Dramatherapy and Destructiveness

Creating the Evidence Base, Playing with Thanatos

Ditty Dokter, Pete Holloway, Henri Seebohm, Ditty Dokter, Pete Holloway, Henri Seebohm

• Editorial: Routledge
• Año: 2012
• ISBN:
  9781136661495
• Edición: 1
• Categoría: Psicologia
• Categoría: Consulenza psicoterapeutica

Dramatherapy uses the healing aspects of drama and theatre as part of the therapeutic process and is increasingly required to supply evidence of its effectiveness. This book aims to provide an evidence base for practice with destructive clients, and raise the profile of dramatherapy as a distinct therapeutic intervention in this field.

Dramatherapy and Destructiveness discusses working with those suffering from conduct disorders, mood disorders, schizophrenia and personality disorders. Divided into three parts, topics of discussion include:

• theory and research underpinning the understanding of working with destructiveness
• in-depth case studies of dramatherapy with a wide range of clients
• analysis and evaluation of the evidence base for dramatherapy with these clients
• guidelines for best practice

Dramatherapy and Destructiveness covers a wide range of client groups, settings, methods and therapeutic approaches. As well as being an invaluable resource for dramatherapists, this book will be of interest to other therapists, health professionals, social workers, teachers and artists.

Part I

Destructiveness and Dramatherapy

1

Understandings of Destructiveness

Pete Holloway, Henri Seebohm and Ditty Dokter

Destruction, hence like creation, is one of Nature’s mandates.

(Marquis de Sade)

Brief Overview of Chapter

This first chapter aims to explore historical and contemporary constructions of the phenomenon of destructiveness as it is manifested in the psyche and in wider culture. The chapter will provide a critical commentary on psychodynamic, cultural and artistic perspectives in an attempt to develop a lens through which the subsequent clinical chapters may be viewed and appraised.

Introduction

‘Destructiveness’ as a word – a linguistic signifier of socially constructed and culturally negotiated meanings – has an apparently straightforward denotation, thus:

1. The quality of destroying or ruining.

2. (psychology): the faculty supposed to impel to the commission of acts of destruction; propensity to destroy.

(Online Medical Dictionary 1998; www.mondofacto.com)

Were we to interrogate the word a little further we would see that ‘destruction’ (according to Webster’s English Dictionary) is defined as:

The act of destroying; a tearing down; a bringing to naught; subversion; demolition; ruin; slaying; devastation.

(Webster 1913)

And ‘to destroy’:

To damage something so badly that it does not exist or cannot be used.

(Cambridge Online Advanced Learner’s Dictionary 2008)

When we start to think, however, about destructiveness as it manifests itself in experience and behaviour, we see a much wider multiplicity of connotations than these relatively straightforward definitions indicate. Thus, there are indeed destructive forces and acts of destructiveness – such as tsunamis, earthquakes, terrorist attacks and successfully executed murders and suicides – that do ‘damage something so badly that it does not exist or cannot be used’; but there are also other acts of destructiveness which damage, maim and traumatise without resulting in the complete destruction of the recipient, and indeed other manifestations of destructiveness which remain in the darker phantastical recesses of our psyche, barely causing a ripple on the surface of our intentional behaviour.

For the purposes of this chapter, and the clinical discussions which follow, it may be more accurate to define ‘destructiveness’ not by its effect, but by its internal momentum. Thus, a typhoon, for example, has such momentum of destructiveness independent of whether its course takes it through a building. Similarly, the destructive potential of the human psyche has an internal energy regardless of its effect if and when enacted upon the external world. However, in some of the clinical discussion which follows such destructiveness has resulted in real catastrophic effects, such as arson, homicide and suicide; but in others of the clinical settings discussed it is the immanent energy of destructiveness that carries potency, rather than the actuality of destructiveness having totally obliterated something.

We will therefore consider ‘destructiveness’ as primarily a propensity within the psyche, and within relationships between people. This propensity may at times be clearly manifest in acts of aggression, violence and verbal abuse; at other times this propensity may inform, or drive, our external behaviour but is not necessarily directly expressed as a destructive act, such as sulking, boredom or withdrawal. In other contexts such energy may bubble away at a truly subterranean level – experienced as far too potent and toxic by the individual to be ever given vent – and what we may see on the surface is a ‘passive-aggressive’, overly-compliant or completely dissociative response to the external world.

Seen thus, as an internal energy or driver of external behaviour, we may attempt to locate destructiveness exclusively within the Freudian notion of ‘the death instinct’, later referred to as Thanatos by Freud’s successors (Jones 1957: 295). Many theorists and commentators have discussed the human being’s potential for, and enactment of, destructiveness through just such a psychoanalytic frame.

Psychoanalytic Understandings: Destructiveness and the Death Instinct

The psychoanalytic tradition suggests that although the most recognisable form of aggression is violence towards self or other, unconscious aggressive processes also find many disguises and may emerge through treatment as underlying phantasies. This is explored more fully by Perelberg (1999) in her chapter ‘A core phantasy in violence’ in Psychoanalytic Understanding of Violence and Suicide. In the first chapter to her book, ‘A review of the literature and some new formulations’, Perelberg states:

. . . the term ‘aggression’ has been used to cover a wide variety of behaviours, from self-assertion to destructiveness. The various theories of aggression cover the plurality of psychoanalytic formulations, from drive theories to ego psychology and object relations theories.

(Perelberg 1999: 20)

The drive theories that Perelberg is referring to begin with Freud, who believed that the human condition was made up of a set of ‘drives’ that were mobilised by either the ‘libidinal instinct’ (Eros), whose direction was towards life, or the ‘death instinct’ (Thanatos), whose aim was the extinction of life in order to reach ‘Nirvana’, essentially, destruction of the self (Freud 1920). He asserted that it is the fusion and/or de-fusion of these two instincts in operation – the struggle between them – that lies at the root of all mental conflict. The ‘death instinct’ came from Freud’s struggle to understand the human compulsion to repeat destructive patterns and it helped him to contextualise the resistances and negative therapeutic reaction in the analysis. Freud came to believe that aggression could be coupled with both of these ‘drives’, and saw that aggression had the potential to be both healthy and destructive: healthy in the context of being an impetus towards maturity and sexual expression, and destructive when assigned to the self-preservation instincts, particularly in a hatred of anything that was perceived to threaten the equilibrium of the psyche. Aggression, when applied to the ‘death instinct’, inevitably manifested itself destructively towards others and the self (Harding 2006: 6).

Melanie Klein developed ideas about the death instinct from her clinical experiences of children who presented a constant struggle between destroying and preserving their ‘objects’. Comparable to the life and death instincts, the life-sustaining state of the psyche is the depressive position and the psyche’s tendency to disintegrate is the paranoid schizoid position. For the healthy development of infants, they need to move from one position to the other, from the paranoid schizoid position to the depressive position, although the residue of each position is retained and can be returned to at various points in life.

When the infant is in the paranoid schizoid position, Klein believed that terrible anxieties are experienced, which threaten annihilation (Klein 1946). In order to defend against these feelings, a ‘splitting’ takes place, during which:

. . . part of the death instinct is projected into the external object, which hereby becomes a persecutor, while that part of the death instinct, which is retained in the ego, turns its aggression against the persecutory object.

(Klein 1946)

Rosenfeld adds that at the same time:

. . . the life instinct is also projected into external objects, which are felt to be loving or idealized . . . the idealized and the bad persecuting objects are split and kept wide apart . . . simultaneously the splitting of the self into good and bad parts takes place. These processes of ego splitting also keep the instincts in a state of de-fusion.

(Rosenfeld 1971)

Projective identification takes the projection process one step further, where unwanted aspects of the self are not just projected onto, but into the external object. In projective identification the individual enables the other person to feel (emotionally/physically) the feelings which s/he cannot tolerate to bring into consciousness (Jenkyns 1996).

In looking at the literature, it is possible to see that some psychoanalysts adopt the ‘death instinct’ as an integral part of what informs them theoretically, whilst others, such as Robert Royston, suggest that the death instinct should be viewed with suspicion and used only as a metaphor. He describes it as ‘a necessary fiction’ and concludes:

Even if there is constitutional destructiveness, another level exists. Here destructiveness operates powerfully and its original impetus towards self-damaging behaviour comes from toxic experiences with caretakers.

(Royston 2006: 36)

Towards Attachment Theory: Destructiveness and Development

Winnicott would agree with Royston’s argument that the ‘abusive or negligent childhood object’ is the source of toxicity. He traced most origins of clinical manifestations of destructive tendencies to emotional deprivation in infancy and early childhood. In developing Klein’s idea of object relations, Winnicott saw aggression as something that we are born with. However, he departed from Klein in that he viewed aggression as a way of defining what is self and not self. He saw it as representing the dramatisation of inner reality, which is experienced as too bad to tolerate. When children have no space in their personality for containing the aggression and destructiveness, their capacity for playing is replaced by acting out (Winnicott et al. 1984). By acting out the destructive role, the control that they are unable to find internally will be enacted by an external authority. In this way, Winnicott believed that a delinquent act was the expression of a desire to return to the moment of deprivation in an attempt to experience the good object providing external control and security.

In her book From Pain to Violence, De Zulueta welcomes the break that attachment theorists made from a theory based on instincts to one based on relationships. She describes the Freudian instinctual theory as ‘untenable’ (De Zulueta 2006: 120), although she begrudgingly acknowledges a need for it to be understood. She places object-relations theory as the founding platform for attachment theory and, in keeping with Winnicott’s view, emphasises that ‘the experience of deprivation of our basic attachmentrelated needs leads to destructiveness’ (De Zulueta 2006: 54). In her review of psychoanalytic theory, she pays particular attention to Fairbairn, who openly rejected Freud’s instinct theory, believing that the human is ‘essentially object-seeking, that is to say relationship-seeking, and not pleasure-seeking’ (De Zulueta 2006: 128).

When looking at different attachment patterns, in particular disorganised attachments, De Zulueta relates the ‘splitting’ identified above as seen in people suffering from a range of dissociative disorders ranging from borderline personality disorder to dissociative identity disorder (De Zulueta 2006: 97). Skogstad, who works with people with severe personality disorders (SPD), identifies that these patients tend to use action instead of thought, actively getting rid of thoughts or feelings that are experienced as too painful by violently projecting them outwards. He asserts, as cited by Welldon:

. . . more often than not these actions are of an aggressive and destructive kind. Many patients turn their destructiveness towards themselves and their own bodies, which they cut, burn, bleed, starve or overdose. Others turn their destructive action towards other people and become, as offenders, abusive, sadistic or violent. Some do both.

(Welldon 1988)

A recurring theme from such attachment-based theorists is that destructiveness is not so much the expression of an innate drive, more that it has its genesis in failures of the attachment figure or primary-care giver to contain, mediate or de-toxify aggression and frustration in the developing child. Alternatively, the experience of profound neglect or trauma at the hands of the external world may also result in the developing child’s inability to ameliorate its own aggressive responses. The context of destructive phantasy and behaviour subtly shifts within this theoretical perspective from one which is purely internal to become a relational phenomenon.

In their research conducted over the last decade, Fonagy et al. have attempted to close the circle between external experience and the internal working of the brain and functioning of the psyche, by linking attachment experiences with the neurochemical development of the brain. Their research suggests that disruptions in attachment have a profound developmental effect on the internal communication pathways of the brain as an organ, as well as on the psyche as a relational entity. Thus they have discerned, through sophisticated neuro-imaging techniques, significant changes at the level of receptor cell sensitivity and response to certain neurochemicals. This, in turn, they suggest, affects the individual’s ability to mentalise, by which they mean reflect upon, process and digest relational interactions and emotional responses. They conclude that much aggressive, destructive and ‘anti-social’ behaviour is prompted by failures in the ability to mentalise ‘affectivity’, which Fonagy et al. (2002: 15) define as ‘the capacity to connect to the meaning of one’s emotions’. Their research also suggests, however, that positive therapeutic relationships may in turn help to remedy and rebuild some of the disruptions in neural communication pathways and hence develop a capacity to mentalise.

The ‘Problem’ of Destructiveness

Common to all the commentators and theorists discussed so far is the sense that destructiveness per se is an essentially negative force, construed as a problem of human existence, whether it is borne of a failure of the ego and super-ego to regulate innate drives, a failure in the internal world to build object constancy around a ‘good enough’ introject, or a failure in neurochemical and synaptic development. In such psychoanalytically-influenced epistemology, then, destructiveness is seen primarily as an undesirable, primitive phenomenon which should be ‘regulated’, ‘developed beyond’ or ‘treated away’. There is, however, another tradition inspired by the writing of Jung, which, although it had its roots in the early psychoanalytic movement, made a significant break with its intellectual progenitors and spawned ‘analytical psychology’. Jungian and ‘post-Jungian’ (Samuels 1985) theories illuminate a subtly different, yet significant, perspective on the phenomenon of destructiveness.

Analytical Psychology: Jung and the Shadow – Towards Integration

It is not our intention to revisit the theoretical and technical disagreements that gave rise to the hotly contested schism in early psychoanalysis – this has been authoritatively discussed elsewhere by commentators such as Samuels et al. (1997). Rather, we focus our discussion on Jung’s notion of ‘the Shadow’ archetype, its relationship to the ‘collective unconscious’, and Jung’s proposition that it is only by integrating ‘Shadow’ material that the psyche can achieve ‘individuation’.

Jung’s simplest definition of the ‘the Shadow’ is that personified structure of the psyche which contains ‘the thing a person has no wish to be’ (Jung CW16, 1966: para 470). He contrasts this with his own concept of persona: ‘what oneself as well as others thinks one is’ (Jung CW9 1975: para 221) and develops his definition thus:

The Shadow is that hidden, repressed, for the most part inferior and guilt-laden personality whose ultimate ramifications reach back into the realm of our animal ancestors.

(Jung CW9 1975 ii: para 422)

Jung, like Freud, saw the evidence at play in the unconscious of destructive impulses and instincts, but as well as viewing such a propensity as intrinsic to the personal unconscious, Jung proposed that it was also formed and informed by the collective, ancestral and transpersonal unconscious – that sum total of human evolutionary experience which leads us towards combativeness, defensiveness, fear of ‘the other’ and of the external environment. For Jung this potential destructiveness is (to borrow a phrase from Irvin Yalom) a ‘given of existence’ (Yalom 1980: 5). In and of itself such potential is morally neutral and essentially inert. It is only through the active psychic mechanisms of repression and projection that its potential finds a devastating realisation. Once repressed, and confined to ‘the Shadow’, destructiveness or – as Jung refers to the phenomenon in a number of his post-World War II writings – ‘evil’ (Jung 2002) appears to draw nurture ...