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ΕΥΓΕΝΙΑ ΓΕΩΡΓΑΝΤΑ PsyD - ecp
To DNA της ψυχής
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This is a theoretical paper that describes development as a double helix leading from birth to death. Our psychological development and its basic ingredients can be visualized as an equivalent of the DNA double helix that progressively leads to a higher state of being with the ultimate goals of individuation and self-actualization. The paper is based on an integration of the developmental theories of Erikson, Freud and Piaget, as well as on the humanistic and existential theories of Maslow, Frankl and Yalom. It discusses the major developmental achievements of each stage and what constitutes the favorable and unfavorable outcome of each one of them. Our understanding of the factors that can enhance our psychological growth can help us de-mystify the process by which we can attain happiness and self-fulfillment. This paper was presented at the 4th European Conference of the European Association of Integrative Psychotherapy held in London, U.K., March 2006.
Integrating Developmental Issues with Humanistic – Existential Theory
IntroductionExistential theory uses a psychodynamic model of personality, which postulates that the basic conflict is between the individual and the “givens of existence” (May & Yalom, 1995). The roots of psychopathology are to be found in the struggle of the individual with the four “ultimate concerns” (Yalom, 1980), death, freedom, isolation and meaninglessness.
In most existential psychotherapies the focus is in the here and now. May & Yalom (1995) write: “The individual is to be understood and helped to understand himself from the perspective of a here-and-now cross section, not from the perspective of a historical longitudinal section” (p.277). However, human beings are not a-historical beings. Existential theory will profit greatly by integrating the developmental model in its understanding of the current situation. It is important to conceptualize the human being’s present situation as a continuum from birth till death instead of an existence with no past or future. It is true that existence manifests itself in the now and that the here-and-now is where therapists can see the past re-enacted as well as re-formulated. Most therapists would agree, however, that dealing with the ghosts of the past plays a vital role in the healing process. May & Yalom (1995) suggest that: “the therapist must continually keep in mind that we create our past and that our present mode of existence dictates what we choose to remember of the past” (p.278). However, it would be a mistake to underestimate the biological and psychological influences that play a role in the development of the particular individual. When we look at a newborn baby we can see the extreme vulnerability, dependence and unique idiosyncrasy. No doubt as attachment theory proposes infants are not passive in the creation of the bond with mother. Their temperament will play a critical role but it is no doubt either that mother’s temperament, psychological well being and ability to cope with the strains of parenting will influence the infant. Human beings have the option, through heightened awareness, to change the psychological influences they have received. Thus, a major goal of therapy is to raise awareness as to what was termed (Georganda, 2002) “the DNA of the Soul”. The DNA of the Soul is a symbolic representation of the influences we “inherit” from our family of origin with regards to our psychological make-up. To the extent that we remain unaware of these influences we are determined to think, feel and act in certain ways, patterns, scenarios, etc. These patterns could be changed once we become aware of them decide to do so and use our will power. This is, in other words, what we call therapeutic change.
Humanistic and Existential theories (or the third force in psychology) disagreed with psychoanalysis and behaviorism not just because they are both deterministic theories but also because they lack a structure in their theory of personality that is responsible for change. Who changes in psychotherapy and who does the changing? The individual changes. It is the therapee who is responsible for change and who is changing himself or herself. We need, not only to want to change but to also put into action our decision for change. Although insight into our situation is of paramount importance it is not sufficient in itself. We need to wish and will; decide out of desire and act out of conviction. The ability to act out of will is I believe similar to other traits and characteristics of human beings. It is inborn but requires practice and cultivation in order to flourish. The early circumstances of our life play a crucial role in the opportunities they give us for training our will power. Our development also plays a significant role in the development of other properties and skills that will prove very useful for success in life and in therapy. Development through the life spanDevelopment proceeds in stages and the attainment of different skills and capabilities can be viewed as steps in a ladder that lead us higher towards the ultimate goal of our development, individuation and self-actualization. Biology offers us a valuable schema with which we can visualize psychic development and its basic ingredients. The photograph of a DNA molecule helps us grasp the idea of development as a non-linear process. It rather takes the form of a spiral where what has been gained (or lost) in the previous stages has a cumulative effect. It is often the case that individuals in therapy realize that they are again and again working on specific themes that they believed they had already resolved. They often become discouraged and feel as if they are not progressing. It is important however to realize that such repetition, may differ from the known repetition compulsion where one seems to be stuck in a vicious circle and instead, may be viewed as a normal process by which someone is working on the same theme but on a higher level until s/he can reach full realization and thus resolution. The upward movement of the spiral suggests the unfolding and evolutionary nature of our journey in life and our struggle to ascend to a higher way of being.
Life as we know it, is a process that begins with birth and ends with death. This life long process has been divided into eight stages. Infancy, toddlerhood, early childhood, latency, adolescence, early adulthood, middle age, and old age. What happens in each stage is important for the next. Different theorists have proposed different stages but we can combine them and integrate them so as to have a more unified picture. Erikson (1963,1980) was the first one to introduce the idea of a positive and a negative outcome depending on the quality of our early relationships. Our parents (or parent substitutes) are responsible not only for the basic DNA material that we inherit, but for our basic psychological constitution as well. Although the knowledge of our biological structure cannot help us to change it—so if we are born with blue eyes we will have to accept that we will die with them— the understanding of our basic psychological make-up can help us to alter it. This is why the discussion of such material is valuable for psychotherapy. As Mahler and other theorists have suggested the goal of development is separation / individuation. In other words to reach a higher level of development where we can function as autonomous individuals; to exist as separate unique beings. Many things can go wrong during this process of development and block our way towards individuation and actualization of our potential. The goal of individuation is attained through a process of separations that lead us from a merged and symbiotic way of being to an existence as unique beings. To be able to stand on our own, to become the best that we can be and to claim responsibility for our life are considered by, at least many, existential and humanistic psychotherapists the ultimate goals of therapy as well.
Infancy
Birth signifies the first and most important moment in this process of separation/individuation. It is with the cutting of the umbilical cord that we become physically separate from our mother. This physical separation will be followed (or has to be followed) by a number of separations on the psychological/emotional plane, before we can reach self-actualization. The loss of the sense of security offered by the protected life in the womb can be replaced only by a very secure attachment to a mother who is always there for her child. Although the consistent care provided by a loving mother (or “mother” substitute) is absolutely essential for the development of a basic feeling of trust, it can nonetheless never be perfect. There are no perfect mothers; there are no perfect childhoods. Some feelings of mistrust and a basic fear of abandonment cannot be avoided. However, with a reasonably good mother-infant relationship we can attain the first and most basic virtue of all, the virtue of hope. Hope and optimism were shown to be important coping mechanisms, in Harvard’s longitudinal study of successful graduates, as reported by George Vaillant in his book “Adaptation to Life” (1977). Most therapists recognize from their experience that positive thinking and hope are invaluable assets for therapeutic work and believe that it is hope and trust that have to be restored by the therapeutic alliance. The creation, or recreation, of a trusting and hopeful environment is the first and foremost step in the healing process.
By the 6th month infants start to develop the ability for self-object differentiation. So, at least cognitively, the infant can begin to develop the idea of a separate existence from the surrounding world. However, whether this cognitive skill will be translated into an emotional reality will depend to a large extent on how the mother deals with separation and whether she is able to handle the loss of a dependent and dependable object. An ability, which is, related to mother’s process of individuation and her capability to find a meaning in life other than her child. According to Freud (1973, 1978) our ego starts to develop in this first oral stage alongside our ability to differentiate self from object. How well it will develop and whether it will be able to deal with the pressures and the demands of the id and the superego later in life, depends on the relationship that is established with mother and the gratification (or not) of the basic instinctual drives that are associated with the different erogenous zones. The pattern of relating and the faults of this initial relationship will be re-enacted later on in the relationship with the therapist in what we call transference. The resolution of this transference can be (and has been) described as a corrective emotional experience by which the faulty patterns can be altered.
Toddlerhood
The first emotional separation is attempted during the second year of life, the period known as the “terrible two’s”, when the toddler takes the first steps in life. This greater physical autonomy is coupled with the greater cognitive autonomy offered by the use of symbols and the development of language (representational thinking). The young child is able not only to move around on his/her own, but also to communicate his/her needs verbally. It slowly acquires a greater ability for self-control, both on the physical and the emotional plane. What happens in the relationship with the parents is of great importance. Will the child develop the virtue of will? Will it be able to learn how to stand on its own two feet physically as well as emotionally, or will it be led to feeling shame and doubt and I would add fear? Fear is a major obstacle in our development. Fearful and shy children become adults who are unable to take risks and grow. Although a certain degree of fear is useful and realistic most of our fears take unrealistic proportions and stop us from our struggle to attain higher and higher goals. Overprotection and authoritarianism are equally devastating both for the development of autonomy and for the creation of overwhelming feelings of fear in the two-year-old. Such negative outcome of this early stage thwarts the development of our ability to become independent and responsible adults. In addition, the way toilet training demands are handled by parents in this second anal stage can serve as a prototype for the way conflicts and general social demands are experienced and dealt with, by the child.
Childhood
Our ability to initiate activities, including sexual play, can be hindered by excessive feelings of guilt. Excessive moral demands, too much criticism, and generally a very demanding upbringing can curtail the virtue of purpose and block our ability to act and achieve goals that we set. In addition, the way the Oedipus conflict is resolved will play a crucial role in the development of both our sexual identity as well as our ability to form satisfying sexual relationships in later life. The development of a very strict superego can block our effort to fulfill our potential. A strict and unrealistic conscience is a hindrance since it moves us away from what is meant for us and towards what is desirable and approved by others. It makes us feel guilty when we do things that we like and desire, instead of what we have been taught we should do. Such a conscience is not a positive influence on our struggle to become the best that we can be since what we can do best is what we desire and is meant for us. Similarly, an extremely unrealistic ego ideal can be the cause of great pain and frustration for what we cannot be, which anyway may not be in the givens of our existence. The ability to accept who we are, with our strengths and our weaknesses, is absolutely essential in order for the healing process to take place and is hindered by any unrealistic demands and expectations that have been incorporated into our self-image from very early on.
In the next stage of our development, sexuality becomes latent and we become absorbed in our effort to learn social skills, in our effort to become competent academically and socially. The virtue of skill gives us a first good basis for building our self-esteem. We feel competent and productive. Feelings of mastery and self-control are absolutely essential not only for a positive evaluation of our self and our strengths, but also for our ability to cope with crisis and handle our fears and insecurities. The first powerful relationship outside the family is created with what Sullivan (1953) calls “the chum”, our buddy, our best friend, usually of the same sex. Learning how to relate and form intimate relationships is a skill essential for life. Living without loving leads to a bear existence. Our ability to trust is essential once more. Can we trust? Are we too scared of failure and rejection? Do we believe in our value? Do we think of ourselves as lovable? Crucial questions which will have to be addressed as we enter into adolescence and we start to form our own identity. How well prepared we are in order to face this crisis is of paramount importance. The increasing numbers of suicide attempts, of drug use and of breakdowns in adolescence lead us to believe that we are not doing a good job in preparing our children to face adult life.
Adolescence
Adolescence is a transition and thus a complex stage. A number of physical developments signal the end of childhood and the re-emergence of sexuality (genital stage). However the adolescent is not yet an adult and does not know how to handle all of the changes that take place in his body and in his mind. Cognitive changes lead to the development of hypothetical and abstract thinking. Questions around the meaning of life and one’s own role in it are prominent. Existential theory can begin to take an important place in our understanding of what happens to the life of a human being. The adolescent is starting to form an identity as a unique being and has to face up to the task of claiming responsibility for his/her life. Can s/he face up to this difficult task? Does s/he feel the strength to stand up for himself/herself? We, as adults often shy away from responsibilities and prefer to claim that others are responsible for what happens in our life. How then, can we expect a teenager not to be overwhelmed by the difficulty of his/her endeavor? How much respect, acceptance and support have we given to the teenager all along? How competent and skillful does s/he feel? How much does s/he have a sense of belongingness and acceptance by peers, which is so essential for self-esteem and the process of breaking away from the family? Is the family there to provide the support and guidance that is necessary? Can the family let go of the adolescent and allow for individuation? Will s/he develop the virtue of fidelity and be ready to form commitments so necessary for success in early adulthood?
Of course, we often see in our day and age that many children and teenagers suffer more from neglect than overprotection. Our ability to give is hampered by our dissatisfaction with our life and our misguided effort to reach satisfaction by doing more and more things for ourselves rather than those around us. The teenager needs us to be there. To care and to give for what is necessary, while respecting the desire to experiment by doing things on his/her own. The flexibility of the family in this aspect has been shown from the beginning, when the teenager was still a toddler. Now, the family is going to be tested again. The parents, who by now are usually facing their middle age crisis, have a very difficult role. How satisfied are they with their life? Life satisfaction depends on choices. Our ability to choose in an authentic way depends on the extent of our ability to be in touch with our true self. Ability that is hampered, as already mentioned, by a very strict upbringing, which results to the development of a rigid conscience and an ego ideal that has no relationship with our true nature. Therapy can help in altering such faulty perceptions and in allowing the individual to be more in tune with who s/he really is.
Adulthood
As we enter adult life our ability to commit ourselves gains primary importance. Commitment in love and work is essential for success in either aspect of our life. Forming intimate relationships and establishing a family of our own is related to life satisfaction, as long as this is not done as another duty or as a means of proving that we are “normal” and we can do what others do. How serious we are with our choices and the responsibility they imply relates to our level of consciousness and self-awareness. Are we just driven by life and by expectations or are we in command of our life? Our ability to be in command depends on the development of many skills. The development of the virtue of love and of self-esteem are necessary for believing that we are worthy and that we deserve to be treated well.
First and foremost we have to learn how to treat our own self well. How much we care for our well being is essential in our struggle to become the best that we can be. Self-care and self-love must not be confused with narcissism, self-centeredness and egoism, but must be conceived as the basic dictate of “love thy neighbor like thy self”. This positive attitude towards our self and towards others is the only remedy for alienation and isolation. Our positive outlook on life, our self and other people can improve both our intrapsychic and our interpersonal isolation. The awareness of our existential isolation, as discussed by Yalom in his book “Existential Psychotherapy”(1980), although incurable, can help us increase our awareness of the responsibility we carry for our life and for the course it is going to take. No one else can live our life for us and no one else will die in our place. So what we do with our life is purely a personal matter. As Sartre said “we are equally responsible for the things we do and for the things we decide not to do”.
The realization of the responsibility we have for our life and our choices is important for both love commitments and work commitments. It is often the case that our choices are veiled by what others (primarily our parents) desire and by what we believe will bring acceptance and recognition. Marriage that is motivated by reasons of prestige, or the pressure of social and familial demands, can have detrimental effect for the life both of the couple and the children they may decide to bring into this life. Similarly work commitments which are motivated by reasons other than our feelings of love for what we do can lead to dissatisfaction and unhappiness. A large amount of our time and energy is devoted to work. And if the latter is not satisfying in a deeper and more personal level, it very often leaves us with a feeling of emptiness. It is this existential void that Victor Frankl describes so well in his book “Man’s Search for Meaning”(1984). Finding meaning is an essential part of our struggle in life. This quest for meaning is intimately related to the spiritual nature of human beings, which unfolds, as Jung suggests, after our 40’s. The importance and the ways with which spirituality can be integrated into treatment are beautifully illustrated in APA’s seminal publication of the book “Integrating Spirituality into Treatment”, edited by William Miller (2000).
It is through the new physical changes, which signify our entrance into middle age that we usually realize that our physical, material existence is not the one that can provide for happiness or eternity and this realization can increase our quest for a spiritual path. Both happiness and eternity are much desired, by at least most human beings, but neither can be brought about by a larger bank account or by more material possessions. Our body is beginning to betray us and the concept of death can no longer be denied as much as in adolescence or early adulthood when it seemed very far away. It is actually the very idea of death that can save us, as most existential theorists would agree. Our awareness of the ultimate and unavoidable end can help us live in an authentic way and thus aid in the attainment of our ultimate goal –becoming the best that we can be. Death awareness is usually heightened in middle age. However, chronic and life threatening illnesses, accidents and other serious life threats can help us increase our awareness of the end which most often results in the realization of the value of life. Such realization leads to dramatic life changes, to an appreciation of the here and now and of what one has rather than what one lacks
Whether we will develop a feeling of generativity instead of a feeling of stagnation depends on how well we feel with our self. It is now that our struggle to be true to our self will bear its fruits. We can feel joyful and satisfied; we can care and give. In addition our desire for knowledge, beauty and order, as defined by Maslow (1970) in his hierarchy of needs, can move us to a higher way of functioning. Our quest for understanding the meaning of our life and the cultivation of our higher aesthetic needs lead us to a higher form of morality, what Kohlberg (1969) defined as the universal ethical orientation. Thus, we develop beyond what is personal to a more universal outlook. We can let go of our ego and our selfishness and understand that we are part of a greater whole.
Equipped with all the skills and virtues that we acquire throughout the journey of our development, we can truly be wise and make up for the lost physical vigor and beauty. External beauty and strength can be replaced by internal. Thus, we can reach a stage of self-fulfillment and satisfaction that are necessary for the feelings of integrity that Erikson suggests. Personally I believe that there is nothing more tragic than dying unhappy and unfulfilled. There is nothing more painful than the realization that one has not lived his/her life well. That if s/he were to live again s/he would make different choices and lead life differently. The older we get the more difficult and more painful it is to realize that we have taken a wrong path and the more strength it requires in order to decide to change it. So the sooner we begin our journey of self-awareness the better off we are. It does not have to be that something tragic happens before we realize the value and impermanence of life. It does not have to be that we lose what we have before we realize its value. Human beings are thinking beings and we can help them confront the reality of the fragility of life and the freedom we have for shaping it. Environments, which respect the individuality of each and every human being, can support and enhance this path towards individuation. Psychology and particularly psychotherapy can play a major role in advancing our understanding of this process. The de-mystification of the process by which a human being can become a satisfied, integrated, fulfilled and happy individual can prove immensely valuable for mankind.
References
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Erikson, E. (1980). Identity and the Life Cycle. New York: Norton and Company
Frankl, V. (1984). Man’s Search for Meaning. New York: Touchstone
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May, R. and Yalom, I. (1995). Existential Psychotherapy.
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Maslow, A. (1970). Motivation and Personality. New York: Harper and Row
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