Short-term dynamic psychotherapy (STDP) is designed to create intrapsychic crisis leading to psychic disequilibrium, followed by narrative construction.

The triangle of persons gives a new understanding of new emotions and impulses relating to the past (P) and current (c). The therapy directs the person to their feelings and impulses engrained in the conflict (F/I), highlighted in the transference projection and worked through in the working alliance. This is like desensitisation to emotional phobias, traumas and past transgressions. The process evokes the repressed emotional and cognitive experiences, relived and re-experienced, resulting in new psychic restructuring. The child had previously been shamed to a level of annihilation due to abandonment and rejection, left with intense emptiness, helplessness and worthlessness. Terrified of emotional intimacy and closeness, alternating between withdrawal (distancing) and clinging (engulfment). Some of the nonverbal cues may be as follows.

  1. Weeping
  2. Smiling and giggling
  3. Air of detachment
  4. No eye contact
  5. Arms/legs crossed off to intimacy.

The Double Bind

When the words uttered are contradictory to the nonverbal/implicit experienced message. The cognitive person picks up the verbal message, but the body registers the contradiction in facial expression or gestures, causing confusion, uncertainty and anxiety. If the child tried to stay in contact with their visceral response and the internal reality, they were probably shamed, abandoned or rejected. This disintegrates the body-mind connection, with broad damage to reflective life; the self-ego axis has been broken and walled off, distrusting the inner world and perceptions.

This creates an intrapsychic split (cognitive left brain from the affective right brain) and an interpersonal split between the self and the other. The child learns to distrust their feelings, disassociate and repress them, interrelating superficially. The child (abused victim) always feels uneasy, uncertain, fearing any sensation or change, believing something innately is wrong with them, confused about what it is, expressed via rage or dysfunctional behaviours. They become hypersensitive and hyper-vigilant to the same stimuli, suspicious and paranoid of their instincts, complying with the explicit (content) message and world. Double bind sequence.

The victim cannot disengage from the dynamic of communication and is forced to participate in the game; he or she can’t comment on the paradox and explore the contradictions. The child can’t survive this emotional destabilisation without compromising their internal truth. If they compromise and sacrifice the true perception of the experience, they will be propelled from assertion to shame and reacquainted with the compounded bodily response. The first experience in the chest (quick jolt) is followed by a gripping tightness (fear), then a sinking or dropping chest sensation (sadness). The client may recognise a wave of anger rising, a boundary-setting emotion, but may repress and deny it. The anger must be felt, experienced, expressed and actively encouraged to release one from the double bind.

The Double Loop

An empathic, attuned therapist stands alongside the client whilst they re-experience the shameful moments that have split them apart from themselves. Empathic transactions or supportive affirmations lead clients into their internal world and interact with their self-identity. The client will shift back and forth between content and feelings, struggling to stay in contact with their feelings and the other (therapist).

The therapist encourages the client to attend to and feel his embodied experiences; simultaneously, they describe them to the therapist. The intrapsychic content comes into harmony with the affective, interpersonal realm of the other. Shame splits the mind apart; the double loop unifies it.

The neurotic child often holds the unconscious belief they have little or no personal power. The lack of assertion generates unease, insecurity, and weak, unclear, unfocused perceptions of reality. When there is a constituency between inner needs and their exterior expression, they can grow in integrity, honesty, and authenticity with full self-expression and self-possession. When the assertion is blocked by shame, the damage to the true self and personality is devastating, and they will seek out partners to deepen and justify the shame. If the client can attain their aggression and assertion, there is no longer a need to act out or embrace addictions and other dysfunctional behaviours sexually.

The shame posture may be evidenced as a passive withdrawal and humiliation. Still, under the surface, it is angry defiance with an obstinate refusal to be emotionally aware or dependent on another person.

The classic narcissist family triad environment encourages the development of the false self. The child can be detached from himself and pleasing to the mother or attempt to be self-assertive and activated and risk emotional abandonment. The false self protects the child from the assertion-shame conflict (Oedipus conflict). A cultivated persona, a place of hiding that conceals the child’s vitality, stops spontaneity and creativity in a grey zone of numbness and immobility. The self-assertion is met with the parent’s displeasure, where innate masculine strivings are rejected and disowned to persevere the maternal bond.

Narcissistic Triad

The grey zone is characterised by a persuasive state of disappointment, frustration, pain, loneliness and emptiness. The gap is the space between enacting a dysfunctional response and the will, the final chance to choose to change the behaviour. The helpless, hopeless, inaccessible state in the grey zone is the most formidable obstacle to treatment and change and is met with great resistance.

To move out of the grey zone, the client must feel and express his emotions at the moment, empowering themselves by taking the risk of self-assertion. It is essential to work through the perception of parental abandonment and the core injury, to sit and experience, repeatedly, the discomfort and pain of the abandonment, and learn to grieve the loss of the idealised parent. The more the client is prepared to penetrate and resolve the attachment loss, the greater and quicker the self-actualisation journey will occur. The best openings to grief work are when the client reports complaints associated with shame and acting out. Open discussion, interpretation and confrontation of the shame experience allow the client to access deeper emotions, and anger may start to surface.

Conflict Model

The movement from shame to grief is anger at others and sadness for self. It is the narcissistic identification with the love object that postpones healthy mourning. There Is great pain associated with the loss and it needs to be relieved and worked through, where the therapist contains and holds the client as they survive the experience psychologically intact.

The grief resolution is complete when the client can surrender the illusions and distortions used to cover up the pain of loss. The loss is gradually assimilated with the integration of consequences and memories, creating a realistic, authentic perspective and experience. The client will start to be curious about who they are, what they desire and what they like. The abandoned, enfeebled self Is allowed to thrive, grow and develop into the person they were supposed to be 

Nicolosi, Joseph. Shame and Attachment Loss: The Practical Work of Reparative Therapy. Kindle Edition.