Sex Addiction by Johan Obbes

Sex addiction is an illness of escape, a repression mechanism and a mental illness which we often find in  society, yet it is still widely misunderstood. Like all addictions its goal is to medicate, ignore reality or serve as an alternative to allowing oneself feel hurt, betrayal, worry, stress or loneliness. It is not an inborn illness but rather a consequence of a childhood trauma or dysfunctional family.

The journey for the acknowledgement of Sex Addiction (SA) has only started. Already we are seeing patients coming to treatment centre’s with SA as their primary addiction, we are finding trained and qualified SA therapists and highly successful Sex Addiction Anonymous & Love and Sex Addicts Anonymous support groups, yet the truth is that SA is still being debated amongst some professionals whether it is a real addiction or not. According to the latest DSM (Diagnostic and Statistical Manual of Mental Disorders) it has not been included as an addiction, yet the symptoms, destruction, neurological damage, and root causes are all clear indication that this is an addiction like any other substance or process addiction.

While the debate continues, it is wise for counsellors and therapist to learn more about this mental illness as we see numerous patients in our practices who are being diagnosed as bipolar, obsessive compulsive disorder or narcissistic, which are all symptoms mimicking SA but yet never being correctly treated or diagnosed as SA.

So how would one describe Sex Addiction (SA)? SA is first of all an intimacy and attachment disorder. As addiction is an indicator that the addict is trying to repress some form of hurt, betrayal, stress etc. by acting out, SA is focused on the sexualization of feelings or the distortion of uncomfortable emotions. Reality distortion starts within the family.  Addicts typically come from families in which addiction is already present. Often, parents, grandparents, siblings, or extended family members or extended family members struggle with alcoholism, compulsive gambling, nicotine addiction, eating problems, illegal drug use, compulsive sex or often a combination of addictions.

According to Dr. Patrick Carnes (Internationally acclaimed speaker and authority on addiction treatment) –as children, sex addicts grow up in environments where there is the classic “elephant in the living room” syndrome: everyone pretends there is no problem in the family although there’s a huge issue interfering with everyone’s lives. In such a situation, children learn very early with everyone pretending there is no problem and everyone pretends to avoid the painful and the obvious: to look at addiction and family dysfunction and not see it.

Sex addicts also tend to come from rigid, authoritarian families. These are families in which all issues and problems are black and white. Little is negotiable and there is only one way to do things. Success in the family means doing what the parents want to such an extent that children give up being who they are. Normal child development does not happen. By the time children enter adolescence, they have few options. One is to become rebellious or develop a secret life about which the family knows nothing. Both positions distort reality. Both result in a distrust of authority and a poor sense of self.

In the family’s rigidity, sex is also perceived negatively (children are taught that sex is dirty, sinful, bad or nasty) sex becomes exaggerated or hidden. Worse yet, the forbidden can become the object of obsession.

An important observations by most therapists are that most sex addicts come from families in which members are “disengaged” from one another – there is little sharing or intimacy. Children develop few skills about sharing, being vulnerable, or risking anything about themselves. As a result, they learn to trust no one but themselves in such families. Children who are abused or neglected conclude that they are not valuable. They live with a high level of anxiety because no one teaches them common life skills or provides for their emotional needs. Yet this is not the only cause for addiction to develop. Abuse victims (emotional, sexual, and physical) tend to distort reality and also distort the reality of emotions.

Addicts suffer from an inability to express their emotions, suffer from connecting with other people in an intimate way and have learned through time that the only way that they can connect with someone else is through a sexual manner. Somewhere through their childhood development a psychological link is made between meeting their needs and the kind of sexual arousal which eventually becomes their way of acting out. SA is not about having a high libido, or wanting a lot of sex but it is about masking an emotional need through their sexual choice of preference.

Feelings are being sexualized that has nothing to do with romance, sex or relationships. For instance an addict acts out as a loved one dies. The death of the loved one is not erotic in any way, but because the addict does not know how to express his grief in a healthy way, he acts out sexually by picking up a prostitute.

According to Dr. Carnes sex addiction is a process addiction and diagnoses can be done by evaluating the following phenomena:

1.     Recurrent failure (pattern) to resist impulses to engage in acts of sex.

2.     Frequently engaging in those behaviours to a greater extent or over a longer period of time than intended.

3.     Persistent desire or unsuccessful efforts to stop, reduce, or control those behaviours.

4.     Inordinate amount of time spent in obtaining sex, being sexual, or recovering from sexual experience.

5.     Preoccupation with the behaviour or preparatory activities.

6.     Frequently engaging in sexual behaviour when expected to fulfil occupational, academic, domestic, or social obligations.

7.     Continuation of the behaviour despite knowledge of having a persistent or recurrent social, academic, financial, psychological, or physical problem that is caused or exacerbated by the behaviour.

8.     Need to increase the intensity, frequency, number, or risk of behaviours to achieve the desired effect, or diminished effect with continued behaviours at the same level of intensity, frequency, number, or risk.

9.     Giving up or limiting social, occupational, or recreational activities because of the behaviour.

10.  Resorting to distress, anxiety, restlessness, or violence if unable to engage in the behaviour at times relating to SRD (Sexual Rage Disorder).

Specialists in obsessive-compulsive disorder and addictions use the same terms to refer to different symptoms. In addictions, obsession is progressive and pervasive, and develops along with denial; the person usually does not see themselves as preoccupied, and simultaneously makes excuses, justifies and blames. Compulsion is present only while the addict is physically dependent on the activity for physiological stasis. Constant repetition of the activity creates a chemically dependent state. If the addict acts out when not in this state, it is seen as being spurred by the obsession only. Some addicts do have OCD as well as addiction, and the symptoms will interact.

According to proponents of sexual addiction as a disorder, addicts often display narcissistic traits; these are said to often clear as sobriety is achieved, although others exhibit the full personality disorder even after successful addiction treatment.

Sex Addicts are often described sufferers as repeatedly and compulsively attempting to escape emotional or physical discomfort by using ritualized, sexualized behaviours such as masturbation, pornography, including obsessive thoughts. Some individuals try to connect with others through highly impersonal intimate behaviours: empty affairs, frequent visits to prostitutes, voyeurism, exhibitionism, frotteurism, cybersex, and the like.

Patrick Carnes argues that when children are growing up, they develop “core beliefs” through the way that their family functions and treats them. A child brought up in a family that takes proper care of them has good chances of growing up well, having faith in other people, and having self worth. On the other hand, a child who grows up in a family that neglects them will develop unhealthy and negative core beliefs. They grow up to believe that people in the world do not care about them. Later in life, the person has trouble keeping stable relationships and feels isolated. Generally, addicts do not perceive themselves as worthwhile human beings . They cope with these feelings of isolation and weakness by engaging in excessive sex.

According to Patrick Carnes the cycle begins with the "Core Beliefs" that sex addict’s hold:

1.     "I am basically a bad, unworthy person."

2.     "No one would love me as I am."

3.     "My needs are never going to be met if I have to depend on others."

4.     "Sex is my most important need."

These beliefs drive the addiction on its progressive and destructive course:

§  Pain agent — first a pain agent is triggered / emotional discomfort (e.g. shame, anger, unresolved conflict). A sex addict is not able to take care of the pain agent in a healthy way.

§  Dissociation — prior to acting out sexually, the sex addict goes through a period of mental preoccupation or obsession. Sex addict begins to dissociate (moves away from his or her feelings). A separation begins to take place between his or her mind and his or her emotional self.

§  Altered state of consciousness / a trance state / bubble of euphoric fantasized experience — Sex addict is emotionally disconnected and is pre-occupied with acting out behaviours. The reality becomes blocked out/distorted.

§  Preoccupation or "sexual pressure" — this involves obsessing about being sexual or romantic. Fantasy is an obsession that serves in some way to avoid life. The addict's thoughts focus on reaching a mood-altering high without actually acting-out sexually. They think about sex to produce a trance-like state of arousal to eliminate the pain of reality. Thinking about sex and planning out how to reach orgasm can continue for minutes or hours before they move to the next stage of the cycle.

§  Ritualization or "acting out." — These obsessions are intensified by ritualization or acting out. Ritualization helps distance reality from sexual obsession. Rituals induce trance and further separate the addict from reality. Once the addict begins the ritual, the chances of stopping that cycle diminish greatly. They give into the pull of the compelling sex act.

§  Sexual compulsivity — the next phase of the cycle is sexual compulsivity or "sex act". The tensions the addict feels are reduced by acting on their sexual feelings. They feel better for the moment, thanks to the release that occurs. Compulsivity simply means that addicts regularly get to the point where sex becomes inevitable, no matter what the circumstances or the consequences. The compulsive act, which normally ends in orgasm, is perhaps the starkest reminder of the degradation involved in the addiction as the person realizes they are a slave to the addiction.

§  Despair — almost immediately reality sets in, and the addict begins to feel ashamed. This point of the cycle is a painful place where the Addict has been many, many times. The last time the Addict was at this low point, they probably promised to never do it again. Yet once again, they act out and that leads to despair. They may feel they have betrayed spiritual beliefs, possibly a partner, and his or her own sense of integrity. At a superficial level, the addict hopes that this is the last battle.

According to Carnes, for many addicts, this dark emotion brings on depression and feelings of hopelessness. One easy way to cure feelings of despair is to start obsessing all over again. The cycle then perpetuates itself.

However dark this situation looks like, freedom, hope and sanity does exist for these sufferers. The question then arises, are we as counsellors and therapists trained enough to handle this ticking time bomb?

Exerts from this article was taken from “Facing the Shadow”, Patrick Carnes, pH.D. Gentle Path Press, ISBN 0-977 4400-0-1

Growth through Counselling Course - Louise Terhart

“Praise be to the God and Father of our Lord Jesus Christ, the Father of compassion and the God of all comfort, who comforts us in all our troubles, so that we can comfort those in any trouble with the comfort we our ourselves have received from God.” (2 Corinthians 1:4). 

That was the word that God gently whispered into my heart, after I had encountered Him.  An encounter, which not only brought about healing and restoration of my childhood pain but assured me of His undeniable power, love and desire to restore “the years the locusts have eaten” – a 7-year journey for me.  A process timed well enough for me to work through my issues and experience lasting restoration and wholeness.

So, how does one comfort others?  I had years of experience of hiding and avoiding my pain, had finally surrendered and accepted comfort from God, was actually rejoicing in that when God’s Word penetrated my heart;  Somehow, I did not feel qualified enough to give the comfort I had received.  While wondering about this, I was invited to consider the Level 1 Counselling Course in 2008.  This course offered a preview into counselling and demonstrated basic skills which helped me to understand my journey and recognise how comfort could be offered to others. 

With God’s Word now firmly embedded in my heart, I then proceeded with the Level 2 Advanced Certificate in Counselling.  The theory which offered in-depth insight into the different approaches to Counselling, and to the development of advanced skills, proved invaluable.

I have been counselling for just over 2 years, and in hindsight I can see that the greatest preparation for giving comfort, started from the very first day of the course.   The course was structured in such a way that an atmosphere of safety was first created to replicate a trainee counselling room.  The early morning devotionals, subsequent discussions together with our daily journals aimed at developing our self-awareness.  The various exercises involved group work which meant continuous dialogue.  This and the personal nature of some of these exercises required that we practiced an important set of skills - genuineness, respect, and empathy.   

Thinking back, as much as I would hate to admit, the dreaded fish bowl sessions have stood me in good stead.  Role-playing a client exposed emotions that needed a response of care, sensitivity and empathy to be displayed – a crucial aspect to be captured in order for comfort to be given.  This is always important, but especially when meeting with someone new, where trust is yet to be established.   Role-playing a counsellor was a new experience, which necessitated honest critique.  So, a teachable spirit is absolutely essential, especially in areas where more growth is required.

It was beneficial that this course was not run consecutively, but rather spaced out over a 3-month period.  In this way, it allowed me to continue considering a single weeks’ training.  This further developed self-examination, resolved issues triggered, and allowed application of my counselling skills.  This enabled me to gain clarity as we all debriefed on our practical experiences upon our return for the 2^nd and 3^rd weeks of training.  The assignments thereafter just strengthened and moved me to remember that God is the Healer and that I am just a vessel which He has chosen to be used in this way.   

          

What I have found is that this ministry requires regular maintenance.  So it has become necessary for me to hold onto the outline of the course which is daily devotions and meditation, constant self-awareness, continuous dialogue in the form of supervision and on-going training to stay abreast of various troubles.   

Giving comfort from a Christian perspective, is not giving advice or telling a person what to do, it is about taking what God has done in our lives and offering it to someone in trouble, creating a space for hope and peace to be restored, culminating in renewed dignity, value and self-worth - ultimately holistic restoration.

My thanks to you, trainers at Philippi, may God continue to bless you with all you need to continue this vital work of empowering others to bring comfort to those in need.   

Introverts vs. Extroverts - by Liezl Cromwell

Are you an Innie or an Outie?

So, do you know if you are an Innie or an Outie? And no, we‘re not about to contemplate our belly buttons, but rather explore introverts and extroverts.  Most of us have heard these terms and can randomly allocate them to our nearest and dearest. Yet, do we truly understand what they are and why are they significant to everyday life?

Generally, we assume that extroverts are the ‘live wires’ at a party or those that are assertive and outgoing.  I’m sure you have just thought of someone, who loves being the centre of attention, the ‘typical’ extrovert. Or your introverted friend who seems so shy, withdrawn, sometimes lacking in self confidence. That’s right, the one that’s never keen to try something new and the proverbial wallflower at parties.

 In fact, the way to tell if someone is an introvert or extrovert is determining how they recharge their energy levels. This is the key difference. Do you need to withdraw from people, noise and activities when tired, when needing to process or just simply think? Then the chances are pretty good that you are an introvert. Extroverts on the other hand need people to recharge and energise. They need other people to process decisions, experiences and feelings. For example, an extroverted child will want to do their homework in your presence at the kitchen table, while the introvert prefers the quiet of their bedroom.

In general, we find that for every introvert there are three extroverts. The Meyers Briggs type indicator is a well known test used by psychologists to determine personality preferences. This is the route to take for a more accurate assessment, which is conducted in the form of a questionnaire. Myers-Briggs uses the terms extraversion and introversion. Extraversion means "outward-turning" and introversion means "inward-turning. There are four areas of preference that are assessed, but that is a subject for another time.

Another component often overlooked is the temperament continuum, which ranges from extreme extrovert to extreme introvert.  Most of us function in the middle, shifting from one side to another when appropriate, as we feel safe, comfortable or when in different roles. Dr. Laney (see below) compares this to being left or right handed. We can use both hands, but are more orientated to either the left or right one.

Extreme Extrovert

Middle Ground

Extreme Introvert

So why is this important to know? Let me share a personal experience. I’m not typically seen as a classical extrovert, yet I score highly on Meyers Briggs test as one. My mom, an introvert never understood my need to socialise, after complaining bitterly how exhausted I was. This often led to me feel misunderstood and that I was ‘faking’ my exhaustion. By understanding how we operate we have a better understanding of ourselves and others. I recently stumble across a book, The Hidden Gifts of the Introverted Child, Helping your Child Thrive in an Extroverted World, written by Marti Olsen Laney, Psy. D. In this book Dr. Laney focuses on helping us see the contribution that introverts give. This is often overlooked as extroverts draw more attention and introverts often feel unnoticed and undervalued.

In this book she identifies how we function and thus gaining insight and understanding.  Innies and Outies are often defined by their behaviour, rather than how they source their energy and their orientation to the world.  These are the following key differences:

Extroverts:	Introverts
Love action and excitement	Like to be stimulated in small doses
Prefer to get an overview of a topic	Explore topics in depth
Emotionally react in the moment	Process emotions before reacting
Energised by the outside world, depleted by quiet and solitude.	Feels depleted and drained by too many people and activities
Danger: overstimulation and exhaustion	Danger: getting lost inside their own heads
Wearied by too much quiet and solitude	Take longer to get their bodies moving
Tend to shoot from the ‘lip’	Use a longer brain pathway, hence do not always answer immediately
Enjoy attention, talking and activities	Tend to hesitate in unfamiliar environment
What immediate gratification, want it ‘now’	Harder to get their body moving, have to tell their body to move.
More vulnerable to addictions	Highly observant and detail focussed
May walk, talk and eat fast	Difficult to get to know

It is important for both introverts and extroverts to balance their tendencies. An Innie needs to be encouraged to engage the world, grow in confidence and not become lost inside their heads. The Outie could burn out from overstimulation and would benefit from periods of contemplation and relaxation. This should be kept in mind as we parent our children and in our relationships with our spouses. For example, an Outie parent with an Innie child may be frustrated by their child’s lack of enthusiasm and perceived lack of confidence.  The Innie parent with an Outie child may feel exhausted trying to keep their noisy child ‘under control’.  These children are often misdiagnosed with ADHD (Attention Deficit Hyperactivity Disorder)  or ADD (Attention Deficit Disorder) In our relationships conflict may rear its head, when one partner needs time out and the other needs a night on the town.

All said, we are all created different and unique. This should not be seen as a disadvantage.  Everyone has something to contribute and what we do and say is of value. Here’s a simple scenario, look at couples around you, perhaps your own marriage. Who is roaring to go, take risks and talk the talk? Think about who is the one who applies the brakes and brings perspective to decisions that needs to made. Do you see how we could balance each other’s tendencies, creating harmony in our significant relationships?

Why Love Matters - a book review by Janie Loubser

Janie Loubser writes about the thoughts that are provoked by Sue Gerhardt’s book Why Love Matters

Why Love Matters: How Affection Shapes a Baby's Brain
by Sue Gerhardt
264pp, Routledge

Available on www.amazon.co.uk/exec/obidos/ASIN/1583918175/

Why Love Matters is the title of a book I recently read. It is written by Sue Gerhardt and she explores how the earliest relationships shape the baby’s nervous system. As psychologists and counsellors we know that childhood experiences have a great affect on adult life. We are familiar with John Bowlby’s attachment theory and Margaret Ainsworth’s  “Strange Situation” study that showed how a child’s development is a direct result of the way the child's main carer responded to and engaged with him or her.  Yet it seems that attachment theory has almost been forgotten or is being downplayed. The whole issue of mothering has become sensitive and even politicised.   Sue Gerhardt however goes and uses neuroscience to prove the attachment theory. She provides the scientific explanation for the importance of early experiences. She is very honest about how parents fail their babies and what the consequences can be. But she also describes a mother’s experience of being with her baby with sensitivity and provides insight into why a mother is limited in the way she mothers. She goes further and gives a rich description of psychological disorders such as depression and borderline personality disorder. I say it’s rich because she helps the reader imagine the baby’s experience that possibly contributed to the disorder.  She makes it clear that she believes that prevention is key and that early intervention with mothers and babies are much more effective. But she also explains how psychotherapy with adults can help to repair some of the damage.

 

This quote summarizes Gerhardt’s viewpoint: “The human baby is the most socially influenced creature on earth, open to learning what his own emotions are and how to manage them. This means that our earliest experiences as babies have much more relevance to our adult selves that many of us realise. It is as babies that we first feel and learn what to do with our feelings, when we start to organise our experience in a way that will affect our later behaviour and thinking capacities.” 

The book is divided into three parts. I am going to present some of the key ideas from this book that I have found helpful in my work.

The first part of the book deals with brain development in infants and how this can be influenced by attachments and the corrosive influence of cortisol. Gerhardt sets out the scientific basis for understanding babyhood as a crucial time in emotional development. She uses the concept of “the unfinished baby” and explains that the baby has many systems that are incomplete and will only develop in response to other human input. Babies also rely on adults to manage their emotional states so that discomfort and distress are reduced and comfort and contentment is increased.  If a baby is exposed for too long or too often to stressful situations (such as being left to cry) its brain becomes flooded with cortisol and it will then either over- or under-produce cortisol whenever the child is exposed to stress. Too much is linked to depression and fearfulness; too little to emotional detachment and aggression. 

  

The second part of the book looks in more detail at the links between various adult disorders and their roots in babyhood. Gerhardt highlights the concept that insecure attachments and the consequences can make one more vulnerable to specific psychopathologies. She does not say that the one ‘causes’ the other, but explains how poorly developed emotional systems impair one’s  capacity to manage one’s feelings . The likelihood of finding dysfunctional solutions to emotional problems are increased, such as eating too much or too little, drinking too much alcohol, reacting to others without thinking, failing to have empathy for others, falling ill, making unreasonable emotional demands, become depressed, attack others physically, and so on.  Gerhardt looks at the links between early emotional regulation and the immune system, depression, as well as personality disorders. Her description of the baby’s experience that developed into a borderline personality is a helpful reminder of the baby within the adult. In fact she says, “whether you focus on the parent, the baby or the adult with the mental health difficulties, the core problem remains the same: the insecure baby within.”  Insecure attachments tend to develop because parents find it hard to respond adequately to their babies. This is mostly because of their own limitations in regulating their emotions.

Gerhardt  writes about an emotional framework that is set up and consists of both a physiological and psychological  capacity. If the framework is secure, it gives the individual a confidence in regulating the ups and downs of emotional life, with the help of others when needed. But if the framework is insecure, then the person will find it much harder to cope effectively with stress, and will feel little confidence either in coping as an individual or in relying on others to help. She describes self-esteem as the confidence in oneself as well as in others and says that self-esteem is not just thinking well of oneself in the abstract, but also having the capacity to respond to life’s challenges.

Part three looks at treatment and repairing the damage. Gerhardt acknowledges that this information can leave one feeling heavy with guilt about the parenting one provided and hopeless about the parenting one received. Gerhardt argues that improving the relationship between parents and their babies is a much more cost-effective way to improve mental health than any number of adult therapeutic interventions. She advocates parent-infant psychotherapy as one way to prevent damaging emotional patterns from repeating themselves.  

She does however acknowledge the possibility of development and change extending across a lifetime and not just infancy. She explains that important pathways continue to be established through childhood until the brain is fully fledged at 15 years old. Change and development do continue after that, but as we know from our own work, at a much slower rate. She explains how through psychotherapy an individual can explore the way that he or she regulates himself or herself in relation to others, and can attempt to modify old emotional habits and introduce new ones. She writes, “the therapist’s acceptance allow a mental space to reflect on the feelings and consider how to respond afresh. Whilst the feelings are alive and active, so too are the stress hormones which will assist new (higher brain) cortical synapses to be made in response to the subcortical signals. Together with the therapist, new networks can be developed.”

We can probably all relate to how difficult it is to talk about early experiences. Adults cannot remember their babyhoods even though they have feelings about it. And mothers find it hard to express their intense emotional and physical experience with their babies.  Gerhardt’s writing does not only provoke thoughts and feelings about early childhood experiences, but provides a language to talk about it. It is accessible to not only those involved in mental health, but to parents too.  The book can help create awareness in parents about how much their babies need them.  It can also be helpful for adults in explaining why they have the difficulties they have. It has helped me to teach parents how to respond to their babies; and to teach adults how to respond to the baby inside them in an empathic way.

-          Janie Loubser is a clinical psychologist in private practice, Cape Town. She has a special interest in relationships and helps people to discover and remove the obstacles that keep them from having meaningful relationships. This includes relationships between parents and children.  www.janieloubser.co.za    

Dream Work as a Tool in Counselling - by Liani Kruger

“I have no theory about dreams; I do not know how dreams arise. And I am not at all sure that my way of handling dreams even deserves the name of a ‘method’. I share all your prejudices against dream interpretation as the quintessence of uncertainty and arbitrariness. On the other hand, I know that if we meditate on a dream sufficiently long and thoroughly, if we carry it with us and turn it over and over, something almost always comes of it.”   (Jung, 1966)

Dreams, with their enigmatic and often baffling nature, have fascinated humankind for centuries. For as long the purpose and meaning of dreams has caused controversy. Some believe that dreams are divine and supernatural messages to be interpreted by the gifted; others dismiss them as a biochemical products of the brain at rest, while yet others assume that dreams process information compiled during the day.

Both Freud and Jung, regarded as the fathers of modern psychology, saw dreams as important tools in psychotherapy. According to them dreams can provide invaluable insights into the client’s image of self, defense mechanisms and core conflicts, and research findings show this to be true.

However there are many different approaches to dream interpretation – how to decode the meaning of a dream, how to interpret it and how to use the insights it provides. These approaches are as different as the diverse schools of thought that birthed them, and counselors are encouraged to explore these many different approaches to find one that best suits their style of counseling.

For those who have neither the time nor resources to undertake such an investigation, the approach used by Gendlin, an experiential therapist, could prove a useful starting point. His approach contains important aspects of the three main theories underpinning our modern understanding of dreams and dream analysis.

Freud described dreams as the “royal road to the unconscious mind” (Freud, 1913) and that the meaning of a dream could be found in the events of the day preceding the dream. However, those events could have aroused emotions and associations that the dreamer finds unacceptable or have repressed, and so in the dream they would be disguised or veiled in strange images and puzzling happenings. The work of dream analysis was to unveil these hidden desires, impulses, emotions and associations.

Jung believed Freud's notion of dreams to be too simplistic. Dreams, he said, were far richer and more complex and in fact had their own unique language – the language of metaphor. The task of dream analysis was to decode that language and so have access to the wealth of insight they contained.

Perls viewed dreams as a spontaneous expression the parts of the personality that are being left unexpressed. He believed that the goal of dream work was to re-experience in the here and now the content of the dream so that these disowned aspects of the personality could be reintegrated (Coolidge, 2006). True to the Gestalt approach dreams are re-lived in the session with the client acting out parts of the dream by using tools such as the “empty chair technique”.

Incorporating aspects from these theories, Gendlin held that dreams could only be meaningfully interpreted by the dreamer (Gendlin, 1986) and so the best way to begin analyzing a dream was to encourage the client to engage with it. He used the Freudian technique of free association, Jung’s theory that each image or person represented an aspect of self, and the gestalt approach of re-experiencing the dream in the here and now, including Perls’ “empty chair” technique in which he invited the client to enter into a dialogue with a particular dream character or element.

Once the client had explored and expressed the key emotions and issues in the dream, Gendlin would then encourage an exploration of how the dream and its associations related to the client’s current challenges or conflicts.

Key to Gendlin’s approach are questions designed to lead the client into exploring the dream material more fully and more meaningfully, namely:

• What thoughts or feelings arise when thinking about or visualizing the dream? 
•  When last did you feel this way? 
• What does this feeling make you think of?
•  What do you remember about yesterday? 
• What occupied you internally?
• Summarize the story of your dream. Ask yourself: “What in my life is like this story?
• Think of each person in the dream, or the central characteristic of the person, as a part of yourself.
• Does the dream make sense if you understand it as a story about how you feel about that part of yourself?
• Look at the important objects in your dream. What is it? What is it used for? 
• Replace the object with the general function, place this in the dream and see if this brings insight.
• What in your dream is different from the true or normal situation? What meaning could be attached to this?
• Can your dream connect to a memory, feeling or experience from your childhood? 
• What current themes exist in your life regarding your development or growth? 
• Can the dream or characters in it be about something that you are still developing or that you should work on?

(Gendlin, 1986)

Guidelines for using dream work in therapy

In order for dream work to be meaningful, the therapist must firstly believe in the significance of dreams and find an approach to dream work that fits into the therapist’s overall theoretical approach.  Secondly, dream work should always be rooted within the broader therapeutic process since the individual’s psychological functioning at the time of dreaming is as important as the content of the dream itself. Thirdly, therapists are advised to take an inquisitive stance towards their clients’ dreams and to act as facilitators only, helping the clients explore their own dreams. This approach is especially important in the South African context with its rich cultural milieu, where a therapist may lack the cultural information that contextualizes the clients’ experiences. Dreams hold multi-faceted meaning which is greatly impacted by cultural norms and traditions and create a unique and valuable meeting place for Westernized psychology principles and African belief systems.

Finally, rather than immediately focussing on “finding the meaning of the dream”, clients must be encouraged to write down the dream after waking, since this should produce the purest possible version of the dream. Interestingly it seems that dream journaling improves the ability of remembering dreams over time.

Concluding remarks

It is unlikely that consensus will be reached on the meaning of dreams. However theorists seem to agree that disregarding the significance of dreams is to disconnect ourselves from a part of our awareness and in doing this, disowns a part of ourselves. Perhaps the key to approaching dreams is to leave behind dichotomous thinking that forces individuals to decide on the meaning of dreams. Humans are body, soul and mind and perhaps dreams should be viewed as complex experiences that are products of our holistic existence. In fact, some therapists suggest aiming to integrate dreams instead of purely analyzing, stating that to purely view dreams as a message is to underestimate them.

Encouraging an awareness and curiosity about dreams teaches openness for the infinite complexity of our unconscious, as well as consciousness, and in this the positive impact of dream work may reach much further than insight regarding dreams.

References

Coolidge, F. L. (2006). Dream interpretation as a psychotherapeutic technique: An introduction to Fritz Perls' dream interpretation techniques. Milton Keynes: Radcliffe Publishing.

Freud, S. (1913). The interpretation of dreams. (A. A. Brill, Trans.) New York: The Macmillan Company. (Original work published 1900).

Gendlin, E. T. (1986). Let your body interpret your dreams. Wilmette: Chiron Publications.

Jung, C. G. (1974). Dreams. Princeton: Princeton University Press.

Jung, C. G. (1966). The Practice of Psychotherapy: Essays on the Psychology of the Transference and other Subjects. Princeton: Princeton University Press.

About the author: Liani Krüger is a registered clinical psychologist currently employed by the South African National Defence Force. She is passionate about applying psychology in the South African context.

The author can be contacted via e-mail: lianikruger@gmail.com