Kitabı oku: «Emotion-Image Therapy. Analysis and Implementation», sayfa 6

1. Spontaneuos images

The EIT method is based on the certainty that something accidental doesn’t really happen by accident, and spontaneous images created by the client, that express his feelings and his psychosomatic state, demonstrate exactly the problem which gave rise to this undesirable emotional and psychosomatic state. Every séance confirms this principle as well as all other projective psychological methods.

But the first question that is posed to me during seminars is: “Are all people able to easily produce images?”

Yes, certainly. All people are able to do it. If a person wasn’t able to operate imagined images, he wouldn’t have finished the primary school. There they asked him: “If you have two apples and you give one to Vasja, how many apples are left?” Visually imaginative and visually active thinking is more simple and easier to understand than abstract-verbal. We have already said that images are primary language of our psyche, created by nature itself.

All people have dreams, our psyche creates absolutely ingenious stories, makes “movies” about ourselves, and we must use these abilities. We try to use spontaneous images which are created by the subconsciousness, they are most truthful. For that reason we ask the client to tell us about the very first image that comes to his mind, proceeding from the principle what occurred will do.

Another thing is that not all people want to use the language of images. There are a few categories of inconvenient clients.

1. A highly intellectual man with a technical mindset. This type of people usually tries to speak at an abstract-logical level treating himself as a mechanism. He doesn’t trust freely emerging images, he wants to logically substantiate everything, to work consciously, to discuss versions, to control the process. He is careful not to plunge in the world of emotions, his technical mindset made a comfortable niche where he can avoid any contact with the irrational part of his personality. The problem is that his problems are in the irrational world of emotions, and it’s right there that he doesn’t want to go. According to Sigmund Freud, he is disposed to psychological defense called “intellectualization”. People with obtrusiveness are also disposed to such defense.

Sometimes it helps if you tell such an English anecdote and it is to the point:

A drunk man is looking for something in the park under a street lamp. A policeman comes up to him.

– Sir, what are you looking for here?

– Well, I’ve lost my keys over there, in the park, I can’t get into my house!

– But sir, why are you looking for them here if you lost them there?

– But it is dark there!

You can say that the EIT method gives to the patient a hand flashlight so that he could look for something where it is dark.

2. Any other clients who are suspicious about psychotherapy. They are afraid to trust the doctor, want to expose his incompetence, to contradict him. They perceive therapy like struggle. They realize that creating an image they reveal themselves and it is just this that they are afraid of. You have to spend some time to win his trust and create the atmosphere of cooperation.

3. Clients who create images but don’t associate emotions with them. They discuss and dream up but they don’t feel. They work but as if from the outside towards themselves, which means that nothing happens to their feelings. You must switch over to discussing the reasons why they avoid having real feelings.

In every case when images are difficult for the client to create it is the sigh of some worry [the ways to facilitate creating images are discussed below], or some defense mechanisms. So as psychoanalysts realized before, if you face a defense or resistance you should focus on this defense or resistance. This can be discussed verbally but it is better to ask the client to create the image of the defense preventing the creation of images, to find out how it works and for what purpose and so on.

But in the final analysis, if this method doesn’t suit somebody it only means that he is deprived of the opportunity to use its advantages. If he wants to get the result he must try and if he wants to find a more suitable method then let him try. The choice is very big today, and every person can find what he likes more, what will prove more effective in solving his problem. We don’t claim that we have created a panacea. In medicine in

general a lot of people look for their method and their doctor, even the right diagnosing may be a very complicated task.

The second questioned that is usually asked is where you can find a full list of images and their interpretation. I have already mentioned that there are special reference books on this matter, there is a brief dictionary of images in this book too, but it is not enough. The question should be asked in a different way: how to analyze images? In our method there are no mechanical ways of analysis, the work is always creative, but there are main principles and methods of image analysis.

The following methods may help:

1. The study of sensory qualities of an image. At first the doctor asks the client to describe the image in detail. If it is a tree then what kind of tree it is, trees may be different… If it is a stone then what its form is, its color, its weight. If it is a dwarf then how tall it is, how it is dressed, how his face looks. For example: You said it was a stain. What kind of stain? Stains can be different. Is it big? What about its form, color, consistence?

In determining the character of an image its color is very important. According to the color definitely positive colors are shining, silver, gray, sparkling, transparent, blue, light-blue, golden, rainbow, white, pink and so on. But color alone doesn’t reveal the meaning. Sparkling colors definitely have the emotional tone of joy. All nature images are positive: trees, grass, soil, flowers and so on. Intuitively all people think that black colors are by all means “bad”. This is not true. Black soil, for instance, is quite a positive image. But other black images may simply hide their real meaning. For example, a black imp is the image of a mischievous, naughty child. But doesn’t mean he is bad. “Bad” colors have the tone of poison, they are rotten, annoying, oppressive and so on. The same is true of disharmonious, sounds. So are all stinking smells, like that of burning rubber. Kinesthetic feelings – pressing, causing pain, prickly, tearing feelings, that of something alien. The feeling of emptiness, of being drained, of lacking something.

The main thing is the emotional meaning of an image.

2. The interpretation of the meaning of an image according to past experience. We mean the experience registered in some reliable enough dictionary of images or the experience of the doctor himself, gained during his work with other clients. Often such knowledge helps to solve “a riddle” at once, but as we say – “trust, but check”!

3. The subjective meaning of an image. When an image is quite clear in his mind the doctor starts “to try it on” the symptoms that the client is complaining about. He tries to understand the hidden meaning of the image and the emotional conflict it holds. For example, if you speak of fear, Does the image embody the part of the personality that feels this fear or the dangerous object? What is he afraid of? How does it embody the frustrated demand? And so on. The doctor has already got a primary hypothesis explaining the meaning of the image and its place as a visually expressed emotion. Other information that he got from the client during the preliminary conversation contribute to that.

The qualities of the image can prompt the doctor what kind of problem is expressed in it. For example, if the client imagines Pinocchio, we know that it is a wooden boy, it is an image of the Inner Child. “woodenness” means lack of flexibility, tension in the body, suppression of feelings, mechanical quality of life, stubbornness. Comparing these qualities with the appearance of the client, his life history the doctor may suppose that in his childhood the child was exposed to physical or moral violence, he was intimidated, he was stubborn he was repeatedly punished, but he kept on defending his independence. He didn’t want to study and was inclined to running away from home, to adventurism and demonstrativeness.

You can mace these ideas more precise asking the client about his childhood, some of these ideas may be confirmed some – not.

4. Questions to the image. Following the hypothesis if it hasn’t become the certainty, the doctor asks questions that allow to know the hidden meaning of the image. The client is asked to tell anything that comes to his mind even if it seems a complete nonsense. The most frequent questions are:

– What would the image tell you if it could talk?

– What is it feeling, what is it thinking about?

– What is it doing to you, how does it influence you?

– Why is it doing it, for what purpose? Why is this purpose necessary? And so on.

– What would like to do with it, what would you like to tell it?

– Did you have a man in your life who behaved as this image?

5. Identifying with the image. If the hypothesis doesn’t become clearer, you can ask the client to sit down on the chair on which the image was projected and to imagine himself to be this image. Then you put questions directly to the client who identified himself with the image. Client aren’t always willing to do it; their reluctance means that the image is connected with some very strong negative emotions. But this method of actor-like reincarnation makes it possible to reveal profound subconscious meaning of images. Sometimes the doctor does it to help the client understand something that is already clear to the doctor.

6. The doctor identifies himself with the image or with the client’s role. Sometimes the doctor can sit down on that chair acting as the image or as the client. Becoming the image created by the client the doctor can realize more deeply what its real meaning is, and what the feelings it expresses are. Becoming the client, the doctor can perform true relationships between the client and the image, expose the real conflict. “I will be you and you press on my shoulders as this image does. What are you feeling doing it? Why are you doing it?”

7. Research experiment. In some cases, you can ask the client to tell something to the image, to impact it in some way, in order to see how it will influence the image. If the hypothesis is correct the image will change in the way the doctor expected, otherwise the hypothesis will be specified. Some emotional reactions of the client can be expressed; they will reveal the meaning of the problem. We call it a therapeutic experiment.

Example 8. “Depression from love”

Once a young girl suffering from depression came to me for a consultation. She had been taking medicine for some time already but was getting worse. I found out that before the depression started she had broken up with her boyfriend who was from her point of view “too much of a child” [they both were 18 years old]. She tried to reform his character but failed… I suspected that the problem was the break up with the one she loved, but the girl refused to believe it.

Then I advised her to imagine that the young man was sitting in front of her, and then to tell him that she would love him as he was and wouldn’t reform him. She felt better at once… I asked to repeat those words again and again. The depression passed right before our eyes, but she still refused to believe it. “Tell me honestly, – I asked, -you love him very much, don’t you?” “I do, very much!” – she confessed. When she was leaving she said: “Thank you so much!” The depression disappeared, she stopped taking medicine, the result remained a year later.

Commentary. This case shows that you can use images of real people, not only of emotional states, if this is determined by the hypothesis and the supposed solution of the problem.

8. Creating additional image. You often have to create additional images. If, discussing his fear the client created the image of shaking jelly, it easy to understand that this image is a symbol of just his fear. Then the question arises: who is frightening him? That image becomes more important. For instance, it may be the image of a gorilla and the gorilla is beating a child. Then you have to establish who of the parents [or other people] beat the client in his childhood. The doctor gets back to discussing the client’s childhood and looks for ways to remove the held-up emotions.

9. Analytical “mosaic”. The doctor always keeps in his mind three realities: image reality, the reality of those feelings and relationships, that are partly expressed in images, and real events in the client’s past that gave rise to sustained pathogenic feelings.

He asks the client to work with images, but understands that the real task is to change feelings, convictions, conflicts and so on, which exist in the inner world of the client. He watches psychosomatic manifestations of the client and compares all this with the client’s personal history and his demand. So image analysis is a complicated intellectual work, carried out here and now, so to speak, “on-line”. The analysis is conducted according to the psychological hypothesis of the doctor.

10. Dialogue a la Socrates. When the doctor understood [or not quite understood] the essence of the main inner conflict of the client, he asks questions the aim of which is to lead the client to the exact understanding of the source of his problems. For this purpose, the method of the dialogue a la Socrates is used. As is known, Socrates could put questions to even an illiterate person in such a way that he was bound to come to the right conclusion and discovered a great truth. No doubt, Socrates knew this truth before but he helped it to appear in the mind of his opponent. In actual fact these questions presuppose a forced, evident answer. A chain of such questions leads to insight! That is why we say that truth is born in argument [but it’s more correct to say in dialogue]! Applying Socratic method the doctor may lead the client to self-knowledge and self-change, naturally if the client accepts this process.

11. Impacts and interpretations. At the moment when the doctor is sure that he understood the real cause giving rise to suffering, and the image of this cause is clearly manifested here and now, he can give his explanation [interpretation] of the problem. After that he offers the client to use one or another means of impacting [see below] the image of the cause to adequately resolve the initial dynamic conflict.

At this point the pace of the work and current feelings are very important, if you lose the moment the vital feelings will go away, the image will lose touch with emotions and the impact on it will be useless. For that reason, sometimes you shouldn’t spend time on interpretations. But it is quite necessary that the client agree to some actions with the image and take these actions himself in his inner world, informing about the results. The doctor assesses these results as confirming his hypothesis or disproving it. The work with the image goes on in the real- time, the doctor follows the dynamics of the client’s feelings and his psychosomatic reactions in the course of the impact. If the dynamics of the changes are positive, he offers to repeat the impact several times, until the full positive change of the image and the state is achieved. If the result is negative the doctor interprets it too, then this impact can be canceled and a new impact of a completely opposite meaning may be applied. But the reasons of the initial failure are analyzed and sometimes it turns out that in spite of the explanations and clear instruction, the client did everything in the opposite way. For example, the doctor asked him to accept the Inner Child but the client rejected it again. The reasons of such actions are again analyzed together with the client.

The interpretations are often given later when the correction is successfully completed. Though, when the individual work lasts long and consists of a number of séances, numerous interpretations and explanations are given, many impacts are made which let remove layers of psychological defenses and delusions one after another.

Different technics, which will be described below, may be used to correct the problem revealed. A special chapter will be devoted to these technics. They are used not automatically but according to the meaning of the problem. The methods of correction themselves are essentially emotional impacts, not just “technical” changes of images.

12. Working with resistance. A client is often resistant to realizing something about himself and changing it, even though he says he seeks self-knowledge and recovery. We have said already that in keeping with the principles used in psychoanalysis, we analyze the resistance itself. Usually we ask the client to create the image of what prevents him from understanding and changing himself. Then this image it studied as all others.

For example, a woman participating in the work of a therapeutic group, who usually answered my questions promptly and without thinking, suddenly started “to brake”. The reasons of that were not clear and I asked her to present an image of her “braking”. For some reason, it was the image of a three-year-old girl. Then I asked her to sit down on the chair where the image of the girl was projected and identify with it. When she did so her “braking” became even stronger, she stopped answering my questions altogether: why? what for? I guessed and asked: “Who are you braking for?” She answered at once: “For my grandmother!” Then I found out that at the age of three the girl was brought up by her authoritarian grandmother and resisted her by passive stubbornness. It turned out that her resistance to me as a doctor was the transfer of her resistance to her grandmother! In psychoanalysis, it is considered that the realization of the fact is sufficient for removing the resistance, but in actual fact it is not true, because the initial conflict is not resolved. Because of that we went another way, we offered this woman to tell her grandmother on behalf of the girl that she is clever enough and doesn’t want her grandmother’s lectures and pressure. After some repetitions the girl [and the client in the same person] felt full liberation from the grandmother’s influence and “the braking” stopped.

My student Irina Tabolina offered her original method of working with resistance. When the client, having identified himself with the image, doesn’t answer questions, doesn’t see the image and doesn’t feel anything, she asks him to stand up from the chair, move behind the back of the chair and tell who he is and who doesn’t let the client speak. If the client is still silent, he is asked to make another step back and stand behind the back of the previous imagined character. He is asked once again who he is and why he doesn’t let the client speak. This process sometimes continues as far as seven steps back. But sooner or later after one more step the client begins to speak, and then it becomes clear which parts of his personality or images of other people stopped him from moving forward. After that the resistance stops.

Other methods of work with resistance are also possible, for instance those which are traditional in psychoanalysis and in other therapeutic modalities. For example, you can praise the client for fortitude and resourcefulness that he displayed showing his resistance. You can say that he is awarded the honorary medal “Hero of Resistance”. You can conclude an additional agreement with him: “I will gain success in therapy even if my mother [my father] and my doctor don’t like it”. After that the resistance diminishes or completely disappears.

2. Creating the hypothesis

We have already said that the whole study of images is conducted proceeding from a hypothesis, that in some way emerges in the mind of the doctor. It is necessary to pay special attention to this process as everything depends on it. How does a hypothesis appear? This is a creative process and it can’t be fully discovered. But we can explain what a hypothesis is and define some important prerequisites for it to emerge as well as the procedures of its verification.

A hypothesis is a well-grounded supposition of the consultant about mechanisms and the psychological reason, that gives rise to the client’s problem. In the course of the work the hypothesis turns into a sure knowledge.

In literature, there is practically no information about how a therapeutic hypothesis is created. It is connected with the fact that, as it was said before, it is nearly impossible to describe the creative process that leads the doctor to his guesses. Besides a hypothesis is created on the basis of this or another theory, that’s why hypotheses may be different and the process of creating them differs in different schools. However, we will try to fill this gap as much as possible, despite differences in schools.

A well-formed hypothesis contains the answers to the following questions:

– What unrealized [frustrated] desire [or attraction] of the client gives rise to the problem under study?

– What is the nature of the barrier that doesn’t let achieve the desired?

– Which conditions or events of the client’s past were conductive to the origin of the conflict?

For example, a client has the fear of water. The imagined gradual plunging into the water showed that the fear comes when the water touches her throat. It seems to the girl that the water can strangle her. To the question if anyone ever strangled her in the past she answered in the affirmative: “A man attacked me in the dark park, tried to strangle me. But some people were passing by, so he got frightened and ran away”. She is afraid of dark alleys too.

The hypothesis is obvious:

a] the frustrating need of security;

b] the barrier to feeling safe and secure is her past experience, when the client couldn’t defend herself, felt helpless and frightened. The fear materializes in the situations which, by association, make her remember the trauma [water touching her throat or dark alleys];

c] the event that caused the fixed state of fear – the attack of the maniac who tried to strangle the girl. The memories don’t come by themselves probably because they were ousted, the emotions are experienced without the realization of their connection with the initial situation.

The final check of the hypothesis happened after using the method of restructuring of the past experience. For this purpose, the client was asked to imagine herself to be strong, invincible and doing with this scoundrel all she wants. She beat him till felt fully satisfied, and he [in her imagination] didn’t run away. She felt that she was not afraid of him any longer, the imagined plunging into the water didn’t frighten her either. In her mind, she could plunge into the water not only to her throat but even with her head underwater and she didn’t have any fear. This confirms that the hypothesis and curing actions were correct.

This case is quite simple to analyze, that’s why it is given here as an example. But even here you can notice that there appear some new aspects of the hypothesis. For example, the idea is raised in what way the past experience gives rise to fear and why the client remembers only emotions and not the traumatic situation.

A hypothesis can have many additional ideas explaining:

1] in what way inner psychological conflict originates symptoms;

2] what the meaning of every symptom from the viewpoint of its place in the structure of the problem as a whole is;

3] why the client doesn’t understand some psychic phenomena;

4] in what other way the inner problem can tell on the client’s life;

5] what forms of adaptation the client uses to avoid facing the problem;

6] what he gains from the existence of the problem;

7] how the problem is connected with the character of the client of some particular features of his parents’ family and so on.

For example, if you answer points 1—4 about the previous story, you may suppose;

1] that the client has distorted relationships with men;

2] that she doesn’t only refuse to go into the water bur develops a pseudo theory that something is “happening with her head”;

3] that she has a closed character, that’s why she didn’t tell anybody about the attack;

4] that she displays a helplessness complex in other situations and so on.

You can verify these suppositions asking the client additional questions, but they may be unnecessary because the main reason is clear and the treatment has taken place.

The given example, however, doesn’t reveal the process of creating the hypothesis, you may say that it just “fell” in the hands of the doctor practically in the form of clear knowledge. So, we should reveal not only what the ideal form of a hypothesis should be but also how it is created and checked.

1. First and foremost, the basis of creating a hypothesis is a certain psychotherapeutic theory. It may be psychoanalysis, Alfred Adler’s theory [30—32], transactional analysis of Eric Berne [33—36], gestalt therapy [37—39], Victor Frankl’s logotherapy [40], and so on. Usually a doctor naturally advocates one definite concept and creates a hypothesis in the frameworks of concepts used in it. But he may use another theory most suitable to explain the given case. Such eclectic approach seems to be most sensible at present.

2. The awareness of the so called particular models facilitates the search for an adequate hypothesis. These models readymade theoretical constructions which exist in scientific psychotherapeutic world. They explain the origin of different symptoms. The doctor tries the patterns known to him to explain the phenomena he faces and chooses the one that is most suitable, checking it by asking test questions. A lot of such models are described in my book “Psychological counseling. Theory and practice” [5].

3. The knowledge of different therapeutic cases also helps the doctor. New cases may be somewhat similar to those he had in his practice before. Or it may remind those he read about in literature. Or those he watched in the work of other professionals, for example when he studied in a group.

4. His own practice of being a client in the course of the so-called learning therapy. He solves many problems by analogy with problems he solved before, using the whole arsenal of methods of the professional instructing him. Gestalt therapists joke that “the client always brings us our problem”. For that reason psychotherapy cures the psycho-therapist himself, and curing the client is a by-result. But there is more truth than humor in this joke. The doctor always applies the client’s problem to himself, if he can solve it for himself he will solve it for the client too.

5. The doctor is also helped by broad erudition, the knowledge of philosophy and religion, just great life experience, being familiar with various life collisions and people’s characters.

6. The doctor is led by intuition, his ability to empathy, using the feeling of emotional resonance with the current state of the client, his ability to put himself in the situation of the client, being attentive to details, meditations leading to insight.

7. Finally the doctor must be very shrewd and have a great intellect. His work at the stage of creating a hypothesis is like the work of an investigator. Among detectives you can meet a Sherlock Holmes and a useless Lestrade, the same may be true of doctors. You should train your professional and psychological thinking.

8. But probably the most important thing that helps a doctor is the skill of looking for “evidence”. In psychoanalysis this is the method of free associations and dream analysis, in A. Adler’s therapy it is the analysis of early memories, in therapy through emotions and images it is the work with the images of emotional states, in cognitive therapy this is registration and analysis of automatic thoughts and so on.

A ready hypothesis originates very seldom. At first it is very vague, then is verified and checked. They are collected as parts of a mosaic from very different sources. To collect them you use various methods allowing to extract the necessary information out of the subconscious world of the client and from the anamnesis. But you should remember that you can get part of the information by asking simple questions about the life story of the person. A client may deliberately hide some information, he may distort some information, and he may simply not know something about himself. We gain some information watching his non-verbal behavior, and some we “calculate” analyzing the facts given by the client.

We have already mentioned that in the EIT the main source of “evidence” are images produced by the client, when he is asked to imagine how feelings and emotions look. For example, a girl complains about the pain the whole left part of her body. She is asked to create the image of what causes this pain. In surprise, she said that she saw her father who is shouting something in her ear and she didn’t want to hear it. The reason of her psychosomatic state becomes quite clear, though you can still ask her many questions clearing up her relations with her father and thy will probably take us to her distant childhood. To correct her state, I asked her to offered her to tell the image of her father: “Shout, shout louder, I want to hear you better!” In surprise, she confirmed that “the father” calmed down and the pain she felt passed. Because the pain originated from virtual struggle with the opinion or her father whom she was afraid of. When the struggle stopped, the pain disappeared.

But whatever method a doctor uses he collects the necessary and sufficient information about how the problem reveals itself at present and in the life story of the client and tries to make one whole of it from the point of view if cause and effect. If the picture he created lack some parts, he asks additional questions to fill these gaps. All methods like those of free associations of creating images are just ways to ask the right question. The task is to get answers to key points of the hypothesis, enumerated above, which must be revealed.