Suzanne Foster Counselling Counsellor for Battersea, Clapham & Balham

December blog

The need to idealise

"A second strong need of the developing self is the need for what Kohut called an idealised parental imago. It is important that the child can believe that at least one parent is powerful, calm, and confident. If this need is fulfilled, the child can count on help from that powerful, knowledgeable, and calm person in the face of an external world too complex for a youngster to comprehend and internal events too chaotic and frightening for an immature ego to deal with.

Here, too, parents must sometimes fail. No parent is omnipotent or omniscient, and from time to time that fact will reveal itself even to a young child. And the child who has had repeated opportunities to identify with power and knowledge will be able to discover, when the failures come, some power and knowledge of her own. Thus, bit by bit, through the process of transmuting internalisation, the child will come to see herself as powerful and to feel confident of her ability to cope both with the external world and with inevitable internal conflicts and pressures. This confidence is a key part of the self.

As this part of the self grows and matures through childhood into adolescence and beyond, it develops indispensable capacities. First, it is the repository of the ideals by which life is guided. Second, it exercises control over the impulses, enabling one to use them rather than to be overrun by them. Third, it develops the capacity for self-soothing in times of stress and pain.

We might pause here and note that all therapists know the importance of the capacity to soothe oneself. Many clients, perhaps most, lack this ability to a significant degree. Painful events happen to everyone. Everyone sometimes experiences anxiety and almost everyone sometimes experiences guilt or shame. The question is how a person responds to these experiences. According to Kohut, people who have successfully internalised a calm, parental figure will expeditiously and quietly soothe themselves, deal with the situation, and go on. Many of our clients (and many of us), however, suffer prolonged, sometimes very prolonged discomfort.

Finally, Kohut believed, the "higher" aspects of their personality - humour, empathy, creativity, and wisdom - come from a successfully internalised experience of an idealised parental imago.

Here the danger is that the child cannot idealise either parent. Perhaps the parents are locked into a pattern of denigrating each other before the child, or they may have such serious behavior problems that it is painfully obvious to the child that they simply are not candidates for idealisation. The child will then have no opportunity to develop this part of the self. Kohut taught that when we meet people who seem to take no joy in life, to have no capacity to be inspired and little vitality, we may be seeing evidence that a need for an idealised parental imago was not met".

Extract from "Between Therapist and Client - The New Relationship" by Michael Kahn. pub W.H. Freeman and Company c 1991 and 1997

November blog

The developmental theory of self psychology

'In Kohut's view, three strong needs must be fulfilled if the self is to develop fully: the need to be "mirrored", the need to idealise and the need to be like others.

The need to be mirrored

The first need to arise is what Kohut called the gandiose-exhibitionistic need. Children need to be shown by one or both parents that they are special, wonderful, and welcome, that it is a great pleasure to have them around. Kohut taught that children learn how their parents value them not through anything the parents specifically say or do but through the most subtle of cues: gesture, expression, tone of voice. And presumably the message can be conveyed in varying degrees. To the parental message of delight in the child Kohut gave the name mirroring. The child looks to the parent for the answer to "Mirror, mirror on the wall, who's the most wonderful of them all?" If, a reasonable percentage of the time, the mirror replies, "You are, my wonderful child," the grandiose-exhibitionistic need is met.

Now, no parent can possibly be the perfect mirror all the time, and Kohut says, that's a good thing for the child. Inevitably the parent will sometimes fail to provide adequate mirroring. If that failure doesn't happen too often or too traumatically, it provides the child with an opportunity. Children who have been well mirrored many, many times can draw on the memory of those experiences and thus discover an ability to get along without the mirror - at least for a brief time, at least once in a while. And when that happens, they discover that at least for a brief time, at least once in a while, they can be their own mirror. Kohut called this a "transmuting internalisaton, by which he meant that children seize the opportunity of the selves and, as a result, change something basic in their self. His way of describing that change was to say that bit by bit the child adds structures to the developing self. By structures Kohut referred to the adaptive and satisying functions of the self. Gradually, as the child grows and develops, these transmuting internalisations and the structures they create add up to one important aspect of a strong and cohesive self. Now the grandiose-exhibitionistic needs are no longer primitive. Children who have been well mirrored no longer ask or care if they are the most wonderful on of all. they know that they are attractive and likable people, no matter what messages they may get from the outside world. Their self-esteem is firmly rooted, presumably forever.

If the parents are too disturbed or too preoccupied with questions of their own self-esteem, however, the child never gets enough of those early positive messages. The grandiose-exhibitionistic needs are traumatically frustrated and then repressed because it is too painful to be in touch with them when the child has no hope that they will ever be gratified.

Psychoanalytic theory teaches that one of the costs of repressing an important need is that the need does not become integrated into the developing personality. The need is walled off from the ego, and because the ego is the part of the personality that orchestrates integration and appropriate maturation, the need remains in its primitive form. This is the fate of grandiose-exhibitionistic needs that are not gratified. The person, then, is likely to suffer from insecurity and feelings of worthlessness, interrupted on occasion by surges of unrealistic grandiosity and, in some cases, maladaptive boasting when these powerful needs for mirroring burst momentarily through the barrier of repression and futilely strive for some crumbs of gratification. Thus a necessary structure of the self in stunted.'

To be continued in December's blog

Extract from "Between Therapist and Client - The New Relationship" , by Michael Kahn. pub W. H. Freeman/Holt Paperback c 1991 & 1997.

September blog

The Long Bag We Drag Behind Us

"It's an old Gnostic tradition that we don't invent things, we just remember. The Europeans I know of who remember the dark side best are Robert Louis Stevenson, Joseph Conrad, and Carl Jung. I'll call up a few of their ideas and add a few thoughts of my own.

Let's talk about the personal shadow first. When we were one or two years old we had what we might visualise as a 360-degree personality. Energy radiated out from all parts of our body and all parts of our psyche. A child running is a living globe of energy. We had a ball of energy, all right; but one day we noticed that our parents didn't like certain parts of that ball. They said things like: "Can't you be still?" Or "It isn't nice to try and kill your brother." Behind us we have an invisible bag, and the part of us our parents don't like, we, to keep our parents' love, put it in the bag. By the time we go to school our bag is quite large. Then our teachers have their say: "Good children don't get angry over such little things." So we take our anger and put it in the bag. By the time my brother and I were twelve in Madison, Minnesota we were known as "the nice Bly boys." Our bags were already a mile long.

Then we do a lot of bag-stuffing in high school. This time it's no longer the evil grownups that pressure us, but people our own age. So the student's paranoia about grownups can be misplaced. I lied all through high school automatically to try to be more like the basketball players. Any part of myself that was a little slow went into the bags. My sons are going through the process now; I watched my daughters, who were older, experience it. I noticed with dismay how much they put into the bag, but there was nothing their mother or I could do about it. Often my daughters seemed to make their decision on the issue of fashion and collective ideas of beauty, and they suffered as much damage from other girls as they did from men.

So I maintain that out of a round globe of energy the twenty-year-old ends up with a slice. We'll imagine a man who has a thin slice left - the rest is in the bag - and we'll imagine that he meets a woman; let's say they are both twenty four. She has a thin, elegant slice left. They join each other in a ceremony, and this union of two slices is called marriage. Even together the two do not make up one person! Marriage when the bag is large entails loneliness during the honeymoon for that very reason. Of course we all lie about it. "How is your honeymoon?" "Wonderful, how's yours?".

Different cultures fill the bag with different contents. In Christian culture sexuality usually goes in the bag. With it goes much spontaneity.
Marie Louise von Franz warns us, on the other hand, not to sentimentalise primitive cultures by assuming that they have no bag at all. She says in effect that they have a different but sometimes even larger bag. They may put individuality into the bag, or inventiveness. What anthropologists know as "participation mystique", or a "mysterious communal mind", sounds lovely, but it can mean that tribal members all know exactly the same thing and no one knows anything else. It's possible that bags for all human beings are about the same size.

We spend our life until we're twenty deciding what parts of ourself to put in the bag, and we spend the rest of our lives trying to get them out again. Sometimes retrieving them feels impossible, as if the bag were sealed. Suppose the bag remains sealed - what happens then? A great nineteenth-century story has an idea about that. One night Robert Louis Stevenson woke up and told his wife a it of a dream he'd just had. She urged him to write it down; he did, and it became "Dr Jekyll and Mr Hyde". The nice side of the personality becomes, in our idealistic culture, nicer and nicer. The Western man may be a liberal doctor, for example, always thinking about the good of others. Morally and ethically he is wonderful. But the substance in the bag takes on a personality of its own; it can't be ignored. The story says that the substance locked in the bag appears one day somewhere else in the city. The substance in the bag feels angry, and when you see it it is shaped like and ape, and moves like an ape.

The story says then that when we put a part of ourselves in the bag it regresses. It de-evolves toward barbarism. Suppose a young man seals a bag at twenty and then waits fifteen or twenty years before he opens it again. What will he find? Sadly, the sexuality, the wildness, the impulsiveness, the anger, the freedom he put in have all regressed; they are not only primitive in mood, they are hostile to the person who opens the bag. The man who opens his bag at forty-five or the woman who opens her bag rightly feels fear. She glances up and sees the shadow of an ape passing along the alley wall; anyone seeing that would be frightened.

I think we could say that most males in our culture put their feminine side or interior woman into the bag. When they begin, perhaps around thirty-five or forty, trying to get in touch with their feminine side again, she may the by then truly hostile to them. The same man may experience in the meantime much hostility from women in the outer world. The rule seems to be: the outside has to be like the inside. That's the way it is on this globe. If a woman, wanting to be approved for her femininity, has put her masculine side or her internal male into the bag, she may find that twenty years later he will be hostile to her. Moreover he may be unfeeling and brutal in his criticism. She's in a spot. Finding a hostile man to live with would give her someone to blame, and take away the pressure, but that wouldn't help the problem of the closed bag. In the meantime, she is liable to sense a double rejection, from the male inside and the male outside. There's a lot of grief in this whole thing.

Every part of our personality that we do not love will become hostile to us. We could add that it may move to a distant place and begin a revolt against us as well. A lot of the trouble Shakespeare's kings experience blossoms in that sentence. Hotspur "in Wales" rebels against the King. Shakespeare's poetry is marvelously sensitive to the danger of these inner revolts. Always the king at the centre is endangered".

Extract from "A Little Book on the Human Shadow" by Robert Bly. Edited by William Booth. Pub. Harper Collins:1998

August blog

'My taking the piss didn't bother or offend the counsellor. She let me joke around. She wasn't uncomfortable sitting in the room with me, even if I was'

'I was 19 when I was first referred to therapy by my GP. I was sleeping on a friend's sofa, unemployed and not in education a NEET, only the term hadn't yet been invented. My GP clearly recognised I was at a point of personal crisis. She asked if I would speak to a counsellor who worked at the practice, who she said might be able to help me. She led me down the corridor, knocked on a door and introduced me.

I was surprised to see the counsellor was wearing jeans and a pair of trainers with a luminous green dragon design on the sides. It was a total contrast with the smart, formal dress of the GP. I was intrigued. I assumed she must be a little bit of a rebel. A couple of days later, I attended my first appointment.

Her room wasn't like the GP's. There was a desk with a computer, and shelves with books, but there was no sign of medical equipment. In fact, the room looked quite cosy. I half expected her to offer me a cup of tea when she invited me to sit down. We sat away from the desk, of soft chairs, opposite each other, with a small table between us.

I was very nervous and responded defensively when she asked me to complete what I now know was a Clinical Outcomes Routine Evaluation (CORE) assessment. Being a rebel from a working-class background, where statutory services were viewed with caution and suspicion, I refused to answer any of the questions on the form. It was just a case of, 'You don't trust and you don't tell'. And anyway, I'd never considered how I felt before; nobody has ever asked me.

She didn't insist. She just put the assessment form gently to one side. On the table there was a bowl full of glass and stone pebbles. I assumed they were for decoration. She asked me if I would like to choose a pebble that represented me or how I felt. I thought this was a laugh - I didn't feel like a chuffing pebble! However, I decided to play along. I rummaged around in the bowl and found a small dark stone at the bottom and declared. 'This is me.'

It wasn't that I didn't understand the purpose of the exercise; it was more that I wasn't used to relating in this way. I felt uncomfortable because I couldn't speak this language. I couldn't draw meaning or identify with it, so I mocked her attempt to connect with me. Looking back on it now, I can see I was desperate for help and finding it hard to identify my distress and articulate it. Behind the mockery, I was vulnerable and acutely depressed, but my taking the piss didn't bother or offend the counsellor. She let me joke around. She wasn't uncomfortable sitting in the room with me, even if I was. She didn't insist on using her language or ways of expression, and it was this that helped me feel at ease with her and kept me coming back to appointments.

Today, in my own practice, I am mindful of the young working-class woman I once was. I see similar reticence and alienation in my young clients. I try to help them find their own words to express themselves, so they too can come to recognise their power and autonomy.

My therapist with the green dragon trainers was genuinely interested in me. She took notice of me, acknowledged my feelings, believed in me and affirmed me - things that had been very lacking in my life up until then. This was my first experience of professional counselling and it helped me trust and return to counselling some years later, and to train as a counsellor'.

Article by Katy Woodger a person-centred therapist and supervisor. Published in Therapy Today; July 2018: Vol 29. Issue 6

June blog

'Better to talk about it in the session with the client than for it to come back into their minds in the middle of the night, when there is nobody to listen'

"I had been working as a counsellor for a few years, and had been to a seminar where a colleague had described working with a boy who had cancer. The boy spoke about buying a motorbike when he came out of hospital, and driving it really fast. I was surprised the therapist hadn't asked him whether he wanted to kill himself; the therapist had said the boy wasn't ready, that he 'couldn't take it'. I would have asked him immediately, but I now worried that perhaps I would have done some harm.

I told Hanna Segal, and older, more experienced psychoanalyst, that I still worried about saying the wrong thing to clients - what if I put an idea into their heads that they hadn't had before? She said two things that stayed with me. First, 'if it has occurred to you in the session, it will already have occurred to them'. She said that pupils of Melanie Klein (like herself) were taught to be more concerned about 'leaving patients alone with a worry'. Better to talk about it in the session than for it to come back into their minds in the middle of the night, when there is nobody to listen. 'Defences are raised against frightening ideas that are always worse than reality; you can help reduce them to a realistic level,' she advised.

Putting this into practice was a revelation. Time and again with clients, a clear idea has come into my mind that to me seems literally unspeakable - thoughts about a client being crazy; a client dying because nobody loved him enough: a mother not loving her daughter. Time and again, Hanna Segal's words have come into my mind, and I have taken a deep breath and managed to speak these thoughts, although hesitantly, and as a question. In every case, the atmosphere has changed, there has been a palpable sense of relief, and the work with the client has taken a huge step forward. It has been clear that I have understood something that has worried them for a long time, but they have felt unable to share it with anyone. The thoughts have in themselves been frightening, but they have become less terrifying to the client after we have talked them through. Defences are indeed raised against fantasies or ideas that are worse than reality, not against realistic ones. The client and I have sometimes been left needing to grieve for real losses, but there has also been a huge relief at the disappearance of the exaggerations.

I now see this as part and parcel of counter-transference or projective identification. Normally, when we share ideas with a client, there is a natural to and fro of unconscious communication that recognises and acknowledges shared understanding. But these particularly powerful ideas are blocked by the client because they have some kind of terror attached to them. As a result, I think, we attribute them to ourselves alone, as if they had nothing to do with the client. It is this that makes them hard to say. That is where the input of a more senior therapist is helpful; first in supervision, but later, in our own minds, we need to hear their voices casting doubt on our most disturbing assumptions and giving us confidence in our role and capacities."

Extract from article by Julia Segal who has worked for 35 years as a psychoanalytically informed counsellor, lecturer and trainer, and is an author of numerous books. She currently works in North-West London as a counsellor for people affected by neurological and other physical health conditions. Her latest book is: 'The Trouble with illness: How illness and disability affect relationships'. (Jessica Kingsley, 2017).

April blog

'I now think that as soon as we think we have the answer and the client does not agree, the therapy is doomed'

'Three times in 37 years I have sacked a client. There is not much discussion of this in the literature, and I felt very alone when it happened. Surely we have to be endlessly patient, and stick with the client? I believe it is very rare for a therapist to do anything else.

The first time, I was working with a young man who found relationships difficult. He said he wanted to have a girlfriend, but he always found a way of sabotaging any opportunities that came his way. We went through a long period of exploring how and why he did that. Gradually, he came to see that it was not something that happened to him, but something he did.

After a few months, he acquired a new girlfriend, and I felt pleased for him. It seemed as though he had learned a lot about himself and how and why he did what he did, but we continued working together on other issues.

A year later, he told me his girlfriend had left him. I asked him what that made him feel. He shrugged and said, 'Nothing much.' After a few more questions, it became clear to me that he had almost no emotional response to the event.

I had been working with him for two years, and he had no emotional feelings about what, to me, was a big event in his life. I thought that if he was immune to therapy, there was no point in giving him more, so I gave him the boot.

The second time was with a woman who loved two men. When she was with one, she often thought she preferred the other one, and when she was with the other, she often thought she really preferred the first. We did cover other issues in her life, but she kept coming back to this. I was, for a long time, patient with her, and we explored various aspects of what might be going on. There seemed to be nothing in her past to explain it, and I became a bit baffled.

Eventually, I realised that, for one reason or another, she was not willing to give up this pattern. We had a discussion about it, and she argued that she was working on it and could not give it up yet. This happened more than once. In the end, I got fed up, and told her I could not go on with it. She argued, but I stood firm.

Sometime later, I have a client who came with a very specific problem with his relationship with a woman of a different race. He invited her to his house, but she did not invite him to hers. He had a brother and liked to go out to a pub with him on Friday nights; she did not like pubs. There were other issues like this, but when they went on holiday together, there were no such problems. He showed no signs of changing what he did, and I became sure there was no exit from his problems unless he did so. I pointed out the impasse, but he did not move. In the end, I have to tell him to leave, and he was quite ready to do that.

I now think that as soon as we believe we have the answer and the client does not agree, the therapy is doomed.

Is it OK to sack a client? I still don't know, but I thought it might be interesting to raise the issue.'

Article by John Rowan who has been a therapist since 1980, and is the author of several books, including 'Ordinary Ecstasy, Healing the Male Psyche and Subpersonalities'. First published in Therapy Today: December 2017, Vol 28, Issue 10.

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