How to choose a Therapist (the short hand version).


**Because we start life connected to our mothers the eternal struggle is the need for connection versus the need for independence….we are hard wired for connection**

Relationships are the most powerful tool for psychological health we have at our disposal. 

Finding a therapist you want to have a relationship with is really essential and vital to the psychotherapeutic process. Theory and modality does matter but time and time again we are shown that it is the relationship that heals. They are powerful vehicles for developing awareness, connecting with our pasts and cultivating real and lasting change.

Credentials are obviously important as you want to be ensured that the person you choose is qualified, competent and practicing safely, of course.

Beyond that, choose someone you want to have a relationship with. Every time. 

Life Scripts.

Written by Katy Lee.

‘Each person decides in early childhood how he will live and how he will die, and that plan, which he carries in his head wherever he goes, is called his script.’ (Berne, E, What Do You Say After You Say Hello? 1972, p31)

The theory of script, as developed by Eric Berne and his contemporaries revolves around the above principal. It adheres to the notion that, in early childhood, not only does a person set down a general view of the world for themselves but that they go as far as to create a comprehensive life plan that, unless awoken to, they will go on to live out. Early Transactional Analysts discovered that it was in fact early childhood decisions rather than grown up, adult planning which ultimately determined the destiny of the individual. So, no matter what they said they were striving for, what career path they wished to pursue, what type of man they were searching to marry, ultimately they appeared to be driven by some internal compulsion towards an often contradictory or at least very different conclusion. Because the script is formed in early childhoodit is based on feeling and intuition as at this time the child does not have the ability to translate its experiences into words. Therefore much of the script is formed at a non verbal level. In adult existence the script often lies in the realms inaccessible to conscious memory as generally the closest we can come to our early childhood years is through dreams and fantasy.  Therefore, though we may be living out and experiencing our childhood decisions in the here and now through our behaviour, we are likely to remain unaware of these decisions ever having been made. Berne’s most comprehensive definition of script can be found in ‘What Do You Say After You Say Hello?’ where he said; ‘A script is a life plan based on a decision made in childhood, reinforced by parents, justified by subsequent events, and culminating in a chosen alterative’ (Berne, E, What Do You Say After You Say Hello? 1972)

A script is adopted when a child’s inert expectations regarding protection and natural development are challenged. It is this that leads to what is called the script decision being made, where the child adapts all of their expectations to enable them to survive in their external environment. Steiner, a contemporary of Berne’s, has said  ‘The script is based on a decision made by the Adult in the young person who, with all of the information at her disposal at the time, decides that a certain position, expectations, and life course are a reasonable solution to the existential predicament in which she finds herself.’  (Steiner, C, Scripts People Live, 1974, p55) Put bluntly, a script is adopted so the child can get by in their home situation. For example if a child learns to get love and attention from their parents or parent figures they must be quiet and well behaved this will form a crucial part of theirscript, perhaps leading them to believe it is only possible to receive love under these conditions. i.e. ‘I am only lovable if I am quiet and well mannered’. Because the script is believed to be decisional it does not necessarily follow that different children brought up in the same environment will adopt the same or even similar Script beliefs and develop the same life plans. 

Though parents cannot solely be held responsible for determining a child’s script decisions they are a hugely influential force upon them. From the time they are born a child will receive messages from their parents on which they base their conclusions about themselves, others and the world. Because the world is perceived as a hostile, life threatening place to a small, physically vulnerable child early decisions are based upon extreme emotional experience. It is then no wonder that script decisions are often, themselves, extreme. Nor is it any wonder that a young child will make decisions based on the fact they perceive their parents as being all powerful and in total control. If a child is hungry and Mother does not come to feed them, will she ever come? And if she doesn’t come this means death or a life time of being alone. Further to this, due to the frame work for early script decisions being constructed of entirely different stuff to an adults basis for decision making, the child may go on the believe that because it’s Mother did not always come when he needed them to that therefore all people, or perhaps all women, are untrustworthy. It is then this belief that becomes fused into the very core of the child’s being and perpetuated throughout its adult existence.

When a child writes its life script it also writes the final scene, the closing scene. This is what Berne referred to as the ‘chosen alternative’. In TA language we call this the script payoff. Everything else that is written in childhood and played out is a build up to this final scene, the payoff. What this means is that in adult life we are likely to behave in ways and find ourselves in situations that ultimately bring us closer to this payoff.  To achieve psychological predictability and justify our script decisions in adulthood we chose to make reality fit our script decisions, our view of life, the world and each other unwittingly being driven towards the payoff of doing so. 

People often respond to the here and now realities of their adult lives as if the world were still the way they viewed it when they made their early decisions. In TA Today it is expressed that we do this because we are ‘still hoping to resolve the basic issue that was left unresolved in our infancy: how to get unconditional love and attention. Thus as adults, we frequently react as if we were still infants.’(Ian Stewart and Vann Joines, TA Today: A New Introduction to Transactional Analysis, 2006, p110). It is a common condition to fall into script, or script determined behaviours under stress or in a stressful situation. Another factor that can determine an individual behaving in this way is if there is a resemblance between the here and now situation or environment and a stressful situation experienced in childhood. An aim of personal therapy is to enable a person to deal with certain levels of stress before engaging in script behaviours and implement or improve their ability to solve here and now problems rather than reverting to script. 

Berne made a distinction between script content and script process. While an individuals Script content is entirely unique to them he has said that we can classify script content under one of three headings; winning, losing or harmartic, or non-winning or banal. A winner is defined as ‘a person who fulfils his contract with the world and with himself. That is, he sets out to do something, says that he is committed to doing it and in the long run does it…….If he accomplishes his goal, he is a winner.’ (Berne, E, What Do You Say After You Say Hello? 1972, p204). A winning script is relative to the goals which the individual sets for themselves. The goal can be anything, be it to become a wealthy statesman, a family man or a hermit living in a cave devoid of human contact. What defines the script as a winning script is that the goal is met comfortably and happily. By stark contrast a losing script or a ‘loser’ is defined as someone who does not meet their declared purpose or achieve their set goals. As with winning scripts it is not just the accomplishment of the goal that is important but the degree of comfort and happiness that go hand in hand with it. For example if someone’s goal is to be wealthy and famous and  they end up a factory worker living on the bread line they are a loser. But they would also be defined by Berne as a loser if they achieve their goal only to find themselves miserable and lonely because of the pressures of living the life of a celebrity and constantly surrounded by people who are only attracted to them because of their status and wealth. In addition to this it is possible that someone decides, in childhood, upon a goal that cannot be achieved without misery, limitation or suffering. If a person decides that ‘I should fail at everything I do’ and does so then this is also classified as a losing script, despite the achievement of the set goal.

The importance of achieving a ‘declared purpose’ in a comfortable manner is highly important and was so to Berne when he coined the expressions Winning and Losing/Winner and Loser. These definitions are not to be confused with achieving material wealth, possessions and status but more the manner in which a set goal is accomplished. However, in addition to this it is possible that someone decides, in childhood, upon a goal that cannot be achieved without misery, limitation or suffering. If a person decides that ‘I should fail at everything I do’ and does so then this is also classified as a losing script, despite the achievement of the set goal. Losing scripts can also be divided into first, second and third degree losing scripts depending on the severity of the eventual script payoff. 

Finally there is a third classification, non winning or banal scripts. In ‘Scripts People Live’ Claude Steiner defines a banal script as ‘melodramatic: they have no clear beginning or end, they go from bad to worse, they have no impressive, sudden reversals, no really suspenseful moments. Superficially, they may look good; but, in fact, they are devastatingly boring.’ (Steiner, C, Scripts People Live, 1974, p98). These scripts belong to people have to work very hard, not to become the boss or the leader, but to stay even. Berne has said they belong to people who say things such as ‘I could have been…..’ or ‘At least’. For example ‘I could have been a dancer if I had been more disciplined but at least I have all this to be thankful for’. Berne also stated that these types of people make excellent employees because they cause no upset, no trouble, are loyal and thankful and that they are socially very pleasant. 

‘Scripts are artificial systems which limit spontaneous and creative human aspirations’ (Berne, E, What Do You Say After You Say Hello? 1972, p213). If one is following a plan made before verbalisation and rational thought, where life is desperate and dramatic and one was physically vulnerable to their parents or care – givers and their environment they are living out their script and not responding to the here and now spontaneously or autonomously. Thusly they are placing limitations upon themselves, their development and their destiny. ‘Winning or losing, the script is a way to structure the time between the first Hello at mother’s breast and the last Good-by at the grave. This life time is emptied and filled by not doing and doing; by never doing, always doing, not doing before, not doing after, doing over and over, and not doing until there is nothing left to do.’ (Berne, E, What Do You Say After You Say Hello? 1972, p205). 

Yes, I’ve tried ginger…

I wrote this article for publication in a health magazine several years ago. I thought it worth posting again here for anyone who might be struggling in pregnancy.

Hyperemesis gravidarum (HG) is a rare disorder characterized by severe and persistent nausea and vomiting during pregnancy that may necessitate hospitalization. www.rarediseases.com 

It hit around week five this pregnancy. And by hit I mean swelled within every corner of my being. That’s the thing with HG, you can’t escape it. The nausea and for some physical vomiting is unrelenting. Rest helps but it doesn’t actually aid in halting or easing the condition. 

Even now while I think back to the first trimester it takes me back, physically, to the experience of living with HG in those first months. Weeks five to sixteen were by far the worst for me. I survived on grapefruits, sips of apple juice and mashed potato (none of which I could keep down) and was pretty much bed bound. But even after that as the symptoms have lessened slightly I’ve still lost weight, been unable to keep any food or liquid down, no matter the quantity or the type, time of day or how quickly/slowly I eat. 

As I enter the last few weeks of my pregnancy now it’s completely commonplace for me to put down my plate and go and sit in the bathroom because I know within moments (and I wish this were an exaggeration) the food will re-emerge. This morning I ate two slices of toast and had a small coffee and was sick three times. Sometimes even drinking water, which I couldn’t do at all in the first trimester, is enough to make me vomit. 

I’ve lived with this the last eight months and during a previous pregnancy and it doesn’t get any easier the more used to it your body and mind become. If anything I’m so depleted now that every time I feel I’m going to vomit my entire body recoils. I read the other day about a woman who vomited so violently one of her retinas detached which possibly didn’t help, psychologically speaking. 

It is no exaggeration when I tell you that HG is a life changing condition for those who suffer it. It’s not something you can ‘work around’ or ‘just get on with’ unlike it’s very, very distant cousin twice removed, morning sickness. Though I cannot tell you how impossible it is to discuss your experience of HG without many people reminding you ‘nausea is normal in pregnancy’ and that they too had ‘awful morning sickness’. Some, though I’ve been lucky enough not to encounter anyone with this mindset, medical professionals are not immune to this attitude either. 

When I realised I was going to be afflicted a second time round I scoured forums and Facebook groups etc to try and get ahead of the game (turns out for me I couldn’t but for some early medication can be key to a reprieve from the physical act of being sick at least, for me it never was) and learned just how many women are fobbed off or denied vital care because they aren’t fully believed in their experience and this scared me. To live with this for nine months is torture enough let alone on top of that to have to fight for care or to be heard and taken seriously. 

I’m writing this sat waiting for a growth scan, I’ve had three additional scans, at week thirty six because they are concerned the baby isn’t growing as much as would be expected in the last few weeks of gestation. Thankfully he is healthy but smaller than they would like, considering I’m also highly likely to deliver before 40 weeks (but that’s a separate story). It’s hardly a surprise given I weigh less now than before I conceived and still to this day havn’t kept one single solitary meal or snack, or even dry cracker down. So to go through all of this and feel unsupported by friends, family, partners or medical staff is entirely inexcusable but really it comes down to lack of awareness and/or education. 

That’s the main reason I’m sharing my experience here like this. In the hope that someone may read my words and think twice before asking someone suffering with HG if they have ‘tried ginger as that really helped (them) with their nausea’. Believe me. We’ve tried it. We know it won’t work but we’ve still tried it. We’ve tried taking small sips of water and small bites of food. We’ve tried eating small and often. We’ve tried everything. Nothing works. Sometimes we know you mean well but mostly it feels like you aren’t taking us seriously because morning sickness is a breeze compared to this. And while we don’t want to undermine your experience it doesn’t help us feel supported. 

Katy Lee. 

Getting Back on Track: What to Do After Relapse

 A guest blog by Kimberly Hayes

 

Getting Back on Track: What to Do After Relapse

 

For many on the journey to recovery, there may be stumbles. Sometimes, relapse is a part of the path to sobriety. It isn’t a failure. It’s a moment to learn more about yourself. If you have relapsed, this is what you need to know and do.

 

Getting Help

 

Try not to let a relapse in sobriety define you, or your recovery. Accept that this has happened, and learn from your mistakes. This may be a sign that the treatment you were using wasn’t right for you. If you weren’t before, it’s time to get professional help either in the form of therapy, inpatient treatment, or another means that works for your individual needs. A relapse does not mean you have given up on yourself or your recovery. It means something needs to change.

 

Don’t put that change off for when you’re less stressed, or whatever other excuse may exist. Things can always be better or worse. Instead, focus on what you can do going forward, and the help you need to get to adjust your sobriety strategy. That doesn’t mean you aren’t experiencing the emotions you have right now. Grieve for yourself, if you need to, but don’t let those emotions hold you back from progress.

 

Have the Talk

 

One of the hardest parts of recovery is the act of talking to your friends and family. It’s especially hard to ‘fess up your shortcomings to your parents, spouse, or children. You don’t want to disappoint or hurt them. However, a relapse cannot be hidden. We need the support of our loved ones. Trying to recover without love and help from our family and friends can be even more difficult and leave us prone to relapse. You may find it easiest to tell them in a letter where you can have time to write out your thoughts, but do tell them. Allow them their reaction; they may be in shock or feel a sense of relief. Sometimes, they get really angry. If this is the case and they are unwilling to help during your recovey it may be best to not involve yourself with them for now.

 

While other people hold no control over our relapses, stress can make sobriety difficult for some. If you can, work with your loved one/s to determine a plan to get you back on track and moving into the future sober.

 

Stay Healthy

 

Addiction can cause our brains to burn out. It can become more difficult to use the feel-good chemicals our brains release. One way to help heal what’s in our heads is through exercise. Working out can also combat fatigue, depression and anxiety, all of which you may be facing during your recovery.

 

You may need to start small and build up, but even exercising three times a day for 10 minutes can greatly improve the state of your well-being. Diet is just as important during your treatment, especially if you haven’t been eating well. By abstaining from processed sugars, caffeine and by making sure you’re eating plenty of vitamins and minerals, you may be able to feel better emotionally and physically. You can read more about diet and addiction recovery at MedlinePlus.gov.

 

Another way to stay healthy and avoid relapse is by learning to steer clear of your triggers. This could be anything from stress to people who encourage you to use drugs or alcohol. Sometimes, it makes sense to start over somewhere new. Before making any rash decisions, however, evaluate the likelihood that you’ll have the support you need in a new town and whether or not you can handle the stress of moving on top of the burden of recovery.

 

Forgiveness

 

It may seem difficult, but the best thing you can do to successfully recover is to forgive yourself. Others have been in your position. Beating yourself up and holding yourself accountable are two separate things. You are not a bad person for relapsing. You may have made mistakes, but you can learn from them. If you continually dwell on your past, you won’t be fully able to commit to your present and future health. Instead of wasting time and energy by wallowing in what you did, which may actually contribute to further relapse, you should use this as a teaching moment to really focus on what went wrong. Why was your treatment not working? This doesn’t mean it’s time to blame others or make excuses. If an argument with someone caused stress which triggered a relapse, how can you better handle stress in the future? Focus on what you can do, rather than making excuses or being upset with yourself.

 

Relapse can be a normal part of recovery. It can teach us more about ourselves, and may help us find better, more effective treatment. If you have relapsed, don’t waste any time. Move forward and recommit to living your best, healthiest life.

 

Image Courtesy of Pexels.com

Alternative Recovery Methods For Addiction.

Alternative Recovery Methods For Addiction.

A guest blog by Kimberly Hayes.

The most popular recovery method for addiction in the United States is, by far, the 12-step program. Designed by Alcoholics Anonymous, the 12 steps are highly religious in focus and involve accepting yourself as an addict for life. While this has worked well for many people, it can be ineffective for many others. According to NPR, the success rate of AA has been estimated to be just 10 percent – this leaves 90 percent of addicts still in need of treatment.

Most other recovery treatments are based on medical and psychological interventions. These aim to counter withdrawal symptoms with alternative substances (e.g.: methadone for opioid addiction) while solving emotional and psychological issues that may be underlying through counseling and therapy.

Alternative recovery methods are anything else that could have a beneficial effect on recovery, but that is not formally acknowledged as a medical form of treatment. This includes elements of complementary and alternative medicine (CAM) such as yoga and meditation as well as other relaxing activities including exercise and certain manual hobbies.

How Do Alternative Recovery Methods Work?

Overall, most of these alternative methods work by reducing negative emotions that tend to trigger drug use. What most alternative methods have in common is that they are relaxing or meditative in nature, either by focusing on the breath and the movement of the body (yoga, swimming, meditation) or by keeping the mind occupied in a repetitive or creative task (art therapy, manual crafts).

According to Everyday Health a persistent negative mood and high rates of stress are significant risk factors for relapse. The majority of alternative recovery methods are effective in reducing stress and improving mood. Once incorporated as a regular habit into a daily routine, they become something an addiction survivor can rely on to feel better without having to reach for drugs or alcohol.

When To Use Alternative Recovery Methods

The main thing to remember when considering alternative options for treatment is that, by their very nature, alternative methods may not be extensively backed by science. You should learn to differentiate between those methods which have been shown to help and those with only anecdotal evidence to support them. If you cannot find any research on addiction specifically, look for research on the effectiveness of a practice in general – this should help you understand its value.

The most supported forms of alternative treatment are probably yoga and meditation. Both practices have a good amount of evidence them as effective tools for recovery addiction. Both focus on controlled breath – and in the case of yoga, physical movement – to calm the mind and body down and achieve a sense of peace and relaxation. For addicts dealing with stress, anxiety or depression, this can be a huge help. You could also apply this to other forms of meditative exercise such as swimming, or anything that helps you clear your mind.

Even then, you should not rely on alternative methods entirely. In fact, you should probably not rely on any one thing. Just like traditional recovery methods are a combination of therapy, group counseling, medicine and personal introspection, an alternative path to recovery still needs to involve several components.

Including yoga into your recovery could do wonders, but it is unlikely to help you overcome your addiction by itself. You may need the camaraderie of a recovery group, your own personal therapy, or the medical help of an alternative substance to stave off withdrawal. Different methods work for different people.

Many alternative methods can be effective in supporting recovery, particularly those which help you relax and put you in a positive state of mind. It may be a good idea to try out a few different options to see if there is anything you like or that makes you feel particularly good. Maybe you will feel great after acupuncture or a massage, or maybe yoga does the trick for you. Know that it’s OK to experiment and try different things and, if in doubt, ask the advice of a medical professional.

Author

Kimberly Hayes enjoys writing about health and wellness and created PublicHealthAlert.info to help keep the public informed about the latest developments in popular health issues and concerns. In addition to studying to become a crisis intervention counselor, Kimberly is hard at work on her new book, which discusses the ins and outs of alternative addiction treatments.