Sunday, March 15, 2015

clinical techniques: conflict and loss

I've been having some good success with a technique lately and I thought I would share it here and, see if a couple people might try it out and see what it gets them. 

A patient suffers from an auto-immune problem and has been sick regularly for months. I was impressed with the way she had some splitting with her husband's mother who was seen as a horrible figure while her husband was idealized and would "fight off" her mother and her mother's partner for her. I asked her to associate to fighter and she said boxer. I asked her to imagine her body was a boxer fighting another boxer representing her virus or disease and to tell me how she'd describe her body. She said her body was "a sissy, a scared little girl". I asked her to use these as I-statement and  whether that described how she interacted with anyone. She said her mother-in-law and we went on to talk about the situations this arises in...

Another patient complained of a horrible memory. I said that this was a bad thing and that it's very important to be able to remember things. He agreed. I asked him what his most important possession was. He said his cat. I asked him to imagine that he was reaching out for the cat but he couldn't reach her and she wasn't coming closer. I asked him how he's describe the cat and he said "gone" and "irritated by me". I asked him to say these as You-statements and whether any person came to mind. He said his ex-girlfriend and discussed how he'd call all the time and she'd never answer or make up an excuse to go right away and this led him to feeling angry with her...

Another patient got to a top dog and underdog moment of feeling like he should live as efficiently as possible. He should get up early in the morning and be prepared for work, he should not eat out and shop so much and save money, he should go fishing because he likes it, etc.  However, he often pushes the snooze button and tells himself "5 minutes" (which turns into an hour), talks himself into buying new things, and convinces himself that he should stay in town to do stuff at home and then ends up watching youtube videos. I ask him to talk about the underdog and his cleverness and then how the under dog sees the top dog. He said he sees him as weak and irritating. I ask him to put these into you statements and he brings up his father who he thinks is weak for lacking conviction and irritating because he said he cares and would be around more but he never is. 

The ego ideal tensions in the last example have been discussed before in relation to volar Time and seem to resemble what W. Reich regarded as the 'living machine' aspect of the compulsive. I think it stands for a good candidate as the proto defusion and contrasted with the omnipotence of wishes of the deutero. 

The second example, deductively, would be part of the auto-erotic stage. Not only does memory belong to the early titans in Greek mythology but also Death is represented as "gone" or absence here (as contrasted to the later stages in which it can mean death of the reputation, death of belonging to society, death of the body, etc.). 

The second example has many applications in things like not remembering one's dreams, loss of personal items, etc. The conflict of ego ideal (what you should be) and ego (what you are) should be contrasted by the appearance of loss, absence, fallenness, etc. in patients.

I've already discussed the first example but would add that the body-ego is the first form of the ego and that the auto-erotic stage would also be the stage or libido being blocked from health. I think I've posted before about Eigen's formulation of a person not allowing themselves to experience pleasure as a form of what I termed  ego ideal conceit tensions in the altruist. In the auto-erotic this operation happens with the body in general, it's not allowed to thrive, while, in contrast, at the volar one's needs/pleasures aren't allowed to be place before anyone else's. However, I would like to add that basic ahedonia probably also belongs at the auto-erotic stage. I've had a few patients who, in a vampire-like way, talk about there problems with the sunlight. It seems to represent physical health and feeling alive in one's body and they avoid it and stay in doors and often smoke, over eat, or do things that deadens any natural pleasure they find in their health. As always, there is proto, deutero, trito phases to each stage and it will require references to symbols, parental imagos, and erotogenic zones across many patients before these can be plotted with confidence.   
I'm not touting this as curing the problems, although many have brought up reduction of the inner conflict or loss on their own. Mostly, I consider it as a way to lead the person to bring up things that are more important to them and after they bring up these more affect laden relations there is more intimacy and progressive communication.

If someone tries it, please post your findings.

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