Mail Jim

Relationships, communication and change

--Jim Challis, Ed.D., Tina Tessina, Ph.D., and John Burik, M.Ed.

What you find below is a cyberlogue which began as discussion about relationships, communication, and change. It touches upon some of the ways we can muck them up, and fix them up. It began, specifically, with John commenting to Jim via email about a Q&A site done by Tina. It grew from there. John's first email to Jim got the ball rolling:

I wish would-be therapists would read the questions, gay, bi-, and het. What I see are all relationship questions, more similar than different among the self-reported sexual-orientations. For these questions, I see primarily communication answers.

The other thing I see, discounting chronological age, are that said questions represent adolescent issues. This is by no means to play them down, questions of Who/what am I? Who/what's a friend? What's love? What's the place of sex in love and life?--all these are extremely important. We have no effective cultural means of initiating adolescents into adulthood.

From there, the conversation quickly evolved into some of the most compelling situations needing change, namely, addictive and abusive relationships. We hope you'll find it useful.

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Acceptance vs. lost in problem

John:

The way this is shaping up for me is that an immediate requirement of any intervention for change, is getting the person out of the presenting problem or symptom. If someone's drunk or stoned, in a dissociated state, reliving a trauma, or relating to zir SO in a fashion that's perpetuating the problem relationship, then probably nothing we do will be very effective.

Jim:

I agree. My action of choice would be to reschedule. As my sainted Mother used to say about trying to talk with my Alcoholic Father, "You can't argue with a drunk."

Tina:

The danger here is that we'll throw up our hands (the anti-rescue) and say "we can't do anything as long as you're acting like this." Which helps no one, especially not children and spouse. I'm truly shameless about using whatever motivation I can to get the cient to change behavior. ie: "you have a better chance of getting into so-and-so's pants if you give up drinking/yelling/whatever." Or, "just try what I say for a day/week/month, and I'll admit it if you prove me wrong" or "if drinking is not a problem (how often I hear this) and you can stop anytime, then do it, and prove it to me." Whatever I can get to work, I'll use, because I know when the client changes behavior things will begin to look different.

Jim:

I would agree that those tactics might be worth trying; however, I wouldn't try them if I had the slightest hint that under the circumstances it would be a waste of zir and my time -- over which I like very much to have control. I would like to use that scarce commodity in a productive manner.

John:

There's a delicate balance suggested here. There must be some recognition of a problem, yet if the person's lost in the problem (drunk, beat-up, having a flash back), communication's difficult at best. I agree that rescheduling can be an effective option, and note with Tina there's a danger of doing nothing, especially in a couples situation. Some of the chemical dependency (CD) programs have a 100% abstinence requirement for participation. This makes it relatively easy for the CD staff person to cover zir ass ("Zie's broken the rules; zie's just not ready to change."), and difficult for the client, as well as all the other professionals involved (case manager, job coach, therapist, psychiatrist, day program staff, housing support worker), and the client's SOs. All the rest of us couldn't so easily take time off from the client's problem.

Tina:

Absolutely, John. There's a point at which there is no communication you can do with a client, for example, zie's drunk -- but, it can be useful to spend that time listening to or even taping the client, to gather info to use when zie's sober. Taping a raging drunk is a technique I often suggest to spouses who want to intervene.

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The real problem, secondary gain, and making some progress

John:

OTOH, we must also somehow satisfy the need of these problems/symptoms. If the sober person's in your office, and you don't have to convince zir of the benefits of facing the problem. Of course, if you can keep the person straight enough, long enough (90 mtgs in 90 days), there may be enough experiential learning to sink in (down to zir drinker aspect or part) but maybe not.

Jim:

I hesitate to be one who throws cold water, so I hide behind the fact that I have not had the clinical experience that you two have had, when I say: I think the "maybe not" will win here 80% of the time. However, if one wishes to work on that 20%.... go for it.

John:

If we can recognize (honor) the legitimate needs (goals, outcomes) of the drinker, perhaps zie will cooperate and change much sooner (and again, maybe not).

Tina:

Part of the genius of AA is that it's a bunch of alcoholics helping each other. It's not so threatening as someone with a lot of education and licenses; and also you can't kid a kidder. These guys are tough -- and not easily fooled with denial. They've been there. And the example of their stories is powerful. Even their honesty when they fall off the wagon and get back on can be a real potent force for change.

Jim:

That's my reading of AA too.

John:

That's my understanding of Beisser and Perls as well. Though I think it's usually an incremental understanding. That is, in the beginning a client may understand that zir SO is going to leave the relationship unless zie comes to therapy. Zie may have some understanding that "the problem" has something to do with zir drinking and yelling.

Jim:

"Zie" Oh! that's "She/He".

Tina:

Yep. That's often all you can hope for. Or even, that the drinker/yeller comes to therapy to see what's wrong" with their partner. I often advise partners, if they will handle their 10% of the problem, and get out of the problem altogether, that's what will make the person with the 90% problem see that there's something wrong on zir side of the table. Unfortunately, it's usually the victim who recognizes there's a problem, and not the abuser. So, as unfair as it seems, only the victim can do anything to create change.

Jim:

Uh, if you mean "the victim is 'usually' the one who 'initiates' change", I'm with you. If you mean Only the victim is able to change, I'd like to hear more about that.

Tina:

That is, if I rage, and you get all upset and hysterical, and try to please me, and stick around, then I can look at you, say "geez, you're a mess -- no self esteem at all -- you must be the one with the problem" (don't laugh -- it's the way it usually happens) and I don't have to look at my problem. But, if you learn to recognize when I'm setting you up to rage at you, and take care of yourself, removing yourself from the situation, or take the family away from me as long as I'm behaving this way, or even call the cops on me, then, being isolated with myself, I might see that at least some of this problem could be mine. Denial is powerful.

Jim:

Well, you did tell me some more, and what I read you saying is that the victim has to learn what options are open to initiate change, like running to the shelter or calling the cops, right?

John:

Back when the term "schizophrenogenic family" was in vogue, "identified patient" was also used. Both were a recognition of the systemic (cybernetic, Batesonian) nature of problems. Unfortunately, lots of moms got blamed for their schizophrenic children. This was similar to the current situation in which we recognize the systemic (cyclical) nature of violence/abuse, yet drop back to Newtonian causation with the offenders. In the former situation it was mom's fault, in the latter it's the abuser's fault.

Tina:

It's really that nature/nurture debate we were talking about at the beginning of our e-mail discussions, isn't it? Being too wholeheartedly in either camp, and also looking for too simple a solution, means we just create more victims, and more finger-pointing, and we don't ever get to "what to do about it." Probably Mom and the abuser and everyone else all need a little help. In families like this, no one really understands their options without help.

John:

Hopefully, whether the client realizes it or not, our interventions begin to meet the real need of the client. Sometimes, as Tina mentions, she participates in "fixing" the other persons involved. I'll reframe relapse as evidence of success (You couldn't have relapsed, unless you'd successfully put together a string of sober/clean days, could you?). I look at any of the options we've mentioned as ways of changing the system, similar to Tina's treating the relationship.

Tina:

Yup, the "sneaky" school of therapy. In Alan Watts The Two Hands of God he talks about positive double binds, which is what you're doing, John, when you "reframe" falling off the wagon as a limited success. That really messes with a negative belief system -- isn't it fun? Also, I am not unwilling (although it's tough to do) to be the "bad guy" who tells the harsh truths that may send a client somewhere else. Often I find (it happened Friday) someone comes back after a long time with someone else and says "you were right, I do have contempt for myself, I can see it now, and I'm ready to work on it." I consider that a success, too.

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Reactions and ghosts

Tina:

Did I tell you my idea about relationships being 80% response?

Like this: A does something, B responds. A responds to B's response. B responds to A's response to B's response etc, etc, etc. Therefore, if you're the only one who's aware, you can control way more than 1/2 of the relationship, by controlling your initial actions and your own responses. I use that to get people to believe that they can change their relationship interaction without waiting for the partner to do it.

John:

You may be too conservative in your figure! I'm thinking it's maybe like 99% response, and that includes the relationship with ourselves. Here's an example of what I mean: client walks into zir office, sees a tax form on desk, and remembers with accompanying anxiety last year's audit which cost zir $2K. Now, SO telephones and receives a tirade befitting the client's honest response to IRS. On hearing said tirade, SO now time-travels back to being yelled at by zir father, cries, and so on (ad finitum).

Tina:

Right on -- there are a lot more people in a relationship than just the couple. All kinds of ghosts hanging around.

Jim:

Might this not be close to Ellis' concept of the A-B-C of personality? It seems to me that the cause of the "crying, and so on"(C) is not caused by the "Tirade by the SO"(A) but rather the re-activated trauma (B). Let me know if I've jumped the track again.

John:

Let's see: Activating experience; Belief; emotional Consequence--is that it? I read Ellis (at least theoretically) saying, well, it's not what happened 20 years ago, it's the irrational belief you hold now. I see truth in both views: past trauma, and present belief. Aaron Beck would say cognition, wouldn't he? Perls would say it's unfinished business (from the past), but insist you have to deal with it in the here-and-now. I often pick a theory based on the opposite of how a person routinely organizes zirself. That is, if someone's very aware of zir feelings, I'll talk Ellis or Beck and demonstrate how getting into their head can impact zir feeling state. If zie's very heady, I'll do a Perls thing and get zir into the body and feelings.

Tina:

Yes. There's no point in treading ground already trodden to death. The client needs to be jarred out of the standard (for zir) mind-set. It's easier, though, I usually find, to help a mentally-aware person, used to abstract thinking, get emotionally or physically aware than to get those who are very concrete (I have one now, a brick-layer, in actual life) to be aware of the more ephemeral aspects of personality. Feelings are a no-no, and thoughts are too nebulous to understand.

John:

Going back to the systems thing, I'll try to get the most out of the least, tho' sometimes it seems there's only one option, like giving a spouse the telephone number for the abuse shelter--anything to pry loose the inertia of the system.

Tina:

A wedge, a foot in the door. Anything to get out of the impasse -- even if it feels as if it's in the wrong direction, it's something.

Well, we finally got too long for my e-mail system. I hit my own impasse with the computer, and it wouldn't let me write anymore until I cut the last part of this off and pasted it in a new message. So, part 2 is coming up.

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