[From Bill Powers (950827.0100 MDT)]
This seems to be a day for clashes between applications people and
theoreticians.
I still believe that in PCT there are the seeds of a new approach to
therapy -- not just to the methods of therapy, but to the way we
evaluate what seems to be wrong with people. The conventional categories
of symptoms are only that, categories of symptoms; they don't tell us
what has gone wrong.
I sent out my reply to Goldstein's post before I read your post. It
probably wouldn't be much different but I aggree that medication without
trying to understand the problem from the point of view of the perceptual
control system is not normally of much use.
If there is really a conflict involved, it is useless to try to treat
the condition at the same level as the conflict. Whichever way you push,
one of the conflicted systems will push back or the aiding one will
relax, if you actually succeed in changing the behavior enough. The
approach that HPCT suggests is to try to identify the reference levels
in conflict, and then to use some method like the method of levels to
shift the person into a higher level of functioning, where the systems
are that are maintaining, and thus can change, the lower-level reference
signals.
Many times this does work. Sometimes the function of the obsession is to
avoid the loss of either possible outcome removed through deciding. The
agony of indecision is perceived to be better than the loss of the potential
outcome preserved by fence sitting. I have found that vivid and prolonged
imagination of one outcome followed by the same for alternatives sometimes
breaks the deadlock.
Worry, a mild to moderate form of obsession, sometimes serves to ward of a
potential threat which never gets thought all the way through to imaginaing
with feeling the worst case outcome or to engage in problem solving for
prevention or damage control. When asked why this is hard to do people say,
"I don't wont to think about it. The feeling would be too bad." Switching
or scanning back and forth over an array of "awfuls" feels productive but
doesn't really take care of the problem. Its too scarry to really take care
of the problem--to think about it enough to take in to account all necessary
aspects of the situation an potential outcomes.
Cognitive behavioral therapy " commissions an observing attitude " to
monitor this process and change it. Relaxation training teaches tolerance
for calm* and innattention to potential thereat. It often tends to take the
steam out of worry and obsession. When the person is calmer, perceives no
threat and feels comfortable, persons can sometimes dose themselves with
thoughts of "bad" outcomes. This is also how desensitization for phobias
proceeds as well..
Sometimes the paralysis from obsessions is so disabling that the person is
unable to develop sufficient detachment to accomplish this without a
temporary trial of medication. Similar for "panic disorder"
[the]Best
Dennis
*Yes, tolerance for calm is not easy for persons who have highly developed
control systems for threat monitoring. Kids abused in their beds at night
have a hard time relaxing to sleep as adults. "Its not safe to relax." Could
it be that subtle sensations accompanying relaxation are perceived as error
and prompt threat monitoring activities? Some of my clients panic after a
new level of relaxation is reached. Before relaxation training really "kicks
in" : Radar on= [I perceive myself as listening and seeing/not daydreaming]
=perceive self to be "safe enough" though tense= no error. Have normalized.
to tension. Relaxation teaches (facilitates reorganization) progressive
comfort in perception of capability for self protection, tolerance for
sensations from parasympathetic system activity and sympathetic activity
comes to perceived as error except when needed: running from a real threat,
mobilizing for vigorous physical activity, etc.
ยทยทยท
____________________________________________________________________________
Dennis McCracken,MSW,PhD
2038 Joyce Ln. http://community.net/~dennis/index.html
Suisun City, CA, 94585
dennis@community.net "Reality is always in Beta"