The Psychotherapies

THE PSYCHOTHERAPIES

It's at this point that our author, Hoover, makes the claim that all psychotherapies--apart from the one he is going to advocate--work on the principle of minimising our consciousness of the (perceived) threat we are facing. And they minimise our threat awareness by using the defences outlined in the last post such as denial, blame shifting, minimising its impact, busyness and/or any combination thereof.

Hoover illustrates what he means in the following examples:

1. Denial and Diversions
For example, John has got into serious financial debt and is obsessing about his woes to the point where it is affecting his work and health. In therapy he is told to forget about what he has done--would any counsellor do this I wonder (?)--and get his thinking onto something positive. He is told to realise that he has not done anything that all humans haven't at one time or other done. So John does not change his ways at all but gets angry about the system that has got him into debt; the therapist feels good that John is no longer beating himself up.

2. Minimisation and Value Shifting Deceptions
The next example Hoover gives is a marriage difficulty where Mary wants to stay in what is an unsatisfying relationship. The counsellor believes it would be best to leave the husband. She uses a technique of challenging the wife with the question, 'Just how bad would it be to leave him?'. Hoover says that the therapist is using an anti-'awfulsing' technique with the client. Eventually the wife is persuaded to leave the marriage.

3. Rationalisation and Intellectualisation
'Leon' who has been anxiety and unable to sleep for over three weeks seeks help from a health professional. In the ensuring counselling it emerges that Leon has taken advantage of some friends in business just to get his monthly quota. The professional invites Leon to rethink the situation in this way: 1) you didn't do anything wrong because you were only doing your job; 2) your friends must have been contributing to their being cheated because it takes 'two to tango' in such situations; 3) realise that you actually did your friends a favour: they might not to be so gullible in the future. Leon is told, 'Look on the brighter side'.

4. Suppression
Gerald has been washing his hands too much and the behaviour is increasing. He confides to his therapist that he hates the thought of 'germs'. The therapist teaches him the technique of 'thought stopping': where every time he thinks about 'germs' he instantly says to himself STOP in a forceful way. After he practises this technique for 2 weeks Leon is happy to report that his hand-washing frequency has been halved.

Hoover does not comment on these four examples other than implying that each is non-therapeutic because each appeals to the better use of a defence rather than addressing the ADVERSITY itself.

A CONCLUSION TO PART ONE: The Mechanics of Mood
Hoover leaves us with some questions that he regards as crucial to understanding his therapy such as:

(1) what is the difference between causation and tolerance in emotional unrest?

(2) what is an obsession or the mechanism by which a compulsion gets its existing force?

(3) can you explain those forces that can make an emotional reaction seem out of proportion and out of thin air?

(4) why did develop a system [as a result of the Fall--my gloss] that would leave us suffering at the occurrence of some adversity or adverse potential that has relevance for us?

 His final word in the chapter is

'.......did you know?

the psychological alarm is the 

Rosetta Stone* (the key)

to the human mind' (p. 55).

*The Rosetta Stone was discovered in AD1799 and enabled the translation of Egyptian hieroglyphics which had not been possible up to that time.

Next time we begin: PART TWO, Mood Antagonistics . . . . and the primal rule 

Compulsions and Defenses (sic)

The next two sub-parts of the first major part (The Mechanics of Mood) of Hoover's Non Cognitive Psychotherapy (NCP) are first,

The Compulsions*

The author defines a compulsion as 'the automatic attempt to prevent . . . pain or dissatisfaction, or to preempt that discomfort when it's actually occurring' (p. 48). Compulsions typically try to prevent or reduce the discomfort of pain either being felt or likely to be felt. Compulsions are more than ordinary habits.

To understand compulsions (such as repeated hand-washing for example) they must first be accepted as rational attempts to mitigate pain. However, that said, compulsions are 'unwholesome' by definition just as long as it is also accepted that 'to avert or preempt pain . . . is not a clinical issue' (p. 48) in itself. That is, it is normal to want to avoid pain if possible.

When compulsions are primarily expressed at the intellectual-verbal level they are known as defences; when primarily expressed as an action they become what is called 'acting out'. These protective devices are used for the immediate affect of 'relieving discomfort' (p. 48) and tend to be learned from imitation and observation.

Sometimes adversities do not suggest any method of relieving unease leading to the sufferer getting fixated on methods of getting respite. this situation will often lead to an obsession where intrusive thoughts or ideas predominate. Hoover gives an example of a man's fiancee who throws him over for another man. The abandoned man begins to suffer from depression and anxiety but strives to win back his former fiancee by pleading with her to reconsider. His efforts fail dismally. This result leads him to ruminate tirelessly and painfully on his betrayal; he continually obsesses over ways to woo her back.

The second sub-part of this post are,

The Defenses** (sic)

Adverse emotions like anxiety, anger and depression--remembering that I have already said that (IMO) Hoover wrongly fails to distinguish between emotions and moods--are moods and emotions from which we all seek to escape.

These avoidances 'disconnect all or part of one's awareness of the adversity [from] which the painful emotion is produced' (p. 50). We may deny it will or did happen; shift the blame ('It was them not me!'); minimise its impact ('It's okay.', or 'I can handle this.' ; distract oneself by busyness; or a combination of any of these.

Although we might succeed in controlling our mood we are none the less reducing our effectiveness in being able to audit likely impact of the adversity. Hoover says by way of illustration: it's as if we have turned off our home's smoke-detector alarm and boast that the smoke-detector never annoys us!

Various factors contribute to which defences any one person will choose related to one's history and experience, personality predispositions, level of threat posed, or the physical condition of the person concerned. Hoover instances a man suddenly faced with the news from a doctor that he has prostate cancer who yet shows no emotional reaction; in Hoover's opinion the man must be considered to be using a defence of some sort.

Next time: The Psychotherapies

*This sub-part (and the next one dealt with in this post) appears as in the heading but it is not evident to me why it is not in upper-case as have been the preceding sub-parts. (Compulsions don't appear to be a sub-sub-part of THE EMOTIONS, which we dealt with last time. So I'm confused.)

**I've spelled this according to U.S. usage because that's what is used in the publication. In Australia of course, we follow the British tradition of spelling and would spell this word 'defences'.

The Emotions

When something we value is threatened a corresponding mood is triggered by an Alarm* warning us of the threat to whatever it is that we value.

Two occasions of threat readily spring to my mind: one with a large, growling dog and another with a slithering snake which both led me to stand paralysed in fear with heart beating. Both animals came from nowhere and were unexpected; my reaction was understandable and if I took the time to explain more fully the circumstances all readers would make sense of my fear (because we all share a common humanity if not always common fears).

We all understand that, generally speaking, humans' welfare are threatened by aggressive dogs with which they are unfamiliar and by rapidly-moving snakes in the wild.

Hoover, author of Non Cognitive Psychotherapy, says that the mood or emotion following the Adversity* is not 'arbitrary or chaotic' (p. 44) but the ensuing mood depended on various conditions:

• type of threat (internal or external). My dog and snake examples above were both external but an internal example would be if one suddenly begins to feel panicky and nothing seems to be causing it.
• recognition/understanding of adversity. For example, a small child may not understand the danger of the hot stove whereas a normal adult would.
• origin of the adversity; who is/are responsible for it?
• its temporal status: is it impending, happening now, or concluded?
• nature of its possible impact; is the damage resolvable/repairable or not?

'Adverse emotions' are categorised by the author as 'anxiety, depression, guilt and anger' (NCP 2001: 45).

[I would argue against his calling these 'emotions' and with the seeming implication that emotions and moods can be equated. I think these states are moods except for 'anger' which can be associated with irritability which is better classified as a mood. However, moods and emotions are usually distinguishable by noting that the latter are intense and short-lived while moods are less intense but experienced for a longer time. (See Paul Ekman on this topic.) Moods can become disorders such as depressive disorder or major depressive disorder as can anxiety.]

Hoover notes that anxiety relates to 'impending' adversities while depression to some already incurred damage to one's health, status or well-being. (This observation explains why anxiety and depression so often occur together.)

Losing one's job is a pertinent example of an adversity that given it is recognised as a threat will result in anxiety over future employment and depression over the losses in social stature, work itself, friendships, etc. If the job was lost through one's own fault then guilt and shame might also be involved as opposed to being retrenched by a company who is downsizing where one might feel hostile and resentful.

The Action of Past Events

Hoover finishes this subsection with the well-known observation that, 

When an adversity of the past is linked to some current hardship or threat, that past event can stay emotionally active and bothersome--even enhancing reactions to that current hardship to which it is connected (via the psychological alarm)--without absolute confirmation that any link exists (p. 46).

Sexual abuse of children provides the classical example of this principle: 'past events do not remain functionally active without due cause' (p. 47). A young girl or boy abused sexually will probably experience sexual problems within their marriages at a later stage if not before because such abuse unaddressed remains functionally active. This upsetting of later sexual experience will occur whether the person concerned recognises the link or not. The same interference with normal adolescent and adult life can occur with other types of child abnormal experiences including severe emotional and physical deprivation and neglect, as well as physical and emotional abuse.

* These words are technical terms within Hoover's presentation.

Next time: The Compulsions