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Assessing The Subconscious Mind

4/30/2015

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Projective tests are used to assess and analyze human behavior occurring on a subconscious level – to include a person’s innermost thoughts, fears, inhibitions, repressed memories, and feelings. I embrace the efficacy of projective tests being used in the assessment phase of clinical treatment, but with some reservations. Before getting into what I don’t like about projective tests, I must say this. I believe that most behavior happens on a subconscious level, much like what we see in human communication.

It is a widely accepted and validated belief that over 90% of communication is non-verbal and is expressed in the way we say things (i.e. rate of speech, tone of voice) as opposed to what is actually being said. This is to say that the messages in our communication are mainly conveyed through our non-verbal body language which stems from the subconscious mind, rather than the conscious mind – which has a filter that is able to cognitively decipher between what is morally acceptable and what is not. So a person who is angry, but is concerned about what others may think may say verbally through words, “I am not angry,” yet could be boiling with anger inside as evidenced by their non-verbal language typified by an elevated voice, sweaty palms, dilated pupils, and a slammed closet door. The unique thing about non-verbal language is that it often reveals the true meaning behind the words that a person utters from their mouth. So even in silence a person speaks.

The connection that I am attempting to make here is that the subconscious mind can reveal a lot about a person, not only through non-verbal communication, in the form of body language, but also within the context of a clinical assessment through the use of projective tests.


Before I share the drawbacks of projective tests, I must make it clear that I do understand and support the efficacious use of projective tests in therapy. I think they lend some credible information to the clinician who wants to confirm a questionable or uncertain diagnosis. For instance, if through a clinical interview, self-reports, and questionnaires, a clinician finds that their client meets the criteria for a diagnosis of schizophrenia, and the clinician wants to get a third opinion (so to speak) to validate his provisional diagnosis, a projective test (like the House Tree Person) could be administered. It provides an objective, unbiased appraisal of the client’s symptoms, something that a clinical interview and self-reports alone may lack.

However, one must be careful to not rely on the use of projective tests like the HTP alone, as the results can be misleading. Let’s say a person who presents with some symptoms of psychosis, depression, or anxiety, tries to impress the clinician, picks up a pen and paper and draws a very pretty picture to show off his artistic ability and the picture that he draws is reflective of something you may see in a Disney coloring book or the back of a cereal box. Consequently, the interpretation of the projective tests would not reflect an accurate representation of what the client is feeling on the inside because the drawing lacks the subconscious motivation and took place on a conscious and cognitive level, skewed by the client’s intention to impress the clinician.

The same can be said if the opposite were true for a client who is mentally and emotionally healthy but is inspired by “dark art” that depicts death, dying, and the underworld – characteristics that would typically be indicative of a client’s drawings who presents with symptoms of depression or suicidal ideation.

So clinicians should be mindful of these limitations when administering projective tests.

Copyright 2015 Danielle Leach All Rights Reserved


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Keyshia Cole : Dysfuntional Family Ties

4/14/2015

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I'm not much of a big fan of television, but there are a few shows that grab my attention. Keyshia Cole, an African-American R&B singer, whose life has been everything but normal decided to air her personal life story in a reality TV show in 2006 entitled, Keyshia Cole – The Way it Is. The show highlighted her experiences of being a platinum selling R&B artist and what life was like for her growing up as an orphan without a mother and father. Her biological mother, Frankie abandoned her when she was a toddler and left her in the hands of a close family friend, Yvonne, who would be her primary caretaker from age three through her adult years. Keyshia's mother Frankie, who has six other children, all from different men, struggled to find her way on the streets of Oakland, California. Since Keyshia Cole was born, Frankie has battled with her addiction to cocaine – a substance that she feels has destroyed not only her life but her ability to establish and maintain healthy relationships with her seven children. To support her addiction, Frankie took to the streets of Oakland, California, selling her body for any amount of money that could support her crack habit.

Meanwhile, Keyshia Cole had her odds stacked up in her favor, being raised by Yvonne – a woman of strong faith and determination. It was Keyshia's close attachment to her adoptive mother and loving support of her adoptive family while growing up that nurtured a multi-million dollar earning star.

After two seasons of her first show, The Way it Is, Keyshia Cole parted ways with her family to start a family of her own. In the second stage of the Family Life Cycle, referred to as “Coupling,” Keyshia met, who she thought was her true love, Daniel Gibson (a former NBA basketball player). They took to the traditional approach and got married, then gave birth to a healthy baby boy who Keyshia named after her husband, Daniel Gibson. With all positive intentions, Keyshia and her husband Daniel decided to go public with their marriage and created a TV show entitled, Family First (2012) which only ran for one season before getting canceled.

Tension surrounding Keyshia Cole and her husband Daniel’s wedding began to surface rapidly. Her close sister, Neffe, who also had a feature role in Keyshia’s first reality TV show entitled, “The Way it Is” did not show up to Keyshia’s wedding. Keyshia, being the youngest child in her family, also considered the “golden child” because of her rise to fame, grew very angry and distant toward her sister for not accepting her wedding invitation. Keyshia, who is used to the spontaneity of booking flights at last minutes’ notice for shows and performances across the country sent an invite to Neffe and her husband, who are raising five children of their own, only a few days before the wedding. With little time to make travel reservations, it became obvious why Neffe and her family did not show up.

But fans of Keyshia Cole, like myself, would venture to say that it was more than just a late wedding invitation that caused a divide between Keyshia and her biological sister Neffe. When you look back at the second season of Keyshia’s first show, The Way it Is, you will see that Keyshia Cole took on a motherly role by inviting her mother Frankie, her sister Neffe, and Neffe’s four children at the time, to move in and live with her. After months of living under the same roof, the tide began to turn and Keyshia, not wanting to put up with the stress from being the hero of the family decided to evict her sister and her four children. As an alternative, Keyshia Cole provided her younger sister, Elite with a brand new house, paid for in full.

Fast forward several years to the present day and you will see Keyshia Cole starring in yet another reality TV show, self-titled, Keyshia Cole: All In. Only six episodes into the first season, and you see a family that is dysfunctionally functional. It’s a group of people with their own personalities enmeshed together trying to create a prototype of the ideal family, yet struggling with their own insecurities, fears, and life challenges. In the show, Keyshia Cole and Daniel are divorced and are co-parenting an attention seeking and needy toddler. Her mother, Frankie, is a recovering alcoholic, but is still using cocaine. What appears to be the story of a successful R&B star turns out to be an uncovering of a woman who is still struggling to find her own identity and happiness within the context of a family who is highly dependent on her for their own success and happiness. The show is a picture perfect idea of what a family looks like that has suffered generations of dysfunction for so long that it’s almost invisible to their own naked eye. I will continue to tune in and watch the outcome of Keyshia’s story as it is one that many young women and men across America can identify with.  


Copyright 2015 Danielle Leach All Rights Reserved
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Treating Adult Children of Alcoholics

4/6/2015

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 Published: April 6, 2015
Written by: Danielle Leach


            Treating individuals with alcoholism can be a lengthy and challenging process. Counseling families where there is chemical dependency is a much more complicated and extensive process that requires an intimate look – not only at the relationship an individual has with a substance, but also a deeper look into the impact the substance has on the entire family system. From my research, I have learned several eye-opening facts about alcohol and the detrimental impact it can have on an individual and subsequently the children of the individual with alcoholism that I explore within the context of this article. These revelatory truths are pertinent for any clinician working with recovering alcoholics, especially mental health counselors and it’s important to first dispel the myths concerning addiction recovery, beginning with the assumption that once an alcoholic becomes sober, the rest of the family will get better automatically.

            It goes without saying that what affects one person affects those around them. In the context of addictions counseling, this anecdote rings true. When a husband leaves work and stops at a Seven Eleven to pick up a 12 pack of beer, goes home, flops down on the couch and immediately cracks open one can after another until the whole pack of beer is no more, it will inevitably raise a concern. His wife, who is clean and sober and expects her husband to have enough ego strength to resist temptation and deal more effectively and responsibly with the stress from his workplace, ignores her husband’s behavior and goes into the other room to watch TV. Their three year old son and one year old daughter trail behind the mother, hollering and screaming. After chugging the last can of beer, the husband yells, “Honey, get in here.” The wife, while in the other room, sighs and wipes a tear from her eyes and kisses her son and daughter on their foreheads. The husband stands up, bumps the table, knocking half of the cans onto the floor and pushes open the bedroom door and screams, “Bitch, didn’t I tell you to get in here!” The wife, tells her son and daughter to go into their bedroom and then bows her head. The next 10 minutes, the husband spends yanking his wife by the hair and punching her in the face. Familiar with her husband’s uncontrollable behavior, the wife stands up from the bed, goes into the bathroom and washes the tears from her face. Looking into the mirror, she notices a purple patch around her eye and a busted lip. She pulls her scrunchie out of her hair and notices a chunk of her hair missing from the front. She turns off the light, walks silently into her kitchen and pours her a glass of wine. Her husband snatches up his keys from the table, and before stumbling out of the house says, “Be back babe. I’m going to the store for another pack of beer.” After the keys are in the ignition and the sound of the engine vibrates through the front door, their son and daughter run outside of their room, jump on the couch with koolaid smiles plastered across their faces and ask, “Mommy, where is daddy?”

            “He’ll be back,” the mother sighs while sipping her glass of wine. Although this scenario is a fictional story I made up, it is the reality for many families living across America and serves as a template for explaining the dynamics of the impact alcoholism can have on an entire family system. So if what affects one person affects everyone around them; in theory, when one becomes sober, it should not be assumed that the rest of the family will magically and automatically go back to normality. It is important for those working with people of addictions to understand how addiction not only affects the user/abuser, but also how it affects everyone around them. Nevertheless, understanding the “why” of addiction can shed some light in understanding the “how” of treatment.

            As Dr. Tian Dayton so eloquently put, “People who use drugs and alcohol are often times attempting to numb disturbing emotional and psychological pain that they don’t want to feel” (2010). So typically, the more a person drinks, the more pain they’re trying to cover up and heal from. As in the above scenario, on the surface, the husband’s drinking can be attributed to work related stress. But if a skilled psychologist or psychotherapist were to take a deeper look, he/she may find that there is some childhood trauma in the husband’s history that has impacted his ability to cope and deal effectively with stress. In her article, “The Hidden Pain of Addiction,” Dr. Tian Dayton explains how trauma leads to addiction: “Addiction engenders trauma symptoms and trauma symptoms engender addiction.” So that a person who experiences some type of trauma is at an increased risk for developing an addiction. If he or she doesn’t become addicted to alcohol, he or she will seek out other forms of self-medicating (i.e. food, sex, money, or a hybrid combination of the three) (Dayton, 2010).

            Considering the above scenario, based on statistical analysis of families with alcoholism (as it relates to the cycle of addiction), the son and daughter are at an increased risk of developing an addiction. According to the National Council on Alcoholism and Drug Dependency, more than 78 million Americans or roughly 43 % of the adult population has been exposed to alcoholism in the family (Gold, Mark). 26.8 million of them are children (Weintraub, P, 2007). With numbers as staggering as these, it is apparent that there is a dysfunctional cycle of abuse at work within families of alcoholism that needs to be interrupted at the earliest stage possible.

            If the numbers aren’t enough to make you raise an eyebrow and scratch your head, take a look at the effects of what life is like for many adults who grew up with an alcoholic parent. Janet Geringer Woititz created a list of 13 characteristics of adult children of alcoholics. Here are several I found to be quite alarming: difficulty with intimate relationships; overacting to changes over which they have no control; are either responsible or super irresponsible (there’s no middle ground); are extremely loyal, even in the face of evidence that the loyalty is undeserved; are impulsive (they tend to lock themselves into a course of action without giving serious consideration to alternative behaviors or possible consequences. This impulsivity leads to confusion, self-loathing and loss of control over their environment. Then they spend an excessive amount of energy cleaning up the mess) (Weintraub, P, 2007).

            On AdultChildren.org’s website, you can find a laundry list of 14 traits of an adult child of an alcoholic. I have listed several here:

  1. We became approval seekers and lost our identity in the process.

  2. We either become alcoholics, marry them or both, or find another compulsive personality such as a workaholic to fulfill or sick abandonment needs.

  3. We have overdeveloped sense of responsibility and it is easier for us to be concerned with others rather than ourselves; this enables us not to look too closely at our own faults.

  4. We became addicted to excitement.

  5. We confuse love and pity and tend to “love” people we can “pity” and “rescue.”

  6. We have “stuffed” our feelings from our traumatic childhoods and have lost the ability to feel or express our feelings because it hurts so much (denial).

  7. We judge ourselves harshly and have a very low sense of self-esteem.

  8. We are dependent personalities who are terrified of abandonment and will do anything to hold on to a relationship in order to experience painful abandonment feelings, which we received from living with sick people who were never there emotionally for us.

  9. Alcoholism is a family disease; and we became para-alcoholics and took on the characteristics of that disease even though we did not pick up the drink.

  10. Para-alcoholics are reactors rather than actors.

     

    Conceptualizing and treating families with alcoholism from a systemic point of view allows for the clinician to work from the ground up, addressing issues from childhood that could have played a role in developing the addiction and therefore assessing and addressing the risks for children of alcoholic parents, in preventing them from developing an addiction. Looking at alcoholism from a family systems perspective can also be helpful in treating the addicted user by bringing the other affected members in and showing them how their own behavior can contribute to the identified patient’s addiction. After all, what affects one of us, affects all of us. So alcoholism isn’t just a problem for the person who goes to the store and buys a pack of beer twice a day. It’s a problem for all of us on a national and global level as well.

    According to The National Institute on Drug Abuse and the National Institute on Alcohol Abuse and Alcoholism, the annual costs of alcoholism and alcohol abuse to alcoholics/abusers and to society is a whopping $148 billion (Jones, A.S. 2001). Generationally, the effects of alcoholism on children of alcoholics can include poor school performance, truancy, repeating grades, and dropping out of school. In turn, these behavioral problems can have a direct effect on the child’s future educational attainment, job opportunities, and wage rates. These in turn, will have a negative impact on the future financial well-being of the child and the child’s future family. On a national scale, the impact of alcoholism in families can have an effect on work productivity costs thus increasing tax revenues (Jones, A.S. 2001). So before we can point the finger at an alcoholic, we should first consider the high probability that he or she may be a product of a family with alcoholism and understand that an alcoholic’s decision to drink excessively is a systemic problem that must be addressed on more levels than one.

     

     

    References

     

    Dayton, T (2010) The Hidden Pain of the Addicted Family

    Gold, M.S. Children of Alcoholics

    Jones, A.S. (2001) COAs and Economic Costs

    The Laundry List www.adultchildren.org

    Weintraub, P (2007) A Toxic Brew

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