Tag: introjection

dandelions in a field

Weeds or flowers? How neurosis is all about context

One of the core concepts in gestalt psychotherapy is contact. Specifically, gestalt therapists are interested in what happens at the contact boundary; itself an emergent phenomenon that arises wherever self meets other.

In gestalt’s founding text, Perls Hefferline & Goodman’s Gestalt Therapy (PHG), the self is defined as “the system of contacts at a given time”. This is an idea of the self as an emergent, moment-to-moment, constantly created and re-created entity (a theme explored in broad terms in Philippson’s The Emergent Self).

But what is in contact with what?

In concise terms, this is the work of the ego, described in PHG as having the task of alienation and identification. It is the ego’s job to define me and not-me at any given time, for any given information. This is in contrast with the id, which can be taken to be the sum of all experiential information at any given time. And this is in further contrast to the personality, which can be taken to be the cumulative effect of our preferences over time; the story we tell ourselves about who we are to make the ego’s work easier.

Note: this outline of id, ego, and personality differs to the use of these terms in psychoanalysis, and is one of gestalt’s points of departure with that tradition.

Back to the contact boundary, and it’s fair to say that the ego’s main function is to determine where the contact boundary is by dividing experience into two sides: me and not-me, self and other, organism and environment.

The contact boundary mediates experience, and this is where the concept of modifications to contact comes in. I find two ways of thinking about this to be particularly useful: information, and experience.

The contact boundary serves an important information gathering function. I hear the world through my ears, but I don’t hear all the sound that comes into my ears. I can tune out background noise, just as I can suddenly tune in to a distant conversation if I hear my name. That is the work of the contact boundary, distinguishing between useful and useless information.

The contact boundary also serves an important experiential function. Some experiences are pleasant, some are neutral, some are unpleasant, some are painful, and some are overwhelming. Part of the contact boundary’s function could be understood as keeping experience within a tolerable range. Reflexively moving my hand away from a burning surface is part of the contact boundary’s work. So is moving to the beat in a satisfying way.

Modifying experience, modifying information

Modifications to contact become important when withdrawing from contact with something is difficult or not possible. Back to the sound example. If we’re having a conversation in the park on a busy day, I can’t simply withdraw from all that sound. But I can focus my awareness on the sound of your voice, and automatically relegate most other sound to background noise. That process involves a degree of desensitising to all or most other sound.

Alternatively, consider the flow of information, and the difficult job of taking in information in a meaningful way. Suppose I read something or someone tells me something. I need a certain amount of time and space to register that information, make sense of it, ensure I understand it. Now suppose someone is giving you a stream of information, rapidly, moving from one subject to the next without a moment’s notice. If you can’t get that person to stop and go slowly, then you might find yourself zoning out and trying to absorb as much of what’s being said as possible.

This is a merger strategy called confluence, where you try to lose the boundary between yourself and the other person and enter a we-state. Much of the information you take in during this state will likely be introjected, that is taken in uncritically and not given much reflection or contemplation.

The ego’s work of discriminating between me and not-me is bypassed by the temporary erasure of the contact boundary. Later, much of this information will come to feel alien because it hasn’t gone through the integration of being received, broken down, and re-created; it remains something someone else said that I pseudo-identify with, not something I broke down and reconstructed out of my own thoughts.

A plant in the wrong place

Gestalt therapists work with various defined modifications to contact. Their therapeutic value is in identifying how awareness of the here and now is being in some way impeded. They are somewhat like weeds in the sense that a weed is simply a plant in the wrong place. In other words, modifications to contact are only problems when they are problematic.

The initial therapeutic task is becoming aware of how contact is being modified. From there, it is sometimes appropriate to work with that modification (eg applying some critical thinking to the introjected views of parents that are holding you back from pursuing something important to you). It is also sometimes appropriate to leave things be (eg respecting that a memory fragment from a past trauma needs to stay desensitised because you don’t feel ready to go there yet).

Context is everything, and modifications to contact give gestalt therapists an important concept for exploring how and to what end a client adjusts to their present situation.

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Image credit: dandelions by Mike Mozart shared under Creative Commons.

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Recursive spiral clocks.

Timing is everything. I repeat, timing is everything!

the bristol therapist facebook page digest – january 2018

Quite a while back, I got excited and over-committed myself to an in-depth process of chewing over everything I read online that would culminate in a weekly digest. The two main outcomes of that experiment were an inability to get beyond week two, and a consequent reduction in how much online content I read.

The original point was to reduce the risk of introjecting ideas and values by ensuring that what I was reading was subjected to at least some degree of critical thought. As I couldn’t keep up with what I was reading, I was forced to question the behaviour as it started to seem compulsive. The end result was of becoming more discerning about what and how much online content I read; the unforeseen and welcome side effect of a gestalt experiment.

I still like the core idea though, so am resurrecting it in amended form for this therapy blog. I’ll aim to make it monthly rather than weekly, and focus on the articles I share through my facebook page. This also opens more possibility for dialogue, as I’m open to being sent links to interesting articles in a broadly therapy/psychology/being-human kind of vibe.

January was a quiet month for me on the facebook page, so I can overview everything here instead of choosing a top few articles. I imagine that in months where I post more, I’ll likely stick to a top five to stop this spiralling out of control.

I’m also going to err on the side of sloppy as this is meant to be about initial responses and chewing things over, so feel free to have at me in the comments.

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If It’s Important, Learn It Repeatedly.

This blog post is a reflection on Cal Newport’s book Deep Work, which seems to be all about practices for focusing on in-depth pieces of work and not getting distracted. (I’ll let you know if I ever manage to read it!)

Reflecting on the inspiration he felt whilst reading the book, and how even by the end of the book that feeling was disippating, Ben says:

“The window to act on a timely idea is very small. The heat of inspiration only lasts a few days, or even hours, and if it runs out before you’ve formed and implemented a plan, you’re essentially back at the status quo.”

This resonates greatly for me in my work as a therapist (and reflecting on my own time in therapy as a client). The problem with breakthrough moments in therapy, the insights and the ah-ha of realisation, is that these moments by themselves aren’t usually enough to shift actual behaviour.

As therapists, we kind of rely on a naive assumption that, following such a breakthrough experience in the therapy session, the client will then automatically go out and change things in their everyday lives. But even a brief reflection on my own process reveals that I’m more likely to lose the “heat of inspiration” than turn it into tangible action.

This is in part why gestalt therapists assimilated the behavioural therapy practice of setting homework tasks to be carried out between sessions. This practice also lives on in modern day Cognitive Behavioural Therapy.

Then again, what we alos find in therapy is that the insights that are most important and driven by organismic need tend to recur. So at least part of the point of being in therapy long-term is to allow the repetition of gaining the same insight several times to take place in order to reinforce the necessary changes.

So when Ben talks about re-reading books:

“If you’ve ever read a book a second time, you may have noticed that it’s an entirely different experience from the first time. It doesn’t feel redundant or repetitive. Instead, it feels like gaps are being filled in. Different details strike you as important. The points you do remember now have the benefit of context, and much of it seems entirely new.”

He’s also summarising why the same insights need to be discovered and talked over in therapy. The analagy is with chewing food. Most mouthfuls of food need to be chewed several times before they are ready for swallowing. The same is true of insights in therapy; talking them over, then rediscovering them later and talking them over again allows us to assimilate the lessons and the changes more effectively.

TL;DR: “If it’s worth learning, it’s worth learning repeatedly.”

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Antidepressants: Please, PLEASE, do not just abandon your meds!

This article is part of a continuing backlash against erstwhile journalist Johann Hari’s new book, Lost Connections: Uncovering the real causes of depression – and the unexpected solutions.

In short, Johann’s book seems to rely heavily on a simplistic medication = bad formulation that gives the impression people should abandon anti-depressants in pursuit of real “cures” for depression. This particularly article is a simple plea that people wanting to come off any kind of medication for depression, anxiety etc don’t just stop their meds, and at least go talk to their GP about it.

As for the wider issues with Johann’s book, well I’ve not read it so can’t comment directly on the text. However, one of the reasons I haven’t read it, and am wary of reading it, is that the very title contains two huge red flags. One is “real causes of depression”, and the other is “solutions”. The very idea that depression can be reduced to something that has identifiable causes and solutions is facile, and flies in the face of what most people discover about depression for themselves, both in and out of therapy.

I don’t mean that reasons for being depressed can’t be found, or that ways out of being depressed can’t be found. Just that, for the most part, you can’t say to someone, “your depression is caused by x, and if you do y, you will be cured”. Depression isn’t a disease to be cured.

Johann also doesn’t seem to be aware that there is a decades long tradition in psychotherapy of challenging the reductive idea of depression as a problem of brain chemistry. And performs a classic throwing out of the baby with the bathwater by seeming to conclude that medication can simply be jettisoned. Many people need to work on their depression through both medication and therapy.

So in part I shared this article to siugnal that I’m not in the “medication is inherently bad” camp. I’m still skeptical about the extent to which medication like antidepressants are prescribed, and think that a society that took depression seriously would be able to support most cases of depression without medication. But then, almost by definition, such a society would most likely experience very low levels of depression in the first place, such is the problem with any “in an ideal world” formulation!

In our current society, very little room is made for people to work through depression in the ways they need and in their own time. I get the sense that Johann Hari is arguing more or less the same thing, but presents it as a unique idea that has only just been stumbled on, and gives the impression that it’s possible to simply throw away the meds and kickstart that world right now.

TL;DR: It’s ok if you need meds. If you want to stop your meds, always work out a plan with your prescriber first.

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This Is The Best Time To Do Anything: 4 Powerful Secrets From Research.

I’m a sucker for “secrets from research” type posts, even though the secrets have clearly been published in books and journals, so aren’t that much of a secret.

In the context of gestalt therapy, stuff like this plays to the idea that you’re better off tuning in to your own experience and working out what you need (organismic self-regulation) than adapting yourself to externally imposed ideas about what you should need (introjective or shouldistic self-regulation).

Which of course immediately throws up the objection that following our own needs is largely impossible given the consistent demands of school timetables and the workplace. But therapy doesn’t end at individual behavioural changes. To me, one of the signs of effective therapy, is getting people to the point at which they are able to challenge their own society and take political action.

Yes, school timetables are often rigid and tend to prioritise the needs of the school over the needs of the children and parents. So find parents who agree and channel that frustration into political pressure. Yes, the workplace grinds people into dust. So join a union, organise politically, negotiate explicit demands with other workers, and be prepared to engage in long-term political action.

Practically every course of therapy hits the boundary between individual need and social demands. These conflicts can’t be solved in one to one therapy. But they can be brought into awareness, explored, and a subsequent movement into political action can be supported.

TL;DR: Highlights from Dan Pink’s book When: the scientific secrets of perfect timing, especially for larks, night owls, and third birds.

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Here’s what the evidence shows about the links between creativity and depression.

I really enjoy the British Psychological Society’s research digest. It’s a really good example of using blogging to make academic research accessible to a wider audience.

This post is based on a meta-analysis looking at the link between creativity and mental illness, prinipally mood disorders as this seems to be where the most research focuses. It suggests that a fruitful focus for further research would be into how creativity links to mood disorder.

Interestingly, in considering possible explanatons, Alex suggests creative lifestyle and the possibility that creativity simply expresses in a way that is more likely to match the symptomology of mood disorders eg:

“many aspects of the “flow state” – extended bursts of activity, disregarding the need for sleep or food, absorption or attentional wandering, rapidly flowing thoughts – are also treated as markers of bipolar disorder”

Working regularly with creative people in therapy, I’d suggest that highly creative people tend to also be more sensitive and emotionally oriented, and this opens them up to being more easily hurt by a society that tends not to value creatvity. The arts tend to be undervalued in education for example, and many of the creative clients I’ve worked with have reported feeling like they were a square peg being hammered into a round hole.

So yes, the lifestyles of creative industries likely contribute to the development of mood disorders, but the way creative people experience their world might be more casutive. Especially if you’re going to reference “the profligate substance misuse” as a given aspect of the creative lifestyle without asking from where the need for substance misuse arises.

TL;DR: Creative people are more likely than average to have a mood disorder, but people with mood disorders are not more likely than average to be creative.

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Want to take your psychotherapy to the next level? Ask for what you want.

As will become clear as I unfold The Golden Arrow, wanting offers a major in-road into understanding what we need. What I like about this post is that it encourages clients to ask for what they want from their therapist.

I’d extend that to most relationships. It’s useful to ask yourself every now and then, “what do I want from this relationship?”. This is often hard for people because it feels like a very selfish or transactional thing to ask of a relationship. But ultimately, healthy relationships develop out of some kind of mutual need, and it’s ok to ask if the relationship is still mutually needful.

Asking for what you want is a way into that, not necessarily an end in itself. And in therapy at least, it can make for really interesting sessions that can redefine where the therapy is going.

TL;DR: It’s ok, and actively good, to tell your therapist what you want.

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Photo credit: “…Time…” by Darren Tunnicliff, shared under Creative Commons.

Chewing digital food in my pocket

An enduring metaphor in gestalt therapy is to imagine experiences as food. Whilst this was a concern of the founders back in the 1950s, social media has given emphasis to its appropriateness. We regularly refer to what’s appearing in our feeds, mostly without pursuing the hint that the information delivered by our feeds is a form of sustenance.

One of the ideas this leads to in gestalt therapy, is a concern with the process of chewing food. This relates to the critical examination of what we are experiencing / have experienced in order to aid the process of digestion (ie, to assimilate our experiences as fully as possible), and to be more choiceful about what we take in (swallow) and reject (spit out).

Most appropriate to our information rich age of social media, is the observation that if we take in too much information, too quickly, we don’t have time to critically evaluate that information, and are more prone to simply absorb other peoples’ views/biases/prejudices (introjection in gestalt therapy). This is by no means an observation unique to gestaltists; it’s a staple warning of anyone who values critical thinking and independent thought.

A while back, I decided I wanted to keep track of what I read online and started using pocket. You sign up for an account, then download the plug-in for any browsers you’re using, and the app for your smartphone. It’s then possible to save any link in pocket, and assign tags to make the links searchable by keyword. As the pocket account is in the cloud, links saved can be accessed from any machine that has the plug-in / app installed.

Since November, I’ve kept track of my online reading using a weekly tag (wc for week-commencing, then the date that week started) in addition to relevant keywords. This has already made it easier for me to track down articles I vaguely remember having read. I’ll either remember the main keyword and scroll the articles under that tag, or remember roughly how long ago I read it and scroll back to that week.

I’ve also become more discerning about which articles I read; the minor hassle of tagging something in pocket is enough to make me do an initial assessment of whether reading the article is going to be worth the hassle of tagging it afterwards. My eyes are no longer bigger than my stomach!

More recently, I’ve decided to experiment with more of a chewing process. Each week, I keep a pocket scratchpad in my email drafts. My aim is to record the thoughts that come up in relation to what I’m reading. At the very least, this consists of a TL;DR of a couple of sentences, usually with some notes on basic responses (thoughts, feelings, images, associations etc).

I’m finding that with some links, a commentary emerges, which might only be a more detailed reaction than just notes, or may turn into a blog post in its own right. Where a blog post emerges, I’ll be publishing it as a separate post, and keeping just the TL;DR and a link to the blog post in the scratchpad.

Which is all an elaborate way of describing the production of a weekly digest, but the fact we call it a digest in the first place helps reinforce the point. I’m using Medium to publish the digests. It feels kind of like Livejournal: The Next Generation.

To extend the food metaphor, the weekly digest itself could be the equivalent of chewing and swallowing. What happens to that blog post in the wilds of the internet is maybe more akin to food’s journey through the intestinal tract. Maybe other people read the post and leave comments that help me consider what I’ve taken in from new perspectives, like gut bacteria breaking food down into useful nutrients.

It’s also a good way of putting into practice this article’s advice on using systems not goals. I tend to want to write more blog posts than I get round to writing, and can go a long time between ruminating on something and actually getting it out there.

By doing little bits of writing on a regular basis, without worrying much about quality or putting together commentary (some of my responses simply involve typing “welp”), I’m at least chewing stuff over and making a discipline of a really basic blogging skill: picking out figures of interest from articles and responding to them.

Follow me on Medium if you want to see how it pans out. And if you use a system of your own for keeping track of and processing your online reading, tell me all about it in the comments!

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Photo credit: Chewing the cud by robdownunder

introjection visualised by jennydrewsomething

Shoulds: the internalised wants of other people

One of the arch-villains of gestalt therapy is the word “should”.

If you’re in therapy with a gestalt therapist, and you start talking about things you should be doing, chances are your therapist’s self-talk has started going, “holy shit! Introjection at twelve o’clock! Kill it! KILL IT WITH FIRE!”. This is because “should” is treated as a dog-whistle term for introjection, and if gestalt had a Wanted: Dead or Very Dead list, introjects would be towards the top.

Introjection is a hang-over from gestalt’s psychoanalytic heritage that hasn’t quite been deconstructed satisfactorily. Which is ironic, really, considering that that’s what introjection is all about. Essentially, introjection is the uncritical internalisation (metaphorically, swallowing whole) of the thoughts, opinions, rules etc of other people. Two main types of introjection can be identified: force-feeding (ie, I introject your rules because you force them down my throat), and inferences (ie, no one says anything directly, but I develop the impression that such and such is the case). The key factor is that I do not apply critical thought to (metaphorically, I don’t chew) what I take in.introjection visualised by jennydrewsomething

A key force in gestalt therapy is semantics. The words you and I use to communicate don’t just contain valuable information about the kind of people we are, they also shape the very experiences we are attempting to communicate. In day to day therapy, this translates into drawing someone’s attention to the words they are speaking. This then raises that person’s awareness of how they are creating their experience in the moment.

I find it instructive to replace “I should” with “x wants me to”. The word should is most usually used to invoke an external authority. What Gary Yontef calls shouldistic-regulation (ie, regulating oneself according to external authority) stands in direct opposition to organismic self-regulation (ie, regulating oneself according to organismic need). When someone says, “I should do better”, they nearly always mean, “x wants me to do better”, where x is a significant internalised other. Shouldistic-regulation is striving to do better because I should. Organismic self-regulation is striving to do better because that’s what I need to do at this time.

The same applies to societal norms and moral codes. “I should not steal”, is really, “x wants me to not steal”. This is obviously the case with regards to force-fed introjects; someone has to do the force-feeding. This is less obviously the case with inferences because, at first glance, no one is doing any force-feeding. The modification I would make in this case is, “I imagine x wants me to”. That is, the inference I am making derives from either the kind of social atmosphere I am experiencing, or the extension of pre-existing rules.

Social atmospheres “give me the impression” that such and such is and isn’t acceptable. But social atmospheres emerge out of the interactions of actual people, allowing me to identify who it is that I am imagining wants me to x. Pre-existing rules give me a way of anticipating what possible rules might apply to a new area of activity. As pre-existing rules are put in place by actual people, I am again able to identify who it is I am imagining wants me to x.

The therapeutic objective in this odd little game is grounding social constructs in actual people. Moral codes do not spontaneously come into being of their own accord; they are created and maintained by people. The kinds of introjects that become the focus of significant therapeutic effort generally need to be traced back to their origin. And that origin is frequently “my dad”, or “my mum”, or “God”.

A hugely important part of therapy is deconstructing the introjected rules by which a person is constrained. That process will invoke resistance from the internalised originator of those rules. And frankly, if I’m going to be up against someone’s internalisation of God, I’d rather know about it!

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Image credit: jennydrewsomething.

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