OTRAS ACTIVIDADES ESPECÍFICAS QUE INTERVIENEN

When a client’s communications indicate that contradictory knowledge and a juxtaposition experience have arisen in response to overt statements (or any other step of integration) of a pro-symptom schema, this is the therapist’s cue, firstly, to elicit more completely, if necessary, the contradictory knowledge that emerged and then, using this sharpened understanding of the contradictory knowledge, to guide a few explicit repetitions of the juxtaposition experience, fulfilling the requirements of the transformation sequence.

Clarifying the contradictory knowledge, if needed, can be done straightforwardly—in this case by the therapist saying, “When you said, ‘No boundaries equals death,’ I could see from your whole manner that you know this in a way that is very real to you, not just as some idea you’ve come across. Can you tell me some more of this personal knowledge you have of how lacking boundaries and merging with someone has very, very severe costs?” This elicited additional content: “Well, it’s just so clear that if I have no boundaries in order to feel connected, I’m actually giving up the possibility of ever being seen for who I am by the other person—ever. I mean, that’s what the

‘death’ is—never being seen because I avoided ever really showing

up.”

With those particulars, the therapist could now begin guiding repetitions of the juxtaposition experience. This was done simply by revisiting the two incompatible knowings in an empathic manner:

Th:

So, let’s go over what has emerged—these things you’re in touch with now. If you can feel them emotionally as we go over them, that would be good. What I’m understanding from you is that one part of you Pictures Nina and knows that in order to have the feeling of strong connection that’s so important and so good to feel, you have to go over into her feelings and needs, and leave yourself behind. This part of you really yearns for that primal kind of connection and feels it’s good for you to merge like that.

And at the same time, another part of you has a very different knowing, a very clear knowing that merging into her world gives up the possibility of ever being seen for who you are. This part of you feels that merging is a kind of living death and is not good for you. And these two realities about merging are so different, and yet each feels so real and true to you. [Pause. The first repetition of the juxtaposition is now complete.] How is it to be feeling both of them together, like this? [That question cues renewed attention to the both-at-once experience for a second repetition.]

Cl:

It feels like, how could I possibly have thought it could work to leave myself out like that? It’s kind of puzzling right now to even see why I actually thought that could be good for me.

Notice the complete absence of any suggestion from the therapist that one of the knowings is more correct or valid than the other. This is critically important for successfully facilitating the dissolution of the symptom-requiring schema.

We noted in Chapter 3 that the therapist’s question How is it to be feeling both of them together, like this? begins to probe for whether the pro-symptom schema still retains or has already lost emotional force. Charlotte’s response, above, indicated the latter (i.e., non-reactivation). With that initial marker of possible dissolution of the schema, the appropriate homework task was an index card with sentences that would guide her yet again into the juxtaposition

experience at each reading. The collaborative process of crafting those sentences—a process which itself induced yet another repetition of the juxtaposition—led to this card:

I really want merging because I’m sure that primal connection will make me feel happy and secure, the way it feels to be in utero; and at the same time, it’s so clear to me how lost, invisible, and miserable the grown-up me actually feels in that kind of connection.

Outcome

Charlotte subsequently reported that she continued to feel free of her former attraction to the merged, in utero state. However, she was still contacting her former partner regularly because of a persisting urge to do so. When a pro-symptom schema is dissolved but symptoms continue, this indicates the existence of at least one other pro-symptom schema—that is, some other implicit emotional learning(s), according to which the same symptom is necessary. In the course of Sessions 2 through 9, which occurred at two-week intervals, the therapist guided Charlotte to retrieve two other, entirely different pro-symptom schemas requiring her to hold on to her connection with her ex, one of which we describe here. It consisted of an unconscious problem and solution that she formed at age 12 and that now became verbalized as, “Mom and Dad’s divorce means that maybe love isn’t strong enough to keep together people who love each other. I’ve got to prove that isn’t so! I’ve been struggling to prove it isn’t so since I was 12, and if I let go now of this relationship, I’ve failed and it means love fails to keep people together. So I won’t let go!” In that schema, the master problem-defining construct is, “Love alone should be enough to keep people together, and it’s a horrible world if it isn’t.” With Charlotte explicitly feeling and affirming that view, the therapist guided her to revisit a number of terminated couple relationships within her circle of close friends and relatives. She knew people who still loved each other dearly after separating due to incompatibility. This was vivid contradictory knowledge of the opposite current experience type (like Richard’s in Chapter 3): What keeps people together is not love alone, but love plus compatibility,

and the world isn’t “horrible” because of that. The ensuing juxtaposition experience deeply revised her early, idealistic model of love and attachment, so the ending of her relationship no longer had a dire, intolerable meaning about love or the kind of world it is and was acceptable.

In her tenth and last session, she reported that she had ceased making contact with her ex-partner and felt a calm acceptance of having no further contact even though she and her ex-partner had made no progress on reaching a satisfactory mutual understanding.

She said, “Now I just feel like, no, we don’t have to get anything worked out. We just don’t … Well, it just shows me that I have a greater distance now if I’m willing to say, no, we don’t have to work it out.” Markers of non-reactivation and symptom cessation seemed steady. When she returned a year later for a different matter, she said the obsessing had not recurred.

At no time did the therapist attempt to counteract or prevent the obsessive attachment by, for example, teaching thought-stopping, building up her social support system, addressing her self-worth or insecurity, or carrying out reparative relationship therapy. The work never focused on intervening upon the obsessing per se, but rather on the underlying emotional learnings that had been requiring obsessive involvement as the necessary way to avoid various sufferings.