Friday, February 8, 2013

Anxiety and the Drama Triangle

“How can you be so rude and insensitive? You always act that way. I don’t know why I come  back here every year?”

“As I heard this from my older sister I wondered:  What happened??? It had been a great day, lots of excitement and fun with all us sisters being together again. Was this breakdown inevitable?”

The sister’s reunion was fun, something the 4 sisters looked forward to all year, but they all knew the darker sides of each other and inevitably the fun broke down into the old roles and habits each had developed growing up.  While this old way to cope did work it got in the way. This reversion, some might even say regression to the emotional reactivity of acting like children again was both distressing and at times hurtful. As always the triangles formed.

From a clinical viewpoint as I listened to my client describe what had happened at the reunion I was not surprised. As I have known for some time the basic stable unit of human interaction is the triangle. Murray Bowen one of the 5-6 therapists credited with the development of family systems theory in the 50’s and 60’s says:  “The  basic building block of any emotional system is the triangle.”

Many of you may be familiar with the drama triangle: That triad of roles, Persecutor, Victim & Rescuer, we so easily fall into whenever there is tension between people.  “As I learn more about this I can see that my oldest sister is often in the blaming (Persecutor)  position, somehow she expects us to know what she thinks and wants without ever having to say. I am usually in the Rescuer position soothing one or the other of my sisters after my oldest sister goes off on them.”  Over  time my client also came to see how she could move from Rescuer to Victim when 2 of her sisters joined together against her. Then she would get hurt and blaming and lash out and become a Persecutor.  This is the Drama Triangle when the tension is low 2 insiders and an outsider trying to get in and be a part of a cozy dyad. When the tension is high 1 or both of the 2  insiders want to move to the outside, hopefully more calm position.*  The triangle is the coping mechanism to discharge and displace anxiety, the anxiety that arises out of encountering another, their separateness, strangeness and difference.

Triangulation doesn’t just occur with other people, an object or a situation can also be triangled into a dyad. The most common objects to become triangled are one or the others work, addictions of any form, hobbies or recreational pursuits or a sickness, disease or condition. This object is the third silent partner that the couple argues about “He spends so much time on his work that it seems like thats his mistress and I am left here all alone.”

As I worked with my client from this family systems perspective she came to be able to recognize the triangles she was in and then tolerate the anxiety she felt if she did not engage in the old behavior. Detriangulation means to keep up direct contact with each other member of the triangle and not talk or gossip about the other not present third person. This of course is easier said than done. For my client she had to be willing to give up the power of being the understanding one, the helper to others. She was often in the rescuer position in the triangle but understood that even if that was her intention she often was drawn into the victim or persecutor roles. She would later wonder:  “How did this happen, how did I end up in this mess again”.  Only when she was able to correctly predict her old reactions and allow herself to feel and tolerate the tension of staying separate and continue to communicate with the other two members of the triangle was she free of the confines of the normal triangles she and all of her sisters had developed over the years..

*Low tension is of course relative and subjective to each dyad. A level of tension can be quite hurtful and toxic for most others to be around and be normal for that dyad. When an event shakes the stability of the couple and overwhelms their coping styles then one or the other member will seek the stabilizing of a triangulated person or object.

Tuesday, January 29, 2013

Posture & Self-Esteem

You say you feel assertive but I can tell from looking at your body that you don’t feel that way. You are trying to override with your mind the honesty that your posture cannot hide. You are scared. You lead with your chin and roll your shoulders forward. This protects your heart and shows the world you are headstrong. You are not open to new ideas and protect yourself from emotional closeness. Of course you do, that was an adaptive strategy effective earlier in your life.
How we carry our bodies and hold ourselves says a lot about how we feel. Much of the posture that we have today is not the result of proper body mechanics and functionally correct alignment. Most of our posture developed as a reaction to the emotional environment we grew up in. That posture becomes our normal way of moving through the world and stays long after the emotional environment changes. Even when our present situation is good and as adults we are more in charge our posture often does not change to reflect that. A protective body stance and dysfunctional habit patterns we learned about how to carry ourselves remain.
Wilhelm Reich (1897-1957) developed the idea of muscular armour: the expression of the personality in the rigidity of the body. His writing influenced many body workers and psychotherapists most notably Alexander Lowen (Bioenergetics), Arthur Janov (Primal Therapy) and Fritz Perls (Gestalt Therapy). Counseling with someone trained in posture and how it affects self-esteem can be transformative. At Counseling on Burnside together
with Backs on Burnside (A Chiropractic and Massage clinic) we take a look at the whole person and not just the content of their issues.

Tuesday, January 15, 2013

Perpetual Anxiety

“I can’t believe how tense my muscles are when I tune in and do a body scan like you taught me.”  My client was reporting in on the body awareness focus that is part of our clinic. He had no idea prior to coming in how tight certain muscle groups were. What he didn’t know was that without thinking about it he was acting on a biological imperative.

“We have evolved into a species prone to anxiety.”  This quote caught my attention at a recent workshop my wife Gail Karvonen D.C. managing chiropractor for Backs on Burnside and I attended on:  The Immune System:  The Mind-Body Connection Who Gets Sick and Who Stays Well.  The context for this quote was that through the process of natural selection the individuals who survived were the ones who paid attention to their fear. Individuals who did not pay attention to their fear often did not survive long enough to have children. It isn’t just a habit that we feel this urgency to act on our fears. To feel fear and act is more of an instinctual response. We are hard wired to notice and act on our fears.

We live in a world that has many triggers for anxiety. The speed at which we transport ourselves and the crowded environments many of us live in all demand our attention. In all the information we process there are many cues to trigger anxiety. Anxiety while not always fear is a signal to pay attention to our feelings and do something. How we handle our emotions and the emotions of others around us will be determined by how we handle the anxiety we feel.

It was no wonder that my client was feeling so tense and had developed pain and tightness in his particular tension carrying zones. What he was learning at our clinic was putting him back in charge of his body and giving him some ways to deal with his anxiety in better ways. For the world we live in anxiety management is a necessary skill. To effectively manage anxiety we need 3 things:  a way to recognize anxiety and differentiate it from other feelings, a regular practice time to decrease anxiety and new habits to replace old habitual unhealthy ways we deal with anxiety.

When my client and I first laid out a plan for making lifestyle changes he was excited and made good progress. After a few weeks he began to fall back into old habits and sabotage his recent progress. Now we were into the work of therapy, developing and making time for lifestyle changes was not enough. Together we had to look at the secondary gain he received from engaging in his old unhealthy habits. In his case he needed to join a group to use the support, feedback from others and accountability to sustain the changes he wanted to make.

We all have found ways to manage what seems like our perpetual anxiety. What matters most is how do these ways serve us and those we care about long term.  Are we meeting our greater goals or do we overeat, use other substances, excessively worry and attempt to control things we have little or no control over. How are you doing with implementing the 3 strategies to effectively manage anxiety?

Monday, January 14, 2013

Breath, Posture and Self-Esteem

“Do you know how you are sitting, especially your posture? ‘Yeah, I am curled in.’ You are rounding your shoulders & protecting your heart. So, what would it be like to repeat to the group what you said but put some more breath into it and open up your posture?” As she does this my client reports she feels more confident and has a stronger voice. It is the effect on the group members that is most profound. “I felt more emotionally connected with you.” “I felt what you said rather than just agreeing with what you just said.” Just a slight change in posture and awareness of breath translates into an immediate effect.
Breath is the link between the conscious and the unconscious. When we don’t focus on it breathing is automatic and happens without thinking. When we focus on our breath we notice more, we link with our bodies. In Gestalt therapy we call this breath and body focus, proprioceptive awareness. Breath awareness is the link to the unconscious, to knowing more about ourselves right now. All it takes is focused attention to become aware of the chest, are we breathing freely? Where in our lungs are we breathing? Are we narrowing our chest? Lower lobe breathing is relaxed and most efficient. Breathing in the back lower lobes gives us more power to bicycle up a hill or confront a bully. What does our normal posturing say about our self-esteem? I could say a lot about that but it is best to find out on your own. Messages we hear from others don’t have anywhere near the power of direct experience.
At Counseling on Burnside we focus on process and experimentation. Breath awareness coupled with attention to our posture can have a profound effect especially as we practice the lessons learned during therapy in our daily lives. We can change habit patterns moving from a defended posture to one that is more open, effective and powerful.