Overdose

It is an interesting process. I just stopped writing for two weeks. There was no decision to, I just did. The previous month I produced a lot of words for the book I am writing on counselling drug users. I just started writing again today.

It was similar to the first book. I treat my Free Child with great care which is a good thing really, therapeutic as well. I listen closely to it or more just follow its lead. I don’t push myself at all to write. I don’t have a schedule of writing. I need to be very careful of my rebellious side and not to engage it in this large writing project.



I must admit I do start to wonder a bit as a week goes by and nothing has been written. But I sit back and let the FC take charge. I suppose I am trusting it a bit more as I know it will come back to the keyboard when ready. That happened last time and is happening this time.

Yesterday I mentioned this to someone and they asked if I had writers block. I don’t think so but then I don’t really know what writers block is. I didn’t feel blocked. It is more a feeling of I am taking very close care of that part of me and trusting it will do its stuff when ready.

Heroin overdose

One hears this term quite a lot but it is in fact somewhat of a misnomer.

Part of chapter 2



Poly drug use.
Anyone in the drug counselling field will come across the term poly drug use. This is seen to be the contrary of mono drug use. In real terms there would be very few mono drug users on the planet. The vast majority of people are poly drug users. If one has a wine during dinner and a cup of coffee at the end then they are a poly drug user using both alcohol and the stimulant caffeine. However the term poly drug use usually refers the use of illicit drugs maybe with alcohol at the one time. The person ingests a combination of drugs in the one session.

Where poly drug use assumes most importance is when considering the possibly of drug over dose. The drug counsellor needs to be cognizant with the effects of possible combinations of drugs. Over dose from one single drug is much less common that over dose from multiple drug consumption. One study of drug related over dose, Hickman et al (2006) found only one drug present in just eleven percent of deaths with the average being more than three drugs detected. The most common drugs found in over dose were heroin, cocaine, benzodiazepines, alcohol and methadone. The least common were amphetamines, ecstacy and cannabis. (Also see Newcombe and Woods (2010), McKenna (2002) and Giroud et al (1997))



As a matter of course any drug counsellor will enquire as to what drugs the client is using. They should specifically ask if the person uses heroin, cocaine, benzodiazepines, alcohol and/or methadone and in what combinations in any one drug taking session. If there is a combination used then the counsellor would obviously inform the client of the potential for over dose and look at ways by which the client can reduce the risk of a fatal over dose, such as not using alone and so forth.
(end quote)

As you can see it would be more correctly named as a poly drug overdose as only 11% of fatal overdoses result from the ingestion of one drug. 89% result from a combination of drugs taken. So how can you say which one was the fatal one or played the most part in the death? So heroin overdoses are rarely just heroin over doses.


This comes from chapter 5



Research study
Kerr, D., Dietze, P., Kelly, A. and Jolley, D.
“Improved response by peers after witnessed heroin overdose in Melbourne”. Drug and Alcohol Review. 2009. 28, 327 - 330.


Heroin related over dose
Current IDU recruited at a needle and exchange programme (ie not recreational users)
61% had reported they over dosed after injecting heroin with the median being 3 times
84% reported witnessing an over dose with the median being 4.5 times

46% reported witnessing an overdose in the last 6 months

These figures show that these people are really living on the edge of self destruction. To go that close to death that often would strongly suggest some suicidal or self destructive urges play a part in what they do.

It should be noted that the subjects in this study would be the dependent drug users and not the recreational heroin users because of how they were recruited for the research.

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Linda life script currency analysis

Results



Uniqueness +++

One and Only na

Tears and Feelings na

Sex + 

Violence n/a 

Pied Piper n/a

Drugs n/a

Booze n/a

Food +

Power na

Reverse Status ++

Words +++

Money ++

Beauty ++





Analysis



Words

Games: Psychiatry, Greenhouse

Psychosexual stage: Anal or possible oral

Lifestyle/occupation: Lawyer, politician, writer, journalist, orator, salesman, psychotherapist, debater

Illnesses: Elective mutism, migraines, neck/shoulder pain,

Therapist: Intellectual therapies are attractive

Personality: Obsessive compulsive, paranoid









Issues:

These people are sometimes said to be “Dead from the neck down”. They retreat to the safety of thinking and thus there can be a mind body split. Out of touch with their body and thus one can have eating disorders or various forms of self harming. Out of touch with what their body is saying and thus detached from part of the Free Child.



Retreat to intellectualisation so as to hide from feelings (at least some of the painful ones).







Need to access the Free Child in therapy. The Free Child has gone into hiding for some very good reason and accessing it will bring up those reasons which may be quite distressing.



Body therapies might be an idea to deal with the mind body split. Physical contact needed as there may also be a history of prolonged stroke deprivation.



If it is a reflection of oral stage issues there could be obvious suicidal or self destructive impulses or more subliminal self destuctive impulses displayed through such things as alcohol abuse, chronic cigarette smoking or severe eating problems.



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Free Child communication in relationships

As a marriage or couples counsellor a common problem one sees is about the Free Child in relationships. In terms of the perceived quality of a relationship or a relationship that is wanted by both parties then these types of transactions must occur at least some of the time.



To understand such a diagram just think of a relationship which you like and enjoy and have a desire to be involved in. It is highly likely you have just identified a relationship in your life that has a significant amount of Free Child transactions between you and the other party.

In the honeymoon stage of a relationship these types of transactions occur quite often. Of course a solid relationship involves much more than just FC to FC transactions but my point here is that if a relationship does not have such communication then it will tend to fall on hard times. If there is very little then the ‘end is nigh’ often.



As a marriage counsellor one often sees couples who present with this type of communication problem, few FC transactions. This often occurs because the Free Child of both parties have ‘left the building’ as they say. The sensitive part of the personality has retreated into hiding for some reason.


Elvis leaving the building



In particular there are two common scenarios where this happens and presents a very real and difficult situation for the couple. This is often presented in marriage counselling and guess what they both involve sex and drugs! Why you may ask, because both sex and drugs often involve a degree of Free Child if not lots of Free Child.

Sex
Level of libido of a couple. If the couple have these combinations then sex is not going to be so much of a problem or at least it is a very good start for the couple not having difficulties in their sexual relationship. Both parties are either:

Low & low
Medium & medium
High & high


If they are either

Low & medium
Medium & high

then there is the potential for some degree of problem. If they are

Low & high

then there is a very real possibility of difficulties.



Why is this so? Because the Free Child is going to be affected. If the male has a high libido and the female has a low libido (which is usually the combination) then they have a significant problem that could contribute to destroying the relationship.

He is going to be asking for sexual contact often (or at least feel the desire to ask often). She is going to want much less. If she says yes when she wants to say no, it wont be long before her FC starts to retreat into the distance. She is having intimate physical sexual contact when she does not want it and the FC is not going to tolerate that for very long at all.

If she says no when she wants to say no (which will be often due to the different levels of libido) then one problem is solved but another is created. Her FC will feel satisfied but his wont be. His FC will feel ‘ripped off’ in some way. If this is occasional it does not matter all that much. But if it is happening most days what will happen after 5, 10 or 15 years? His FC is going to have disappeared in a similar fashion long ago.

A very real and difficult problem for a couple.


Cooperation in the relational

Alcohol and drugs
The most common scenario is the male likes a drink or a smoke and the wife finds him unpleasant or repugnant when he is intoxicated. The wife may say things like:

“He is embarrassing when he has been drinking”
“He snores loudly when he has been drinking”
“It is bad for the kids to see him like that”
“He may drive while intoxicated”

and so forth

So she asks, demands, threatens that he does not drink or use drugs (or significantly reduces the use). If he obliges and stops then her FC needs are met but this creates another problem. His FC will feel ‘ripped off’ in some way. If he continues to drink then his FC needs are meet but her FC will retreat into the distance.

After this occurring for 10 years what is likely to happen? Either one or both FC ego states have disappeared out of the relationship and probably do not even want to come back.

A very real and difficult problem for a couple.

In both these instances there are no winners. No matter which solution you take both parties loose in the long run.

It is best if the couple do not allow it to become such a large issue in the relationship. That’s easy for a bystander to say when not directly involved in it. Also most couples do not realise it is becoming a big issue until it gets there. And as I have said before most couples actually get into couples counselling 6 to 12 months late when the small issues have evolved into the very communication style of the couple. It is best to get to the problem when it is still relationship dystonic not when it has evolved into a relationship syntonic problem.

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Kahless - Transactional Analysis Sentence Completion Test results

1. I can't remember reading books much as a kid, or what was read to me. My favourite story was based on what I watched on TV. I loved Dr Who and the Cybermen the best.

2. I like when people are nice to me.

3. My mother always told me to be good.

4. I always try to do my best.

5. Most men are selfish.

6. What bothers me more than anything is noise (at the moment.) Also people being late.

7. If I could I would quit work.

8. When I was a child, I , like Roses wanted to fly.

9. My father always told me not to make a fuss and also not to upset my mother.

10. I think I have a right to feel but I rather I didn't at times.

11. If I get angry enough I will tell you to fuck off out of my life.

12. I shouldn’t be so lazy.

13. As Snoopy once said "Love is, never having to say youre sorry."

14. I can’t feel any va va vroomm for life any more.

15. I get depressed when I think too much about life.

16. A mature adult is a person who takes responsibility for their own actions.

17. One of my most important rules is “Don’t make a fuss." (But I do break it if I am angry.)

18. My parents always told me that I should always try my best..

19. I failed to stick with things.

20. My biggest fear in life is being ignored.

21. Someday I will lose some weight!

22. The child in me is very sad at the moment.

23. Sometimes I think “if only ...
I am not an if only person.

24. People like myself are fools to themselves.

25. I need to lose the weight I have put on since quitting the smokes.

26. Winners are people who never give up.

27. Marriage is marriage!

28. Death is inevitable. The timing is choice.

29. My role in my family is to be happy go lucky.

30. One thing I try to hide from others is what is going on in my head.

31. My dreams are usually about (I cant remember my dreams)

32. Most woman are self conscious.

33. I really feel guilty when I think about my parents dying.

34. When things get tough I go into myself.

35. When I was a child, my parents never came and watched me in fencing competitions

36. Sex Female.

37. When someone disagrees with me I will listen to their reasoning.

38. If I were an animal I’d be a dog.

39. The last thing I want to do is to go out.

40. What I really learned in school is that children can be destructive.

41. I want my children to N/A

42. God is and will always be.

43. A part of me wants to ????? I am not good at knowing what I want.

44. Why can’t people just be straightforward and honest and fair?

45. The story of my life would be ordinary.





Kahless - Transactional Analysis Sentence Completion Test results

3. My mother always told me to be good.
4. I always try to do my best.
9. My father always told me not to make a fuss and also not to upset my mother.
12. I shouldn’t be so lazy.
14. I can’t feel any va va vroomm for life any more.

Results - Injunction: ‘Don’t get your needs met’. High Conforming Child ego state. Possible pull to non-life structured into personality.





14. I can’t feel any va va vroomm for life any more.
15. I get depressed when I think too much about life.
22. The child in me is very sad at the moment.

Results - Repression of Free Child ego state




17. One of my most important rules is “Don’t make a fuss." (But I do break it if I am angry.)
11. If I get angry enough I will tell you to fuck off out of my life.


Results - Internal release of the life script





5. Most men are selfish.
9. My father always told me not to make a fuss and also not to upset my mother.

Results - Need for a male psychotherapist




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Final fantasy 4 (Edit # 1)

The various forms fantasy can take.


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Desensitization and dissociation

If one does not desensitize, when placed under stress they will relatively quickly collapse psychologically, become incapactited, incapbable of functioning at least in any significantly productive way. When confronted with very unpleasant or painful stimuli the person must desensitize in order to psychologically survive and remain a functioning individual. For instance, a soldier enters a war zone and sees his first mutilated body. In reaction to this his Free Child ego state will be shocked to some degree. The sensitive part of his personality gets damaged or injured.

In order to cope with this and remain functional he has to hide away the FC part of his personality. He has to desensitize or he will be overwhelmed and go into a state of incapacitation to some degree at least. This is shown in the two diagrams below:


Diagram 1


Diagram 2

In the first diagram the Free Child can be open and exposed to the environment as there is no unpleasant stimuli confronting it. If painful stimuli does occur the person has to begin the process of desensitization and restructure their personality to a state indicated in the second diagram. That is meant to indicate the FC is hidden behind a wall or sealed off in some way. For most this is a natural and instinctive process that will automatically occur even without the person realizing it. If successful in making this transformation of the personality the person achieves a state where the FC is protected and thus is less sensitive to painful stimuli. The person is in a desensitized sate of mind. By the time the soldier sees his fifth mutilated body it has less impact on him because he has been able to restructure his personality as described above.

Some people cannot make this transition to a state of desensitization. They cannot transition from diagram 1 to diagram 2. This is likely to be found in those who are childlike to some degree. They have weak Adult and Parent ego states and may have injunctions like, “Don’t grow up”. In the desensitized state the Adult and Parent take over more of the functioning in the personality. If those ego states are weak the person will have a tendency to go into some kind of incapacitation rather than desensitize.



An example of this could be hysterical paralysis. This is sometimes found in soldiers who have been placed in very frightening and life threatening circumstances. They are simply overwhelmed with fear and develop a paralysis of the legs. There is no medical reason for the paralysis. Instead the FC is not adequately protected in the personality and thus it unconsciously incapacitates with the paralysis. The soldier then cannot function and is removed from the theatre of war.

The process of desensitization
Consider this graph


Diagram 3

In the initial stages there is no stress and thus the person will not desensitize and they can function in an effective way to deal with any situations life presents them with. If the person is placed into a ongoing stressful situatuion such as entering a war zone then he is subjected to stress and hence the desensitization process will instinctively begin. For instance seeing a mutilated body. This may cause in him some kind of shock and revulsion. When this happens the FC will automatically start to seal itself off. If there is no assault to the senses then the desensitization will not occur. Desensitiaztion will occur more significantly and rapidly if the person knows it is likely there is more painful stimuli to come.

The soldier in war knows it is highly likely there will be more horrible things for him to cope with probably quite soon. If it is just a one off situation desensitization may occur but in a less dramatic form as the FC knows it does not have to prepare itself for future asssaults. If you see a car accident where a child is killed it is highly likely that will not occur again tomorow so the desensitizing is less so.

The graph is meant to indicate that the desensitization occurs at an inverse exponential rate. Initially there is a rapid rate of desensitization as the shock and stress occur. As the desenistization develops subsequent shocks will have less impact and thus less subsequent desensitization will occur. It seems reasonable to conclude there is a direct correlation between the degree of shock experienced and the degree of desensitization that results. Eventually, it is hypothesized, one reaches their optimal level of desensitiaztion and then there is a plateau effect.



Should the period of stress cease such as when the soldier is sent home then the need for the desensitization ceases. The FC does not need to be protected like it has in the past. It could be expected that over time the level of desensitization will slowly reduce. That process will be substantially facilitated if the person can do some ‘working through’. That is they talk to someone about what happened and how they felt and they are given a sympathetic response. That can be to an official therapist or to someone else who can take on that role to some degree such as a spouse, relative or close friend. The degree of shock and horror experienced dictates the degree of working through that needs to be done. The person is transitioning back from daigram 2 to diagram 1.

As mentioned before when desensitized the person hides away the sensitive parts of the personality. Humans can not survive for long periods without access to the sensitive aspects of them. If it does persist for an extended period of time then some other problem will evolve such as depression, anxiety, alcohol problems, insomnia, anger outbursts, flashbacks or simply an emotional coldness which leads to relationship difficulties. Common symptoms found in PTSD. Indeed part of the teatment of PTSD is to again resensitize the individual.

Dissociation
There is another way to cope besides desensitization which also hides the FC away from painful experiences. That is by dissociation. This can be seen as a more severe coping style. For some reason the person feels they must take more drastic action than just desensitizing. This can also occur in miliatry personell and is also not uncommonly found in people who have been physically and or sexually abused as children. It is also often reported by torture victims.


Diagram 4

With dissociation there is said to be a splitting of the personality. When this is the case the person will report in some form, “That is not me”. They will experience self or part of self as not belonging to them or as separate from them. When this is reported one can consider dissociation as an explanation. Desensitization and dissociation both serve the same function of protecting the Free Child from further assaults but operate in different ways.

Desenistization can be seen as a normal human response to trauma. The vast majority of people will engage in this psychological process instinctly as a way of protecting self. Dissociation could be considered less ‘normal’ and is used less commonly as a way of coping. It will usually be used when circumstances are more psychologically and physically dire. For example in childhood with physical and sexual abuse and in adult torture victims.

Procrastination and the Parent contract (Part 3)

In order to gain a more robust understanding of the Parent ego state contract one must eventually examine the phenomena of procrastination as the two are closely linked. It also highlights how humans can be self defeating even when they are quite aware of doing so.

Procrastination has its origins with some kind of Parent ego state ‘telling off’ by either the person them self or from some outside source. This moves the person from the Free Child to the Adapted Child ego state. The pathological procrastinator is the person who has forgotten what they want. They have become caught up in what others want them to do.



As soon as one is told to do something that makes it harder for them to decide if they want to. As soon as one told to do something their Adapted Child ego state is being enlivened. Pressure is put on the person to go into that ego state which makes it harder for them to respond from the Free Child ego state or the Adult.

Pressure is put on the person to respond from CC or RC (which are both subsets of the Adapted Child ego state). In either instance they are not responding from a decision on what they want. That comes from an understanding of the FC need, then an Adult decision on that FC need.



This diagram shows how a Parent ego state directive moves the FC away and stimulates the AC in the personality.


The FC does not reject the the parental directive it simply does not listen to it. It is hard to respond from FC if someone else is repeatedly telling you what to do. Each time a Parent transaction is perceived the AC is more alert.

The problem for the procrastinator is he has lost sight of what he wants. His AC has been stroked so many times by the Parent transactions from self and others that the FC is lost. He has forgotten what his FC wants.

This is why the “telling” type of therapies can have trouble. The therapist that tells the client what to do negates the client being aware of their own Free Child need.

For example the therapist who says to the client; “Stop smoking marijuana”. The client is put into a position where it is harder for him to know if his FC wants to stop smoking. Then the Adult can not make a decision on what the FC need is. The therapist is pressuring him to respond from either CC or RC.



Long term behavioural change will happen when there is a FC want. The client may have even wanted to start giving up marijuana but if told to do so he will begin to loose sight of that. Regaining an understanding of one’s own FC is one central component to dealing with pathological procrastination.

The procrastination transaction.
All Parent contracts involve an internal transaction that forms the basis of procrastination.



As the client makes a Parent contract one knows there is an internal CP transaction inside telling the client he is bad. The client then will most likely respond from either CC or RC.

If they respond mainly from CC they will slowly descend into depression or a sense of low self worth. If one tells a child repeatedly that it is wrong or bad eventually the child will take it on and develop a low self esteem. This is particularly so for the child who does not fight back.

We are all born with one primary response to stress either fight, flight or freeze. The child who freezes is the most vulnerable as they will tend to take on the external criticism from a CC position. Those who have a basic sense of fight in their temperament will tend to respond from RC to parental directives. Thus we have the basis of the pathological procrastinator as shown by the procrastination transaction.



The procrastination transaction is quite a simple. It involves a CP transaction to the Child ego state. This is responded to by the RC in a disguised way. It is not open rebellion against the Parent ego state. If that happens then procrastination cannot occur. Indeed this is another way to deal with procrastination. To bring the hidden rebellion out into the open.

The chronic procrastinator initially gives the perception of agreeing to the parental directive. Often they will be convinced of such a thing them self but underneath the RC has no intention of complying. Hence you end up with procrastination.

The woman brings work from the office home. She has to write a report which she plans to do after the evening meal. She is complying to a Parent ego state directive to work at home this evening to catch up at the office. She prepares well by putting her paperwork next to the computer ready to go. She then has dinner which tends to drag on with a long coffee and discussion with hubby afterwards.



Eventually she sits down at the computer, turns it on and realises she has to go to the restrooms. On the way back she makes herself a little snack and notices a magazine on the side board which she flicks through for a while. Eventually she gets back to the computer, is ready to go when she notices a new incoming message in her email. It is a long lost friend from high school who has found her on FaceBook and requested her as a friend. She immediately confirms the friend request and must chat with her as they were such good friends such along time ago. She goes onto Facebook and that is the next two hours gone. Finally at 11pm she quickly types half a page of the report before she has to go to bed feeling angry and frustrated with herself.

All along she gives the appearance of complying to the CP directive and all along the RC is sabotaging the plan making sure it is not going to happen or only happen in a half arsed form. These transactions can (and often do) go on endlessly for many years. Hence we end up with the pathological procrastinator.

1. Lost touch with what the FC wants
2. Tries to comply with the CP directive
3. Has an active underhanded RC which will not comply

Procrastination is the consequence of an internal Parent contract. In the example of the woman above she made a Parent contract with herself, “I should take the report home tonight and finish it so I can catch up at work”. She made this contract with herself and as we can see she has an active RC and thus considerable procrastination eventuated.

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Working with shame in the therapy process. (Part 6)

What does a therapist do when a client presents with strong feelings of shame. One knows what to do when a client is angry. They feel the anger, they express the anger and when ready they drop the anger. When a client feels sad the therapist acknowledges the feeling, the client expresses the sadness with some kind of crying usually, one listens to the client, empathises with them and is compassionate. Then the sadness is dealt with.

However shame is different. Unlike sadness and anger, shame tears at the very sense of who we are in a way that other feelings do not. With shame one experiences a sense of painful self diminution. Their sense of worth, importance and sense of who they are as a person is painfully reduced. With shame there is a sense of ‘I am bad’. What does a therapist do with this?

When people feel shame there is a strong desire to withdraw or change the topic. The person wants to go into hiding in some way. This seems to be the natural Free Child reaction to shame. The problem with this, is it does not deal with it, in the therapeutic sense.


Now that's embarrassing!


In essence it is an avoidant, ‘Lets try and forget about it’, approach. This works with small ‘traumas’ but with big ones it does not work. They need to be brought out into the open, experienced and then one can ‘get over it’. The Free Child reaction with shame is to hide and avoid. With most other feelings the Free Child reaction is a therapeutic one that will bring resolution of the painful event like expressing sad feelings when one’s cat dies. With shame the natural Free Child reaction will not bring resolution or closure to the event. Thus shame is somewhat unique in this way.

I will cite how I have developed my approach to shame over the years.
The first step is to clarify the shame, the guilt and the internally directed anger. As I have shown before these can be articulated by three separate transactional diagrams:







These three transactions can coexist in various combinations at the one time and often do. The therapist needs to assist the client to untangle them. Sometimes when a client initially reports a feeling of shame one finds there is not a shame reaction but it maybe a guilt reaction or internal anger reaction.

One indicator that shame is present the client’s unwillingness to bring it up and discuss it. If there is a true shame reaction the client may be quite unwilling to mention it which is a problem in itself because the therapist may not hear about it for some time. Obviously if the therapist does not know about it then it cannot be dealt with. Examples of this can be self harm or bulimia. The shame that is felt about these activities may result in the client not mentioning it for some time.

However when the client does raise the shaming event the therapist knows this is a positive move indeed. It means the client now experiences the therapeutic relationship in such a way that she is prepared to raise such a sensitive and intimate issue. The therapist is now being trusted in way that he has not been before.



When this happens the therapist untangles the three possible reactions of inward anger, guilt and shame. The therapist then deals with the inward anger and guilt in the usual therapeutic ways. Whilst doing this the stage is being set for the shame to be dealt with.

The client is then asked to do something that is unnatural for them to do. With shame the Free Child wants to hide and withdraw but the therapist asks the client to come out into public (with the therapist) and talk about the shame and the shaming event.

This to my mind, is the first step to resolving the shame. As simple and unsophisticated as it is. The shame is simply brought out into the relational with the therapist and the therapist responds in an empathetic fashion. Once the shaming event has been disclosed the therapist can bring it out into the open at the appropriate time. This requires some caution such that one does not reshame the client in the therapy setting.

From what I have seen once the event and shame have been discussed a number of times it seems to loose its potency. The catharsis obtained from speaking about it with the therapist seems to reduce the need to hide it. Subsequently it can be raised much more easily by either party when need be.



Thus the initial therapy process is to come out of hiding, speak about the event and the feelings with another trusted person. If that person responds favourably the shame and embarrassment diminish over time.

However this is not the end of the story. Whilst it may be easier to discuss it with the therapist, the underlying damage that resulted from the shaming event still remains. With guilt one has the sensation of ‘I am bad because I did x’. With shame it is simply, ‘I am bad’.

This is treated with the usual various redecisions, awareness of the shame, acceptance of shame as a natural thing, hypnotic suggestions when the client is significantly regressed, working through the negative and positive transference reactions, forgiveness of self and so forth. This takes time depending on the depth of ‘badness’ the client experiences. However this process is significantly helped if the shaming event looses it impact in the ways I have described above such that the event can be more easily spoken about. The need to hide with the shame fades and diminishes.

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Male mid life crisis

This of course is generalising about men but I think it is representative of a significant group of men.

The young adult male can have a large Free Child ego state which he enjoys in his activities as a young man. There are two events in his life which significantly change this. First when he becomes a husband and the second when he becomes a father.

In both these events there is a loss of Free Child as he assumes a more responsible role in life. Usually this happens spontaneously in his own mind. He sees that this is the right thing to do as a husband and father. The woman in his life does not have to say anything for him to make this change in his personality. In other instances the woman may exert pressure on him to assume this more responsible role in life.


Doing the right thing

The bottom line of this change however is the Free Child will feel unsatisfied to some degree. For some men that is just a little and for other men it can be much more pronounced. As I said before the man will often do this in his own mind himself as he thinks it is the right thing to do. Sometimes the wife may also exert pressure for this to happen.

As a result of this change in his mind there is a crucial period from the mid 20s up until about 40 years of age. In this period there maybe a change in his life where slowly there is a loss of contacts and activities that were Free Child related. Then he reaches about 40 years of age. Some men at that point will look back over the past 20 years and it becomes apparent to him the transformation that occurred over those years in the way just described.

Then he looks forward to the next 30 years and he sees fairly much the same. He is then faced with the question of the meaning of his life. If he sees 30 years more of high responsibility and low Free Child that may come as quite a shock. It is this that can precipitate a psychological shift, sometimes quite sudden, back to an adolescent psyche similar to what Eric Berne called antiscript phase of adolescent development.



He may end a marriage, buy a sports car, date women half his age, take up sport he played 20 years ago, loose weight, dress in a way that is quite unbecoming and by and large live in an adolescent way on the singles scene.

He is doing the same as the teenager does from a psychological development point of view. The direction his life is going (his life script) scares him and this is a loud and unsophisticated attempt to do something about it. He does not know what else to do.

What to do seems quite clear. The Free Child needs to get satisfied over the long period when it was neglected. How this is done of course varies from man to man. What does the boy want? It maybe something that he did all those years ago from fishing, to hunting, to golf, to surfing, to the football, to having a regular night out with his mates. Or it maybe something else that is less boyish but still meets the Free Child needs.



The hard part is keeping this in his life with all the pressures of fatherhood and mortgages and then there is his relationship with his wife. She may have a problem with him doing such things. In Australian culture you don’t often hear of a wife who regularly encourages a husband to do such things. This is probably most often due to the fact that she simply does not realise what is happening in his psyche over such a long period of time. How can she when he probably is not even aware of it himself.

However one thing is true for all members of the human race, if the Free Child needs are not met in a satisfactory way over a long period of time then sooner or later something drastic is going to happen. There will be a psychological explosion of some kind. Just go ask the Catholic church.

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The anorexic relationship (editted)

OLJ asks:
does the adapted child take over as a protection for the free child?


My response:
One could say that the AC protects the FC. If a child is confronted with adverse parenting its first thought is to survive. It will make a decision on what it needs to do so as to survive physically and psychologically.

For instance, a child does not eat its dinner to which mother gets very angry and hits it. The child is then forced into a position where it has to make a decision on how to survive. That decision can be anything and they will vary widely between children. The decision results in the Adapted Child behaviour. The Free Child part of the youngster senses danger and thus it makes some adaption to the environment as a response to that danger.

For instance the child may decide that mother’s anger is very frightening so it will conform, behave and eat up all its food. It does this as a short term solution to the danger. This is the AC

Another child may decide that mummy is bad for getting angry, it is being unfairly treated and throws its plate full of food on the floor. The AC response in this case is an angry rebellious response that fights back which the child sees as its solution to the problem. This is the AC.



As we know the AC is divided into the Conforming Child (CC) and Rebellious Child (RC) ego states. Both these adapt to authority. The CC by doing what it is told and the RC by doing the opposite to what it is told. Neither is what the child wants fro itself (the FC).

Hence we end up with an eating disorder like anorexia. This person adapts to the authority by swinging between CC and RC responses to authority. At one level these people are often quite nice people who seem to conform (CC). On the other hand anorexia is one of the most basic rebellious responses a child can do to a parent. Food refusal.

Mother puts the spoon full of food into the mouth of the young child to which it closes its lips tightly. One of the most primal forms of rebellion a person can do. Mother pushes the spoon harder onto the lips to which the child squeals in defiance and ‘accidentally’ knocks the plate of food off the table onto the floor.

The anorexic is highly rebellious individual. However often when you meet them they will not appear so. This may explain why the majority of anorexics are female (95%). In our child rearing patterns open angry rebellion is usually less acceptable for girls than it is for boys. The girl has to express her rebellion in a more disguised way. She says, “I just don’t feel hungry and I can’t eat”. Angry rebellion expressed in a polite way. Whereas the rebellious boy is more likely to hit our angrily in a direct and open way.



The other feature of all this is the Free Child is no where to be seen. It has been lost long ago in the past. The anorexic and authority get deeply engrossed and locked into CP to AC transactions The FC is forgotten about.

The anorexic is not lying when she says she does not feel hungry. In this instance hunger is a function of the FC. She has been so out of touch with her FC for so long she can no longer even recognise it. Thus she does not feel the hunger sensations when they come. Thus we end up with the dynamics of the anorexic relationship.



The anorexic comes from a background where she perceives the parents to be overly controlling and authoritarian and thus perceives transactions coming from their CP to her Child ego state (1). She responds to this with two transactions at one time.
2 - she will appear to be CC and compliant
3 - underneath she is highly rebellious and uses a most primal form of rebellion against authority, food refusal.

At the same time she has become so divorced from her FC over a long period of time she no longer can even recognise when she feels hungry.

So what does the counsellor do
1. Establish a relationship with the anorexic that includes other transactions besides CP to Child. This may be hard to do as the anorexic will perceive you to be CP even when you are not. Secondly she is so rebellious that she may kill herself from starvation. This can force the authority to intervene in an authoritative way even when they don’t want to.

This is one reason why I have a general rule of thumb when working with client’s who have eating disorders. I will not spend more than 50% of the consultation discussing food, weight and eating. We will spend at least 50% of the consultation discussing other matters unrelated to these areas. Some clients find this hard to do at first because food, eating and weight is all they ever talk (and think) about.

This allows the client and me to get away from the CP to C transactions and introduce other kinds of transactions into the therapeutic relationship. Also I don’t want to have a relationship with the client that is food obsessed. I want a more normal relationship with the client were we can talk about good things sometimes that feel nice for the client and me.

2. Assist the anorexic to reconnect with her FC
If one can get some FC to FC transactions going in the therapeutic relationship then that is a very good start indeed. If this happens then the anorexic relationship is already starting to morph into something else.

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Carl Rogers and health

Harriet states: I also thought of Carl Rogers when I read this. What did he say? Something like every person's goal should be to be the person who they truly are.

Carl said a lot of things Harriet. In his original writing there is a lot on transference that includes taped dialogue from sessions he did with clients. They are very interesting to read as one gets a bit of insight into how he worked as a therapist. However most of this is forgotten and he is most widely known for his clarification of the three essential features of the therapist in relationship with the client.

Genuiness - Therapist is aware of his own feelings, thoughts and attitudes and these are not concealed from the client.

Empathy - Understanding the client’s experience from the client’s point of view.

Unconditional positive regard - Conveying to the client that they are worthwhile humans no matter what they do.

Home wrecker

This has had a profound effect on the practice of psychotherapy which is why he is regarded as one of the greats of the field. As usual it is the simplicity that makes for it being more profound.

It seems reasonable to conclude that he was not the first to think this up. People would have known long before Rogers time that being genuine and empathetic was good for a relationship especially a helping relationship and I am sure teachers long before Rogers would have told their students such a thing. However he articulated it well and was in the right place at the right time and thus he became known as he is.

However this does raise an interesting and debated point of view. His approach and philosophy rests on the assumption that, “Love will cure it”. That is if you place a person into an environment or relationship that is genuine, empathetic and has unconditional positive regard they will naturally get better.

If you place a person in a nurturing and positive environment then their natural urge to grow and develop will be activated and the person will grow and develop towards psychological health. In transactional analysis terms it would be said that the Free Child aspect of the personality is energised or cathected and this is where the desire to grow towards health results from.

There is another school of thought that says, “Love alone is not enough for cure”. Without a doubt a loving, positive environment is good for one’s psychological health, but there is also an Adapted Child part of the personality that propels the person to ill health (or to their life script).

This side of the debate say that pure positivity is not enough to counter the drive to psychological ill health. At some point in the treatment you have to deal with this and that means doing something with the client that is experienced as painful in some way. That may be a confrontation of some kind that the client does not want to hear, getting the client to face their mother or father who abused them and so forth.

Some form of painful treatment is applied and this raises much heated debate. There are a group who say a client should never be subjected to painful treatment techniques with a common example being ECT or some form of aversion therapy like happened in the movie Clockwork Orange. You could argue that Carl Rogers would have been of the view that you do not apply painful treatments.

Carl Rogers workshop (1965)

My father back row third from right

Carl Rogers front and centre.

Of course there are much less dramatic painful techniques than ECT or aversion therapy and I certainly use some of them myself. For instance some two chair techniques could be placed in this category and this fits with my personal philosophy. Unconditional positive regard, empathy and genuiness as most useful in allowing the client to grow towards health but they are not enough in most instances. The AC is an active part of the personality that ‘love’ alone cannot over ride. It needs at some point to be dealt with directly and that usually involves some kind of angst for the client. Keep it to a minimum for sure but it is needed at times.

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The 'x' factor in therapy

I was reading a book on counselling the other day and it discussed the therapeutic alliance. These two guys had done a meta analysis of the literature on what are ‘important therapist attributes’ for the development of a strong therapeutic alliance. They came up with:

Therapist attributes - flexible, honest, respectful, trustworthy, warm, confident, interested and open.

This seems like a reasonable list and includes some of the things one would expect to find. But this is indeed an elusive and indefinable topic. The quality that allows a good therapeutic alliance to develop between client and therapist. I have discussed this before and talked about the ‘x’ factor.

This is usually mentioned in relation to singers and musicians. There is a quality that the very good ones have that the not so good ones do not have. What that is however is largely indefinable, but you know when it is there and when it is not. A bit of an odd situation really - you know when it is there but you can’t define it (easily).

The same applies for the the therapeutic relationship. Some therapists have a ‘presence’ where they can have that special connection with clients, but what that is, is hard to define.

The list above is good and accurate but it’s one dimensional. It is a list of things and this will not define the ‘x’ factor. One cannot produce a list of things to do that. Instead one has to talk in more general terms that are less concrete because the ‘x’ factor itself in not concrete.

Theoretically it is quite easy to explain, it can be called the Free Child. This is best explained by looking at the training of therapists.

When therapists begin their trade they learn lots of things like how to do therapy and how to be a therapist. They learn the basic techniques and the basic process to follow. As they master these they become a therapist which undoubtedly is a positive thing. However it is an adaption and thus forms part of the Adapted Child ego state. They learn to be a certain way and a kind of professional role or way to be. They adapt to what authority is teaching them. The down side of this is they loose a sense of who they are and how to be themselves in the therapy setting. They are moving away from their Free Child part of the personality and becoming something else - an adaption.

This is not conducive to forming a connection with the client. The client will feel a sense of connection when the therapist simply be’s who they are. When they be them self which theoretically is the Free Child.

When client’s see the highly trained therapist they get good therapy that is of much assistance but that extra bit is not there. They do not get to meet the therapist as a person.

Some therapists never move beyond this because either they don’t particularly want to or they are not prepared to take the personal risk in doing so. To put the Free Child out in any relationship is a risk including the therapeutic relationship.

To move beyond ‘just’ being a therapist the person has to kind of unlearn what they have just spent the last few ( or many) years learning. They have to unlearn being a therapist and learn again how to be them self as a person in the therapy setting. If they achieve this then the Free Child again becomes accessible to the client and thus a special sense of connection can again occur. In my view this is part of the ‘x’ factor in the therapy setting.

The therapist moves away from being a therapist and becomes a person who happens to do therapy in the relationship with the client. The person comes first and the therapist part comes second. They have already acquired the therapy skills and now they relate to the client and happen to use those skills when necessary.

If the therapist allows self simply to be who they are in the therapy relationship then in my view the client experiences an extra dimension to the therapeutic relationship.

Just being who we are is surprisingly difficult. Most in childhood loose that ability.

Allowing self to just be who you are sounds simple, but is not easy. Indeed I would say that most people loose this after childhood and never achieve it again in adulthood, let alone those who have it trained out of them as happens in the training of therapists.

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Personality and dissociation **

Kenoath states, “...is it necessarily the free child part of personality which splits off in dissociation?”

That is the way I would theoretically explain it and my reasons are as such.

Dissociation in essence uses the censorship model of personality development. It works in the same way as the government censorship of our movies does. Why does government make it illegal for a young child to see a violent, horror movie? It is assumed that it would be damaged psychologically. The government hides the movie from the young child.

The Free Child ego state is that part of the personality that is conceptualised as being the most sensitive and vulnerable. It is where we can have the most intimate and sensitive contact with others. It allows us to meet with others and understand ourselves in the most sensitive and vulnerable ways. It is where we have a true understanding of who we are.

If a youngster is subjected to very adverse parenting styles then it is the same as the child seeing the horror movie, it will be damaged. One solution is to use a self censorship model. The child thinks, “I can deal with the physical and verbal abuse by hiding from it. If I hide from it then it does not really matter or it cannot really hurt me”. The child then sets about hiding the sensitive part of itself, the Free Child ego state. And this works at least to some degree.

I would suggest there are two different levels of this self censorship by the youngster that both use the same model of survival. First there is desensitisation which could be diagrammed as such:

The person sets up a kind of psychological barrier that isolates the Free Child and this results in desensitisation. This allows the child to receive abuse but it has less impact because the child has adjusted psychologically such that it gets used to it. When a child sees mother bashed for the first time it has a big impact, when it sees mother bashed for the 20th time the impact is less. It has adjusted by partitioning off the Free Child. The censorship is working.

If the abuse is more severe then censorship by desensitisation is not enough and the child has to take more drastic action. One solution is to dissociate. And this is shown as in this diagram.

This is more severe censorship in the desire to hide from the ‘horror movie’. The Free Child is split off from the personality. This hides the sensitive aspects of the personality and the person gets a sense of, “That is not me”. The person reports that when they were being abused it was kind of like they were standing separate and watching a stranger being abused. Torture victims often report this when recounting their episodes of torture as do bulimics some times as they vomit into the toilet bowl. It feels like they are standing back and watching this stranger vomiting.

This is a main difference between desensitisation and dissociation. With desensitisation there is not a sense of “That is not me”. With dissociation there is a sense of self alienation. And the censorship works at least to some degree. The Free Child is protected from future assaults. The problem is the censorship continues into adulthood and humans can not survive psychologically without reasonable access to the Free Child part of the personality. If the Free Child censorship continues then some symptom will develop whether that be depression, anxiety, substance abuse, insomnia, OCD, eating disorders, sex problems and so on endlessly.

With such symptoms the Free Child is simply shouting out loudly that they are still here and they want to be allowed back in. If the therapy assists the Free Child to be allowed back in then the symptoms will subside.

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