Tag: Psychotherapy

Mustn’t Grumble

Do I suffer from Health Anxiety?

Am I healthy enough to do all the things I need to do? Would I feel better and achieve more if my health was better? And am I spending more time worrying about my health than doing something about it? If these are questions you find yourself asking then perhaps you suffer from health anxiety. And perhaps you spend so much time worrying about your life that the anxiety itself gets in the way of what you want and need to do.

Well, like many people you may feel anxious about the challenges confronting you each day. You may feel as if you’ll never be able to change your circumstances or to achieve your personal goals. And such anxieties apply to healthy people and unhealthy people alike.

Maybe you just don’t feel healthy enough to do what you want to do and to live a good life. Ok, so health itself, whether you are in fact healthy or unhealthy, can always be a source of stress. Nonetheless, many people in poor health make honest efforts to keep their mood up and to fill their day with good things to do. People in poor health can appreciate the value of having nice people to meet and good friends to socialise with just as much and maybe even more than healthy people.

So what can we do about this? How can we live our lives free from unnecessary worrying about our health? In other words, how can we live free from health anxiety? Some people are able to resolve anxiety about their health through engaging in deep and challenging self-examination. Such people would say that we should all do this albeit in our own individual way. At the same time other people may feel that they are simply unable to do this while others may be unwilling to take the time and effort needed to do this. Well, whatever your feelings, surely we can all take steps that will allow us to gain some satisfaction from life and to live free from unnecessary anxiety.

And isn’t it true that even very healthy people feel stressed? Relationships, work, finances can all be stressful for anyone. We may, for example, may be unable to see our way forward. We may find it hard to trust the people we rely on and need to trust. We may not always pay enough attention to our partner, to our relatives or to our friends. And this may extract a high emotional cost from us. It may damage our established relationships of every kind, and it may spoil our new and growing ones.

Ok, so given the choice we all want to be healthy. And good health surely makes it easier to carry out the basic needs of living, which in turn leads us to a secure sense of subjective well-being.

So, what can we actively do to address our anxieties about our health? Well one approach is to get some help at some level be it from relatives or friends, or professionally through issues-based counselling or in-depth psychotherapy.

If we choose the professional path, we should expect to receive fair, compassionate help with our anxieties of whatever kind. And this goes back a long way. Freud and Breuer themselves saw their task as follows:

“I do not doubt that it would be easier for fate to take away your suffering than it would for me. But you will see for yourself that much has been gained if we succeed in turning your hysterical misery into common unhappiness. With a mental life that has been restored to health, you will be better armed against that unhappiness.” – Sigmund Freud and Josef Breuer, Studies on Hysteria, 1895.

While these words would clearly apply to someone suffering mental anguish they may also apply to those who consider themselves relatively healthy. For the healthy person may be less insulated against such mental difficulties than those who have experienced difficulties while growing up, been able to gain self-awareness and who has hence built up some resistance to their adversities. And sometimes, healthy people feel less comfortable seeking help, fearing for example that their therapist might be privately thinking “What have they got to worry about?” So, the healthy person may be more reluctant to ask for help when they need it than those people with identified health issues. 

Here it is worth remembering that therapists owe all of their clients sincere empathy in coming to understand and to support them as unique and valued individuals. In this way empathy may even be seen as the most important active ingredient in counselling and psychotherapy. Every client, healthy or unhealthy, needs and deserves to be regarded as a whole person, with their own individual wants and needs.

No matter who you are, no matter how you feel, talking can help you feel better. No matter how you do this, to a friend or to a therapist, whether individually or in a group, opening up and sharing can help you feel better.

Jung at Heart

The two ‘great men’ of psychoanalysis are Sigmund Freud (1856-1939) and Carl Jung (1875-1961). That said, their mature thoughts about our conscious mind and our unconscious mind are very different. While Freud focussed on explanations of our current psychological states, Jung looked behind them to where they came from and how they came to be the way that they are.

Jung does not take a single approach or adopt a particular scientific methodology. This means that it is difficult for the reader to assess his work as a whole or to pin down what is particularly Jungian about it.

From my perspective as a practicing therapist, a good way to approach Jung is to go with the flow. Accept what Jung sets out. See where this leads you and work out whether you agree. Then you can ask whether what Jung is saying is helpful to you. For example, Jung’s concept of Archetypes may be viewed as a useful way to understand human psychology. The Archetypes may be thought of as showing the similarities and the differences between different types of people – between you, your close ones, your friends, people in your working life and, yes, people who you dislike or who may dislike you.

Jung’s work is illustrated in ‘Memories, Dreams, Reflections’ an autobiographical work written at the end of his life. I say “autobiographical” as most of the book was written by Aniela Jaffé. Nevertheless, this book offers perhaps the easiest way into Jungian psychology.

In my view ‘Memories, Dreams, Reflections’ illustrates many of the good things in Jung’s thought. These include Jung’s thoughts on the indeterminacy of meaning and the influence of context on who we are. Jung’s emphasis is not so much on what we think and feel but where we came from and how things were set out for us. From this position it then becomes possible for us to live our lives with a rich and informed understanding of ourselves. And what better way into the wonderful world of Jung.

The Question of Freud

How are we to account for Freud the thinker alongside Freud the human being?

The place of Sigmund Freud (1856-1939) in relation to contemporary psychotherapy is, to say the least, interesting.

Freud and Josef Breuer (1842-1925) trained in medicine and became interested in the phenomena of the human mind. Together they developed psychoanalysis as a method for treating mental illness based on their studies of human behaviour. Though Breuer’s interest waned, others joined Freud in developing a psychological model of mental illness. In this way the psychological, as opposed to the medical, means of treating mental illness came to be called ‘psychotherapy’.

For Freud the events of our childhood continue to influence our behaviours as adults. For example, traumatic childhood experiences cause and may be used to understand anxiety in our adult lives. Though we may no longer be aware of these childhood events they may nevertheless be causing difficulties in our adult life. In such cases the role of the psychotherapist is to bring these events to our awareness. This will allow us to resolve the trauma and be released from the anxiety it is causing.

In this way Freud may be viewed as a practical-minded scientist who used all he had available to explore the operations of the human mind. To do this he collaborated with others to develop new theories and to improve contemporary practice. This ‘Good Freud’ shared his findings among the research community, while practicing his latest methods in order to help resolve the anxieties of his patients.

However, Freud’s behaviour has been described at various times and by various people as secretive, possessive, dishonest, sexist, patronising, and abusive. This ‘Bad Freud’ hid important developments from those he regarded as competitors. He withheld and ignored results that contradicted his own thinking. He took the ideas of others for himself. Worse still he regarded women as objects for his own use and he abused those who dared to disagree with him.

This leaves us both with a Freud who is a genius of modern science and a Freud who is a despicable cheat.

All of which may be so but is this any more than a historical debate? Well, certain aspects and techniques developed by Freud are still considered to be important and are still in use. Elements such as a client talking confidentially one-to-one to a therapist who listens attentively come directly from Freud. The idea that there are things about our lives of which we are unaware and which influence our present thoughts, feelings and behaviours is something explained and developed by Freud. The belief that these things may be brought to our awareness and in this way our issues may be resolved comes to us (at least in the West) from Freud.

Indeed Freud’s ideas have spread and grown, though not without much debate and disagreement.

Some analysts such as Melanie Klein (1882-1960) adopted Freud’s approach and developed his ideas, making them their own. Whereas others have rejected Freud’s ideas as false, misleading and damaging. So, in the time since Freud first set out his ideas there have been several schools of psychotherapy directly related to his thought and some significantly different. And importantly Freud’s ideas continue to be discussed and debated often using Freud’s own frames of reference.

For myself I find that Freud is neither all good nor all bad. Uncomfortable it may be but while I acknowledge Freud’s remarkable contribution to psychological understanding and therapeutic method, I cannot – indeed must not – excuse his inexcusable behaviours.

Claude Steiner

How to live free from script

Claude Steiner (1935 – 2017) developed Transactional Analysis (TA) to include more of the social aspects of our experience and the ways in which how our life history affects the way we interact with others.

In “A Warm Fuzzy Tale” (1969) he used a fairytale format to explore the impact of different human interactions. When people give each other “warm fuzzies” (Berne’s positive strokes) they flourish. When fuzzies are withheld, rationed, or replaced with plastic fuzzies (e.g. giving a child sweets instead of attention) or “cold pricklies” (negative interactions) people, and the societies they live in, are damaged.

In “Scripts People Live” (1974) Steiner explored how the messages we give ourselves (or are given by others) in childhood (such as “I am boring” or “I am more intelligent than other people”) can be carried through the years and become part of their “life script” forming important parts of their self-image and affecting their personality.

These script messages may no longer be true – if they ever were – yet people may go on believing them and behaving in accordance with them. This can damage relationships. For example, the message that “strangers are dangerous” may help keep you safe when you are young but can be unhelpful when you are an adult forming mature relationships.

Recognising when we are following a script and learning how to stop following the outdated messages enables us to move into the present. In this way Steiner’s approach helps us understand how we may have become anchored to the past, how we can learn to move into the present, and how we can make a future for ourselves that is happy and fulfilling.

Steiner’s last words were “Love is the answer”.

Eric Berne

An introduction to the founder of Transactional Analysis (TA)

Eric Berne (1910 – 1970) trained as a psychiatrist. He became interested in the Freudian tradition and went on to train as a psychoanalyst. Berne had psychotherapy with Paul Federn. Though Federn was a close colleague of Sigmund Freud he had a different understanding of the ego and believed that people could consciously engage with it.

Berne developed these ideas and ended up rejecting Freud’s notion of unconscious processes. He believed that people could learn to recognise what was happening and change the way they responded. He wrote a series of articles on this topic which led to the San Francisco Psychoanalytic Institute refusing him full membership.

Berne decided to pursue his own path in psychotherapy, focusing on the importance of social interactions in nurturing or damaging our mental health. Berne referred to this way of working as ‘Transactional Analysis’ or ‘TA’.

With Transactional Analysis Berne replaced Freud’s Id, Ego and Superego with Child, Parent and Adult ego states. The Child ego state expresses our feelings and emotions. The Parent ego state represents the orders and rules we have been given or have given ourselves. The Adult ego state represents how we are and what we are learning.

When we are in the Adult ego state we can modify our feelings and question our desires. In this way we may come to feel differently about ourselves and behave in a more psychologically healthy way.

In my work as a psychotherapist I find Transactional Analysis to have certain limitations such as the sometimes confusing use of the terms ‘child’, ‘parent’ and ‘adult’. Nevertheless, I find Transactional Analysis to be a very useful way to understand and to explore our psychological lives.