Tony White’s Weblog

Sex and Aggression

I have always said to counsellors and psychologists that is you ever want to fill up a workshop run it on sex or aggression. Better still run it on sex and aggression. Why would this be? First let us look at these two human conditions – sex an aggression

When we feel angry or aggressive our bodies change physically. 10 of the main changes are:
1. In response to an electrical stimulation in the hypothalamus area of the brain, an extra supply of the hormone adrenaline is secreted and distributed.
2. Respiration deepens. [Provides extra supplies of oxygen to feed the increased blood supply coming into the lungs]
3. Heart beats more rapidly. [Pumps more blood to the muscles and lungs, to carry more fuel and oxygen to and from the battle front.]
4. Blood pressure rises.
5. Sympathetic nervous system diverts blood from the skin. liver, stomach and intestines to the heart, CNS and muscles.
6. Digestive processes are suspended. Stomach and intestines virtually stop their secretions and movements. [Blood diverted to the muscles and heart and lungs. This 'self transfusion' allows more performance of muscular power.]
7. Glucose is freed from the reserves in the liver. [This allows 'quick, short distance' energy supply. Fuel for a sprint.]
8. Cortisone production is increased in order to depress the immune system. [Protection from an instant allergy reaction (such as asthma or closing of the eyes), from a dust up with an attacking foe].
9. Spleen contracts and discharges its content of concentrated corpuscles.
10. Men have an increased supply of the male hormone testosterone

The state of the body in sexual arousal and aggressive arousal are very similar. Alfred Kinsey in his famous report of 1953 says that there are 14 physiological changes that are identical in sexual and aggressive arousal. There are only 4 physiological changes that are different between the two states of emotion. Also it is not uncommon for one response to suddenly switch into the other. This is why an arguing couple can not uncommonly end up in bed. Also in the area of domestic violence, many women report that sexual abuse is viewed by their partners as the finale to a beating

Sex. Perhaps it is not just restricted to these two feelings. That when a person is in a state of emotional arousal they can in fact switch between a number of feelings. As an example of this we humans are a ‘dastardly’ bunch where sexual feelings are so important. (I suppose that makes sense because if the sex drive looses its potency or importance then the species will be skating on thin ice).

Sexual feelings can easily get mixed up with feelings of triumph, superiority and dominance. Then just as quickly some people can switch to the other side and the feelings switch to submission, humiliation and inferiority. Of course what is happening here is because people get sex and power mixed up. Another two important things in human nature. As they sometimes say to couples in couples therapy – “Never argue in the bedroomâ€?. This is because arguments are often about power in relationships and it is good to keep that out of the bedroom.

I suppose it should then follow that one should never have sex on the kitchen table as that may lead to an eating disorder!

Shock. Then of course there is love and hate. Yes it is a thin line between the two. The person who hates the ex or continually derides him/her of course is still in love with the ex. If one hates the ex then it does not take much for that to switch to love. Surely the opposite to love and hate is indifference. It is so much harder to be indifferent to the ex than to hate him/her.

Another example of this is the ‘stockholm syndrome’. Those prisoners who get attracted to their captors and develop an attachment with them and want to copy and imitate them. A thin line between love and hate indeed.

Relief.

Grief and anger.

And then we get to another feeling that of revenge or vengeance. Again these are easy to switch between with an array of emotions. If someone hurts you then you become emotionally aroused with grief, anger, pain, hate or whatever. The feeling then is, “If I can hurt that person back (get revenge) then I will feel better�. Sorry, by and large it does not work that way. The act of revenge often again emotionally stimulates the person and then in one sense they are worse off. They are worse off in the sense of getting over the ‘trauma’ of being mistreated.

Revenge. You hurt me, I hurt you. Don’t get me wrong. To express anger at the person that hurt you is a psychologically healthy thing to do, but then sooner or later you need to “drop the anger� as they say. That is become indifferent to the person who hurt you. Stop being angry at them, stop wanting revenge for the misdeeds done to you. If you don’t then you carry around a big sack of anger and vengeance on your back that slowly and surely grinds you into the ground and destroys you sense of self, current relationships and even physical body. Taking such anger and angst to the grave means you are going to an early grave.

So perhaps the real opposites are the states of emotional arousal and non-arousal. That when emotionally aroused people can easily switch and move between a whole array and variety of emotions. Perhaps these are not opposites but just variants of the same state of arousal.

Graffiti

The paradox of the empty chair technique

In a previous posting I discussed the empty chair technique. It can be a powerful psychological technique indeed, but as with everything it has its down side. Two such problems come to mind.

The first is the compartmentalisation of the personality. Humans are able to project parts of themselves onto an empty chair. That is they can visualise and feel like there is a part of their personality external to themselves. They can project it into an empty chair. This as mentioned before can have many positive therapeutic advantages as one can firstly become aware of it and then establish a new understanding of it.

But it does have an inherent flaw in it. It does compartmentalise the personality. The happier individual is that person who is integrated. They see and feel like they are a whole, one person. They do not feel like they are a collection of bits or parts of a personality. The empty chair technique highlights the bits as separate from each other.

Indeed there are a collection of emotional disorders that are exactly that. Those people who feel they are just a collection of bits and not an integrated person. These are called the dissociative disorders, with the most prominent one being the Multiple Personality Disorder. The Doctor Jeckl and Mr Hyde. The bits of the personality feel like they are separate and not joined.

Well by its very nature the empty chair technique promotes dissociation as it splits the personality into parts. So one should be careful of using it with those who dissociate as it could just promote the psychopathology.

The other paradox of the empty chair technique is its potential to develop self hatred. Often in the empty chair we place the Critical Parent ego state, or the internal critic as it is known. People with a high internal critic do not like themselves. They spend a good deal of their time criticising self. Telling self how bad they are and this can lead to things like depression. Depressives often have a big internal critic.

The internal critic

In the empty chair we can ask people to place this part and then get them to reject or get angry at that part. Well this is feeding the pathology. If someone has a self hatred, then to get them to be angry at another part of self is only going to increase the problem. It feeds the pathology.

In a previous posting I highlighted a inherent flaw in the methadone treatment of heroin addiction. By its very nature it says “Take this drug to stop taking drugs�. A double message which contradicts itself.

Well the same applies in this instance of the empty chair technique. If someone has a high internal critic and you get them to put the critic in the empty chair and ask the person to be critical of it then you are giving a double message to the client. You are asking the person to criticise the internal critic for criticising self. A double message to say the least. That can encourage the pathology as much as counter it.

Graffiti

I have said somewhere before in a blog that psychotherapy can be a surprise because what is sometimes known as the “Helping relationship� maybe helping the psychotherapist more than the client.

Most assume that counsellors and psychotherapists are long suffering humans who listen to their clients recount their lives and the traumas in it. I have often been asked over the years, “How do you cope with listening to people’s problems each day�. Some people start to think of you in a ‘saintly’ way because of this.

However I have stated that I have some narcissistic personality traits. So how can that be when I have been a psychotherapist for over 20 years. If I am constantly focused on the client and not self then that is opposite of a narcissistic personality.

Becoming a psychotherapist
As I have said to trainee counsellors over the years the final stage of development as a psychotherapist, is when you become who you are as the therapist. As people develop as psychotherapists they evolve their own style and and choose their own treatment strategies which they find works best. So in the end you come up with a psychotherapeutic treatment approach that is you. It fits for your personality like a good quality well worn in shoe.

You know what its like when you buy a new shoe. It never fits quite right and is a bit uncomfortable and you may even get a blister or two. As time goes on you and the shoe start to get used to each other and the shoe stretches here and changes there a bit until it fits the mould of your foot, and maybe even your foot modifies a little bit to fit the shoe. Then you and the shoe get on famously.

Well learning psychotherapy is the same. Your original style feels awkward and the techniques you use are a bit uncomfortable at times. One reason is because the approach and the techniques do not fit your personality completely. Over time however that changes and you find a style of counselling that fits for your personality and your personality may even modify a little bit to fit the therapy approach. So in the end the best therapist is one who is just himself. He has evolved a therapy style which fits best for his personality and thus he can be truly himself with the other person (the client). And as we know this is often regarded as the most therapeutic thing of all. Forget the therapy techniques and all, if a psychotherapist can be honest with himself and just be himself in the relationship with the client then that has the most therapeutic benefits for the client. It maybe the first honest relationship that the client has ever been involved in!!.

And my point is?
So if I have some narcissistic qualities (Hey I’m a blogger, I must be narcissistic) what form of therapy did I become interested in and evolve for myself?. Well the treatment style that I naturally was drawn too was the transferential treatment approaches. That group of approaches that uses the relationship between the client and the therapist as the primary tool for change in the client.

As I have said before, in my view transference based treatments are narcissistic in the way they work. Below is a simple diagram that shows how a therapist can focus his attention in the therapeutic setting.

The therapist can focus his attention out onto the client or he can focus his attention inward onto himself. Of course the inward onto self is the much more narcissistic way. Yes you guessed it! That’s one of the key components of a transference treatment approach. In any transference therapy there are two key components
1) The transferential reactions. These are the feelings, thoughts an attitudes that the client develops towards the therapist.
2) The counter-transferential reactions. These are the feelings, thoughts an attitudes that the therapist develops towards the client.

They are opposite sides of the same coin. In any transference relationship the therapist must have a good and ongoing understanding of his own thoughts, feelings and reactions to the client. This firstly allows for a much better understanding of the client and is crucial if the therapeutic relationship is going to evolve and develop as all relationships must do. To get a good and ongoing understanding of my own thoughts, feelings and reactions to the client I have to focus attention onto myself. There you have it! I am back to thinking about myself again!

By the way don’t tell anyone this. Clients come and pay me to focus on them and think about them when in fact I am thinking about myself!

And there is more
Transference involves an idealisation the therapist. When clients develop a transference with a psychotherapist they will start to view the therapist as an ideal person. They will only see the good qualities in the therapist and exaggerate those. Why? The Child ego state of the person is looking around for the perfect parent that they never had and will see the therapist as that. They unconsciously think, “If I have a perfect parent then they must be parenting me perfectly�.

Depending on the person, the degree of idealisation can vary from a little to a great deal. In the latter you, the therapist, can become the most important person in that client’s life. And that can go on for a long time. What do narcissists do? They over estimate their importance. They feel like they are very important to self, others and the world. So if you have a group of people (your clients) highly valuing your importance to them then that is going to be narcissists heaven.

And there is more
One of the difficulties with using a transference treatment approach is that it is very intense. It is an emotionally draining way to do psychotherapy for both client and therapist. That is OK for the client because he only comes once a week, but for the therapist he may be doing it three times per day. And over time that takes its toll.

Narcissists are sometimes described as having a narcissistic void in their relationships. The myth of narcissus states that because narcissus loved himself so much he didn’t have any love left over for anyone else. So he could never fall in love with another person because he was already in love with himself. So sometimes in relationships narcissistic people can have a gap or space between them self and others. They don’t fully attach or become emotionally ‘involved’ with others like non-narcissistic people can.

So in the therapeutic relationship the narcissistic therapist will have a bit of a gap and thus wont burn out like another therapist using transference treatments might. Every psychotherapist using the transference must be able to do this in some way or they will burn out fast. So the narcissist is a natural at having that little bit of a gap between self and the client.

Relational TA
This is where the theory of Relational TA starts to get a bit fragile. This approach focuses as much of the therapist’s emotional involvement in the therapeutic relationship as the client’s. They denote effective therapy as being somewhat dependent on the,

“Extent to which the therapists allow themselves to be penetrated by client’s affective states and meanings,….â€?

And later they state:

“It has been commonly observed that no psychic change will occur in the client unless the therapist, too, is changed emotionally in some way.� (TAJ (2005). P182, Hargaden & Fenton).

For me one of the most significant contributions this theory has made is its study on the narcissistic or self focus of the therapist in the therapeutic relationship. It examines in detail the ways and meaning of narcissistic examination by the therapist of himself during the therapeutic process. It takes the narcissistic component of the therapist in transference based therapies to new heights.

The problem that I have with Relational TA comes with is the statement that the therapist must emotionally change during the therapy. What does that mean and how much emotional change is necessary?. If one is treating say three clients per day that means they would need to be emotionally changed three times a day every day they worked! Simply not feasible I think you would agree. Such a therapist would burn out in a short space of time.

However I do not discount this treatment style at all as it does present as being a feasible approach indeed. My theoretical understanding of it would add a bit which they they have left out. I would rephrase the previous Hargaden and Fenton statement as such:

“It has been commonly observed that no psychic change will occur in the client unless the therapist, too, is changed emotionally in some way. At the same time the therapist maintains the narcissistic void between self and the client.�

How a therapist can be emotionally touched by a client and still maintain a void between client and self is yet to be elucidated. Indeed a subject that I will be further studying.

Graffiti