it is only a minor transgression then one does not have to. If it was significant especially at a young age and especially when over a period of time then one cannot go straight from the hurt to the forgiveness. They have to go through a period of anger.

This is where a lot of people get stuck, in one of two ways. Firstly, as in the case cited above the person is uncomfortable with anger and finds it difficult to go through that stage. They try all kinds of ways to avoid it and the example above shows some of the rationalisations that people will come up with in order to do that. Secondly, the other individual does not avoid it but gets stuck in it. This is not an uncommon scenario to come across in therapy. Some one who is chronically angry at their abuser. Quite often they never see their abuser now or the abuser may even be dead. The client may be carrying around a sack of anger on their back towards some one who died years ago. What does that achieve, and more importantly who suffers from the sack of anger - certainly not the dead person.


Some find forgiving their abuser this hard to do.




If the person does successfully transverse the anger then they are well on their way to achieving a sense of forgiveness. Once done, their life in the here and now is more pleasant and they are capable of more staisfying relationships in their current world. Indeed their current relationships are much less likely to be damaged by such unresolved past events.

However the difficult part for the therapist is to judge how long the angry period is meant to last. This is not an easy thing to gauge. As is often the case in therapy it is usually best to leave it up to the client and they will tell you in one way or another. However this is not always the case. For instance it is highly likely that the client described above will be saying she is ready to pass the angry stage before she is.


Living in the here and now. Can't enjoy this if your head is stuck in the past.



But she may tell the therapist in another way. Over time one will notice that she spontaneously brings up the issue of anger at mother less and less. When this happens she is ready to begin the forgiveness work and the therapist starts that phase of therapy.

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Larissa - anger case study and results

I appreciate your posts on anger because it’s a huge problem issue for me. I’m not really sure how to answer these questions because my parents left when I was young (around two). They came to visit sometimes so I had parents, but they were more like guests and not really like parents. I think my parent ego state is based on my father’s parents (grandparents). So if there's anything I've said here that would help me deal with anger better, I'd love to hear it.

My Parent ego state and anger

When my grandfather was angry he would (Hit, withdraw and sulk, shout, swear, give a lecture, get sarcastic, eat, fight, get depressed and so on)

Say - nothing

Do – slam the door on the way out and leave for awhile

When my grandMother was angry she would:

Say – curse, call me bad names, scream, rant

Do – threaten to send me away, threaten to send my brothers away, threaten to hurt me, blame me for ruining her life

My Child ego state decisions about anger

When I was angry grandmother would

Say – I was ungrateful, call me names, scream at me

Do – whip me, blame me, hurt me

Feel – she hated me more than usual

When I saw grandmother or grandfather angry I would

Say - nothing

Do - hide

Feel - scared

What did your grandmother and grandfather say about expressing anger. (OK, not OK, good, bad, time & place, men & women, etc) I learned very young that it was not acceptable for me to be angry or even look angry in front of them…ever. I don't remember them ever saying anything about it.

As a teenager did you get rebellious and angry? If so how did you express it and how did the parent figures respond? As a teenager, I hated everything about living. I did a lot of drugs and drank. I was not good to myself and did dangerous things. Sometimes I ran away. I stayed away as much as possible. Sometimes my grandmother found my stash and she flushed it (or hell, maybe she really kept it for herself) and she'd tell me I was trash like my mother and a nutcase like my mother's father. Fortunately, I had a couple of really good teachers in high school who motivated me to stay out of trouble and encouraged me to escape home by finding work rather than laying drunk in the alleys. They saved my life.

Summation of early decisions = Anger is forbidden.

---------------

Results

This case study is a good example of how a person can acquire contradictory script messages about anger and its expression. As we can see Larissa made a Child ego state decision:

“Don’t feel anger”

or at least

Don’t express your anger”

This is held in the Child ego state. At the same time she would have introjected her grandmother’s anger expression into her Parent ego state. This is shown with the statements like:

When my grandMother was angry she would:

Say – curse, call me bad names, scream, rant

and

When I was angry grandmother would

Say – I was ungrateful, call me names, scream at me

Do – whip me, blame me, hurt me

Thus she has a strong model which shows that it is OK to feel angry and to express that anger in a forthright and demonstrative way. Thus Larissa has a contradiction in her personality in this way.

It is probably safe to say that the early decisions are more influential in the personality than the models, however at the same time the modelling of behaviour is recognised as a significant factor in personality development.

Logically there are 4 possibilities
1. Decision made with consistent modelling
2. Decision made with contradictory modelling
3. Decision made with no modelling
4. No decision made but with modelling of behaviour

Larrisa is possibility number 2 and this could lead to some outright
contradictory behaviour with anger at times. Or what is more likely is that the decision behaviour will by overt with the modelled behaviour being expressed in a more convert way. Indeed this may be the case with Larissa (however this is based on very minimal information)

She says:
As a teenager, I hated everything about living. I did a lot of drugs and drank. I was not good to myself and did dangerous things.


This could indicate that the permission to express anger has resulted in her expressing anger at herself. Which resulted in some self destructive behaviour. In relationships with others there maybe a suppression of the anger as the decision demands.

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Anger in my personality

Anger work - How anger is structured in my personality


My Parent ego state and anger

When my father was angry he would (Hit, withdraw and sulk, shout, swear, give a lecture, get sarcastic, eat, fight, get depressed and so on)

Say -

Do -


When my Mother was angry she would:

Say -

Do -




My Child ego state decisions about anger

When I was angry mother (father) would

Say -

Do -

Feel -

When I saw mother (father) angry I would

Say -

Do -

Feel -


What did your mother and father say about expressing anger. (OK, not OK, good, bad, time & place, men & women, etc)



As a teenager did you get rebellious and angry? If so how did you express it and how did the parent figures respond?

Summation of early decisions =



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Anger in the personality

Two ways of incorporating personality factors about anger

Injunctions - early decisions by the child (Child ego state)
Parent communicates to the child in some form that it is not OK to feel and/or express anger. As the young child has no Adult or Parent ego state it accepts the message in its Little Professor ego state, (The Adult in the Child ego state (A1)). 1. The child hears the parental directive in its A1
2. The youngster also listens to its own feelings (provided by the C1) as a reaction to the directive .
3. The young child makes its early decision based on these two bits of information and stores that decision in the P1.



Modelling based Don’t be angry injunction (Parent ego state)
As the child grows it begins to store modelling in its Parent ego state in a very rudimentary form. These can never be fully expressed in a grown up way until the Parent ego state gains maturation in the teenage years. The young girl will model on mother and if mother has a strong aversion to expressing or feeling anger the daughter will model that and incorporate it into her own Parent ego state.



The more the Child ego state decisions are consistent with the Parent ego state modelling the stronger the influence in the personality. At times they will be consistent and at other times they can be direct opposites. Consider this example. Johnny gets angry and hits his sister on the head with a piece of wood. On seeing this mother approaches Johnny angrily. With a raised angry voice she smacks Johnny on the back side and tells him not to hit his sister.

Johnny thinks in his A1 ego state. I was angry, that made mother very frightening to me and I got hit so I decide, “Don’t feel angry”. (Child ego state)

At the same time Johnny models on mother’s anger and her expression of that anger by hitting. (Parent ego state)

Thus the Child decisions about anger and the Parent modelling about anger are contradictory.



Problems with feeling and expressing anger

Starting with the most serious psychopathology moving to the least.

1. Don’t be sane. This person does not even acknowledge that a event has occurred that one could feel about. One may have been put down or say ridiculed and the individual does not even recognise that the event has occurred. The Adult ego state is so dysfunctional the facts of the situation are not recognised or comprehended.

2. Don’t feel. This person recognises that an event has occurred but does not feel anything in response to it. Person gets their wallet stolen but has no feelings about it.

3. Don’t feel X, feel Y. Person acknowledges the event, has a feeling in response to the event but it is not the appropriate feeling. Instead of feeling angry at being unjustly criticised the person feels scared or embarrassed. Women will often feel scared instead of angry and men will often feel anger instead of scared.

4. Don’t express your feelings. This person acknowledges an event has occurred, feels the appropriate feeling about it, but does not express the feeling.

5. Feel X, but express Y. This person acknowledges an event has occurred, feels the appropriate feeling about it, expresses the feeling but it is the inappropriate feeling. The woman who feels angry and then cries, the man who feels sad but shows anger

(Ref: Treatment of character)

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Anger work in psychotherapy

Preliminary notes

It is necessary to use anger work in a context in counselling. In some areas such as the bodywork approaches this is not done and anger work can be used just as an exercise in itself. It must be relevant to the contract at hand and have a clear role in assisting the client to achieve that contract.

For example a client could say, “I want to shout at my father because of the way he treated me the other day”. In order for a therapist to go along with such a contract he needs to be aware of what happened between the two people as the anger work could be just a part in the game. What is the client’s script messages about anger and its expression. The client may be chronically angry and to go ahead and do the anger work would be contraindicated.

Anger work is a regressive technique. That is it encourages the client to ‘regress’ into the Child ego state and out of the Adult and Parent ego states. This has obvious uses for the individual who is stuck in his Parent and Adult and excludes the Child ego state, which many people are who attend psychotherapy. On the other hand there are people who are too much in their Child ego state and exclude the Parent and Adult, clearly one would need to be careful in doing such anger work with these individuals. For example the chronically angry person, and the hysteric personality type.



Anger work also destabilises the personality. This is one of its great therapeutic advantages. A client’s script becomes set and solid over time after many, many rehearsals and reinforcements day after day. Anger work can be used to shake it up and loosen the concrete holding it together. Once loosened one can then restructure the script into another form that allows the individual to live a more emotionally liberated life. That is, less script bound and more autonomous.

The down side of this destabilisation is that what if the client is already destabilised such as can be the case with schizophrenia, dependent personality, borderline personality and the obsessive/compulsive personality. One would need to be cautious using anger work in such situations.

Another difficulty with anger work is that anger always has the potential to turn into physical violence. So if the client is impulsive and has a tendency to be explosive then one needs to be very careful with anger work particularly if the client is bigger than you.


These women need to do some anger work, for sure!


In all my years of counselling I have never had a client express their anger in a way which hurt me or any of my property. One can use “Stop” techniques if necessary. Another advantage of this is with the client who comes from a physically violent back ground. By doing anger work they get first hand experience that there can be anger without physical violence.

Anger expression can be self validating. If one feels they have been wronged, then the act of saying so , especially to the face of the other party says to the individual - “I am worthwhile”. So to say such things with the expression of anger can assist with the self esteem.

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Expressing internalized anger

The internalised anger transaction can take two forms.



Firstly the person receives information of some kind. It is disturbing information to which the person reacts in an angry fashion. The person may have been criticised at work, they may have got a “B” for an assignment when they expected an “A”, they may have been rejected by someone or many, many other possibilities.

Once the information has been acknowledged by the Adult ego state the internalised anger can be expressed in two ways which are indeed quite different in their origin and indicate two quite different psychological processes.

The person can express such anger at the Child ego state from the Critical Parent ego state (CP). This person can be said to have a large internal critic inside their head which at times actively scolds and derides them. The origin of this comes from an introjection in childhood of the parent figures around them.

The child may have observed mother and father being critical of others and themselves and he copies that. However the more potent source of an active internal CP is when the parents have expressed criticism of the person when they were a child. The young child is criticised directly by mother and father. This criticism is then internalised by the youngster and stored in their Parent ego state through the process of introjection.



Often the words the person says inside their head as an adult are exactly the same words that were expressed to the person as a child by mother and father. Or the self criticism is about the same kind of things mother criticised the about child as a youngster.

This type of self directed anger is the least pathological and the easier of the two to treat. As with all treatment contracts it is better to look at increasing some behaviour rather than decreasing behaviour. One would not want the contract to be - “I will decrease my Critical Parent comments”. Instead one would want the contract - “I will increase my Nurturing Parent comments”. If one increases their Nurturing Parent ego state then the Critical Parent will naturally go down. One focuses on the Nurturing Parent rather than the Critical Parent.



Interestingly if a person has a high internal critic directed at self then there is always the potential for it to be directed at others as well. If one is working with a client who has a high CP for self then one also wonders if there are high CP thoughts about the therapist as well.

Some with a high CP for self can also have a high CP for others. Those critical thoughts of others may be openly stated or they may never be stated and just remain internal thoughts. But the potential is always there compared to the individual who does not have a high internally directed CP.

Child ego state anger
As the diagram shows the other type of internally directed anger comes from the Child ego state and is directed at the Child ego state. As a consequence these angry statements are not introjects from our parent figures. Instead they result from decisions that the Child has made about itself. These represent more serious psychopathology and thus the person can be seen to be more ‘damaged’.



The nature of the CP statements tend to be; “I am bad because...”

The Child ego state angry statements may also be precipitated by an event and thus one gets statements like: “I am bad because..... and there is an inherent badness in me anyway”. At other times there may be no precipitating event and the person simply expresses anger at self for no obvious reason. At times this can result in self harming type of behaviour.

Whilst an internal directed CP is common, almost every one has an internal critic of some kind. The internally direct Child statements are far less common. It requires the person to believe and feel there is something basically and intrinsically bad about self. This probably represents 5% of the population. As a result it is much more difficult to treat as one is looking to remediate a basic belief about self and not simply encourage NP statements to counter the CP statement from the Parent ego state.

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Shame - edit #4 (Part 1)

This post will develop over a couple of days

When one reads the literature on shame one finds a bit of confusion as to what shame is and is not. Or perhaps it is better to say that people have differing views on it. One commonly finds three things mentioned in relation to shame.

Internalised anger
Guilt &
Shame

These three things are often mentioned as relating to or being part of shame. My own view is that each of these constitute three separate psychological processes. They are three separate entities. However they can and often do occur contemporaneously.



This would explain why some people may see guilt as being part of the shame experience or internal anger as defined as being shame on occasion. They can occur at the same time and often do. If one can define the three separate psychological processes this would clarify the nature of shame and its associated processes.

There are two ways in which internal anger can occur as shown in the diagram



People can express anger at themselves from their Child ego state. When this occurs people will do negative internal self talk such as I am stupid, I was a geek talking to that girl and so on....

Anger can also be expressed from the Critical Parent ego state to the Child of the person. In this case the internal self talk does not start with a “I” statement but with a “You” statement when an internal ‘telling off’ occurs. Examples may be “You were such a jerk talking to that boy”, “You can’t even get a simple report right”, You stupid f**k” and so forth.

Guilt occurs when the person has a sense of breaking an internal rule which they have for them self. If a husband thinks the woman next door is hot and foxy but he has a rule inside his Parent ego state which says, “Thou shalt not covet thy neighbours wife” then he can end up feeling guilt for having such thoughts and feelings.



Or a person may steal money from a brother and later feel guilt about it because he has the rule in his Parent that you don’t steal from your brother. People can feel guilty the next day after a night of drinking too much. Alcohol decommissions the Parent ego state and thus people behave in such ways that they usually wouldn’t. The next day after the alcohol has worn off they feel guilty because the Parent ego state becomes active again.



Finally we have shame which is a natural feeling reaction to a particular environmental stimuli. Often, but by no means always, it is associated with sex, nudity or intimate bodily processes such as urinating or defecating. A prime example is the enuretic child who wets his bed at night. When the child wakes up and realises he has wet the bed it is very easy for him to feel shame about that and he can go to extensive lengths to try and hide it. Indeed parents need to be very careful not engender a sense of shame in a child when he wets the bed. It needs to be dealt with very carefully so as to avoid this. Thus we have the shame transaction.



As you can see this differs from the guilt transaction in that there is no Parent to Child transaction before for emotion is experienced. This is consistent with Freud’s presentations on shame which is probably best summed up by Lynd(1958) who notes that guilt is usually more related to transgressions of clear moral codes and rules. No better example of this is found in religious texts which define what behaviours, thoughts and feelings are regarded as sinful. These are incorporated into the Parent ego state by the young child and when transgressed the individual most often will expoerience guilt.

With shame the rules are much less codified and clear. Transgressions of them are more by tactlessness, errors in taste or bad luck. As a result the Parent ego state is much less involved in the process. Again the example of the enuretic child demonstrates this. Wetting the bed does not break a Parent ego state rule and generally would not be regarded as sinful. Instead it result from bad luck or factors outside the child’s control.

Lynd, H.M. (1958) On Shame and the Search for Identity. London: Routledge & Kegan Paul.


This indicates that there are three separate psychological processes - inward anger, guilt and shame. They can occur on their own or they can occur together. However if we see them as separate processes then the situation as to what shame is and is not can be kept more clear.


The separateness of these three psychological processes can be understood experientially as well. In therapy I may ask the client the following questions:

Recall a time when you felt guilty.
What happened and describe the feeling? Use a few words to describe what the experience of guilt feels like for you?

Recall a time when you felt shame.
What happened and describe the feeling? Use a few words to describe what the experience of shame feels like for you?

Recall a time when you felt angry at yourself.
What happened and describe the feeling? Use a few words to describe what the experience of self directed anger feels like for you?

Most people find this quite easy to do and report that the experience of shame and guilt are different which supports the contention that they involve discrete psychological operations.

If any one here wants to do this exercise I would be interested to hear your answers.




Shame and embarrassment

Under normal circumstances shame is not an emotion that is experienced all that often. The feelings chart shows there are various groups of feelings.



I have purposely used the word “Family” because they are like that. There is a commonality amongst the feelings but they are also all different. Just like members in a family, they all have a basic commonality and they are also all different.

It is proposed that shame and embarrassment are like this. Embarrassment is a minor version of the full shame reaction and thus embarrassment is a much more common feeling for people to experience. It is safe to say that most people could relatively easily recite situations where they have felt embarrassed. Under normal circumstances there would be far less events to recall where the person felt shame.

They both come from the same emotion but vary in their impact. Whilst embarrassment is an unpleasant emotion to experience it does not have the devastating effect that shame can have. Charles Rycroft notes that shame is the cinderella of the destructive emotions. The experience of shame tears at the core of who we are. It effects us at a deep level and the understanding of who we are.



With guilt people can have the experience of,

“I am bad for doing that thing”

whereas with shame the person is more likely to end up with the feeling of,

“I am bad”
Whilst the shame will be connected to a certain event occurring the resultant comprehension of it is more about me as a person rather than about something I have done. Shame has far more destructive power than most other emotions.

As stated above under normal circumstances shame is infrequently experienced. It tends to only be experienced in relation to quite unusual circumstances, where as embarrassment is more frequently experienced in reaction to a wider range of events. There is however an exception to this.


Will he feel embarrassed about ending up like this? Lots of people are watching!


Parents quickly learn that emotions are a effective way to get children to conform.

They can use guilt.

“Mummy will feel sad and hurt if you don’t eat up all your food”.

They can use fear by threatening abandonment.

“Unless you have your bath now mummy will get a policeman to come and take you away”.

These emotions cause pain in the child and thus the child will tend to behave in order to avoid the painful experience. The same applies for shame which can be a very unpleasant emotion to experience. Thus parents can say things like,

“You should be ashamed of yourself for.....”

It works in getting a child to behave in a certain way but it is also particularly destructive in the ways described above. I would strongly advise parents not to employ this kind of child rearing practice.


This will get people to conform, but at what long term psychological cost?

If you are working with a client who reports this kind of parenting in their childhood then you know the person may be damaged psychologically at quite a deep level. Also they will tend to report the experience of shame in the present more than average. They will tend to react to events with shame whereas others would tend to only experience embarrassment. This of course just amplifies the problem.

Rycroft, C.
1971. Reich. Fontana: Great Britain

The discussion about using shame as a parenting technique provides insight into the difference between neurotic shame and Here and Now (H&N) or reality based shame.



This figure shows the two different types of shame are functions of two different parts of the personality. Reality based shame is a function of the Free Child aspect of the personality and the Adapted Child ego state is where neurotic shame would result from.

This proposal rests on the assumption that shame can be a normal and natural human emotion. An assumption that gets plenty of support. Firstly Freud (1942) notes that shame is “,,, organically predetermined...”(p.46). Then English (1994) discusses the topic in some depth. As she notes it would be impossible to instil shame in a child who did not already have the organic receptors for it. The ability to feel shame can be seen to have some evolutionary advantages as well.

English reports that Charles Darwin suggested that shame had certain evolutionary advantages. Shame is often around nudity and sexual matters and that covering up the genitals afforded more protection of them which also increased the likelihood of the propagation of the species. The expression of shame often involves blushing and a desire to hide which corresponds to the feeling of being dangerously exposed.


Why only cover up those parts of the body?



English, F. (1994) ‘Shame and Social Control Revisited.’ Transactional Analysis Journal. 24, 2, 109 - 120.

Freud, S. (1942) Three Contributions to the Theory of Sex. London: Imago.



As a result humans are so constructed that should a particular set of circumstances arise they will naturally feel shame. To make the assessment of reality based shame versus neurotic shame one needs to judge the appropriateness of the circumstances that have lead to the shame reaction.

Sometimes this is clear but at other times it is harder to assess. As said before shame is often, but by no means always, associated with nudity, sex or intimate physical and psychological factors. Below are some instances where many would feel shame as an appropriate H&N reaction.

The child who wets its bed or soils itself.
A woman discovers her ex-partner has placed intimate nude photographs of her on the internet for all to see.
A man is publicly exposed as an adulterer in his church group.
A man publicly jokes about his wife’s vaginismus.
A woman pokes fun at her husband about his baldness which she knows he is very sensitive about.



If a person reports feeling shame in such situations these could be diagnosed as Free Child shame reactions.

Some times the circumstances are less clear.
A teenager gets an F for his maths test.
A lecturer trips on steps as he walks up onto the stage to give a lecture.
Is it appropriate to feel shame in these examples, is harder to judge.

Many people with a social phobia report shame and embarrassment that is neurotic in nature. They feel as they walk into a social gathering that everybody is looking at them, they look awkward and odd such that they experience shame. Or as they talk they think they are blushing and saying stupid things and feel shame as a result.

These are likely to be Adapted Child ego state responses of shame. One reason why these occur can be due to the parenting styles as described above. If the parents have used shame as a method of punishment and said things like, “You should be ashamed of your self for...” the person is primed to have shame reactions as an adult. As a result they will have reactions of shame when most others would not.



This leaves us at the next juncture of what does one do when they feel shame? Thus the distinction between neurotic and reality based shame assumes some importance.


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Emotional literacy

Anger
With drawing the four feelings one is wanting to know if the child (or adult) has the word A.N.G.E.R. (and the 3 others) connected up with the right emotional experience. One looks for these kind of things. Below are two drawings of anger and one searches for the right signs in the drawing.

Do they draw the appropriate facial expressions and body posture and paraphernalia?





These are two interesting drawings of anger. At least at the surface level they indicate a good level of emotional literacy with anger.

The second drawing has clenched fists, exposed teeth, eyes and eyebrows right for the emotion. This is a good sign that they have A.N.G.E.R. and the correct emotional experience connected together.

Further investigation would look into the BOOM and the swirling thing above the head. One is looking for the possibility of explosive anger with the boom and when angry the person experiencing a kind of swirling effect in the head or some kind of change in the consciousness. It is most likely this is not the case and one is kind of ruling the out possibility. But it may lead to something of this kind.

In the first drawing of anger we also have the teeth, the clenched fist and words that are appropriate to anger. Also we have the appropriate paraphernalia with an axe with what seems to be blood dripping from it. Again one would need to rule out the possibility of the inappropriate expression of anger with the use of physical violence as symbolised by the axe. Or the person may have come from a background where anger and physical violence went together. Or it may indicate a very intense level of the experience of anger for the individual.

However in summary both the drawings show a satisfactory level of emotional literacy with anger and areas where subsequent questioning could occur.

Happy


This is a good drawing of happy as the picture has a happy feel to it and the figure looks appropriate with the smile, relaxed posture, the cat and the serene surroundings. Thus indicating reasonable literacy levels with this emotion.

With this emotion one also wants to assess the persons social life. In this drawing the person is alone and not with others or engaged in interactions with others. Subsequent questioning would be on this area. However the instruction was to draw a happy person and not draw a happy person with others so that is the usual explanation one gets when questioning like this.

With such questioning one is looking for this emotion to be experienced in interactions with others particularly others who are of emotional importance to the child such as the parents, (or with adults the spouse).

In the picture the figure looks to be patting the cat. This could be a sign of the NP ego state. It is OK to experience happy feelings whilst in NP and I would be asking about the person experiencing happy just for them self and not when looking after some thing else like an animal or another person.

Scared

If you want to see it larger simply click on the photograph

This is an interesting drawing and reflects the possibility of some level of illiteracy with this emotion. The small figure, wanting to be alone and possibly hiding behind a wall. These are not good signs as in this emotion one is wanting the person to be seeking out others who can provide safety and support. Could indicate the beginnings of the hurried child syndrome.

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Temper tantrum (editted)

A temper tantrum is an uncontrolled expression of anger or tension. It can include arms and legs thrashing about, arching of the back, crying, screaming, stamping feet, throwing self onto the floor.

4 common reasons for temper tantrums
1] Tension outlet. The child becomes like a pressure cooker and it does not have a more sophisticated way of releasing that tension.

2] Manipulation or intimidation to get something or assume the powerful position in the relationship with mother. This can be particularly so if the child has a tendency to throw a temper tantrum in public, like in a supermarket.

3] Temper tantrums are dramatic displays of emotion especially when done in public view. So they can represent the precursors for the development of the ‘drama queen’ personality types such as the hysteric, narcissistic or borderline personality types.


Tantrums? Not this good girl.

4] The child is learning about anger and assertion. Temper tantrums can be a crude expression of these feelings. Most people as the grow learn about their feelings of anger, how to manage them and how to express them in a socially acceptable way. The first thing a child must learn is to focus its anger at the source of frustration or the stimuli of the anger. This is shown in the two diagrams below.



The first shows temper tantrum anger. It is directionless and thus goes in all directions including being directed at self. The child angrily lashes out and will hit those around himself as well as himself. When working with the child one seeks to get the child to identify the source of its frustration. Who or what lead to the angry response? It maybe mummy saying “No”, a sibling getting the last piece of cake, having to go to school, not being able to tie its shoe laces and so forth.

One needs to assist the child to achieve the cognitive task of understanding what caused its frustration. Once done the child can learn to direct its anger at the source as the diagram shows. Then to show the anger at that ‘thing’ in a socially acceptable way.



Responses parents can have to children who are engaging in a tantrum:
The primary problem with a temper tantrum is the lack of control by the child such that they can physically hurt self. If a child is in a hysterical state the parent needs to assess if it’s in danger of hurting self. If it is, then the parent must adopt the first strategy of restraining the child. If the child is not in any danger of hurting self then the parents can adopt strategy 1 or 2. If there is more thinking ability in the child then parents can adopt strategies 3, 4 & 5. The response can also be sequential. Do 1 & 2 first and when the child calms one can do options 3, 4 or 5.


Directing anger

1. Hold or restrain the child physically. Dabbing a wet cloth on the face can also defuse the anger
2. Ignore it. If possible it is best to give the behaviour as little attention (strokes) as possible
3. Distract the child
4. Isolate the child (Time out)
5. Compromise.

Tantrums in adulthood
Sometimes people never properly learn how to have directional anger and thus can have tantrum like anger as they grow into adolescence and adulthood. As I mentioned before this can happen in the emotionally labile and acting out type of personalities such as the hysteric, borderline, narcissistic and maybe the anti social personality type as well.

The problem is with an adult having a tantrum is the circumstances are very different. Compare the young child to a fully grown man who is six foot tall, solidly built having a temper tantrum. The potential danger increases significantly and this could explain some types of domestic violence. However the problems do not end there a fully grown adult also has far more ability to plan and is much more capable of using weapons. So the tantrums can be much more physically violent.

This may explain those situations one hears about from time to time when a disgruntled individual walks into a place where many others are and simply starts shooting people and eventually ends up killing self. We hear of teenagers going into high schools doing such things. These situations do have the directionless expression of anger quality that one finds in a tantrum and thus could be an adult display of a temper tantrum.

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Adult ego state strengthening - Part 2 **

As mentioned in the previous post the Adult ego state is in the here and now whereas the Parent and Child ego states are living in the past. This diagram shows how one can avoid the here and now (H&N).

One way to strengthen the Adult ego state is to practice being in the H&N. The more one gets used to it and the more one does it the more habitual it will become and thus easier to access.

First one does a H&N diary. One gets a note pad and then goes about their day to day business. One can feel bad (angry, scared, depressed, despairing, shame and so forth) because they are reacting to something in the H&N. These are healthy Free Child feelings. One can also feel bad by doing what the diagram shows. They remove self from the H&N by thinking about the future, thinking about the past or thinking about another place. These are considered neurotic feelings because they are not relevant to the H&N. They are self manufactured angst.

Now that is what you call H&N Free Child anxiety!

Every time one feels bad during the day they are to see if they are in the H&N or they have moved out of the here and now in time or place. This is then diarized such that patterns can be identified after a few days or a week of doing this.

When one realises they have moved out of the H&N they then practice moving back into the H&N and thus into their Adult ego state again. This can be done one of two ways.

1. Acknowledging Adult facts. One simply continues to do what they are doing and brings it into the conscious mind.

“I am sitting in my blue chair at work. It is 1.33pm and I had a pie for lunch. I am looking at my computer and it is asking me if I want to buy porn. My co-worker Jimbo is sitting in the next cubicle and is in the process of buying internet porn. I am writing a report on my last client who tried to sell me a years subscription to Readers Digest magazine. ....”

One simply moves into their Adult ego state and observes what is in their current environment and makes note of it in their conscious mind. Some will find this easy to do and can do it for long periods of time. Others will have considerable difficulty maintaining this and will continually slip back into a different time or place and then usually back into some feeling and out of their Adult ego state.

The more one gets used to being in Adult in this way the the more familiar and habitual it will become and thus it is strengthening the Adult ego state. Once done the person diarizes their success or failure at the task and feelings that happened. These are then reported back to the counsellor where patterns are identified.

2. Acknowledging Adult facts about their own Child ego state. In this case the person observes from their own Adult ego state their own Child ego state. For some this will be quite hard to do as it requires the person to get into their Child ego state and their Adult ego state at the same time. In the exercise above the person was only required to be in their Adult ego state and the Child ego state was being ignored.

Instructions for this can be, “Observe and diarize the current state of your body in terms of sensations, soreness, temperature, etc starting from your toes up to your head”.

Or, “Look at the feelings chart and what are you feeling now, what have you felt in the last week and in reaction to what?.

Or, “What makes you feel sad, happy, scared, sexual, angry and so forth?”

In each of these the person is required to firstly get into their Child ego state and then make Adult ego state observations of it and bring those observations into the conscious mind and diarize them. Those with a weak Adult may find this hard but the skill of being able to think (Adult) and feel (Child) at the same time is a most important one to learn and is one of the key factors of a strong Adult ego state.

One would only tend to use this exercise of acknowledging Adult facts about their own Child ego state (exercise 2) when they have shown that they can successfully acknowledge just the Adult facts (exercise 1).

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Negative transference and real feelings

I have written before about the process of transference that the client and therapist go through.

As one can see it includes what is called the positive and negative transference. Those are the stages where the client can have quite strong feeling reactions to the therapist. In the positive transference that usually includes the liking, loving and even at times erotic feelings.

This period can vary enormously in duration. Some times it is quite short and other times it lasts for long periods. One aspect of this is the attachment changes that occur during these phases.

In the positive transference the attachment develops and in the negative transference the attachment is broken down as the psychological separation occurs.

When the client switches to the negative transference they stop being friendly, helpful, agreeable and so forth and become disagreeable and argumentative. This can include arguing about the bills, changing appointments, getting appointment times wrong and so forth.

As regards the emotional quality of this stage I came across a blog post the other day. It was an open letter that had been written from a client to her therapist. I found it captured the emotional quality of the negative transference very well and I will use it in future as a teaching piece and hence I am writing about it here. It goes as such:

“Dear J,

I’m feeling angry about therapy. Here are some of the reasons why:

You always start the session by asking, “So what are we talking about today?” even if it is very obvious what needs to be talked about.

Every week feels like the first week all over again, instead of accumulating knowledge about me and reflecting back.

There is never any silence; I like to have silence occasionally.

I trusted you to read my blog and you searched for “sex” and “job” and then lied about it.

I gave you a really long account of 2009 and you said there was enough material in there to last for a few weeks of therapy and you never brought it up again.

You try to make everything logical and rational and then I feel guilty and I feel like a failure that it’s not sinking in.

You don’t pick up on what I need or what I feel. You never ask me what I need. I don’t even know what I need, but maybe if you ask me I’ll try to figure it out.

You once said in an email, “I think that one needs to work through or resolve issues in order to avoid repeating them.” All I feel like I’m doing is repeating the same things over and over and over.

Your office is so damn beige.

Tags: anger”

(end quote)

To summarise the grievances:

She questions his therapeutic skills

He is told he lied which implies he is also unreliable and untrustworthy

She reports he made her feel bad in this case guilty and a failure

He is told he does not give her what she wants, in this case silence

But it is best summed up in her last comment about the beige office. Translated = “I am angry at you”, as her tag so accurately portrays.

One of the difficulties of defining this as negative transference is the client can take it to mean that their feelings of anger are not real or are somehow invalid. That is not the case as the client feels what they feel and they are real and valid.

However the feelings are out of proportion to what is going on in the here and now because the client is misperceiving the therapist. It is a situation of misperception not ‘unreal’ emotions. I didn’t call it a problem of misperception because such misperceptions can lead to therapeutic gain if handled correctly by the therapist. The misperception is a positive thing in this sense.

If a client states they they have strong feelings for or are in love with the therapist that of course is great for the therapist’s ego. It’s great to think that I must be so attractive that someone has such feelings for me. But alas it is not so. A client does not fall in love with me they fall in love with what I represent to them.

How can you love someone when you hardly even know them? The client therapist relationship is a very specific and restricted one. The client only gets to see the therapist in a very singular way, that is in a sympathetic, understanding, reliable, caring role. The transactions would usually be as such:

In the therapy setting these transactions would most often occur 90% of the time. This is very different to the usual male and a female relationship which in part could be drawn as such:

Whether they be just friends or married both parties are supposed to express their Child ego state wants and needs about 50% of the time. In addition they are meant to be caring of each other about equal amounts as well. Both sides get to see the other’s Child ego state in particular. Thus they know them more ‘deeply’ than a client can know a therapist as the therapist very infrequently expresses such child needs to the client.

Thus the client does not really get to know the therapist even though the level of emotional reaction in the transferences would indicate that they do. In the positive transference the client unconsciously fills in the gaps that they do not know about the therapist thus giving them the perception that they know the person well.

If you go back to that letter one finds a lot of ‘gap filling in’ being done but in a negative transference way in that case. A good deal of therapist motivations and meaning to his perceived behaviour are added in such as about the silence. Also no therapist is that bad. In the letter none of his good points are being acknowledged.

For many years my parents an I ran a counselling training institute together. They were both psychologists and trainers like I was, and we trained many hundreds of people. Not uncommonly over the years a trainee and/or client of theirs would take me aside and tell me how lucky I was to have been raised with such healthy parents. I would just look a bit stunned, (as I was), smile blankly and change the topic.

Now my parents were OK as parents but they were far from perfect, god rest their souls. The client/trainee was in a positive transference and had filled in the gaps about them without even knowing it.

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