Wednesday, July 18, 2012

Organizing Self-Experiences by Marye O'Reilly Knapp

This is an interesting paper that was recently published in the open source International Journal of Integrative PsychotherapyVol 3, No 1 (2012). O'Reilly-Knapp offers a different conception of parts, or subpersonalities, one based in the work of Guntrip and Fairbairn, leading figures in the Object-Relations school of psychoanalysis. But her model is also integrative, based in part on Richard Erskine's Theories and methods of an integrative transactional analysis: A volume of selected articles (1997). You can find many of the articles by Erskine at the Integrative Psychotherapy site.

She references one of her own papers that might also be of interest, although it did not seem necessary for appreciating this one - Between Two Worlds: The Encapsulated Self.

Organizing Self-Experiences
Marye O’Reilly-Knapp

Psychotherapy can provide an organization of experiences so that a person attains a sense of self in relation to self and others. The first part of the paper addresses the developing self, the withdrawn  self, and an introduction to the yearning self. The second part of the paper considers the domain of relatedness with a focus on the development of self via the concepts of coherence, agency, affectivity, and continuity in time.

Here is the introduction to the paper:

“There is this secret part of me”, says Linda, as she begins her session. “I do not let anyone know about this piece of me; when I am afraid I hide here.” As she spoke I thought about a little girl who has no one to help her when she is afraid. She figured out a way to protect herself from the shouts and raging behavior of her stepfather and a mother who withdrew. Linda describes to me this hidden place where big rocks surround her in darkness. She cannot be seen nor can she be found. Her rocks remind me of Tustin’s (1986) description of “an imaginary hard shell” which protects a little child from the hostile world (p. 57). In Linda’s situation her mother was unresponsive to her child and failed to provide the protection needed for Linda to feel safe. In an earlier paper on the nature of the schizoid process, the existence of an individual in such a world was described along with the therapeutic interventions needed to establish and maintain a therapeutic relationship (O’Reilly-Knapp, 2001). Using the theory and methods of Integrative Psychotherapy as developed by Erskine (1997) and Guntrip’s (1995) work on the schizoid phenomenon, a framework was identified to work with the state of self that is split off and encapsulated. Using inquiry, attunement, and involvement in working with the splits described by Guntrip, interventions were documented which invited the self into relationship. Within the theory of Integrative Psychotherapy an emphasis is placed on the therapeutic relationship as healing. The process encourages a person in the therapeutic relationship to bring to awareness what has been denied or disavowed and to be immersed in a relationship where the client can express and learn to connect with the therapist, one’s self and, ultimately with others. An empathic, client-centered inquiry, attunement to the client’s rhythms, developmental levels, relational needs, cognition and affect, and involvement in acknowledging, validating and normalizing experiences provides the course of action for working with a person’s splits.

Fairbairn (1952) and Guntrip (1968/1995) proposed that the ego splits into four parts. The first split is between the central ego which is in contact with the outer world and the withdrawn ego which pulls into the inner world. The withdrawal into an inner state is an attempt to move away from perceived danger. As the central ego attempts to deal with the outer world, the wants and needs of the child are obstructed by the persecutory ego. Thus the second split occurs. Guntrip (1995) describes the struggle with the second split of the ego as a part dealing with unsatisfied desires and needs while another part persecutes desires and needs. This active persecution “keeps the basic self weak” and makes ‘cure’ a slow and difficult process” (p. 142). He went on to describe the ultimate split of the ego into the oral ego and regressed ego. Fueled by fear and flight from the outer world and an internal conflict dealing with helplessness and aggression, this last split holds the “dread of collapse in a depersonalized state”. (Hazell,1994, p. 199).

This paper expands on the previous paper on the encapsulated self by focusing on specific interventions for working with the hidden and lost self. The self-invariants of coherence, agency, affectivity, and continuity in time as identified by Stern (1985) are incorporated in this paper as:

1.) a way to further understand the formation of a core self and
2.) a therapeutic direction to facilitate the organization and emergence of self.

Consideration is given to the person’s use of withdrawal and at the same time, the longing to be a part of life. I propose that in the therapeutic relationship, the therapist must address the discord of persecution that is occurring and the struggle between the withdrawn self and the ‘yearning self’, aching to push out toward life and the world. Since the emerging self has withdrawn into an inner world, the core of self appears to be missing. There is no sense of continuity, inner feelings are denied or disavowed, needs are out of conscious awareness, and a sense of power over one’s actions is absent. Treatment of this self-state involves a connection with the therapist and use of rhythmic attunement to mutually create the holding space for emergence. The therapist provides the relationship where a safe environment allows for the self to be in contact and grow. The involvement of the therapist in the use of one’s own self is fundamental in the therapeutic process and will be demonstrated in a case study. The methods of Integrative Psychotherapy are the foundation of the therapeutic interventions; Stern’s (1985) four crucial invariants used in the early development and emergence of the self are employed in this paper as a way to assist in the organization of a person’s self.

Read the whole paper.
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