by Diane Boyden-Pesso, PBSP Co-Founder
When I begin to work with a client there is the initial stage where I find out why the client is in PBSP and what they hope to get out of it. In order to do good work the client must be wanting to get something, he or she must be motivated to change. This is the ground level that is necessary. I also want to be sure that we are both working towards the same goal with a client.
When I start explaining structures to a person I speak of it as being their time. I tell them that PBSP can help them look for root causes of emotional problems and that they will be able to do something about those problems with the assistance of the group.
When a person who is working mentions a body feeling I first look to see if there is a real physical reason for that or if there is a real emotional reason which would show that the body feeling is actually appropriate, not a malfunction.
I listen to what the client talks about and I also note whatever else seems to show up in their bodies. I listen to the emotional tone of their voice.
My goal as a therapist is to make sure that the client works in PBSP from where he really is, what is really important and real, and not work on something that he or she may have decided in advance intellectually that it would be good to work on. We have to work on what is valid and spontaneous at the moment.
Clients will give feedback about things they have felt in the recent past and that they feel at the moment. This information is useful because it helps me assess whether the feelings are just a phenomenon of the moment or if they are part of a larger pattern extending over time and therefore more important. All this helps me to assess how important it might be to work on the different things that the client has talked about.
Throughout a client’s structure time I try to keep as much as possible an overall awareness of their conscious and unconscious emotion. This gives me indications on what issues the client may want to work on, what age levels might be appropriate, and so on. As I observe the client I am thinking, “why have these emotional patterns evolved, what could have caused them? Who wanted him to act in this way? At what age would this have happened?”
But I let the client, as much as possible, take the lead in finding the direction of the work. I wait to see where he wants to go next.
I may ask clients questions about things they are talking about. Also, I may point out things I am observing in their bodies. This lets them see it, too, and evaluate whether it is a realistic body state or something unnecessary. From that point they can go on and do something about it. However, it is important to make sure that we are both in agreement that these feelings are unnecessary and inappropriate. Thus, part of my role is to educate clients or make information available to them about other things that are happening in their bodies that they might not be aware of.
Next, I ask clients the reason why a person might feel these things. This helps the client to further explore the roots of his feelings. I may give the client alternative hypotheses about why a person might feel such things. This may get them to start thinking.
Whenever a client mentions an idea, feeling, metaphor, and so on that seems important to me I will follow up on it with questions to get the client to explore it further. When I give a suggestion like this I watch the client’s reaction to it. This will give an indication about whether it is important. Also, they give me feedback directly on it.
When a person describes in words what they feel their body is doing this also gives me clues as to how they feel. For example, someone talking about holding their feet may say, “When I take over my foot.” There are many ways he could describe this action and they would imply different intentions and feelings.
Sometimes people will give a report on a physical symptom (i.e. they have cold feet). This usually shows how their bodies have handled objectionable feelings. It may go in two ways; the body can shut itself down in the attempt to prevent action by a certain part (i.e. cut off circulation, make the body part cold) or there may be tension in the part of the body that wants to act on the emotion. I look for what stands out in a person’s body feelings as unusual.
Sometimes a client may talk about several different feelings that could lead him or her to work in different directions. I try to assess which seems to be the most important and which one we should follow to work on. may start to explore a person’s body emotion before I have a clear idea about where it comes from or what it means. I won’t yet have a scenario for it. This is exploratory work. We may not work it through in that session or even locate the origin of the impulses of that behavior. But it will be good exploratory work which will lay the groundwork for future work. And during the exploratory work we will provide satisfactory interaction for some needs.
As a client mentions an important feeling or need I prefer to work on it right away and do a structure about it or perhaps a mini-structure to take care of it. I do this rather than let the client talk about a lot of different needs for awhile and then at the end decide which one to work on. I do this because with each need expressed the body chemically gets prepared to act. It is not good for the body to get overloaded with unmet needs and the chemicals that have been released.
Also by suggesting that we do something right away to help a person when they express an emotion it shows that I am in alliance with the child in the person. My natural concern for the child in the person is demonstrated by my suggestion. When I hear them describe the negative historical experiences they have had and want to work on I sometimes suggest they could have the converse of that experience. I describe what ideal figures would have done in that situation.
I sometimes tell clients that I am an ally with their bodies and their unconscious emotions. I tell them I might not necessarily ally with what they say they want. This warns them that I won’t always agree with what they think is best for themselves. They may say they want something, but I might see that their bodies want something else. This is part of my contract with them. I am not going to settle with what superficially the client says and thinks. I am on the side of their bodies which is the nearest thing to their basic true self.
With a new client I sometimes offer them the possibility of a setting within which the memory of which the person spoke can be re-felt or they can come more fully into contact with their feelings. I will suggest the ideal figures in that memory setting, so that they have the possibility of getting the alternative emotional interaction that they need. The availability of the ideal figures sets up a safe environment in which they can explore their old feelings and needs because it gives them the promise of satisfaction.
I may give clients the suggestion, when they are about to begin a structure, that they close their eyes and try to remember as vividly as possible the original situation. They should try to see and feel it again. Once they get the feelings going they can open their eyes and use the accommodators. This is a technique for increasing the intensity of their feelings.
When setting up an interaction with negative figures I suggest that clients try to place them around the room and in relationship to themselves in a way that reflects as closely as possible the way it occurred in real life. I also suggest they use visual stimuli which are similar to real objects in the actual situation. For example, using a blanket over one’s head to symbolize a child’s woolen hood. As far as possible I try to get them to choose neutral objects with no present-day associations.
Before beginning interaction with negative figures sometimes I make sure that the adult part of the client knows that there is alternative positive interaction available. They can then tell this later to their own child self. In this way I can avoid stepping into a person’s structure to intervene. This allows the client to conduct more of the therapy himself.
It would be best if the child self asks for the positive alternative rather than the adult self asking. It is hard for clients to get to the point where they can be the vulnerable child.
Sometimes I may suggest in the middle of a structure, alternative, perhaps more effective, words and actions for accommodators.
As the client works I check to see their reactions to the accommodator. I assess whether the client has fully expressed his or her feelings and whether there might be more to go. I may suggest that they explore the remaining feelings and find out where they come from.
If a client does not look fully comfortable, then I look for signs of unconscious emotional needs for interaction. I may suggest that the person try something out or I may just point out what I am observing in them. (ex. holding onto himself, D. suggests he hold on to his ideal father)
(Theory. On grieving the death of an important figure. It is important to grieve fully, but people will have difficulty really moving on until they deal with all the unmet needs that are left with no hope of fulfillment from the person who has passed away.)
When a person says they wished something might have happened or wanted something from a person that they could not get I ask them why they would not get it. This brings up the context of the original negative interaction. It also brings up the need and shows what was lacking in the original person. I often have positive accomodators say to the person, “If I had been there then, I would have given you (whatever the person has just mentioned.)
Clients have to fully experience their grief about not having been treated well before they can go on to receive the positive interaction. If a person seems to be stuck in the grief, I will make suggestions about the ways an ideal figure could meet those needs.
The most crucial part of the work is getting in contact with the needs, feeling them again, and then expressing the needs to an “alternative positive figure, which is someone new in that role. This means that the person has to stop hoping that it will be redressed by the original person and that they are now willing to receive from a new figure in that role.
Clients sometimes as they explore movements and feelings may comment with their adult part about what is going on inside. They give the therapist frequent reports on a today level while they are experiencing the work on a child level.
The group gives the client a safe today level environment where he or she can trust and try things out.
Sometimes I suggest to clients that before they begin a particular type of accommodation, particularly limit work, they try it out with their adult-self to test the strength of the role figures before they go into their child levels.
You can use accomodators as the physical extensions of the ideal figure.
(Theory; sometimes things that appear to be sexual in real life are actually the result of infantile needs, for example, wishing to go back into the womb.)
I listen to people’s emotional tone and sounds more than their words.
When I observe clients’ acting I try to think at what point in a person’s history would this type of action have occurred, at what age level is the body acting out? I also see whether what the person is talking about is in synch with their body emotions. I also think about the logical appropriate setting and age for the movements I have been observing.
In PBSP the opportunity for interactions is offered for every feeling that comes up. The interaction is with a person or an object. This focuses the person’s feelings. Otherwise they might go anywhere in the room or in their own minds.
The adult part of the client tells the accommodator what to say and do, and then the child part of the client hears it and believes it.
We are constantly working with role clarifications. If a client mentions that they have had a need met or want a need met by one type of figure when they really should get it from another figure, then I may suggest that the need be met by the appropriate figure.