Towards a PersonCentred DevelopmentalGrowth Model of Madness Garry

Towards a Person-Centred, Developmental/Growth Model of Madness: Garry Prouty and the Animal Symbolicum Ivan Ellingham, Ph. D ivan. ellingham@icloud. com PCE Symposium, Lausanne 2016

Rogers’ Position on the Medical Model ‘We regard the medical model as an extremely inappropriate model for dealing with psychological disturbances’. (Carl Rogers, BBC Radio 1976) 2

Mainstream View on the Person-Centred Approach ‘Within the world of psychology and psychiatry, the Person. Centred Approach has become increasingly marginalised and often viewed by practitioners as a superficial approach to therapy that has little or no relevance to helping people with severe and chronic psychological problems’. (Joseph & Worsley, 2005) ’. 3

What Is Needed We need to develop our own system formulating matters, our own Person-Centred Model, one in which ‘the value of concepts and conceptions for helping us understand [and help] different types of clients are acknowledged’ (Schmid, 2005). 4

A Developmental/Growth Model ‘We regard the medical model as an extremely inappropriate model for dealing with psychological disturbances. The model that makes more sense is a growth model or a developmental model’. (Carl Rogers, BBC Radio 1976) 5

The Goal Formulating a Person-Centred Developmental/Growth model in which the various types of psychological problem, types of mental distress, are understood in relation to a process of psychological growth. A model in which different psychological problems are understood as developmentally interrelated and due to disturbances/inhibitions/damaging of the growth process , i. e. due to impairment of the optimal functioning of the Formative Actualizing Tendency. 6

A Multi-Level Developmental/Growth Process 7

The Reaching/Grasping Hand 8

The Handshake ‘The Greater Whole’ Whole 9

An Even Greater ‘Whole’: The Circle Dance Many Handshakes 10

Dialectical Integration/Co-Creation C-Handshake A-Hand B-Hand A-Hand B-Hand E N H A N C E M E N T Maintenance 11

CONGRUENCE [f = focal; s = subsidiary; ss = sub-subsidiary] Circle Dance Time 3 B 2 ss HS 1 s B 1 ss CD 1 f HS 2 s B 4 ss B 6 ss B 3 ss Handshake. HS 1 f Time 2 CD 2 f H 1 s M 4 s B 5 ss HS 2 f H 2 s M 3 s B 7 ss HS 3 f H 4 s HS 4 f H 6 s H 3 s B 8 ss H 8 s H 5 s H 7 s Hand Time 1 H 1 f H 2 f H 3 f H 4 f H 5 f H 6 f M A I N T E N A N C E H 7 f E N H A N C E M E N T H 8 f 12

My Solution In accord with the multi-level theorizing of such person-centred thinkers as Greenberg, Kriz, Prouty, Seeman, and others, understanding psychological problems as characterized by and interrelated on the basis of the developmental level of sense-making/processing at which the growth process has suffered damage or impairment. Compare Fritz Perls and the Gestalt Cycle.

Beyond Rogers ‘It seems strange that as psychologists they [Rollo May and Carl Rogers] never considered developmental stage theory’. (Shlien, 2003) ‘I think it is somewhat artificial to divide the development of the child into hard-and-fast stages. A gradual development of the picture that he [sic. ] carries of himself is more important to me’. (Rogers, 1975) 14

If this is the Basic Pattern of Development/Growth, what of the Content at each Level? 15

Major Importance of the Work of Garry Prouty Founder of Pre-Therapy Prouty endorses Reichenbach’s multi-level model and Ernst Cassirer’s and Susanne Langer’s conception (their anthropology) of the human being as the Animal Symbolicum (the Symbolizing Animal). ‘Reichenbach conceived these different levels of semiotic conceptualization [‘different levels of symbolization’] as different levels of abstraction and concreteness. . An even more primitive form of concreteness is called the pre-symbol’—[a form of sense-making that Prouty sees as operating in a dominant fashion in psychotic hallucinations]. (Prouty, 2008)

• • • Prouty’s theory and casework with psychotic (‘mad’) persons reveals a psychotherapeutic developmental, growth model congruent with Cassirer and Langer’s model of the phylogenetic cultural growth of human consciousness. Kieran Egan’s ontogenetic model of the growth of consciousness in the child. Heinz Werner’s microgenetic model of consciousness occurring in the moment in the human adult. 17

A Substantive, Common Developmental Pattern Therageny Phylogeny Ontogeny Microgeny 18

Everyday Consciousness (Discursive, Natural Language Symbolization) ----------------------------Mythic Consciousness (Non-Discursive/Presentational Symbolization) (Prouty’s Pre-Symbolic Experiencing) ----------------------------Somatic Consciousness (Bodily Sensing, Signalling) (Gendlin/Prouty Bodily Experiencing)

A. Cassirer and Langer (Phylogenetic/Cultural) Modern Humans (Discursive Symbolizing) ----------------------------Early Humans (Mythic Symbolizing) ----------------------------Animals (Signalling)

Somatic Understanding in Animals ‘To the broody hen. . . a nestful of eggs [is an] utterly fascinating and precious and never-too-much-to-be-sat-upon object’. (William James) In Humans Psychoanalytic ‘acting out’. In Prouty’s clients Catatonia 21

From Animals to Humans Symbolism thus opens the way ‘from animal reactions to human responses’ (Cassirer, 1944). ‘In myth man begins to learn a new and strange art: the art of expressing, and that means organizing, his most deeply rooted instincts, his hopes, his fears’. (Cassirer, 1946) 22

Cassirer and the Dialectical Advance of Human Consciousness in Terms of More Complex Forms of Symbolizing ‘All symbolic forms (including the more primitive ones) are necessary parts of a single phenomenological process of development (again in the Hegelian sense). Mythical consciousness evolves dialectically into language, and language evolves dialectically into science. Conversely, language necessarily has a prior origin in myth, exact science a prior origin in language. Accordingly, each of the symbolic forms can be properly understood, from the point of view of Cassirer’s general philosophy of culture, only by reference to its own particular position in the essentially unitary dialectical process’. (Friedman, 2000) 23

Characteristics of Mythic Consciousness [Pre-Symbolic Experiencing] • Image taken as real • Image charged/imbued with feeling • ‘Meaningful’ in itself yet somehow refers to another object (e. g. the moon as woman) • Chronological time does not exist (everything happens in the now) • Lack of differentiation between a part and a whole (a part of the whole is the whole, cf. Winnicott’s transitional object) • Like/similar things taken as identical (Your therapist is like mother: Your therapist is your mother; Jesus is like God: Jesus is God). 24

Cassirer’s Mythic Consciousness Equates With Freud’s Primary Process Consciousness • ‘The ‘dream work’ of Freud’s ‘unconscious’ mental mechanisms is almost exactly the ‘mythic mode’ which Cassirer describes as the primitive form of ideation’ (Langer 1949). • ‘Alfred Lorenzer calls attention to the fact that Freud’s distinction between ‘primary process’ (Primärprozess) and ‘secondary process’ (Sekundärprozess) agrees in virtually every detail with Cassirer’s distinction between mythic thought and the representational thinking inherent in discursive language’ (Krois, 1987) • Psychoanalyst Charles Rycroft prefers ‘the use of Susanne Langer’s terms non-discursive and discursive symbolization to make the distinction between the two different types of thinking which orthodox Freudian analysts make by referring to the primary and secondary processes’ (Rycroft, 1981). 25

Cassirer’s Description of Mythic Consciousness ‘The earliest products of mythic thinking are not permanent, self-identical ‘gods’; neither are they immaterial spirits. They are like dream elements--objects endowed with daemonic import, haunted places, accidental shapes in nature resembling something ominous—all manner of shifting images which speak of Good and Evil, of Life and Death, to the impressionable and creative mind of man [sic. ]. All mythic constructions are symbols of value—of life and power, or of violence, evil and death. They are charged with feeling, and have a way of absorbing into themselves more and more intensive meanings, sometimes even logically conflicting imports. . . their import is felt as inherent power. . . specific differences of meaning are obliterated in nondiscursive symbolization…many meanings may be concentrated, many ideas telescoped and interfused and incompatible emotions simultaneously expressed’. (Langer, 1949) 26

B. Prouty’s Casework: Theragenetic Change Verbal Description of Trauma ---------------------------Psychotic Imaging of Trauma (Hallucination) (Pre-Symbolic Experiencing) ---------------------------Somatic Representation of Trauma (Catatonic Freeze Response) (Bodily Experiencing, ‘The Body Remembers’)

The Psychotic Hallucination as Pre-Symbolic Experiencing Description of his psychotic hallucinations by a client of Prouty: a ‘ 19 -year-old male’, a ‘psychotic retardate’, ‘diagnosed as hebephrenic schizophrenic’ (Prouty, 1977). ‘It’s evil this thing…That’s why I don’t want anything to do with it. I’m tempted by it, you know. It’s so small but it has so much strength and wants to rip me apart…The evil thing is a picture. It’s a dark purple picture that hangs there…It’s very big and large…It’s evil. It’s like a demon, a bad demon. It wants to chop me up…It’s with the past and it’s not going to come back any more. It’s over with, you know, and talking about the trees and the flowers and the grass…. It’s like air. It’s up above me…it’s very pressing, it forces, a lot of force to it and it wants to grab me…. The feeling is in the picture’. (Prouty, 2008) 28

C. Kieran Egan (Ontogenetic/Children) Older children/Adults (Age 9 +) ----------------------------Mythic Understanding (Age 2 -3 to 6 -8) ----------------------------Somatic Understanding (Age 0 to 2 -3)

Mythic Understanding: Egan ‘Mythic understanding is typically predominant from the time grammatical language develops between the ages of two and three until about six, seven, or eight. The change to a somewhat distinct kind of understanding at about age seven is a result of the mind’s ability to incorporate literacy among the tools it deploys. As Mythic understanding in significant degree incorporates and transforms some of the tools of Somatic understanding, so those of Mythic understanding are not things we leave behind as we become literate. They will remain in significant degree as transformed constituents of all further kinds of understanding’. (Kieran Egan, The Educated Mind, 1997) 30

D. Microgeny ‘The microgenetic process of transforming felt meanings into appropriate linguistic expression for communicating to others’. ‘The earliest representations are presumed to be of an affective-sensory-motor nature, representatives which serve to establish global outlines of the experience. . gradually to images. . progressive channelizing of meanings towards community adequate verbal forms’. Heinz Werner & Bernard Kaplan (1963) Symbol Formation 31

Werner’s Organismic-Holistic Developmental Stance ‘The organismic-holistic orientation, in our framework, is closely interwoven with a developmental orientation: development is a constitutive moment of organismic functioning. We assume that organisms are naturally directed towards a series of transformations--reflecting a tendency to move from a state of relative globality and undifferentiatedness towards states of increasing differentiation and hierarchic integration. It is this tendency, formulated as the ‘orthogenetic principle’, which serves for us to characterize development as distinct from other types of change over time’. (Werner & Kaplan, 1963) 32

Conclusion Re. Psychotherapy Interactions Need to be Appropriate To Developmental Level of Sense-Making As Modelled by Garry Prouty 33

INCONGRUENCE/CONGRUENCE (Madness) [f = Focal s = Subsidiary ss = Sub-subsidiary] Discursive Understanding/Symbolization = ‘D’ Time 3 B 2 f B 1 f M 2 f B 4 s B 6 ss B 3 s B 1 s M 4 f B 6 s B 3 s B 8 s B 5 f B 8 ss B 7 ss M 3 f B 4 s Bodily/Sensorimotor Understanding = ‘B’ Time 1 B 1 f B 2 f B 3 f B 4 f M 3 s B 5 ss Mythic/Non-Discursive Understanding = ‘M’ Time 2 M 2 f B 2 s D 2 f B 7 s B 6 f M A I N T E N A N C E B 7 f E N H A N C E M E N T B 8 f 34

Michael Polanyi’s ‘Logic of Tacit Knowing’ ‘Think of a pair of stereoscopic photographs, viewed in the proper manner, one eye looking at one, the other at the other. The objects shown in the two pictures appear in their joint image as distributed in depth, and tangible. This is what we see at the focus of our eyes; but it involves also the sight of the two component pictures: cover these up and we see nothing at all. But we do not see these two pictures in themselves. In a way, we look through them, at their joint image. So I shall class our awareness of them as subsidiary and observe that the way we look at them integrates their sights into the spacially deepened image to which they contribute. Thanks to our integration, the two flat pictures effectively function as clues to a spacial image’. (Polanyi, 35 1968)

Greenberg, (2010) Emotion Focused Therapy 16: Central to Gendlin’s (1996) thought…. . human experiencing has a rich intricacy that can only …. always is far more to a person’s experiencing than can be put into words or concepts. 17. Symbolization is thus no longer seen as involving congruence between symbols and experience

Everyday Consciousness (Natural Language, Discursive Symbolization) ----------------------------Mythic Consciousness (Non-Discursive/Presentational Symbolization) (Prouty’s Pre-Symbolic Experiencing) ----------------------------Somatic Consciousness (Bodily Sensing, Signalling) (Prouty’s Bodily Experiencing)

CONGRUENCE: Discursive Understanding (Sanity) [f = Focal s = Subsidiary ss = Sub-subsidiary] Discursive Understanding/Symbolization = ‘D’ Time 3 D 1 f B 2 ss M 1 s B 1 ss M 2 s B 4 ss B 6 ss B 3 ss B 1 s M 4 f B 6 s B 3 s B 8 s B 5 f B 8 ss B 7 ss M 3 f B 4 s Bodily/Sensorimotor Understanding = ‘B’ Time 1 B 1 f B 2 f B 3 f B 4 f M 3 s B 5 ss Mythic/Non-Discursive Understanding = ‘M’ Time 2 M 1 f M 2 f B 2 s D 2 f B 7 s B 6 f M A I N T E N A N C E B 7 f E N H A N C E M E N T B 8 f 38

The Yin-Yang/I-Thou/Thesis-Anti. Thesis Creation of the Multi-level Hieriarchy ‘The actualization process is a dialogical process’. Peter Schmid (2008) Symbols and the object symbolized must have the same logical form/formal likeness. Susanne Langer (1953) 39

Diagrammatic Representation Of Sanity (Congruence) and Madness (Incongruence) Diagrams Based upon Michael Polanyi’s Conception of Focal and Subsidiary Sense-Making Processes 40

DIALECTICAL INTEGRATION/CO-CREATION A 1 s A 2 s A 1 f A 2 f TIME 2 TIME 1 Bf E N H A N C E M E N T MAINTENANCE f = Focal s = Subsidiary 41

Madness = Focal Functioning of Former Subsidiary Processes [Maintenance usurps Enhancement] ‘The psychiatric phenomena which illustrate the existence of mythic thought, and point to its ancient and primitive nature, are striking and persuasive. Among these is the fact that in certain pathological conditions of the brain the power of abstraction is lost, and the patient falls back on picturesque metaphorical language. In more aggravated cases the imagination, too, is impaired; and here we have a reversion almost to animal mentality’. (Langer, 1949) ‘When the human process of symbolism is interfered with, deteriorated, then the human behavior begins to resemble the animal’. (Schultz, 65, cf. PSFIII: 276)

The ‘I-Thou’ Tennis Ball 43

Revision of Gendlin 2 Stages 3+ Stages

In Kriz’s Terms Kriz refers to ‘levels of meaning’/’levels of processing’ ‘Cassirer’s analysis of the semiotic levels of consciousness and its originally ‘mythic’ matrix’. (Innis, 2009) Types of psychological problem correlate with the level of sense-making/processing at which psychological damage has occurred. Linkage with theorizing and casework of Garry Prouty. 45