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3/14/2019 3 Comments

A Clinical Approach to the Enneagram Type 4 Client By Tamra Sattler

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You may have heard this interesting word Enneagram or you are already a self-reported expert. In short, the Enneagram is a psycho-spiritual map indicating how we experience the world from a particular point of view. In my work as a psychotherapist with Type 4 clients, explained in detail later, the Enneagram’s wisdom outlines a significant map for our work.

     As a practicing psychotherapist for thirteen years, my practice has attracted a particular kind of client. They are creative, smart, sensitive, romantically oriented, a fluid sense of sense, and an anxious-ambivalent attachment style. It became clear that the clients walking in my door identified as Enneagram Type 4s. The Enneagram literature says a Type 4 is the adjectives I mentioned above with a particular developmental path.

     I will explain in greater detail the type 4 client. The main motivation consistent through most of their life is to have personal significance and to exist. The defense strategy is introjection which means taking in others and surroundings to feel a sense of connection. The object relations theory is that both parents felt mis-attuned and alien to the child. The attention goes to what is missing and comparison or envy to others. There is a familiarity with melancholy and feeling misunderstood and dismissed. Hopefully this gives you more of the feeling of the experience of this client.

     When I administer the initial assessment most individuals who identify as this type will have a feeling of being seen and discovered. Most will start their investigation on their own into the depths of the Enneagram wisdom. In our work it will allow for precise pointers to their experience both internally and externally and the key issues will be addressed through our work. It provides a psychic map while also giving hints at their development as cited in The Wisdom of the Enneagram by Russ Hudson and Don Riso.

     In my experience, if a therapist and a client share a reliable and valid map the work can become very deep in a shorter period of time than it may take to truly understand the nuanced lens of a client. With this particular type the most effective part of the therapy is the experience of being seen, understood, and validated as this is the missed experience in childhood and throughout life. I also have a major advantage because I identify as the same type so my own journey is also critical to the unfolding of my clients. I am walking a very similar path and it helps to know the terrain from the inside.

     In reflecting on one particular client she feels very dissatisfied in her work and comes in week to week with ideas about what additional degrees she can pursue or what additional field she can entertain. The process is very frustrating for her and brings up a lot of destabilization and shame for not feeling content and having a clear picture of her identity. If I hadn’t been so immersed in the Enneagram and did not have a familiar feeling myself I may go on this exploration with her. Instead I was able to ask a question after a session or two when I noticed the pattern. What makes you feel less than? This opened up in experience in the way she views most of her life. The career pursuit shifted to more of a connection with self and with all of her life.

     As another example, many of my clients will feel very attracted to people who are unavailable. And they may also get uncomfortable with people who are very available and present. When exploring we can see how familiar the unavailable pattern is with their primary care taker relationship along with how they feel in their own connection with themselves. Their longing is a way to keep them from their core issue of abandonment so they do not have to experience the feelings again of the pain of being dismissed and not being considered. A lot of their energy is a defense against this core wound. Since we both know this terrain we can drop deeper into the experience to feel into the parts that have not been met.

     In another example I have a client who had abuse and neglect as a child. When this client experiences not being seen and understood by their partner they will often go into a feeling of deep rage for not being attuned and feeing dismissed. If they are not aware of this pattern they will blame and act out on their partner. However if they know that a nurturing mother part can be developed within themselves they can meet the attachment wounding from childhood. Knowing the Enneagram we are able to understand their needs as well as a guess at their partners defense and wounding to allow the client to realize their needs will not often be met by their partner.

     I hope this brief article has peaked your interest on researching more about the Enneagram. It has been the most accurate tool for my own discovery and continues to provide a lot of insight for my client’s and my own unfolding. I also believe it is invaluable to work with a therapist of your own point of view so there is more of an inside out understanding. And if you want to have a more in-depth dialogue feel free to reach out at tamrasattlerphd@gmail.com.

Tamra runs a private practice in Boulder, facilities (facilitates) supervision groups with Marc Azoulay and co-teaches at Naropa University and student taught at CIIS. She has an upcoming personal transformation app coming out that is a result of a collaboration with Uri Talmor.














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3 Comments

5/26/2017 1 Comment

On Reading

Books on Adoption
​By Kate Thompson

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I am a compulsive reader – I read to learn about the world and to understand my own world. The urge to create a meaningful narrative from the events of a life, to understand and to learn, is one of the reasons people come to psychotherapy. Psychotherapists and authors might therefore agree that we read to make sense of our lives and our experience. I have very eclectic tastes – both in fiction and non-fiction. Reading takes me out of my world (I have colleagues who do not read novels except on vacation for that very reason – but isn’t that the point?) and also gives me new perspectives on the known.

Sometimes our professional and personal lives align in a novel in ways that can illuminate both. I love the serendipity of the New Books shelf in the public library. Recently I picked up a couple of novels which both contained adoption themes. I work a lot with clients with adoption stories (from different parts of the adoption triad). I run a group for adoptees. I am an adoptee. Perhaps this makes me particularly sensitive to these themes; I know I am profoundly grateful when I find them. These stories occur in adult fiction from Wuthering Heights to The Orphan Train. Children’s literature has always been full of adoption stories  - think of Anne of Green Gables, The Secret Garden, The Once and Future King. Novels are extra resources I can suggest to clients and show me new perspectives on their stories and my own.
 
Two of the best books on adoption stories which just happen not to be novels:

The birth mother’s story (biography/journalism):
The Lost Child of Philomena Lee: A Mother, Her Son and a Fifty Year Search – Martin Sixsmith (which became a film starring Judi Dench)
 
The adoptee’s story (memoir):
Why be happy when you could be normal?  - Jeannette Winterson

Jeannette Winterson says:

“ Adopted people may feel silenced.”
“We need new ways to tell our stories.”
“Adoption drops you into the story after the story has started.”
“We need better stories for the stories around adoption.”


The work we do in therapy or in the group is all about telling the story, finding meaning in the story and integrating the adoption story into the larger narrative of the client’s life.
​
The Novel Cure – An A-Z of Literary Remedies (Berthoud and Elderkin 2013) has a very short section on adoption – if you have come across any books (fiction, non-fiction – as I said, I’m eclectic) with these themes please do let me know at kate@katethompsontherapy.com or leave a note on my blog.


1 Comment

1/27/2017 2 Comments

Review: American Gods

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Book Review: American Gods, by Neil Gaiman
Elizabeth Stahl
 
“The important thing to understand about American history is that it is fictional, a charcoal-sketched simplicity for the children, or the easily bored. For the most part its is uninspected, unimagined, unthought, a representation of the thing, and not the thing itself. “
-American Gods, p. 8
 
Want something to read that temporarily lifts you up to a view above the anxiety and uncertainty in our current political climate?
 
An experience that provides larger picture with historical, spiritual and meta-physical perspectives?
 
Try reading American Gods a novel by Neil Gaiman
a British author who takes his characters on a road trip through the heartlands of the United States,
where roadside attractions are places of power, where most gods are recognized as foreigners and all gods need sacrifices, offerings,
belief in order to survive.
 
The narrative reads like a pulp fiction American detective novel.
The protagonist is a black man named Shadow who has recently been released from prison.
He accepts a job from a white man who leads him into a world of ancient gods on the brink of extinction, abandoned and scattered throughout the American landscape, left to make it on their own. As the novel unfolds it takes brief pit stops to tell the plights of individual gods.
 
“That’s what it is like for my kind of people…we fed on belief, on prayers, on love. It takes a lot of people believing just the tiniest bit to sustain us. That’s what we need, instead of food. Belief.”
American Gods, p. 254
 
American Gods is full of metaphors that offer poetic perspectives of the American psyche.
In one example the question emerges: How would you find the exact center of the United States?
In the novel a tourist attraction is built at the center of the United States and nobody comes to visit it.
 
 “The exact center of America is a tiny run down park, an empty church, a pile of stones, and a derelict motel”  
American Gods, p.380
 
Like a norm in statistics, it is an estimated space between realities and not a reality in and of itself.
It all depends on the frame you draw around it. How does one define the center?
Do you include Alaska? ​The United States is not a circle.
In the novel the center is described as a place of “Negative Sacredness.”
 
“Places where they can build no temples. Places people will not come, and will leave as soon as they can. “
American Gods,
 p. 383  

"...a land that has no time for gods, and here at the center it has less time for us than anywhere. It's a no-man's land, a place of truce, and we observe our truces. We have no choice."
American Gods, p. 398

Compromise, collaboration and the right to disagree are vital to democracies.
While the center may leave us feeling less than 100%, frustrated and disappointed its vital to our liberty.
 
Chapters often begin with quotes and poems from other writers that offer a variety of insights into the character of our country.
 
Here is a poem from a 19th century poet (American Gods, p.117 ):
 
Wide open and unguarded stand our gates,
And through them passes a wild motley throng.
Men from Volga and Tartar steppes.
Featureless figures from Hoang-ho,
Malayan, Scythian, Teuton, Kelt and Slav,
Flying the Old World’s poverty and scorn;
These bringing with them unknown gods and rites,
Those tiger passions here to stretch their claws,
In street and alley what strange tongues are these,
Accents of menace in our ear,
Voices that once the Tower of Babel knew.


"Unguarded Gates," Thomas Bailey Aldrich, 1832  

The fate of these old gods appears to be in conflict with newer, more modern gods, like technology, media and corporations.
However as the plot thickens everything gets more complicated and less clear. (Sound familiar?)
 
It’s like the mixed up fairy tales and role confusion themes found in modern children’s books, young adult novels and many current TV series and movies.
 
Does anyone remember Fractured Fairy Tales  from Rocky and Bullwinkle?
 
Check out the eerily accurate and twisted plot lines with complex character development of super heroes born out of World War II in the TV and movies series based on Marvel Comic Books:
Agents of Shield
Agent Carter
Dr. Strange
Ironman
The Hulk
Captain America
and many more.........
 
Hard not to believe that Hydra (the evil organization focused on world domination) is not behind all this.
 
“The organization's motto references the myth of the Hydra, stating that "if a head is cut off, two more will take its place", proclaiming their resilience and growing strength in the face of resistance.”
https://en.wikipedia.org/wiki/Hydra_(comics)
 
 
The seeds of the discontented are against integration. They express dis-ease, dis-satisfaction and often paranoid thinking. They are a symptom that something may be out of balance, a reason to review our histories, the shadows of our own minds and track relationships.
​ Integration through cooperation happens over time through the experience of self-knowledge, trust in conflict and through developing
​good form.

Look for the upcoming American Gods TV series on Starz
 
Looking for some background music to channel your angst try:
Leonard Cohen’s prophetic album The Future (1992)
Check out his video on Vemo of the song “Democracy is coming to the USA,”

"It's coming through a hole in the air
From those nights in Tiananmen Square
It's coming from the feel
That this ain't exactly real
Or it's real, but it ain't exactly there
From the wars against disorder
From the sirens night and day
From the fires of the homeless
From the ashes of the gay
Democracy is coming to the USA

It's coming through a crack in the wall
On a visionary flood of alcohol
From the staggering account
Of the Sermon on the Mount
Which I don't pretend to understand at all
It's coming from the silence
On the dock of the bay,
From the brave, the bold, the battered
Heart of Chevrolet
Democracy is coming to the USA

It's coming from the sorrow in the street
The holy places where the races meet
From the homicidal bitchin'
That goes down in every kitchen
To determine who will serve and who will eat
From the wells of disappointment
Where the women kneel to pray
For the grace of God in the desert here
And the desert far away:
Democracy is coming to the USA

Sail on, sail on
O mighty Ship of State
To the Shores of Need
Past the Reefs of Greed
Through the Squalls of Hate
Sail on, sail on, sail on, sail on

It's coming to America first
The cradle of the best and of the worst
It's here they got the range
And the machinery for change
And it's here they got the spiritual thirst
It's here the family's broken
And it's here the lonely say
That the heart has got to open
In a fundamental way
Democracy is coming to the USA

It's coming from the women and the men
O baby, we'll be making love again
We'll be going down so deep
The river's going to weep,
And the mountain's going to shout Amen
It's coming like the tidal flood
Beneath the lunar sway
Imperial, mysterious
In amorous array
Democracy is coming to the USA

Sail on, sail on 
I'm sentimental, if you know what I mean
I love the country but I can't stand the scene
And I'm neither left or right
I'm just staying home tonight
Getting lost in that hopeless little screen
But I'm stubborn as those garbage bags
That Time cannot decay
I'm junk but I'm still holding up
This little wild bouquet
Democracy is coming to the USA"


Songwriters: Leonard Cohen
Democracy lyrics © Sony/ATV Music Publishing LLC


 

 


2 Comments

10/17/2016 2 Comments

REVIEW:The Shadow of the tsunami

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Disassociation and Relational Healing
Karolina Walsh
Click on her name to learn more about her
 
People in the helping professions we all want to become more competent and effective in our interactions with clients. Many of us came into this work to add meaning to our lives and the lives of others. Then through our training and subsequent work we came to see that this whole process of healing is not so easy to conceptualize. While we are showing up with our clients a lot is happening within them and within ourselves. At times it is hard to know what is theirs and what is ours, and where our experiences overlap. I have come to experience the profound healing of stepping into a space of dropping technique and relating openly and honestly with my clients. A space where I name my own feelings of dissociation, confusion, body sensations, emotions, and invite the client to feel me in the room with them. Not as an observer but as a person impacted and moved by them and their various parts, especially the dissociated parts.
 
The responses to this type of relational work are often provocative. The response can be anything from: clients telling me that I’m not allowed to share with them what happens for me, or them expecting me be the expert fixing them, to deep shifts in the wounds of developmental trauma. These shifts occur because of the novel experience produced by fully entering into the relationship in the here and now with my client, my dissociative parts, and their dissociative parts.
 
Before having my own experience around relational work, I was told that we should be very careful in how we share ourselves with our clients. I learned there should be detachment from the client’s process, and that our internal experiences should be shared with our supervisor as countertransference to be worked through.  Yet, at the same time there were discussions about the powerful nature of working with the relationship between client and therapist as it presents in the here and now. The message I heard was, “Ok this relational work is sketchy to navigate, but it could be the most healing relationship this person could experience thus far in their life.” So I began to wonder how and why should we do this.
 
Philip Bromberg speaks to this paradox in his book “The Shadow of the Tsunami.”  He essentially states that through the client/therapist relationship, and the collisions of their respective self-states (often dissociative states), a powerful process occurs that co-creates the conditions necessary for the growth of the relational mind (Bromberg, 2009). The client up until that time has found ways, often most powerfully through dissociation, to deal with the developmental trauma that occurred during their childhood.
 
I often illustrate how developmental trauma is formed by describing the process as such: as a child you were having an emotional experience that was overwhelming to you, maybe fear, sadness, anger, terror, confusion, and your ability to handle it at your age was impossible. What you needed was a caregiver to be attuned to your emotional state and enter into the energetic field of the emotion with you. Not to fix, but to share in the experience and accompany you as the emotion passed through. If that caregiver was emotionally unavailable, absent, frightened of your emotions, or the one who created the overwhelming experience then you, as a child, had very few options. Most nervous systems, and they are designed this way, will opt to cut away the self-state having the overwhelming experience rather than risking a complete annihilation of the entire sense of self. When infants and children experience this amputation of a self-state they often develop the ability to dissociate as a means of surviving, which is what we evolved to do.
 
Bromberg goes on to state that the therapeutic relationship is not a vehicle to get rid of our past, but a way to live together in its shadow. As a result, little by little, the shadow shrinks and the client’s natural capacity grows to feel trust, and “joy in ‘the nearness of you’ and a stability that will continue” (Bromberg, 2009).
 
What I have experienced and continue to experience is the profound healing that can take place through here and now self-state disclosure by the therapist. This is not about sitting around in normal consciousness and chatting about our favorite flavors of ice cream. It’s about dropping into the realm of dissociated parts, developmental trauma, and systemic beliefs together as a way to reintegrate the shattered parts of self many clients come in with.
 
The key word, and point of this relational work, is “together.” As therapist and client we venture into these places together, and this "together" can only happen if the therapist is willing to exit the role of observer and become participant. We use our own experience in the present moment of the sensations, emotions, and thoughts that arise for us in the relational field with our client. This is self-disclosure in one of its most pure forms, and one of the most impactful.
 
The art of therapy is to walk the line of knowing what disclosure is the greatest benefit to the relationship. This takes a lot of mindfulness, introspection, and skill, and a willingness to totally mess up! Because what the client does not need is a prefect therapist. Perfect people do not exist, but what do exist are people who are willing to connect, mess up, and then repair. Allowing yourself and your client to experience that together is healing for both parties.  And it might be the first relationship in their lives where that connection, break, and repair cycle happens. This is one way people heal from developmental trauma.  
 
We all need this, therapist and client alike. We all need to have these journeys into the scary places with someone else not as observers but as participants. And one note about those of you who are thinking about getting overwhelmed by journeying with your client; I have experienced far less overwhelm when I consciously enter into this material together as co-travelers. Without this consciousness and the ability to name what’s happening in the present moment we are, both client and therapist, asleep and replaying dynamics that have been happening for decades. Bromberg speaks of this process succinctly as, “stumbling along and hanging in.” I often think of those words in session when I feel the apprehension of not knowing what is going to happen next, and as a result my desire to control the process arises. Then incredibly, I have the inspiration to tell my client what I am experiencing and off we go towards that connection that transforms and heals.
 
Karolina Walsh is a relational and body-centered psychotherapist in private practice located in Boulder, CO. 

Click on her name to explore her website

2 Comments

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