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Most of the material described in the following pages is relevant here:
We recall here that not all autistic/psychotic/paranoic individuals show obvious symptoms. [see Symptoms—>] therefore, there are a great number of those individuals who seek help and are minimally socialised or even well socialised and have avoided recourse to institutional help from infancy, chilhood, or adolescence. Structural defects will produce permanent discomfort and relational problems, and even worse only in special circumstances these persons very cautiously avoid, since this is the must of their unconscious motivation. In ordinary life, they may not even raise problems for themselves or their relatives more than other well structured people. It is only in the way they avoid definite situations, relations, or subjects, that the specialist may guess that their structure may be incomplete or flawed. Provided they control their moves and person to person interaction, they are safe. However, they lose the frail support and may have strange reactions whenever confronted with contexts (or transferential context) evoking their archaic deficit. Such as:
Those reactions are infinite in variety but may extend from incomfort and fleeing the situation to deep depression, fits of violence (to others or self), out-of-context mania or delirium, retraction.
Usually, these unfortunate persons are not aware of their problems and rarely seek help, for fear of being discovered and labeled crazy (which is the conventional way of looking at these disturbances). In our group, they often come under marginal complaints.
Understanding how they function and what is their real problem under the secondary suffering they show is the first necessity. There is no labeling of their disturbance, since labeling conveys exclusion tones in our society, just explaining how they function and why, and what are the likely causes of their state.
Strategy stems directly from the understanding of how was the disorder produced, and what has gone wrong during the process of structuring the psyche of the person. [see Structural Therapy Fig.Therapy_1]
From our understanding, what has gone wrong, when heavy disdorders are present, is incorrect or absent imprinting in at least one of the following essential imprints:
1. vitalisation of the body at birth
2. creation of a symbiosis with the mother at birth, with the corresponding change of state of the mother at delivery
3. dissolution of the symbiosis both on the mother's side and the infant's side.
The obvious strategy is of course to give the person the necessary environment, ingredients and tools to operate a self-mending process, i.e.
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establish a safe one-to-one relationship |
since the early structuring and development takes place in a dual child-to-mother relation–ship |
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use procedures to vitalise the body (if absent or low vitalisation is the case) |
vitalisation is necessary for the autistic series to initiate neonate life, and for the psychotic series to feed dead zones or dead functions (devitalisation is one of the auto-protective procedures much used in the face of trauma) |
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use procedures to disinvest vitality from the shell and reinvest it in the body (if shelling in is the case) |
a shift from the investment in the regressive uterus protection to the inner body life is necessary as the first step towards dealing with the subsequent traumatic events |
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use techniques for the restoration of body expression and release mechanisms |
since the archaic and early life is instinctual body life and non-verbal, the use of body rehabilitation techniques of the archaic is compulsory |
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favouring the bonding and symbiotic process |
since symbiosis is the first step after the vitalisation of the body, as long as it has not been fully lived, no real development can take place |
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use therapist as symbiotic mother |
necessary for the restoration of elementary functions: contact ability, psychic integrity, emotional stability, trust and self-assertion |
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in the late phases of therapy, introduce elements of separation, so that independence can be constructed |
construction of independence under the influence of various elements is necessary to dissolve paranoic trends; so a such 'effective father' is then implemented in the course of the therapy |
The above strategy of what is needed for restoration of a sound psychic structure can be summed by the following:
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establish a safe transferential stage |
a transferential channel is required for the restoration to happen, but it may meet strong opposition at first, specific tools for establishing this channel are required: the personal state of the therapist |
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produce a safe environment and a safe positive response at all times |
independently of the reactions or acting outs of the person; he or she will respond by flight, violence, or crisis to any adverse transferential position; regression has not to be produced by the therapist and has to come by itself from dwelling in safe conditions |
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provide for transference flow of contents both ways in the beneficial direction |
[see diagram Transference_flow] |
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safe transference is potentially regressive |
re-living of the originary events will begin on the transference stage |
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assess the outline of the original drama and the type of structure that has survived |
the structural assessment will guide the transference work and the methods to be used |
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when required, bring in body techniques |
the originary register and originary events will only display in body form (attitudes, reactions, instinctual needs) and originary events can only be retrieved and released through body techniques; provided they are used in conjunction and accord with the transference work, the whole originary life can be put to light and freed, so that restoration of integrity and reimprinting can take place |
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be ready for imprinting |
occasions will happen when the call for imprinting will show, it is the right time to produce new correct imprints, especially vitalisation and bonding |
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welcome crisis |
crisis are re-living the originary events, freeing them, and voiding them from their violent and painful content, so that a whole psyche (that which was whole before the originary trauma) can be had, whatever young, and be the starting point for reconstruction; crisis may be depression, fits of violence, delirium but in the transferential context and with the transferential work being done, they are rather manageable and beneficial instead of detrimental |
Fig_Transfer
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There are no new or unknown methods to implement for this type of therapy, or very few. The basic can be synthesised in few major procedures:
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therapist attitude | welcoming, without judgement, evaluation, comparison nor any type of social models, thoughts on the client, "shoulds" and "should-nots", ideas of deviance or illness; being a therapist is not a must but a specific state one can reach only by proper transformation | ||
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circulating vitality | the vitality of the therapist is needed to boost that of the person until she has rebuilt her own; vitality is also needed for the feeding and release of archaic patterns and traumatic events | ||
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circulating events | helps to reveal and release of their energetic content the painful and frightful archaic events (or later trauma); the full unconditional true acceptance of those events by the therapist is required (client —> therapist, flow of horrible things); restoring the correct actuality of those events is required even in the face of their having no understandable meaning (therapist —> client, flow of truthful things) | ||
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mirroring | talk and attitude has to be mirrored (not interpreted) in terms of archaic life so that the unconscious psyche acknowledges itself without recourse to the conscious prejudiced mental sets (see Fig_Archaic_mirroring) | ||
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sign reading and sign responding | structurally defective persons do not "speak" by words but by signs (they usually do not have fixed meanings attached to words) since we are facing the pre-verbal sign language of the neonates and infants | ||
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the therapist has to dialogue in this idiom to be in touch with the unconscious of the client, on the same level, and be sure he understands and is understood by the unconscious (i.e. the originary register) | |||
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talk | is used to carry archaic mirroring and meaning, signs, impacts, and for | ||
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reassuring | bringing safety and trust, co-operation for the task | |
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explaining | may be useful to reassure about the procedure | |
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interpreting | usually detrimental since it puts foreign information into the conscious of the client (intrusion), which may have been the case in the past by conditioning; favours control state instead of favouring the return to the archaic state | |
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giving meaning | useful if giving archaic clues in to day's terms so as not to meet conscious mental defences | |
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helping making links | which amounts to structuring and linking elementary functions | |
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non-verbal media | non-verbal transferential media such as drawing, moulding, etc. gives an indirect access to the archaic life associated with a light releasing effect; it may be used to investigate archaic material, create an affective link with the therapist, and induce a mean of expressing deep hidden traumas[1] | ||
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body-psychotherapy | specific and transferentially directed work on the autonomous body energetic and releasing mechanisms gives direct access to the structure for assessment and restoration of sound functioning, with the special mention of: | ||
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- dead zones, inhibited sensory and/or motor patterns | |||
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- fragmentation of the functioning (fragmentation of the body) | |||
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- compensatory zones (over-invested for compensation of deficiencies) | |||
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- crystallised tensions (due to repression) and somatisations | |||
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- effort tensions (structurally deficient psyches generally display tensions of effort to behave "normally", opposite to repression and suppression tensions) | |||
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- insufficient capacity for the release of reactions or emotions, which may lead to 1-delirium, 2-depression or 3-somatization, depending on the history of the protective system | |||
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- compensatory or addictive procedures (support devices) | |||
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- defensive systems against contact and intrusion, or seductive systems to avoid distance and rejection | |||
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- autistic stereotypies, psychotic, depressive and paranoid attitudes | |||
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- various genital sex incapacities | |||
The techniques used are not different than those of other therapeutic methods, but they are framed by the methods and strategy of structural therapy, i.e. aimed at restructuring. Since there are presently more than 300 or so known techniques in inventory books, it is useless to describe them. They can be classified in three groups:
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group dynamics techniques |
useful to display of relation idiosyncrasies, regression due to the group effect, sensivity of the group to attitudes |
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psychodrama techniques |
techniques using transference between characters (goup members) to produce a re-enactment of past situations |
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regression techniques |
body techniques using breathing and movement to produce charge, release and discharge cycles, or reaction units, pertaining to prenatal, perinatal, neonate life or infancy, in order to help the freeing of traumas, access to the past actuality, and reconstruction and reintegration of elementary functions |
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use of auxiliary media |
use of various media to favour the expression of the inner life |
The ones we found appropriate for our purpose are:
Helping a disordered person to reconstruct herself is equal to taking care of a badly wounded child. It requires more care, patience, knowledge than for sound neonates and infants. The therapist is not just a listener or a theorician, he has to be the real uterus, newborn mother, and caretaking father, who were never there in her original history.
We explore how one can be such a helping figure in the section Theory of the Therapist
Of course, rebuilding a child's psyche takes as much time as raising a child from start. However, owing to the enormous capacities for autorepair of our psychic system, for an adult, it takes only a few hours per week, or around a few hundreds of hours per annum to ensure an adequate reconstruction, the total time depending on the extent of the original disaster, the worse and the earliest, the longer the work to be done
[1] along the lines of Carl G. Jung, Gisela Pankow, Stanislav Grof, and many others.
[2] Moreno, J. L., Psychodrama, American Handbook of Psychiatry, 1, Beacon House, New York, NY, USA, 1946.
[3] Perls, Frederick, Hefferline, Ralph, Goodman, Paul, Gestalt thérapie, Stanké, Montréal, CND, 1979.
[4] Boyesen, Gerda, Entre psyché et soma, Payot, Paris, F, 1997.
[5] Orr, Leonard, Ray, Sondra, Rebirthing, Guy Saint Jean, Laval, Québec, CND, 1982.
[6] Grof, Stanislav, Beyond the Brain, State University of New York Press, Albany, NY, USA, 1985; Le royaume de l'inconscient humain, Rocher, Monaco, Monaco, 1983.
[7] Gillis, Alain, Corps et Thérapies, Psychiatrie, 96, Paris, F, 1992, 27-37.
[8] Orr, et al., op. cit..
[9] Landsman, Sandra, Found: A Place For Me The Development Diagnosis and Treatment of Manic-Depressive Structure, Tree House, Stanwood, MI, USA, 1984.
[10] Wassertanz is a technique of letting go and motion during apnoea by Peter Schröter, Zürich.
[11] Dull, Harold, ...
[12] Boyesen, Gerda, Entre psyché et soma, Payot, Paris, F, 1997.
[13] Navarro, Federico, Metodologia da vegetoterapia caractero-analítica, Summus Editorial, São Paulo, SP, BR, 1996; Somatopsicopatologia, Summus Editorial, São Paulo, SP, BR, 1996.
[14] Specific combined regressive and let-go tehniques to help retrieval of archaic innate reactions, especially traumatic events.
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