Conceptualisa-on and Treatment of Low Self-Esteem

Transcription

1 Conceptualisa-on and Treatment of Low Self-Esteem Transac-onal Analysis Cumbrian Conference 2018 Andy Williams TSTA(P)

2 Keeping the Training Safe Confiden-ality This is a weekend workshop and not therapy. Responsibility for self keeping self grounded and safe. Don t over-share. It s OK to pass on any ac-vity but remain engaged. Have fun, ask ques-ons, make comments this is a co-created, learning space.

3 Andy Williams TSTA(P) One of the Directors of Training with TA Training Organisa-on. Live and work in Leeds. Interested in the poli-cal and social responsibility of the psychotherapist.

4 Contents of the workshop Opening Exercise Nuanced ways of thinking about self-esteem. Model 1: Transac-onal Analysis Model 2: Double-Engine Ways of working with this presenta-on. Discussion. How does this apply to my prac-ce?

5 Take an improve your self-esteem sweet! Exercise swap roles. Work in groups of twos or threes where you are sat. Offer your neighbour a self-esteem improving sweet and sell to them all the benefits. Accept and eat a sweet and allow it to work. No-ce how it feels, where you imagine the impact will be; how it affects your body. Self-Esteem Sweets Self-Esteem Mix

6 Exercise Debrief. We used a sweet as a metaphor for some kind of unit of self-esteem. How was this metaphor successful? Can we understand self-esteem in this way? Can self-esteem be traded as a currency? How was this metaphor unsuccessful? Did this metaphor miss the point? Are there be^er ways of understanding?

7 Self-Esteem A concept that is very rarely referred to in TA literature in these terms. The condi-on of being loveable and capable and trea-ng others as being loveable and capable a systemic defini9on. Jean Ilsley-Clarke (2004)

8 Self-Esteem Self-Esteem is ins-nc-vely developed when, in the presence of a good-enough other regulator, the child is able to learn to manage their feelings and experiences, and remain feeling OK My summary from Hargaden & Sills (2002, p18)

9 Self-Esteem What does it impact? Primary areas Cogni-ons Mental Images Mo-va-ons Emo-ons Behaviours Soma-c responses and physiology SELF ONE-PERSON More diverse areas to consider Compe--on Conformity A^rac-on Causal A^ribu-on Achievement Coping with stressful life events. RELATIONAL & SYSTEMIC

10 So are we talking content or structure? Not enough? Misarranged in some way?

11 Those with high self-esteem. Have a strong concept of self A STRONG SELF-CONCEPT They are posi-ve The are able to ar-culate a well-founded view of self They appear to be strongly structured rather than have more of something that can be quan-fied.

12 Those with low self-esteem This group DO NOT have a well-defined, nega-ve view of self. Their self-view tends to be rather neutral HIGH LEVELS OF Uncertainty I m not sure, I don t know what I like. Instability I feel great, I feel awful Inconsistency I like tofu, no I don t like tofu.

13 A model of low self-esteem SELF Knowledge of self. Who am I? Evalua-on of self. How do I feel about who I am? SELF-CONCEPT SELF-ESTEEM Uncertain, Confused, Persistent Surprisingly NEUTRAL

14 Historically Self-esteem has been linked to content. It was thought: High Self-Esteem = Posi-ve Self-Belief Low Self-Esteem = Nega-ve Self-Belief Actual it is more like: High Self-Esteem = Posi-ve Self-Belief Low Self-Esteem = Neutral Self-Belief

15 Low Self-Esteem People with a low self-esteem have a more poorly ar-culated self-concept They lack KNOWLEDGE of self They lack SELF-CONCEPT They are UNCERTAIN They are CONFUSED They appear to LACK STRUCTURE They are PERSISTENT in this presenta-on.

16 High Self-Esteem They hold MORE COMPLEXITY of beliefs They can IDENTIFY MORE self-beliefs They can DEFINE SELF with confidence They are TEMPORALLY STABLE They are INTERNALLY CONSISTENT They have CLARITY OF SELF-CONCEPT.

17 So it is more about STRUCTURE and SELF-CONCEPT Self-Concept An organised schema Episodic Memory Autobiographical events, -me, places, contexts Seman-c Memory Facts about the world that have meaning. Self-Knowledge Who am I? Self-Evalua-on How do I feel about who I am?

18 The Core Self. C 1 P 0 C 1 A 0 C 0 Work by Hargaden and Sills (2002) Early transferences Kohut Mirroring, Twining, Idealisation Research into Low Self-Esteem supports the relational and developmental ideas of Hargaden and Sills. 18

19 The Double Engine Model Work by Melanie Fennell

20 Early Life Experience Childhood Events, rela-onships. living condi-ons. Early transferences Twinning, Mirroring, Idealisa-on A^achment pa^erns and processes Early origins The BoVom Line as a belief structure Assessment of worth and value as a person Conclusions about self, based on experiences This is the kind of person I am. Bad, worthless, stupid Core Beliefs Rules for Living Defensive Strategies / Assump9ons Contaminated beliefs for gejng by. Standards against which self-worth can be measured. Counter- Injunc-on s Trigger Situa9ons when the Rules for Living are broken! Reinforcin g Memories

21 Trigger Situa9on A rule for living is at risk High-profile piece of project work is due in. ACTIVATION OF THE BOTTOM LINE Core beliefs become ac-vated. Depression LOOKING BACKWARDS Rumina-on. Feel down. Do nothing. Feel hopeless. Nega9ve Predic9ons LOOKING FORWARD What if s? What if I m not done in -me? What if it s not good enough? Anxiety Hot, heart racing, feeling sick and anxious. Self-cri9cal thoughts Now look what you ve done! You are an idiot! How could I be so stupid! Unhelpful Behaviour Avoidance. Procras-na-on. Perfec-onism. Racket Behaviours. CONFIRMATION OF THE BOTTOM LINE Things crash and burn. What else did I expect?

22 Treatment Proposal Two-pronged approach Developmentally bo^om-up Hargaden & Sills - Structure Rela-onal Framework Two-person psychology Maintenance top-down Double Engine - Maintenance How are you keeping this going in the here-and-now?

23 Treatment Targets Shared conceptulisa-on Origins of the problem Early Experience. Three arenas Depressive Looking Backwards Anxiety Looking Forward Lack of Internal Structure Discover Me. Working with self-cri-cism Flexibility in Rules for Living Ques-oning The Bo^om Line

24 The Prejudice Model Work by Padesky, C. A (1993) 1. Think of a person you know who has a prejudice with which you do not agree. 2. What does the prejudice consist of? 3. When your person meets someone who fits their frame of reference, how do they react? 4. When they meet someone who does not fit, how then do they react? 5. What do they do to keep themselves and their beliefs intact? 6. If you wanted to help them overcome the discount or prejudice how would you go about it? What would they need to do? 7. How easy would it be to change? 8. What difficul-es might there be? 9. How would you help them overcome these? 10. Why am I discussing this with you as therapist-client?

25 Summary of Workshop Low Self-Esteem is not about lacking content, but lacking internal structure and self-knowledge. We cannot trade in esteem (like sweets) and provide more. Research supports a Rela-onal and Development perspec-ve of lack of early structure Nature abhors a vacuum what ever is missing developmentally will be filled with something even if this is proac-ve- nothing. Here-and-now maintenance work with clients is very useful, as well as rela-onal approaches and deeper bo^om-line work.

26 References Baumeister, R. (1993). Self-esteem. The Puzzle of Low Self-Regard. 1st ed. New York: Plenum Press. Fennell, M. (2009). Overcoming low selfesteem. London: Robinson. Hargaden, H. and Sills, C. (2002). TransacBonal Analysis. A RelaBonal PerspecBve. Hove: Routledge, p.18.

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