Saturday, June 15, 2013

Transactional Analysis in Psychotherapy (37->46) - Chapter Five


I will now talk about pages 37-46 or Chapter Five - Pathogenesis

I had to look up pathogenesis, although I had a general idea of what it could mean. It's essentially the origin of the disease. In this case it would be psychopathogenesis or the origins of psychological disease. I don't think anyone knows the origins of disease in general, but the causes of particular diseases can be isolated.

It seems there is an infinite chain of what could be considered a disease. It is not so cut and dry. In the animal kingdom, a so-called "disease" could be the trait that introduces a new species into the world. To use a common example: if a bird's beak is formed longer than the other birds' beaks, it may be an "outcast" among their species but that genetic mutation may allow the bird to reach insects in places the other birds could not. What started out as a "disease" turned into an asset.

That is one idea of how our language taints the actual meaning of things. Disease could be looked at as a spectrum from potentially adaptive to blatantly maladaptive. A problem looked at in one light turns into a non-issue when the power of perspective comes into play

However, humans don't deal in eons. We deal in minutes, hours, days, years. It is not up to us to judge what is adaptive or maladaptive as concerns the species. Where it does matter is with the individual. If an individual is suffering in some way, it becomes necessary to fix that thing that is causing the person suffering, or ameliorate that suffering in some way.

It no longer becomes an issue of adaptiveness or maladaptiveness in terms of the species but in terms of the actual individual. If the "disease" contributes to the person's well-being, then perhaps it should be left alone. However, a happy sadist is still a sadist. Whether a person is happy or not is not necessarily a good indicator of correctness.

I'm discussing all of this because it seems necessary to establish some fundamentals before going deeper. What are the qualifications for determining how a person should be? Berne discusses how a "happy" person does not make a good person. Also, a person whose personality is "well-organized" may not necessarily be a happy person. It seems that there are other qualifications to be determined.

So even if all one's parts are in harmony with each other, that doesn't mean one is following societal standards. And if one is following societal standards, one could still very well be a "psychopath" (if that society condones cannibalism or torture, etc...)

Currently we are looking at the individual in particular and how the various psychological systems work. It has been established that our minds are composed of ego states that can be structurally designated as Parent, Adult, and Child types. It seems that when these ego states exclude each other or, conversely, contaminate each other, then problems arise.

I must not understand fully contamination and exclusion because sometimes it seems as though contamination and exclusion are normal. It means some element is syntonic or dystonic with two or more ego states. In the case of the son who believed that "all dancing is wicked," his Parent was syntonic with his Adult. Because this was a wrong belief and all dancing is not wicked, it would be better if this belief was left in a latent stage in his Parent. What if he was right about something? Let’s say he believed that "all torture is wicked." Wouldn't it be a good thing if his Parent and Adult were syntonic about this?

Is there some universal standard to which all beliefs can be held? I think that standard would be known as Truth, but this seems to be a tautology and it doesn't seem that humans have figured out a way to distinguish a common trait among all true beliefs.

I will explore this chapter and see if I can answer some of my own questions.
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Pathogenesis (pg. 37-46)

Dr. Berne begins by comparing psychic life with "somatic" life. Similar to the bodily systems, the psychic systems can be isolated and treated specifically. In the same way that a doctor can treat a patient's heart, brain, blood, liver, etc. individually, a trained psychotherapist can treat an individual's anxiety, depression, neurosis, psychosis, etc. individually.

Dr. Berne explains that the body tries to maintain its homeostasis in the same way the psyche tries to maintain its version of homeostasis. Berne mentions that the body sustains itself along a continuum and I'm not sure what the two poles of the continuum would be: sick vs. healthy, over-nourished vs. under-nourished... It's possible that there are many continuums and the entire body's healthiness can be judged by measuring where the body's individual parts are along different continuums.

Take digestion for example. Different supplements are digested in different ways. Vitamins K, A, D, and E are the ones that are fat soluble, meaning that there is an upper limit where too much of those vitamins can cause an overdose. Too little of them can cause other problems as well. However, Vitamin B has no upper limit because it is water soluble and can be urinated out. These vitamins are needed for various processes in the body like building proteins and other things I'm not sure of. The point is that the different systems of the body can be isolated and treated accordingly.

It would be interesting to see all the different psychological mechanisms that people have discovered and compare them and organize them into categories. Perhaps this is what Dr. Berne has done. Of course there is the Parent, Adult, and Child and they act differently, but what about other psychological mechanisms: the difference between assimilation and accommodation, for example.

Berne discusses the idea of an "ego unit," perhaps the most basic form of an ego state. Information that people receive internally from their various parts and externally from the environment is "assimilated" into the brain during the day, and then when the person goes to sleep, the dreams that people have help to further organize the data. The cycle of one waking state followed by a dreaming state can be called an "ego unit." (Dr. Berne puts quotes around the word assimilation possibly because the word assimilation doesn't quite capture the true nature of what is happening... Or because it is more complex than just "taking in" information.)

When the data is not "assimilated," the person's dreams "become repetitive and the waking ego begins to stagnate" (37). When Dr. Berne says stagnate, what does he mean exactly? ...the person tends to do the same things even if they are unhealthy things? Perhaps he means that exclusion and contamination become more prevalent. It is easy to understand how exclusion can be perceived as stagnation. One is caught in the mindset of a particular ego state. With contamination, I'm not quite sure. One can stagnate their development by persisting in believing that "all dancing is wicked" when in fact, it is not.

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 In Ken Wilber's theories, he mentions four distinct realms of being: Body, Mind, Spirit, Shadow. In Dr. Berne's conception, there doesn't seem to be the Spirit realm. I'm not one for believing in abstract sort of things like Spirit, but because Ken Wilber seems right about so many things, I'm kind of leaning toward believing in it.

For example the body has various systems and the mind has various systems. We can agree upon that. When we get into the realm of spirit, I don’t know what systems Ken Wilber has come up with. He divides "energies" into Gross, Subtle and Causal and all of these different realms can be understood to have those aspects. I don't know the specifics so I'm going to stop.

I'm just interested in the possibility of spirit serving as an organizing principle for the mind. It seems as though the spirit system encompasses the mind system and the mind system encompasses the body system (or transcends and includes it). Where would the mind system end before turning into the beginning of the spirit system?

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In the IFS (Internal Family Systems) model, there is a part of the personality known as the Self (capital S to distinguish it from the "self" which is the entire human being). There doesn't seem to be a "Self" part in the Transactional Analysis model. The closest thing to the "Self" that I've come across in TA is the cathexis or ego feeling that the person "has" or "is". The "Self" seems to inhabit the Parent, Child, or Adult at different times or at the same time depending on which ego states are active.
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Coin Metaphor

It is an interesting metaphor that Dr. Berne uses to describe pathology of the psyche. Each waking + sleeping cycle is considered an "ego unit." Every day the ego state is formed and during the night, the ego state is "polished." This can be compared to forging a coin during the day and polishing it at night. The coins are placed in a vertical stack from the first created coin to the last symbolizing the order of ego states in a person's development from the first day of life until the last (the first day representing the bottom coin).

If one of these coins is made improperly (the ego formation during the day is traumatized), then it will throw off the direction of the stack of coins. Ideally a trauma free personality will be a perfect cylinder of coins. If there is one trauma, the stack of coins will be straight up until that particular coin and then will be skewed. If there are repeated traumas of the same kind, then the stack will be skewed in the same direction multiple times causing it to be in danger of toppling over. If there are various traumas of different natures then the stack will be skewed in different directions with the possible result of the top coin being straight; the pile will be unstable however. I think the top coin being straight is the equivalent of a personality appearing stable while in truth, it is not.

Dr. Berne says the most important thing to take from this metaphor is the idea that "in order to correct the situation, it might only be necessary to rectify one or two coins" (39). That is the job of the trained psychotherapist.

Dr. Berne talks about the pennies of childhood up to the silver dollars of maturity..."one bent penny might eventually cause thousands of silver dollars to tumble in chaos" (39).

~-~-~-~-~

Does this mean that we actually do have the equivalent amount of ego states as we have days in our lives or am I taking this metaphor too literally? Do these ego states combine in any way?

Dr. Berne calls the Child "a bent penny" (or a series of bent pennies). Does this mean ideally the personality would have no Child since the ideal personality has no bent pennies? The idea of the Child being a bent penny and not simply all of the pennies, bent or straight, combined is kind of disturbing to my understanding of structural analysis. Why does Berne call the Child a "bent penny"? Does "intuition, creativity, spontaneous drive and enjoyment" all come from a warped ego state? I am just going to continue reading and see what information I discover.

Berne compares a traumatic neurosis with a psychoneurosis. In a traumatic neurosis, the Child was fixated on one particular day. In a psychoneurosis, the unhealthy ego state recurred from day to day for a set duration of time. Dr. Berne mentions that a person only has 1, 2, or "in rare cases" 3 archaic pathological ego states (or series of ego states). This seems important because it will center the therapy on finding only those pathological states and rectifying them. I'm curious about how that works though. The number of pathological ego states must not correspond to the amount of trauma directly; if a person experiences 10 traumatic experiences, why wouldn't they have 10 warped ego states? Why is it only in rare cases that a person has 3?
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Hept Family

Dr. Berne's first example comes from a member of the Hept family (I'm noticing that these names seem to correspond to numerical derivatives...Primus, Segundo, Troy, Quint, Hept). In this example, a grandmother secretly "taught sexual perversions" to her 3-yr-old grandson. He would lie in bed "in a state of expectancy and excitement which he had been instructed how to conceal if anyone came into the room" (40), until his mother left for work. Dr. Berne refers to this as a "complex ego state" and the ego state that followed this he referred to as one of "sexual abandon."

The boy eventually tries to seduce his own mother as she's drying herself after a bath. This is after the boy becomes a "successful deceiver and lover" (not sure what age but Berne still refers to him as a little boy). She responded with such great horror that "the little boy froze in his tracks." The moment of seeing his mother's horror is what caused the boy's "highly charged" ego state to become fixated and separated from the rest of his personality.

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Dr. Berne clarifies that it is the moment of seeing the mother's reaction of horror that caused the ego state to split off and not the seduction act itself. Because the act itself happened in the past and all information is not available, Berne gives 4 separate possible scenarios for what could have happened:

1) A Sexually Confused Man - His sexually excited Child is excluded from his horrified Parent. His Adult is neutral. This causes him to react with horror to behaviors that are child-like in himself and others.

2) A Traumatic Neurosis - The Child is excluded from the Parent as well as the Adult. (How would this manifest?)

3) A Remorseful Perversion - The Adult is contaminated by the Child. (How would this manifest?)

4) A Psychopathic Perversion - The Adult and the Parent are both enmeshed with the Child ego state. This would be the case if the mother played a role in seducing the child.

I'm interested in how these scenarios would manifest behaviorally. I understand the differences when it comes to structural analysis but not in terms of what it would look like. With a traumatic neurosis, for example, because the Adult is excluding the Child as well, does this mean the person does not experience any sexuality at all or does it manifest differently depending on the circumstance?

How does a therapist know when a person's ego state is contaminated? It seems that to identify contamination, one would have to understand different sorts of beliefs. Where is the line between prejudice and healthy conviction? Is it simply a matter of right and wrong? How do I know whether my belief is prejudicial or true? Is it simply a matter of over-generalization?

I don't know much about psychoanalysis and I think that's where these terms (neurosis, psychosis, etc.) were developed. I think the next example will shed more light on these differences.
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Miss Ogden

At the age of 6, Miss Ogden was seduced by her grandfather. Her Parent was decommissioned so she cooperated somewhat. She did not tell her mother because "she had anticipated no sympathy from that quarter" (42). What is interesting is that part of the experience was excluded from the Adult while another part was Adult ego syntonic. The secrecy that she kept was Adult ego syntonic while the sexual aspect was excluded. Does this mean that an ego state can be separated further? It seems that it has been. The "ego unit" of that day was divided into a sexual aspect and a secretive aspect. Perhaps there is an infinite amount of "aspects" that one ego state can be separated into.

In Miss Ogden's dreams, her Child reproduced itself in the same form as when she was a little girl the exact moment of the seduction. It's as if this part of her had not been healed and therefore repeated itself in her dreams. When she was awake, she was "sternly asexual." She was, however, pathologically secretive. So the sexual aspect that was Adult ego dystonic only appeared in dreams when the Adult was decommissioned. The secretiveness appeared in her waking consciousness because it was Adult ego syntonic. It was also Parent ego syntonic because her mother was secretive. Because the secrecy was Parent as well as Adult ego syntonic, Berne referred to this as a "psychopathic" secrecy.

If the secrecy was only Adult ego syntonic and not Parent ego syntonic, it would be "remorseful" and not "psychopathic." To me psychopathic means "without guilt or shame." It seems that people can go back and forth depending on which ego state has the most active cathexis, so sometimes a person can be aware that what he or she is doing is wrong and other times, that person won't be aware of the moral aspect of their actions. Miss Ogden's secrecy was psychopathic so she was unaware that her secrecy was pathological. If her secrecy was only Adult ego syntonic (and not Parent ego syntonic), she would be aware of its pathological nature, and therefore possibly compelled to change it.
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Character Neurosis vs. "Psychopathy"

When Dr. Berne says "character neurosis," I'm not sure if Dr. Berne is referring to a "neurosis" or a "character disorder" or something else. I think it may be a character disorder just judging by the context. Dr. Berne compares "psychopathy" and "character neurosis" briefly, saying that they are similar.

He uses the example of a Fijian chief who was extremely sadistic but his contemporaries did not regard him as crazy, just mean. He did horrific things, but because the culture was not as horrified by these things in general, it was the social context that seemed to validate his behavior. People may be horrified by his actions, but if the culture somewhat supports it, it loses the quality of being wrong. I'm not saying the things he was doing weren't wrong (eating people, clubbing his wives), but in the context of his social environment, they were probably merely frowned upon, not regarded as behaviors a psychopath would partake in.

A character disordered person has something like a superiority complex. I read about it in Erich Fromm's The Art of Listening but I forget all the details. Societal norms may influence whether a character is perceived as "psychopathic," but I think ultimately it can be understood in terms of structural analysis whether such person has a psychopathy, neurosis, or character disorder.
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A "Happy" Person

I've always been interested in the works of Plato and Aristotle concerning "the good life" and the meaning of "happiness." Dr. Berne characterizes a "happy" person as one "in whom important aspects of the Parent, Adult, and the Child are all syntonic with each other" (42-43). It is important to note that even if a person is "happy," it does not necessarily imply they are living well. Even if all the parts are syntonic with each other, the social environment may be validating inappropriate or even terrible behavior.

Just because a person has a career in which all of their parts are being validated or supported, the career itself may be harmful to other people and therefore life is not only about being "happy." As I said earlier, a happy sadist is still a sadist. This raises some deep philosophical questions regarding the meaning of life. I was always under the impression that if you're "happy," you are doing the right thing, but I would be sorely wrong to say that.

Dr. Berne gives the example of a doctor who, despite some marital problems, was still happy because of his work. His parents approved of his career, he was good at it, and it satisfied his curiosity and emotions. His Parent, Adult, and Child "all respected each other and each received appropriate satisfaction in his profession" (43). He segues into a story of how this scenario could be the same for a person who worked in a concentration camp. The worker comes home to his mom and says something like "I got promoted!" and the mother responds "I'm so proud of you!" ...In Dr. Berne’s words, "He fulfilled his mother's ambitions for him with patriotic rationality while obtaining gratification of his archaic sadism" (43-44).

A concentration camp worker who is happy because he was promoted highlights the ineffectualness of claiming that happiness is the only judge of what is right. It seems that virtue would have to play a role as well. I think sadism is still somewhat of a mystery to experts. Is it learned? Are people born with it? Can it be unlearned or does the power of empathy need to simply overshadow it? Virtue needs to be learned and I think by learning the virtue of compassion or connection, one can realize that one's life will be improved by treating people well than by treating them poorly.

If sadism is inherent in the personality, what function could it possibly serve... a protective mechanism of sorts? a means for understanding and protecting oneself from other sadistic people? Why does sadism even exist? It seems like it could be the downfall of humanity.

I think Eric Berne sums it up when he says "It is not enough to want to raise [children] to be 'happy'" (44). There must be other standards of behavior as well.
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The "Well-Organized" Personality

In this sort of personality, the Parent, Adult and Child can be kept relatively separate and function somewhat independently when they are needed to. A Scottish school teacher drank heavily when he was home but he showed up promptly for work every day. His Child was doing the drinking, while his Adult was doing the teaching. His Parent was "weakly cathected" during all of this. One day he stopped drinking altogether and unfortunately for the students, he was no longer a pleasure to be with. His Parent took over and probably because of the Parent's disapproval of his secret life of drinking, he became a "terror" to his students. His personality was "well-organized" but he was not a happy person.

So it seems there's more to life than being "happy" and more to a personality than being "well-organized." Can a person who’s not a psychopath be truly happy though if he or she is acting on their sadistic fantasies? It seems there is an inherent correlation between doing "good" deeds and feeling good.  Dr. Berne emphasizes the need for a person's Adult to be "plugged in." Perhaps one's happiness is determined by how connected their Adult is to their environment (of self and world together). If a person is harmonious with merely their own parts and not the social environment, he or she could be acting sadistically and still be happy. Is there not some intrinsic part of the personality that makes a person feel bad when he or she acts sadistically?

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I'm still pretty confused about all of this. I feel like I've gained insight into how a person ought not to live. I want to know more about how a person ought to live or be. In my understanding, if a person learns how to act virtuously, he or she will secure for themselves the best chance at being happy. How that translates into structural/transactional analysis, I'm not sure.

1 comment:

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