Thursday, 18 March 2010

Man will survive

 Remember the song I posted? After the first verse, Martin Gore sings just that, man will survive. And pauses. The sentence seems to hang in the air on it's own, complete in it's message, before it is concluded with the harshest conditions

The fact is, those words do stand on their own. They convey an idea I've heard before, in the classes of psychology - The belief that 
I will survive thisAnd not only in the prosaic way of living on, but this concept also encompasses not losing hold of yourself, becoming lost - My ego will remain intact.

The storms of life will be difficult, and sometimes you have to risk breaking your heart... but you can still have this sense of security, have faith in that you won't be overpowered, disintegrated. The storm might end in heartaches, but not in uncontrollable catastrophe.

This is important when growing up.
- A child with a sense of security uses hir parents both as a secure port to find solace in and a safe base to explore the world from. When the storms come, mother and father will come to you, hold you, and put you together again.

- My lecturer describes the difficult development tasks (life issues, we might call them!) and how a difficult task (like separation from our parents, for instance) that we manage to master works like a vaccination, strenghtening us the next time something like it turns up (when breaking up with our loved one or losing a relative) – But a much too difficult task leaves us bewildered and feeling overpowered, frightened of it and certain that we cannot handle it the next time it turns up.

- Also, let's look back at Antonevsky's model Sense of Coherence. Antonovsky said that everyone meet stress in their life, but it is whether you find life manageable, understandeable and meaningful that decides whether you handle it successfully. Belief would have man survive.

- In the same way, when going through therapy you will call the storm to you, go into the dark and difficult places of yourself. You must have faith in that this won't destroy you - Grawe describes hope in the therapy and trust in the therapist as the most important components of successfully therapy.

My next post will be on hope.

Writing this, I'm at Kulturhamnen once more.
A woman is reading her poems to us. She is visibly nervous, restless, her swedish grammar falls short at times, but her words ring true to us. Before reading the third poem she tells us ”This one, I haven't practiced at all”

But she goes through with it, with heartfelt applause. Goes into the storm.

Man will survive.

Wednesday, 17 March 2010


I think my triforce is Courage, Sensitivity and Hope. These are my three strengths, my greatests assets in life and as a psychotherapist-to-be.

I have Courage when exploring myself, trusting others with my serets.
I have Sensitivity when I'm listening to others, being careful with their inmost feelings.
I have Hope when finding joy in humanity, putting trust in my fellow humans, believing in them.

But they are also my vulnerabilities.
Too much courage, and I force myself to be self-revealing rather than open, exposing myself and alienating others.
Too much Sensitivity, and I put guilt on myself, project others' disapproval upon myself, closing myself up rather than opening up to others.
Too much Hope, and I charge my life with expectations rather than optimism, I put great expectations on what I will accomplish, what heights I shall reach in my relations to other people, becoming rigid rather than open, anxious of failure rather than hopeful.

One force is balanced by the other two.
Courage needs sensitivity to feel and stay in touch with reality, and when sensitivity recognises a difficult place, it needs courage to actually go there. They both need hope to tell me that, "Yes, people do like you just the way you are, you don't need to be strong or compliant". Hope needs a moderation of courage and sensitivity when meeting reality.


Notice how I define my healthy self as balanced and open, in line with the model of mental health I've posted here. Open to and in touch with the inner and outer world.

Notice how this coincides with good impro: A good impro actor should dare to let out hir inner impulses, stay sensitive to and pick up hir fellow actor's ideas and stay open and trusting, rather than rigid and planning. To stay open.

Notice how psychotherapy could describe these attributes as life problems, but I have decided to describe them as strengths.


Do you have a Triforce of your own?

Tuesday, 9 March 2010

Meaning, story, understanding

I've been reading a book on school psychology. (Psykolog i skolan, Schad 2009) This is what Leif Strandberg has to say about learning (my translation and emphasis):
"Letters, symbols, thoughts and knowledge are the tools of freedom and creation of meaning: The freedom to move beyond the world they [the pupils] occupy right now; the freedom to visit strange places and visit people they otherwise never could reach; the meaningful experience that the air they breathe, the water they drink and the stars glittering above are not only wonderful sensory impressions - they can be understood (!), and when they understand one thing they will discover that there is still more to understand, there is always another step to take, and then yet another one..."
And it struck me like a bomb. No, not the point he was trying to convey, but a different idea made up with the same images:

Meaning = Story = Understanding

We can imagine early humans, gazing up into the sky and conjuring stories of what the stars were, from where they came, what their names were... For man must understand the world.

In his book Psychological Therapy, Grawe cites Epsteins four basic human needs, the need for orientation and control being the most basic one. (The other ones being increasing pleasure and avoiding pain, the attachement need and the need for self-enhancement) This makes sense - What point would there be to all your mental processes if you couldn't use them to predict and exert control of the world?

So man conjured stories to explain and predict nature, and at the same time gave meaning to nature.

Today we can explain and predict nature through science, but science cannot provide meaning. Meaning is the sign of storytelling, the idea that there is a point to what we just heard - Things doesn't happen for no reason in a story, they happen because there was a lesson to be learnt, symbolism we could recognise or themes we could relate to our own lives. Back in the day, the Pleiades were not just a random configuration of stars, they were seven sisters, transformed into stars for a reason; Zeus had put them there to protect them and comfort their father Atlas, and the reason one of them doesn't shine quite as bright as the others is because she is shamed eternally for having an affair with a mortal. Now that's a story, there is a point to it, and it relates to us  humans, our lives and our emotions.

Humans are meningsskapande, (creators of meaning) that is, we seek to understand things in terms of what they mean to us, what emotional significance they carry for us. Events in our life must be interpreted in terms of meaning and emotion to be fully understood and integrated into our psyche. Thus, it can be said that every person has not only their own mental models, but also their own narrative (or story) of their life and the world around them. Psychologist Erik H. Erikson stresses our need to string our history of life events and choices together to make a coherent narrative. If we are unable to make sense of our actions and thoughts, predict them, find a meaning in them, this is a very distressing situation indeed - Our life doesn't make sense anymore!

Sense of Coherence
There is a questionnaire for measuring this in psychology, called Sense of Coherence, or SoC. It measures to what degree your life is characterized by comprehensibility, manageability and meaningfulness. Sociologist Aaron Antonovsky, who designed the model argues that everyone encounters stress in their life, but it is those with a sense of coherence that pull through and manages it, choosing to focus on health rather than disease in his model.

Our lecturer told us that SoC is a good asset when measuring therapeutic progress - Oftentimes other measurements and tests doesn't show improvement: There might be slight improvement on all symptoms and life issues, but no single factor has changed enough to provide statistically significant differences. With SoC you could show that that all these small improvements have lead to a point where the client now feels sie has control of hir life, can understand what's going on in hir life, and that there is a point to hir life - And in the end, that's the one most important thing.

Psychology, sociology, philosophy
In general, therapeutic psychology and psychological qualitative research stress understanding someone's narrative and and their feelings for the world, rather than the cold, hard and objective facts. To be understanding is to know what another person feels, to see things from their perspective.

I suppose this is obvious stuff to students of sociology, but this was the moment things fell into place to me - I suppose you could say I went from knowing it to understanding it, a process sought after in psychotherapy: When the client process something not only intellectually, but also emotionally, it becomes a real process. You need to activate the emotions and work with them to really make a difference. (Process activation)

I think you could also make a parallell to existentialism, the philosophy where mankind must find meaning in a world where science has replaced stories.

I don't really know much about narrative psychology or related sociology, but I think I should check it up. Anyone suggestions for good reads?

Oh, and I picked up Play Unsafe yesterday. Looking forward to it!

Saturday, 6 March 2010

Färgen Sisu

I just have to tell you about last night. I was visiting Kulturhamnen where a friend of mine were playing and singing.

A small, nondescript door in a brick building by the water, with an old sign reading "Greek restaurant" hides the world's most secret music stage. Some people under the banner Färgen Sisu have taken this place and made it their own, a tiny little house of culture. Cramped together on odd, worn couches and chairs, munching on home-made chocolate balls, we sat and listened to David Bergkvist singing of the big human issues of existence - of love, regret, dreams and revenge in a way that felt ancient and new in the same time, to an audience completely captivated. (Sorry, I didn't have the presence to bring out my camera until at the end of night) Yliari, a band made up of eight young friends separeted by life conditions, played reggae full of love. There was a rock band called Fake Snakes as well, not my kind of music, but I was happy to see them there, nevertheless.

And I sat there, in a place people had made their own, listening to musicians singing their own songs and their own words to us (well, except this one, that was a cover), as I wrote of the healthy person seeking hir own way, actualizing hirself on another path than that of norms.

It was genuine, and the audience were with them all the way. It was magical, and when their time was up they didn't want to part with us. The singer said "Since you've all been such good listeners, we would like to play a song that just the two of us made". Just the singer and the guitar player stayed on the stage, singing a song very different from the rest of their program. This is that song. (In norweigan, not swedish)

When you give people your full attention, when you give them empathy, genuinity and acceptance, they will find the safety to show their true selves. To bring it out for you to see, to let it grow.

Friday, 5 March 2010

A model of mental health

During these last few weeks I've been working on a model for understanding mental health and therapy. It is a way for me to make sense of, to make a map of what I'm learning in classes and what I'm exploring in my own therapy. This is my personal understanding of mental health, but I'm hopeful that it will be helpful in understanding and helping others, and curious of which clients and which diagnosises it models well.

I - Life issues
As we grow up, struggle through life, we must all find our own answers to the big questions – Things like....

Who am I?
Is the world a safe, good place?
How do I protect my self from those who would do me harm?
Do I deserve love?
How will I convey my own love?
What sources do I draw from to strengthen my self-esteem, what makes me feel good about myself?
How will I handle a neurological handicap I was born with or a brain injury I sustained mid-life?
Life demands answers to these questions. Our answers become models for handling everyday life, they shape who we are, what we think, what we feel. Without these models, life would be impossibly extorting.

There are some patterns that keep re-emerging as answers to these questions, for instance:

- People neglected by their parents as children become insecure of their self-worth, typically beccoming withdrawn or clingy and love-hungry.
- People denied their individuality and integrity and self-worth (and with the right biological sensitivity) can protect themself by displacing their guilt and shame into an accusing voice or delusions of other people controling them, becoming schizophrenic.
- People who are wrought by difficult loss (by a parent, for instance) and lack of love in their early years may come to the conclusion that it is actually they who doesn't deserve love. This is to retain the feeling they are in control of their life and protect themselves from the very frightening insight that they have to rely on people that deep down doesn't give a shit either way.

Questions resolved in a healthy fashion doesn't follow common patterns of development in the same way, perhaps because mental health is characterised by self-realisation, individuality, to become your own person – That is, to defy patterns and go your own way.
Or maybe just because there is far more research on mental illness than mental health.

Whereas some life questions are resolved in a way that leave the person vulnerable and frail in that domain, others are resolved successfully, and will be a source of strength and confidence for the person, following hir through life. Though typical models keep reappering in the care of mental health, each person, both ”normal” or ”abnormal” must be understood as made up of a unique disposition of life models.

You can understand these "life issues" as a mix of existentialism (It's up to everyone to find answers in life) and cognitive-behaviour therapy. (People live by automatic models, programs so to speak, of behaviour.)

II - Normality
Let us revisit Lucien A Buck's model of normality, placing different answers and strategies to life issues on his continuum of mental health.

Buck describes the abnormal position as a defensive one, protecting oneself from regressing, losing what one has. The schizophrenic person fears sie might disintegrated any moment, and keeps a paranoid wall against all other people. The bipolar (or manic-depressive) person goes into manic states to defend hirself from the soulcrushing darkness of depression. It's all or nothing, either you surrender to unbearable anxiety or you wall yourself off to survive. Abnormality is characterized by this all-or-nothing stance, it is rigid and without flexibility.

To have achieved normality in a life issue is to have accepted the answers provided by society as good. There is safety in this, community and efficiency, but normality is not without it's own problems: There is still a stiffness in letting a norm define you, not daring to explore your own answers. There is stress and ulcers in societies' norms, and it is difficult to change when you are dependent on other people's ready-made answers. And we all change with age, thus the age crisis.

Whereas abnormality and normality is defined by rigidity and stiffness, health is characterised by a form of softness – When you trust yourself this much, you can allow yourself to change according to situation, without losing track of who you essentially are. You can be playful, adaptive, open-minded. You can also be thoughtful and genuine - You know yourself well enough for that. You have explored yourself and found the right answers for your questions, whether they are part of norm or not.

Buck encourage us to take caution when exercising mental care, not to squish a person into a normality that sie doesn't fit into, and would feel alienated by. We should rather give security to abnormal issues and take care of and develop the healthy ones.

The model is actually a continuum and should be drawn as a line, but I like the thought of someone standing in the circle of normality/health/abnormality at a given moment.

III - Security
The difference between these positions can be explained with the words "sense of security".

At the greatest level of abnormality, security is none. Your life issue is at constant threat of regressing, desintegrating, collapsing, so you protect yourself against others fiercely.

Going from abnormality to normality is characterised by establishing outer control: Limits, borders, structure in your life that provides predictability and manageability, even protection from yourself.

At normality, the borders and norms have been internalised - They are a part of you now. Your self is secure enough to let other people near without exaggerated fear of being hurt. There is still a sense of insecurity though – There are still parts of you unknown to you, since you have just accepted the answer rather than exploring the question fully.

Going from normality to health is characterised by process depth: Exploring, understanding and taking control of your inner processes.

At health, security is greatest. Imagine you have built a very sturdy house – You then have the safety to leave it, to explore. You also feel safe going into your dark places, the parts of yourself you don't normally think of, confident you can handle any anxiety it wakes up. The house will hold together.

There are parallells to different psychological theories on security here:

Attachement theory describes how the children with a well founded sense of security are the bravest in their exploring. Safe in the knowledge that you can always return to your parents and they will provide safety, they will go explore the world, not needing to conform to other people for validation and approval. They already have an internal approval firmly placed in their hearts.

Humanist Abraham Maslow has an interesting idea of how humanity have a series of human needs (physical safety, social, self-realization etc), and just like the child can establish a sense of security in their parents, people can establish a sense of security in these different needs. For instance, if I have a sense of security in my social needs, I do not need constant confirmation from my friends that they still like me.

Maslow has also written on the subject of the self-actualizing person, the healthy person so to speak, who seeks to explore and express hirself, actualize hir inner potential, to grow. Just like in Buck's model, Maslow characterizes this person as someone who is genuine, who follows hir own way, not in a forced way but in a curious and open-minded way. Self-actualization is not a goal that can be reached, but rather a process, to be in movement, to be open-minded and fluid.

I associate this model to learning theories as well, but that's for another post.

IV - Therapy
All therapy must somehow first establish a sense of security. This is called therapeutic alliance, a sense of trust and hope between the client and the therapist. When the client feels safe in the therapeutic room, sie can let hir models of thought out into the light and examine them. Sie can, not necessarily consciously, test the therapist with them - If I expose you to what I was exposed to, will you react like I did, or is there another way you can show me? In this way, people's model are changed.

                                               Acceptance, empathy, genuinity ->   
                                                                     New mental models ->

Now, the big question is, does security lead to healthy models, or does healthy models lead to a sense of security? Like so often in psychology, you can work in either direction:

Humanistic therapy
 creates an atmosphere of acceptance, empathy and genuinity, building on the sense of security. Provide the sense of security and carefully prod the client towards processing depth, and sie will spontaneously explore hirself. Having written it down, I can see that this model implies that in humans there is a natural movement towards health, growing and development as long as safety, security and acceptance is supplied, and this is a foundation of humanistic psychology.

Cognitive-behaviour therapy works the other way around, first you assess the clients mental models and provide more healthy alternatives, and with this competence the client will gain a sense of security.

V - Soft-Hard
"Defensive" is a word which has made it's way into everyday english, but it is originally from psychodynamic theory. According to psychodynamic theory, defenses are something we must have to protect ourselves from anxiety, but when defenses are too strong, too primitive or too inflexible they may become a problem.

This points to how different people will handle issues differently: In a way I inhereted my fathers sense of guilt when he raised me, but whereas he keeps this guilt away by intellectualization, I have instead become sensitive and vulnerable to other people's disapproval and sensible to their own insecurities.

Strong defenses also illustrates the rigidity of abnormality: In the hard circle of abnormality, you can either let the problems and anxieties of life issue manifest themselves freely, or you handle it with strong defenses - throw it away completely, deny it, unable to confront it. All or nothing.

The softness and adaptivity of the healthy individual remind me of the ideals of taoism: Do not force yourself onto nature. Be fluid, like water, and you cannot hurt yourself. Be accepting, humble, genuine and happy in the way of the ever-curious and innocent child.

Coincidentally, it also reminds me of impro theatre.

One of my difficult life issues has been romantic love. I've never actually achieved a romantic relationship, which has been the source of great stress - I felt that I had to have it, I had to reach normality, and through reaching this normality I would reach a sense of self-worth. I've had problems with expectations building up - Love encounters became confrontations with the only possible outcomes a) high expectations fulfilled or b) nothing at all. As you can tell, there was a great deal of stiffness involved.

With a greater sense of security, with the safety to explore these feelings, process them deeper and understand them better, with a chance to experiment without the have-to's, love can become something playful and lustful. Something healthy. I can stay in the moment, fluid, enjoying the present rather than building up to some wishful future state.

I don't actually have to have a single relationship if it doesn't feel right - The one important thing is that I find my way to that bright and gentle circle of health.

Monday, 1 March 2010

Right now it's all about psychology

I started this blog when my personal identity, and upcoming identity as a psychologist, entered a process of change, as a way to vent and construct my thoughts. I was very much inspired by the philosophy of impro, and wished to re-evaluate my relationship to the roleplaying hobby, so this cross-platform blog was born. I'm very much still in that process, which feels like a movement towards a clearer and more unified future self. As things have moved towards clarity, I've come closer to understanding what I want to work through here.

You only need to look at the tags right now, to see that there has been very much psychology, some impro and almost no roleplaying. I wanted to make up for that by exploring life issues in roleplaying games next, but I find I would much rather be telling you about a model of mental health I've been working on.

Since this blog is for myself, first and foremost, and since I want to let it grow spontaneously, I'm going to stay in psychology for a while more. It's good to work through things while you're in it, while it is activated. Maybe it will stay primarily a psychology blog, maybe it will start something else, maybe I'll just lay a good foundation of science and psychology for exploring the story-making of impro and roleplaying. We'll see.

Anyway, next up: A model of mental health.