In the first part of this interview, in the October issue, you delineated three basic imagery strategiesto help people cope with pain: 1) Symptomatic 2) Etiologic, which refers to looking at the symbolism pain has in one's life and 3) Transformational. Let's focus now on the third approach, the Transformational strategies. Could you explain Transformational?
With Transformational techniques, we look at the pain in a much broader context. I think people who are in chronic pain are stuck somewhere in the transformational process. They've had a loss of some sort and they're either stuck in that first transformational stage of shock (which is very rare) or more commonly in the second stage-anger and protest. Others move into the third stage of grieving and mourning and get stuck there.
Every now and then you'll see someone who is stuck in the fourth or detachment stage. They just donŐt feel anything. I look at Transformational Imagery as a way of helping people move all the way through the process and get unstuck. Go through their transformation, their recovery, their re-birth.
Isn't that close to Etiologic techniques?
Yes, it is close but Etiologic tends to be more historical. Transformational tends to be more directed toward the future. Bill Glass, the originator of Reality Therapy, says he doesn't really care how people got where they are. He only wants to find out where they want to go and how they're going to get there. That's more transformational.
If I may do a little re-interpretting here: Etiologic refers to the technique of "Listening to Your Symptom."
Can Transformational techniques emerge out of Etiologic techniques?
Suppose you're dialoguing with the image of pain (an Etiologic technique) and you discover that, "Oh, my God I never did recover from my father's death." That's a Transformational process, right?.
And then you move on to the next phase which is dealing on the level of that loss.
Does Transformational include the Spiritual dimension?
Yes, absolutely. Because that often addresses the question, "Why do I have pain?" People aren't looking for a neurophysiologic explanation. They're asking, "Am I a terrible, horrible person?" "Is this Karmic justice for all the wrongs I've done to others?" &quo;tAm I a sinner?" It's JobŐs question.
What techniques do you use in Transformational Imagery?
It's such an individualized thing it's hard to generalize about. I try to get a sense of where people are in that process. We look at issues of resistance, what's keeping them there and not facilitating their movement through it. You can dialogue with the resistance, too.
You can do parts work and see if their parts (sub-personalities or ego states) are in conflict. There are also secondary gains issues. One part wants to overcome the pain, the other part is getting a benefit from it. So the parts are in conflict and you can have a dialogue with each of the parts.
It's the alchemical treatise: Solve Et Coagula, which means, "Separate, then bring together...and in their fusion is given off light." It's the way we do parts work. First you identify each of the parts. People may be in conflict and not even realize they have a part that is resisting the transformational change. Then you separate the parts and allow an image to form for the part that wants to overcome the pain. Allow an image to form for the part that doesn't. Give each a name and a voice. Ask why they are there and what they want and need.
The second step is to ask them what they think about each other...and usually it starts out fairly acrimonious. Then you start to bring the parts together and there are numerous imagery techniques to help in this process. My partner, Marty Rossman, says it's like marriage and family counseling within the skin. So you use all the skills you'd use in couples counseling but you use those techniques to try to bring the parts together.
You mentioned Alchemy. Can you say more about that?
In Alchemy they say "The solution is in the question." And imagery is like that. An image arises and it's full-blown but it takes us awhile to really understand it. You can ask a new part to emerge that represents something higher than the individual parts.
And all this is under the category of Transformational Imagery?
I once read a story of an African tribesman who had to confront a lion as part of his ritual transformation. He met the lion and had his arm torn off...a situation which should call for tremendous pain. But he was smiling in the doctor's office because he had succeeded in his venture.
This phenomenon is very well known. Soldiers during war were looked at who had horrendous wounds and yet were not complaining of pain...because they were in such a state of euphoria that the war was over for them. They were going back home. They were wounded but were not going to die.