Sunday, February 27, 2011

The "Self," Narcissism, and Addiction

Jerome Levin offered a theory of addiction based on the work of Heinz Kohut in 1987 which has come to be termed Self-Psychology. While not addressing the notion of spirituality directly, Levin describes personality characteristics of the addictive "self" which AA maintains can only be remedied by reliance on a "Higher Power." Kohut viewed his theory as having an integral relationship with psychoanalytic thought. Kohut's insights were developed while working with individuals diagnosed with narcissistic personality disorders. He viewed these patent's as suffering from a developmental arrest and not from intra-psychic conflict. The consequence of this arrest was that a normal sense of self never developed. "Addiction" in this model, is viewed as a pathological attempt to remedy the narcissistic disturbance. In Levin's words, "alcohol has become the alcoholics sole love object, alcohol here experienced as part of the self."

Narcissism is a pathological form of self-absorption and has nothing to do with a healthy ego. Individuals exhibiting narcissistic traits have an extremely distorted sense of self. They maintain a vigilant guard on the self in an effort to avoid a slip into psychosis (or psychic annihilation). Levin describes the matter in more detail. "Alcoholics have to self-absorbed to make sure they are still alive. There sense of self is so tenuous that they live constantly on the edge of annihilation. Their barely cohesive selves may fragment at any time. Thus, alcoholics suffer from at least four kinds of self-pathology: (1) they are self destructive; (2) they lack certain components of the self that mediate self-care and maintain self-esteem; (3) they are over self involved; and (4) their very sense of being, their self concepts or representations, are fragile and in jeopardy. Since so many observers, from so many points of view, have pointed to an abnormality in alcoholics; relationships to themselves, it seems reasonable to postulate a relationship between alcoholism and narcissism."

Levin views the repair of the self as essential to recovery from addiction. The addict must learn and incorporate new cognitive structures which permit self-development to resume. To this end, he offers various techniques taken from Self-Psychology.



Self-Psychology and the Humanistic Traditions:



Levin maintains that Self-Psychology is a bridge between the psychoanalytic and humanistic traditions. He views Kohut's theory of self-development as more optimistic than that of Freud. In so doing, various parallels are noted between Kohut's theory and that of Carl Rogers. According to Levin, both theories arrive at core formulations. These include the importance of empathic understanding, unconditional acceptance of the patient, the need for "mirroring" of the self by the environment, and the view of a cure as the development of a "cohesive self." (Kohut), or as "self-actualization" (Rogers). Additionally, both Kohut and Rogers emphasize the need to provide the patient with a "growth-prompting environment" while diminishing the role of intra-psychic conflict. Levin summarizes the parallels:

"Rogers views the self as a subset of the totality of the organism's experience; parts of the organism's ongoing processes become conscious through symbolization's, which are experienced as a gestalt, or unity. Kohut views the self as a center of initiative which is experienced as coherent in space and enduring in time. Rogers sees psychopathology as the result of a constriction of the self in which too little of the totality of organismic experience is symbolized and made conscious. Kohut considers most psychopathology to be the result of an insufficient cohesion of the self. Each of these thinkers were trying to do justice to the indisputable datum that man experiences himself as both a coherent whole and disparate assembly of the disjunctive feelings and experiences."
Levin concludes by noting that the propose for existence according to Rogers is self-actualization (in his later years, Rogers expanded the notion of self-actualization to include more spiritual dimension) and that the need to self-actualize is the single force that motivates behavior. This view is contrasted with Kohut's notion of the "tragic man," or un-actualized self. Levin maintains that the chemically dependent individual is an example of both the tragic man and un-actualized self.

The Concept of Self:

Levin begins his review of the "self" by noting its controversial history in psychological theory. He hypothesizes that much of this controversy stems from the literal translation of the word "self." He notes that Psyche, the Greek root from which the words psychology and psychological are derived are often translated as meaning mind, spirit, or soul. The term "self" came to share this ambiguous definition and the concept "self" became synonymous with "soul." Given this association with soul, the idea of self was rejected by the new scientific, experimental psychology of the 19th century.
This rejection of the concept of self as unscientific in psychoanalytic thought prevailed until Kohut began his work in 1971. Psychologists recognized a need for a term which would describe the individuals inner, subjective experiences. Levin points out that the early Freud's attempt to use the notion of an "ego" to denote the self, but the term was never clearly defined. Freud used "ego" as a synonym for "self." However, he later used "ego" as one of the three aspects of the mind. Levin maintained that Freud's use of the term "ego" was inconsistent. At times "ego" was meant to describe the "I" and at other times "ego" was describing an agency of the mind. With Kohut's work, the term "self" again entered scientific discourse to denote the subjective nature of the human experience.

Kohut's Theory of the Self:

Throughout his career, Kohut worked with individuals diagnosed with narcissistic personality disorders. Levin explains, "These patients were neither psychotic, out of contact with reality, nor neurotic, suffering from conflict between repressed desires and conscience. They seemed to lack a firm sense of self, yet they had the ability to enter into a stable relationship with the analyst. Psychotic patients are rarely able to do this. However, Kohut's patients did not react to him as neurotic patients typically do. Instead, they formed what Kohut first called the 'Narcissistic' and later called the self-object transference's; that is, they related to their analysts as if the analyst were parts of them. Kohut classifies these relationships as either 'mirror transference's,' in which the patients treated their analysts as if they were an extension of themselves, or 'idealizing transference's,' in which the patients acted as if they were part of the analyst, whom they perceived as omnipotent."
In working with these individuals Kohut proposed a developmental model for the evolution of the self. From lowest to highest. These stages consisted of a self in a state of fragmentation, to an archaic (primitive) self, to a cohesive, and finally mature self. Kohut concluded that the narcissistic patients he was treating were fixated at the developmental level of the archaic self. He hypothesized that this fixation resulted when primary care providers failed at empathic relating (mirroring) early in life.

Self Psychology and Addiction:

Levin notes that Kohut wrote a great deal about chemical dependency. Addiction, according to Kohut is a desperate and futile attempt by the addict to repair the self's developmental deficits. Treating the narcissistic self is essential to recovery from addiction. Levin explains the plight of the active addict. "Certainly not all alcoholics suffer from the narcissistic personality disorders; however, narcissistic disturbances are extremely common in alcoholics. Their self-cohesion is tenuous and easily threatened, subjecting them to panic and anxiety. They tend to relate to others, including counselors and therapists, along the lines described by Kohut in his discussion of narcissistic transference. They are subject to 'empty' depression because they lack what Kohut called 'psychic structure,' internal resources for maintaining self-esteem. Finally, they often resist giving up alcohol not so much because they want to drink as because they experience the inability to drink safely as an intolerable defect. We Can thus understand much of alcoholic behavior and denial as a defense against narcissistic decomposition-the fragmentation of the self, which would mean psychic annihilation."
Levin is careful to point out that archaic narcissism is characteristic of the active alcoholic (pathological narcissism) and not necessarily characteristic of the pre-alcoholic personality. He therefore, refers to pathological narcissism as a regression or fixation to the stage of archaic self. This stage of self-development is characterized by by a cohesive but insecure self. It is constantly threatened by a fear of regression to full psychosis (fragmentation). Behavioral manifestation of the archaic self includes arrogance, isolation, unrealistic goals, feelings of entitlement, the need for omnipotent control, poor differentiation of self and object, and deficits in the self regulation capacities of the self.
Kohut's theory of self-development views the grandiose self as the result of merging with (not differentiating from) a mother who used the child to gratify her own narcissistic needs. Because existence itself is dependent on the mother, (Kohut's self-object), the relationship between self and self-object is characterized by primitive, panic level anxiety created by the threat of self dissolution. This dynamic results in the need for omnipotent control of the self-object. Therefore, any significant lack of empathic nurturing on the part of the self-object (mother) results in the archaic self's needs going unmet and is experienced as an injury to the self. This injury is reacted to as with "narcissistic rage." Levin points out that narcissistic rage is understood in psychodynamic terms as a psycho-sexual regression to oral dependence.
Levin views addiction as a substitute self-object which meets the subconscious dependency needs of the addict. He explained, "Although this deep need for fusion with a self-object may be repressed from consciousness or dealt with by reaction formation so that it is not readily apparent in the form of excessive interpersonal dependence, the alcoholic has nevertheless found the 'perfect' self-object with which to meet his need-the bottle. At the same time, that dependency needs, or the need for self-objects, is being denied/repressed, it is being met through the pathological use of alcohol, which is simultaneously experienced as the perfect self-object and as a magic fluid (milk). Further, since the internalization of self-soothing, stimulus augmentation, and self-esteem regulation which are originally performed by the self-objects, have failed or are at least deficient in pathological narcissism, the pathologically narcissistic individuals may openly seek fulfillment of these needs in their interpersonal relations or they may deeply repress them, or, as is more typical, they may be in intense conflict over meeting these needs, which are, in the very nature of the case, always present. However, open dependency is not acceptable in adult males and is increasingly unacceptable in adult females in our society. Hence, conflict must ensue. Thus, dependency conflict is a necessary correlate of pathological narcissism."
Through the bodies of physiological response to addictive drugs, the addict is able to regulate several other functions of the self that he/she otherwise is unable to perform due to fixation/regression to the archaic narcissistic level. Via the use of drugs, addicted individuals are able to temporarily regulate their affect. Additionally, painful or other unacceptable sensations, drives, and emotions are anaesthetised through the use of chemicals. Finally, because the use of many drugs is socially acceptable (at least within certain subcultures) it is not considered dependent behavior. Therefore, individuals regressed/fixated at the pathological narcissistic stage can use drugs to perform self-functions which they otherwise would be incapable of without appearing dependent.

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S

Saturday, February 26, 2011

The Cybernetics of "Self": A Theory of Alcoholism

"Until we can understand the assumptions in which we are drenched we cannot know our selves."

Adrienne Rich


The role of spirituality in the recovery process was discussed in relation to cybernetics and Systems Theory by Gregory Bateson. Bateson is an anthropologist. He began to put forth his theory in 1973 starting with his book, "Steps to an Ecology of Mind." Bateson made three basic hypothetical statements about addictions and the addicted. The first is that the sober alcoholic is functioning in relation to an epistemology which is accepted in occidental culture, but is incompatible with systems theory. Second, the intoxicated alcoholic, by virtue of being in an altered state of consciousness, has taken a partial and subjective step toward a more correct state of mind. Finally, that the emphasis of spirituality within the Alcoholics Anonymous program closely relates to the epistemology of cybernetics.
Bateson maintains that addiction (as well as other mental disorders) is a result of disturbances in communication. His theory regarding addiction is based on the paradigm of cybernetics. The term cybernetic is from the Greek, "kybernan," meaning, "to govern." The field of cybernetics is the study of control and self-regulation in machinery and living organisms. Through his work in this area, Bateson concluded that the mind, or sense of "self" is in actuality not a thing contained strictly within the body, but is a process. The course this process takes is determined by informational feedback to the self-system.
In Bateson's words, "We may say that "mind" is immanent in those circuits of the brain which are complete within the brain. Or that mind is immanent in circuits which are complete within the system, brain plus body. Or, finally, that mind is immanent in the larger system-man plus environment." Consequently, there is no substantial self apart from the system. The self is inter-relational and a product of the communications with its environment.
This notion is in contrast with the epistemology of occidental culture which views the "self" as a separate entity set in opposition to a disjunctive milieu. Bateson has termed this concept an "epistemological error." Addiction then, is viewed as resulting from faulty environmental feedback which conditions individuals both consciously and unconsciously to view themselves as separate from the environment. Alcoholics are caught in a particularly intense form of the epistemological error and tend to overly rely on the separate self as omnipotent to the point of narcissism. Consequently, in viewing the self as a separate entity, the world is viewed as hostile and must be controlled and conquered.
Relationships within this cosmological frame tend to be competitive as opposed to complimentary. This phenomenon is at the core of what AA terms "alcoholic pride" or the need to control the addiction through "self-control." In Bateson's words, "It is an obsessive acceptance of a challenge, a repudiation of the proposition 'I cannot'. This effort to control drinking (or any other addiction) by reliance on self, results in a cycle of attempts followed by relapse. Paradoxically, this cycle increasingly narrows the notion of self (increased narcissism) and further place circumstances outside its scope.
Due to their pharmacological properties, addictive substances tend to break down the barriers between self and environment. In this manner, alcohol and other drugs are viewed as a step toward correcting epistemological errors created by the conditioning one is exposed to in occidental culture. By virtue of a pharmacological process, the addict experiences the self as part of, rather apart from the world. However, given the disastrous physical consequences of prolonged chemical use/abuse these unconscious attempts to correct the epistemological error ultimately fails.
Since the alcoholic has had brief experiences with a more correct state of mind, the common advice to "use will power" to remain sober will fail. Bateson elaborates on this point. "In favor of this hypothesis, there is the undoubted fact that the testing of self-control leads back to drinking. As I have argued, the whole epistemology of self-control which his friends urge upon the alcoholic is monstrous. If this be so, then the alcoholic is right in rejecting it. He has achieved a 'reductio ad absurdum' of the convention epistemology." Give this state of affairs, the alcoholic finds his or herself in a seemingly hopeless situation. Bateson has termed these types of situations, "Double Bind."

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Sunday, February 6, 2011

Mystical Christianity

Stephen T. Prystash, LMFT
28364 Vincent Moraga Dr.
Temecula, CA.
(951) 318-7020


Many years ago I had the opportunity to attend a workshop with M. Scott Peck, author of, "The Road Less Traveled." At the time I was attempting to deal with significant life transitions in addition to my own demons, anxieties, addictive tendencies, yada, yada, yada, and questioning my right to work as a psychotherapist. Despite the sorry case my psyche was in at the time, I was drawn to Peck's work and philosophy of the human spirit. As I listened to his presentation, I was struck by the number of references he made to being a Christian; almost in an exaggerated manner. Now I had been raised as a Catholic and had long since discarded any connection with the church; regarding it as hypocritical at best and as we have seen over recent years, incredibly abusive at its worst.

During a break in the workshop, I asked Peck why he had apparently gone out of his way to identify with Christianity; feeling surly he would be espousing Buddhism, Sufism, or anyone of a number of other ism's I was attempting to identify with. His response gave me pause. A rough paraphrase of Peck's response was that he, "...didn't thing Christianity was a way of life that was tried and found wanting but rather it was a way of life that few had actually lived." Wow, food for thought.

A few years later, I found myself at the Jung Institute in Switzerland. As Mecca is to the faithful Muslim, the Jung Institute is to every seeker of spiritual/psychological insight and all those of like mind should go at least once in their life. At any rate, my arrival in Geneva was just a few days before the start of the first Gulf War. As I and those with me at the institute watched events of the war unfold, the topic of discussion heavily surrounded the human potential for violence on one polar end of the existential spectrum and potential for unlimited spiritual development of the other.

People who are drawn to the Jung Institute come from all sorts of backgrounds (psychologists, writers, poets, teachers, members of the clergy, etc.) but all have a common purpose in seeking psychological and spiritual knowledge. During my time there, I met two monastic clergy; one a Buddhist and the other a Catholic. In discussions with them, I remember being surprised at how much they appeared to have in common in that they seemingly came from such divergent traditions. However, in time, I came to realize that (and as they also freely shared), that members of monastic communities; who spend their days in deep contemplation and prayer, in time, transcend religious dogma and begin to touch the same universal sense of God.

Over several discussions with my new monastic buddies, I expressed a desire to more deeply delve into Buddhist practice given my deep disdain for the Christianity I had grown up with. Their united response was predictably kind but cautionary. The reasoning went something like: "... why would you want to enter into a tradition such as Buddhism when you already have a spiritual foundation in the Christian teachings." They expressed concern that those who enter into religious practice that is separate from their cultural heritage are unlikely to fully comprehend the meaning of that tradition and are in danger of entering into a narcissistic pursuit (i.e. a practice that glorifies the ego-self as opposed aligning one's Will with the Universal Self). Again, heady stuff as I began to realize by problems with Christianity were juvenile in that I had lumped my negative life experiences into a religious practice that is based solely and simply upon Love and Humility. The problem was that the only Christianity I knew had been long since hijacked from true teachings by fundamentalist, narrow minded, judgemental and in many cases abusive clergy.

I left Switzerland having made complete peace with my Christian heritage and began to use it as the base for further spiritual development. However, in working with addictions over the years, I have witnessed numerous people struggle and rebel against any notion of spiritual acceptance based simply on their own negative experiences with Christian teachings in their youth. How sad and unnecessary this is!

Late this past summer I was vacationing with family and friends in Northern California and discovered quite by accident a remarkable little book. We were staying in Fort Bragg enjoying the serenity and beauty there. One morning, a breakfast outing was planned at a local eatery that had come highly recommended. Having been down this road with the family many times before, I fully anticipated a long and unbearable wait to be seated. Given this dread, as is my general practice, I planned to take the book I was reading at the time (Deepak Chopra's-The Third Jesus), grab a cup of coffee, smoke a cigar and read while we waited. Unfortunately, Deepak was not in the car as anticipated and there appeared no respite from the dreaded wait. But stop, immediately next to the restaurant, was a used book store (love these places and have found many life gems in them) and there was still hope. Within five minutes, I found a remarkable little book titled "Mystic Christianity or The Inner Teachings of the Master."

At first glance, the book appeared interesting but nothing I hadn't read before. However, as I thumbed further, passages began to demand more attention. As interest grew, I discovered the book had a copy write date in 1908 and was written by Yogi Ramacharaka. I don't know if it can be easily found anymore but it is highly recommended and more than worth the search. Mystical teaching of Christianity (Jesus' conception, birth, ministry, death and resurrection) is diametrically opposed to western dogma and will ring true for many who have since abandoned it. I will provide a brief quote from Yogi Ramacharaka here and offer more of his insights in future blogs:

"The teaching regarding the Immanent God lies at the foundation of all the Mystic teachings of all the peoples, races and times. No matter under what names the teaching is promulgated-no matter what the name of the creed or religion in which it is found embedded-it is still the Truth regarding the God Immanent in all forms of life, force and matter. And is always found forming the Secret Doctrine of the philosophy, creed or religion. The outer teachings generally confine itself to the instruction of the undeveloped minds of the people, and cloaks the real Truth behind some conception of a personal deity, or deities-gods and demi-gods, who are supposed to dwell afar off in some heavenly realm-some great being who created the world and then left it to run itself, giving it but occasional attention, and reserving his consideration for the purpose of rewarding those who gave him homage, worship and sacrifices and punishing those who failed to conform with said requirements.
"But the mystic teachings of all religions has brushed aside these primitive conceptions of undeveloped minds, and teach the Truth of the Immanent God-the Power inherent in and abiding in all life and manifestations. And Christianity is no exception to the rule, and in its declaration of the Holy Ghost its mystic principle is stated."

More At: stephenprystash.com

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Saturday, February 5, 2011

Addiction-"To Miss the Mark"

Stephen T. Prystash, LMFT
License: MF-24093
28364 Vincent Moraga Dr.
Temecula, CA. 92590
(951) 318-7020

The purpose of this series of blogs is an attempt to put forth the many years of applied therapeutic experience and research I have conducted regarding the role of "spirituality" in the recovery from addictive disorders. The concept of spirituality is obviously a subjective notion. To some, the term engenders anger and is dismissed as voodoo and ignorant. To others it is confusing; shrouded in myth and convoluted by religious fundamentalism. One's response to spiritual matters is generally determined by their own life experiences with formal religions, circumstances under which they were reared and the general karmic role "fate' has played in their lives. Unfortunately, for the vast majority of people, most of these variables have been paired with negative/painful life experiences such as abusive parents or clergy, molest, abandonment, sudden and unexplainable loss of a loved one, or perhaps religious instruction that simply does not make common sense or "add up" to them. Consequently, one's perception of God and spiritual matters is often times confused with a plethora of negative emotions such as anger, shame, guilt and so forth. In any case, an individuals understanding of spirituality is an experience that is unique to them and clouded with the cognitive distortions that results from a life of negative and traumatic experiences. As Rabbi Harold Kushner has written, "God is like a mirror. The mirror never changes, but everybody who looks at it sees something different."

Unfortunately, the subjective and generally erroneous perceptions one forms in regard to spiritual matters places a person in what Gregor Bateson has termed a "Double-Bind" or no-win situation with who we really are as humans; spiritual beings. To begin to understand the nature of the Double-Bind, it is helpful to start with Carl Jung's theory of his Individuation Process. Briefly put, Individuation is a developmental model of life that evolves from ego formation (i.e. who one is in the world as perceived by the senses and how one functions in it in a relatively adapted manner) as a young person to an innate and unconscious "Need" to understand who one is as an existential/spiritual phenomenon as the notion of the finite inevitability of life takes root and grows. The matter of Double-Bind is further complicated by a western culture that has dominated a world epistemology that places significant emphasis on materialism, immediate gratification and bodily pleasures.

The result of Double-Bind tends to have a hypnotic and confusing affect; forming no end of neurotic and pathological psychological manifestations as one attempts to subconsciously make sense of the contradictions and cognitive distortions that results from painful and traumatic life experiences and the conditioning from a material and hedonistic culture on one end of the spectrum and Jung's notion of a "Collective Unconscious" that constantly drives us to understand and accept who we are as spiritual beings on the opposing end of the continuum.

With the above in mind, the addictive phenomenon makes some seemingly paradoxical sense. This was put forth by William James in 1902 (Varieties of Religious Experience) when he stated,"The sway of alcohol over mankind is unquestionably due to its power to stimulate the mystical faculties of human nature, usually crushed to earth by the cold facts of dry criticisms of the sober hour. Sobriety diminishes, discriminates, and says no; drunkenness expands, unites, and says yes. It is in fact the great exciter of the Yes function in man. It brings its rotary from the chill periphery of thing to the radiant core. It makes him for the moment one with truth. Not through mere perversity do men run after it. To the poor and unfettered it stands in place of symphony concerts and of literature; and is part of the deeper mystery and tragedy of life that whiffs and gleams of something that we immediately recognize as excellent should be vouchsafed to so many of only in the fleeting earlier phases of what is in its totality so degrading and poisoning. The drunken consciousness is one bit of the mystic consciousness, and our total opinion of it must be placed in that larger whole."

Also recognizing the initially mystical, but ultimately destructive result of addition, Jung wrote to Bill Wilson (co founder of Alcoholics Anonymous), "....craving for alcohol is the equivalent on a low level of the spiritual thirst of our being for wholeness, expressed in the medieval language: the union with God...You see, 'alcohol' in Latin is 'spritus' and you use the same word for the highest religious experience as well as for the most depraving poison. The helpful formula therefore is: spiritus contra spiritum."

Experience has taught me that breaking the trance state of the Double-Bind is the first step in forming a more correct life epistemology. To do so, one simply has to admit to conscious process that it exists. In so doing, the subconscious becomes conscious and the hypnotic spell is broken. After that it becomes possible to begin understanding the source of a craving for addictive substances that is, in reality, a spiritual quest and that this journey has little to do with formal and dogmatic religious practices. It is ultimately a contemplative and mystical process.

More at: stephenprystash.com

peace/out