Conceptualisa-on and Treatment of Low Self-Esteem Transac-onal - PowerPoint PPT Presentation

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

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.

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.

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?

Take an “improve your self-esteem” sweet! Exercise – swap roles. Self-Esteem Sweets • Work in groups of twos or threes where you are sat. • Offer your neighbour a “self-esteem improving” Self-Esteem sweet and “sell” to them all Mix 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.

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?

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)

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)

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

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

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.

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.

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

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

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.

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.

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?

The Core Self. C 1 P 0 A 0 C 1 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

The “Double Engine” Model • Work by Melanie Fennell

Early Early Life Experience – Childhood origins Events, rela-onships. living condi-ons. Early transferences – Twinning, Mirroring, Idealisa-on A^achment pa^erns and processes 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, Core stupid 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

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 Nega9ve Predic9ons – LOOKING FORWARD LOOKING BACKWARDS What if’s? Rumina-on. Feel down. What if I’m not done in -me? Do nothing. What if it’s not good enough? Feel hopeless. Anxiety Hot, heart racing, feeling sick and anxious. Unhelpful Behaviour Self-cri9cal thoughts Avoidance. Now look what you’ve Procras-na-on. done! Perfec-onism. You are an idiot! Racket Behaviours. How could I be so stupid! CONFIRMATION OF THE BOTTOM LINE Things crash and burn. What else did I expect?

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?

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”

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?

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.

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