Showing posts with label trauma. Show all posts
Showing posts with label trauma. Show all posts

Monday, 19 November 2012

Negative K

I was a teenager in the late 60’s and am from the humanistic tradition of psychotherapy.  It is a tradition based in optimism about what we may be and the sense of basic goodness at the heart of every person which, although it may be corrupted by pain and distress; can be recovered. At its best, I still believe, it represents the deepest spiritual truth; at its worst it is a naïve optimism about people and life and possibilities.  Anyone who has worked as a psychotherapist for a long while is likely to come up against the notion of damage and what can and can’t be repaired in people.  Miracles are always possible and radical change certainly happens.  In the past I have tried with clients to support a realistic idea of what can be changed with the metaphor of the difference between an open weeping wound and a scar. Nothing can create perfect skin but therapy can help change an open wound into a scar; healing doesn’t eradicate all traces of the past, it makes life possible;  the trauma is still discernible but no longer dangerous.

However, clinical experience sometimes takes us to look at the sense that some clients have of damage. Perhaps this is the “Basic Fault” (see M. Balint) that can’t be repaired.  Wilfred Bion, a brilliant  and original developer of psychoanalysis, came up with a theoretical formulation of the functions of Love, Hate and Knowledge in both positive and negative forms.  Negative Knowledge (K minus) is the core part that actively doesn’t want to know and destroys knowledge and awareness.  Its forms can be very destructive of any goodness in the internal world and of any attempts to help. There are many other ways of conceptualising this.  Unless you have led a charmed life as a person and as a therapist , you will have met people who seem impossible to help and who perform the alchemical task of turning gold into shit.  They twist everything good into a force against themselves or others who try and help. 

Melanie Klein gave another way of understanding this through her use of the concept of envy.  Where someone perceives good qualities in another they try and destroy them rather than emulate them or use the gifts being offered. If they receive any goodness into themselves then they turn and try and destroy that through self-attack. The very qualities and experiences which could help them,they seek to destroy. It is very primitive and very real in some people.  I am sure there are Christians that would say that it is the Devil at work. Jungians may say these people are in the grip of an archetype such as The Witch or The Judge. Other forms of understanding this in different cultures can be of possession of the person by a spirit that requires exorcism; a variety of shamanic process. In its positive form this is sometimes called soul retrieval.  Shamanism and psychotherapy are close together as an increasing number of books now recognise such as Christa Mckinnon’s  Shamanism and Spirituality in Therapeutic Practice , recently published. 

The irony is that this work all requires some sort of positive therapeutic relationship; and that is precisely what negative K seeks to destroy. Sometimes therapy and life requires a process of hanging on to this relationship even when results and common sense suggest otherwise. In this respect working as a therapist is an act of faith against a sea of unknowing, unreason and darkness.  The struggle to maintain the therapeutic relationship and get agreement to name and work on the trauma ( which can be very effective using energy psychology methods), is sometimes the bulk of the work. As a committed therapeutic relationship is now against the cultural norm of instant gratification and moving on; this is particularly hard.  The boundary in therapy and life between commitment and masochism is sometimes very hard to discern!

Monday, 29 October 2012

Exciting Times for Psychotherapy

When I started training as a psychotherapist in the 1970's "proper" therapy was psychoanalytic and they  generally wouldn't even acknowledge the existence of any other ways of working. Behavioural schools had been around and were used a bit (after all it works for training dogs) and were looked down on and Humanistic approaches were completely ignored even though they had been around for nearly twenty years. Gradually things have changed; dialogue started. Many conditions, such as anorexia were very hard to improve from just one orientation. Deeper understanding of the therapeutic relationship showed how different approaches focussed on different strands of the relationship. Different therapies came from different social and political milieu and also reflected the preferences of the founders. For example Freud was a doctor, a medical researcher, and came from a scientific and rather mechanistic understanding of the human being. He was also quite a shy person. His methods and his theories reflect this. In the middle of his working life came the Great War, which also affected his understandings of human nature.  Some humanistic approaches came from America in the nineteen fifties and sixties.  A very different world.

Now the dialogue has turned into a real debate with real listening and with many people training and working across modalities. Discoveries in neuroscience, greatly speeded up by the development of brain scanning, have allowed us to see the brain in action and more fully understand the roots of our behaviours.  The move towards recognising the essentially human nature of the therapeutic relationship with two fallible human beings in one room has allowed the subtleties of the interactions to be studied and understood. Increasing respect for human subjectivity has gone along with the knowledge of the mind and body and how they are really two sides of the same coin.

For many therapists,  the move towards integrative approaches to therapy and the inter-subjective revolution are more than enough; but there is more.   Neuroscience has validated the work that body psychotherapists have been doing for half a century or more to reduce trauma. The basic practice of mindfulness from the Buddhist traditions have been incorporated into therapies like Mindfulness based CBT and DBT. Research has supported traditional practices and given them respectability in the West; where we want to know why something works before we will accept the evidence of our own senses.

And there is even more when we move to the edges of conventional psychotherapy.  Remember that psychotherapy comes from Psyche meaning Soul  and Therapiea meaning healing. Healing the Soul which is also reconnecting the Soul to its source and in to Nature is a shamanistic practice. Most shamans use plant substances to help with healing; sometimes through journeying to other realms.  LSD and Ecstasy have been used in psychotherapy in the past; and until recently in Switzerland.  Natural substances such as ayahuasca can speed up the process of therapy by a considerable factor when used in a clear professional capacity. The recent dropping of the Government's attempt to prosecute the Santo Daime people in Britain may give some support to those who want to extend its use to therapy. This of course won't be welcomed by those trying to make psychotherapy as respectable a possible - an impossible task as psychotherapists hear the secrets of people's unhappiness with life and therapy deals with what is not acceptable in the world. 

The other big revolution, also not discussed in psychotherapy circles comes under the name of Energy Psychology; the collection of approaches that use the meridians, energy lines and chakras of the body for psychological healing. Some have fallen more under the heading of alternative therapies and some are more clearly under the banner of psychotherapy. The former include Emotional Freedom Technique (EFT), Tapas Acupuncture Technique (TAT),  Thought Field Therapy (TFT) and the latter; developed by a Jungian therapist,  Advanced Integrative Therapy (AIT). All can have great results in skilled hands. AIT, with which I am most familiar, speeds up the process of long term therapy by about a factor of three. They are not magic methods; just a refinement of what Freud intuited, that energy flows in the body and how it is blocked and channelled is important. AIT removes the block caused by trauma which are held in the body. The silence of the psychotherapy world with all of this is deafening. 

However, things are changing fast. The current issue of both the major professional journals in Britain have interesting leads. Therapy Today has an article on Yoga as Therapy; and the current issue of the UKCP journal The Psychotherapist is mostly on The Theory of Love.  Perhaps things are really beginning to change and fresh air of change is blowing through the world of psychotherapy even as other changes are making what is available on the NHS more and more scarce and restricted. In this blog I want to open the windows wider. Join me!