Background to my interest in teaching children with autism

PSYCHOTHERAPY BEYOND THE FRINGE, continued

Any disinhibiting agent is likely to help ‘the cork to pop’ and a flood or explosion of anger to occur. An obvious disinhibiting agent is alcohol. Jack certainly reacted strongly and angrily when he imbibed, as his ‘bottled up’ anger was freed or disinhibited. But ‘justifications’ for anger may also serve as ‘disinhibiting agents’. If something happens by means of which the person can justify anger, he may well ‘blow up’, become angry and even escalate his angry feelings as they are released even to the point of violence. This too happened with Jack from time to time.   Of course, the tests Felicity administered to Jack also revealed some of the things from his developmental history which the psychiatrist thought needed to be addressed. Jack felt criticized and the brunt of fault-finding. This seemed to be the content around which his high level of guilt feelings had developed. He had always tried to be a ‘good boy’, but always felt he fell far short of what he should have been in his parents’ eyes. He felt used and abused by his supervisor and his fellow employees at work. His good-natured ways set him up to be asked to do extra work and, although he thought he was doing the job better than any of his co-workers, he felt he received nothing but complaints and negative feedback from his boss. Although he considered all this to be thoroughly unjust and unfair, most of the time he was unwilling to acknowledge, or unable to experience, any anger at all. It was true that he frequently thought of killing himself, and he had made several attempts at doing so, including cutting at his wrists and looking down the barrel of a loaded gun.

Felicity felt set-up. It was as though he wasn’t allowed to treat this man, but he had to live with the risk that Jack would commit suicide while under his care. Felicity’s thought made him chuckle as he realized that he had just let himself fall into the same trap that Jack was using — he felt inhibited in the use of his energies for the task, and was feeling hard-done-by as if someone else was setting him up to feel guilty. Of course he could treat Jack. It’s just that he had been asked to do so by behavioural rather than psychotherapeutic (same thing) means.

There are at least three alternative approaches to treatment for people exhibiting the ‘energy test tube’ problem. The ‘cork’ can be removed by the person temporarily to allow him to find ways to use his energy, only ‘giving up’ control voluntarily and only from one moment to the next. The methods for this purpose are generally classed as cognitive therapies or cognitive behaviour therapies. The methods may range from examining and changing ‘self-talk’ or thoughts to ones which have ‘better’ outcomes for the person, through deciding or telling oneself to trust his brain’s good programming just for now, to ‘playing the game of anger’ and enjoying it — but only when not angry. The last approach is analogous to Erickson’s attempt to control epilepsy by learning voluntarily to produce ‘mini-seizures’.

Or ‘little holes can be drilled’ in the bottom of the test tube to let off little bits of energy, not sufficient to arouse anxiety. The methods for this purpose are commonly classed under assertive training. They may include practice in handling recurring situations by rehearsed responses which are slightly stronger than the person’s usual responses, by learning to make brief affirmative statements, or by learning to express personal feelings in place of angry attacks directed at others.

Or the ‘fear’ feelings which have become conditioned or learned to be associated with the use of energy can be unlearned or desensitized to reduce the intensity of anger and return it to its original nature as ‘energy’. The methods for this purpose are generally classed under systematic anxiety desensitization methods, some of which are described in other stories presented here.

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