Psychologically, How Much Can A Person Tolerate?

At university I had a lecturer who taught abnormal psychology. We were sitting in the lecture theatre waiting for him to start talking. Without a word he picked up a piece of chalk, strode to the green board and wrote the word therapist in large letters. He looked back at us, still not speaking and then quietly said “the therapist can sometimes become the…“ He turned back to the board and inserted a dash between the third and fourth letters of the word he had scribed. “…rapist”.

He knew something about the power of experiential learning. That was thirty-one years ago. If you ask me what else he taught us in terms of abnormal psychology I simply could not tell you, but the word-on-the-board-moment has never left me. Now to be honest I cannot remember exactly how he explained why he did what he did; I think it had something to do with the reality that therapy is about power. Power; how it is used, how it is abused, who has it, who wants it, who gives it away, and who gets it. Naturally this includes the therapist who is fully human too and is not always aware of his or her own motivation. Therapists should receive supervision and be in their own therapy, if not, the limits to what the therapist can tolerate will unduly influence the therapeutic process.

So with the board-moment in mind, the question I want to ask is this, how much can a person tolerate?

Can a child tolerate being told by his teacher that he is lazy? Can a battle hardened soldier tolerate death, violence and human destruction without being traumatised? Can a teenager tolerate the anxiety of knowing he is not loved by his father? Can a person tolerate seeing another human being who is somebody’s child living in conditions of deprivation, degradation and poverty? Can a person tolerate being told that they are not facing feelings that have been buried away? Can a person tolerate being told that they must stop finding blame in other places and they alone are responsible for their lives and that they alone are the obstacle to change?

It is the nature of being human that we are vulnerable and it is the nature of life to present challenges to our vulnerability irrespective of whether we have the capacity to tolerate the challenges or not. However there are at least three contexts where care should and can be taken to be cognisant of the limits to what a person can tolerate at a particular point in their lives; these being parenting children, educating children and in psychological therapy.

In order to deal with life’s challenges we know that certain elements help us to do so. The single most significant element probably is the connection to and the presence of support from people, whether organised and structured or informal and loose. Many other elements give us fortitude to face what we have to face. When I was doing my internship I had to present a seminar paper as part of my placement. I spoke of love, respect, courage and the absence of envy being critical to the success of psycho-therapeutic interventions, specifically I remember saying, “at the end of the day isn’t therapy about love, isn’t the work we do about love and doesn’t the client feel and know that?” (1)

The head of the assessment team listening to my presentation pointed his finger up, moved it back and forth close to his cheek and while looking down at the ground pensively said; “you are attributing therapeutic efficacy to non-specific factors”. I felt as if I had spat at the Queen herself; and in her diamond jubilee year!

By non-specific factors the good doctor was pointing out that I was referring to variables not posited as being active causes of change in a given therapeutic theory, in this case psychiatry. He also meant and contended that non-specific factors could not be defined, quantified, and measured, with the requisite scientific precision to be a reliable and valid variable in the determining of therapeutic change. I mean c’mon…love, courage, chicken soup?

I was suitably intimidated. But he was right in his observation, I was attributing (some) therapeutic efficacy to non-specific factors. Technique transpires in a relationship, a specific kind of relationship but still a relationship. Is it preposterous to encourage clients to have courage in beginning to face the defences that are sapping their energy, to try and see things differently, to try and re-frame their beliefs?

We naturally protect ourselves from the threat of pain and emotional conflict; we attempt to prevent our vulnerability from being threatened. This protection takes the form of psychological and cognitive mechanisms of defence. These defences are sometimes in our awareness and sometimes out of everyday awareness.

The defences that we utilise (those in conscious awareness and those not in conscious awareness) may be quite simple, like denying something that you probably know is true. Forgetting is a powerful defence; re-membering can be a powerful healing. Defences may also be quite complex, entrenched, and hard to recognise without help.

Should defences be tampered with?

Any therapy; behavioural, cognitive behavioural (CBT), humanistic or psychodynamic is going to demand change in behaviour and/or beliefs and/or emotions. The capacity to tolerate the processes that create change rests on three things; a person freely choosing to embark on the attempt to change, a person who is genuinely motivated (capable of working through the resistance) to change and a person who possesses sufficient ego strengths and resources (resilience of the psyche) to tolerate such a process.

Defences can sometimes be adaptive in addition to being protective. There are limits to the amount of distress, pain, and emotional threat that some people can tolerate. Sometimes if the adaptive nature of the defences is functional it can be better to leave those defences alone. This would be true if the person’s defences allow for a reasonable quality of life free of dissonance distress or disturbance i.e. they are ego-syntonic. It is also better to leave well alone when it is clear that the person will not tolerate both the identification and the breaching of the defences let alone exposure to the feelings and anxieties that the defences are keeping away from consciousness. In these instances an alternative from of support to create change would be required, less invasive.

Why am I going on about this stuff? I’m going on because I want to highlight a few specific areas of concern that I have.

Firstly commercial mass change techniques. These group activities are usually of a high intensity, emotionally charged, of short duration, and comprise of large heterogeneous groups. They often utilise command techniques, compulsory shared public declarations and disclosures, and the enforcing of rigid rules that forbid any deviation from pre-determined processes and outcomes. They sometimes rely on the use of public shaming techniques to coerce change. This can mean that the apparent change that a person experiences is just the immediately felt intense emotional experience of emotional hope, shared common connection with others and the relentless plugging of a generally common sense idea. They practice intense techniques without knowing the actual intentionality and understanding the capacities of the person even if the person is given warning of the risks up front.

Secondly some popular books, CD’s DVD’s on self-change. In some instance these proclaim and insist on the power and effectiveness of formulas, beliefs, techniques, secrets, rituals and other things to help one change, become unburdened, free and successful, and other desired things that most of us want. The proclaimed content often belies a strong need on the author’s/facilitator’s/organisation’s part to be right, to have the truth and power and thus the respect of lots of people, and to fill a need within themselves, or an unacknowledged motivation. They choose to tell people, the readers whom they have never met and do not know, who they are and what they should do, think, feel, and be in their lives. They often tell the story, moving as it may be, of one person; themselves, and the interpretation of their experience which undoubtedly involves a real struggle with personal pain, truth, and clarity. However sometimes they do not sufficiently attempt to differentiate their experiences in relation to the other.

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Seems simple enough…but is it true?

Thirdly, the often asserted notion; you alone are responsible, you alone are the obstacle. We are told that all we have to do is choose, simply decide to change our negative beliefs, our lives just like that here and now. This ignores or fails to recognise the complexity of a person’s psychic integrity, the role of determining factors some of which are not in awareness. This notion also ignores the role, function and adaptive benefits of defence mechanisms and the absence of assessment and understanding of the person’s ego strength and resilience resources. In addition, sometimes we are too young to cope with certain experiences and feelings; sometimes we are too compromised in respect of health & mind to cope with certain experiences and feelings even if we persuade ourselves that we want change.

Thus some of these things fail to address who and what the person actually is and thus can be risky because they overlook the need to address the following questions.

Do I adequately know and understand this person?

Do I know the nature of their feelings about themselves and others?

Do I understand this person’s resilience capacity?

Do I know what safety and support this person needs in the change process?

Do I have the emotional capacity, love, and strength to help this person see who they really are?

If these questions are not answered the helping risks becoming a violation of the person and a manipulation of power over another. These questions, when taken seriously can only be answered in the crucible of a mutually respectful, bounded and technically supportive relationship. These questions are important in equal measure for those proffering help and for those choosing to seek help.

REFERENCES

The Art of Loving: Erich Fromm
http://www.amazon.com/The-Art-Loving-Erich-Fromm/dp/006112973