Therapy Gem: Reification and Action with Comments on Anger Management and Intervention

Freud’s Study in Vienna

Two Errors in the Application of Psychological Constructs. Since psychoanalysis and psychology first became popular decades ago, the public has absorbed many of their tenets into popular thinking.  Many of those adoptions no longer represent the scientific or exact meaning psychoanalysts or psychologists gave to these terms and ideas.

For example, “ego” means the organization of personality functions which adapt a person’s needs and drives to his or her guiding ideals and/or reality constraints.  These personality functions of self-control, coping, sensation, perception, thinking, judgment, and will, among other functions, help us to satisfy our needs given the realities we face. So “Ego” only means an organized use of these functions in service of satisfying our drives and needs while adapting to 1) our physical and cultural environment, 2) all of our past learning, and 3) our internalized ideals.  “Ego” does not actually refer to any place or thing inside of us.

But since the late 1960s, the term “ego” in common parlance means something quite different, namely, narcissism or egotism, self-absorption.  When we say, “You have a big ego,” meaning something on the order of “You think you are important” or “You are self-centered,” we are almost implying the ego is a place inside of us.

So, many ideas in psychology have become popular, but the precision of meaning has been lost in the translation.  In some cases, the idea has been treated as if the concept represents a real thing.  For example, the term “ego,” as in “Your ego,” implies a tangible structure, a stable characteristic.  Whether people mean by “ego” merely self-absorption or whether they cross a line and treat the “ego” as something tangible certainly is an important discrimination!  As we shall see, the latter is an example of a fallacy named reification, treating a theoretical construct as if it is a reality.

So we have two errors in the popular use of psychological constructs.  First is that the meaning changes from a more precise construct to a more general, imprecise trait or characteristic of people.  The second is the reification of constructs.  That means the constructs are treated as if they were real parts of us.

Note: Before we become psychotherapists, we professionals are members of our culture.  So we grow up using language in these imprecise and sometimes reified ways.  We need to be much more careful in our use of constructs and language.  After all, as therapists, empathy and language are two of our very most crucial tools for promoting change.

Reification of the Term ‘Anger

One of those imprecise propositions is that feelings must be expressed.  So, in this perspective, angry feelings ought to gain catharsis.  In other words, the prevailing popular belief is that our angry feelings should be expressed in words.  Whereas a therapist prefers the client express angry feelings in words, the popular notion is that such feelings should not merely be expressed intellectually.  Rather there should be an affective charge – that is, anger should be expressed angrily.

From there it is a short step to the idea that people have an amount of anger.  If we express anger, that is, vent, then, according to the popular concept, our quantum of anger should be reduced.  If angry feelings can be weak, such as irritation or annoyance, or strong, such as fury, then angry feelings could be thought of as a thing, a place inside of us, with a quantity, a size.  In this naive notion of catharsis, expressing the feelings honestly with their full charge of emotion should reduce or eliminate the intensity of the feelings.  Of course, it’s not so simple in reality.

Because some people express angry feelings more often than others do, it is also a short leap to the most unfortunate notion that anger is a trait which is also a thing inside.  Then it can be a strong trait or a weaker one.  You can have more of it or less.  You can “manage” it well or poorly.  So for the public, the feeling of anger has been transformed;  those who express anger frequently are thought to possess a thing within known as “anger.”  They think of themselves as having this anger, as though it were a thing.  Then it is a small leap to considering this thing controllable or uncontrollable, manageable or unmanageable.  The unfortunate term Anger Management, therefore, institutionalizes this conception that anger is a stable characteristic of people.

Hence, people say, “He has a lot of anger.”  “Where is your anger?”  “Get your anger out.”  “His anger is out of control.”  “I don’t know if I can control my anger.”  “I had to get my anger out.”  “I have so much anger in me.”

But is anger truly a place in us?  No.  Should we get our anger out?  Sometimes.  That is, sometimes it is appropriate, tactful, and useful to express our feelings.  Sometimes we would be better off keeping those feelings to ourselves.  But we can’t actually get our anger out.  We can talk about it.  We can show it.

If it is a trait and a quantity, how is it those presumably high-anger people are often happy or warm or otherwise not angry much of the time?   If they are people of anger, but they are acting pleasantly, how can they not be who they are identified as being?  How could they not be demonstrating this nasty thing within?

Is it really there?  No.

What’s there is a case of our two fallacies, imprecision and reification.

A trait is an action-pattern, namely, an enduring, pervasive tendency to behave in the same way across a wide variety of situations.  The personality psychologist, Gordon Allport, famously defined a trait as a pervasive reaction tendency which renders a variety of stimuli functionally equivalent – acting as if one perceived all the situations as similar in some way and each required the same reaction.  So it does not matter how a range of situations differ; regardless, the person’s perceptions, thoughts, and behaviors will be the same as if the situations were experienced mainly in how similar they are for that individual.  If anger is a trait and a thing inside, logically it should be present or displayed in most settings and much of the time regardless of the circumstances.  But that is not how it works in reality.

An example is the patient with a Borderline Personality Disorder who renders almost all situations as potential abandonments and behaves as if that were occurring in so many situations in which it really is not happening. Often, the threat, emptiness, sense of loss, or hurt the person experiences from interpreting the situation as an abandonment is expressed through that secondary emotion, anger.  That is, the person acts in a hostile way. In this example, we see there is no anger inside.  There is hostile behavior derived from some level of angry feelings derived from an interpretation of the situation as an abandonment which is associated with a history of damaged attachment and mistreatment.  The person’s memories and emotions are easily stimulated, true.  But there is no place of anger inside.

Let’s look further into the pattern of Borderline Personality Disorder as mentioned above.  Most therapists are familiar with clients who react to almost any small breach in the empathic connection as if they had been abandoned when they are not.  They often react with hostile responses.  So the person is vigilant for situations which may be perceived as abandonments.  According to Allport’s view, the person has come to perceive most new situations as potential abandonment situations.   Is this an angry (trait) person?  No, this is a person who reacts to the very painful threat of being alone and, perhaps, unwanted, with a legitimate emotion – threat leads to angry emotions.  She is remembering hurtful or abandoning situations in the past, remembering feeling helpless, badness, hurt, and shame, and she is reacting to those feelings.

A person with so-called “anger-management” problems renders many situations into provocations, situations of threat, or situations of disrespect or retaliation.  He behaves accordingly.

It is common to have a pattern of perceiving and mis-perceiving provocations in a variety of situations, applying the same cognition each time, such as “I am disrespected and that is terrible,” then acting in a hostile way.  That could signify a trait of manifest hostility.  But does it mean there is a pot or place of anger within” No.   A trait is an observable pattern, not a thing.  It merely means this person’s behavior shows more hostile acts than other people tend to show.

Threat does not open the anger pot and let out some of the venom within.

Consider warmth.  It cannot be expressed only some of the time or we should consider the warm person to run hot and cold!

Consider the trait of honesty, meaning being truthful.  It cannot be expressed only some of the time or we should consider the honest person dishonest!  Analogously, a person who is peaceful or agreeable as often as he is angry cannot be thought of as an angry person.  Using trait language where emotion language should be just confuses matters.  Therapists need to be more careful than that.

Oh, there is that other kind of honesty, another imprecise perversion of psychological language which has been culturally-absorbed.  Terms, such as ego, honesty, anal, stress, and vent, pass from the carefully defined confines of theoretical constructs – which we agree are useful ideas, but not real things – into the common parlance.  When those constructs become commonplace terms, their meaning becomes distorted, global, and vague.

As for honesty, the other meaning is saying what you think and meaning it, despite any harm your words may cause.  As Miss Manners, Judith Martin, tells us, honesty of this sort is so valued that people speak ‘in all honesty’ thinking they are being constructive and helpful.  Or they think they are right to do so regardless of the effect.  To say someone is emotionally honest, however, may be a complimentary or a critical statement; but it does not imply a place within where this honesty resides?   Clearly, it is meant as a description of a pervasive characteristic of the person, not a place or thing within.  Nor does it mean the person  does that 100% of the time.

You can see that anger can’t be a trait or a quantity or a structure.  That kind of language for anger makes no sense.  It is not an all-pervasive action-tendency.  It is not a larger or smaller pot of something within.  And it is not a place.

The fact is that when we feel angry, we have a strong urge to “let it out.”  But we are not releasing some demonic thing.  Or any “thing” at all.  When we are feeling any strong emotion, we have an urge to show it., to communicate.  Often we want  to eliminate the condition which is causing that emotion. But we don’t think of most of those emotions as things within us.  For instance, we do not think of an urge to taste or to drink liquids as things within us which have a size or place.  We think of them as urges, needs, or drives.

We don’t think of other emotions, such as hurt, gratitude, or affection, as things, but rather as emotions which we may or may not show.

Showing them does not decrease them.   The venting theory is a misunderstanding of the fact that states of heightened arousal eventually return to baseline levels of arousal.  The emotions associated with heightened arousal subside.

The fact that hypothalamic and limbic structures are responsible for these emotions and cortical structures are responsible for how we show or do not show them does not mean these is a place within those structures for those specific emotions.  In a general way, the amygdala is responsible for some of the more negative emotions.  I have seen research that this structure is enlarged in people who express anger more often.  Oddly, there is evidence that hippocampal volume is affected negatively by trauma; that has an influence on learning new emotional responses.  But it does not mean there is a place where a pot of trauma is located.  These structures are not  specific places for a specific emotion.  They process emotion and emotional memory.

In truth, anger is an affective response, an emotion.   People who more often show angry feelings through angry or hostile behavior have nothing more than a pattern.   To say “She is hostile” is nothing more than to say she is has a pattern of being easily cued to show angry behavior.  Psychologists do think of hostility – the pervasive pattern of showing angry responses in many situations – as a trait, but in no way do they think of it as a thing or a tank of anger.

Therapists and Reification

Psychotherapists ought to be most careful about these distinctions.  Errors in the use of language in the therapeutic situation can be dangerous.  Nevertheless, even psychotherapists make this mistake of talking about “his anger,” as if anger is a thing, a quality, or a trait, rather than an emotion and a pattern.  Further, they accept clients talking about themselves in this same way.

These are damaging errors.

These notions derive in part from a mechanistic view of personality – as if it had structures which are tangible and which have amounts, like a hydraulic machine.  In that framework, if we tap those reservoirs, we can lower the amount of the trait though venting, expressing, sharing, or abreaction, namely, emotionally releasing the painful experience .   But that makes no sense either.  If it’s a trait, then it can’t vary in amount merely because it is expressed.  If anything, the expression of the so-called anger trait ought to make it stronger through reinforcement!  That is just the opposite of the desired outcome.               

The latter is far more the truth!   The evidence does not appear to support a naive theory that venting lowers overall angry feelings.  Those who respond angrily the most can easily come to see the world as confirming the theory that it is a dangerous, threatening, depriving, or hurtful place; hence, more rather than less  hostile behavior seems justified to them.  Of course, it’s a self-fulfilling prophecy.  Angry actions often beget defensive or angry behavior in return.

Fallacious Thinking

This error in the way that people, even therapists, view abstract qualities and emotions comes from a few fallacies.

1. Over-generalization.  We form abstractions, but some abstractions may be incorrect.  That is, when we are dealing with repetitive behaviors, we tend to connect the dots and imagine or infer we see a structure.  So when we see a person react a certain way repeatedly, we see a structure, disposition, or trait.  Thus, a person whose angry affects are easily stimulated and who expresses those affects strongly, or who has a long period to recovery after expressing angry feelings, is thought of as having a trait of hostility.  But that does not mean there is a hostility spot within the person!  Nor does it mean the person is unusually hostile; the observer may be seeing the subject in a small number of situations in which angry behavior was elicited, but which may not be representative of the person’s overall behavior.

2. Selective Inference.  When the repeated affective responses are strong, we tend to attribute a quantity to that presumed ‘trait,’ a quality of intensity which we view as a stable characteristic of that person’s personality, such as a supposed trait of anger.  We fail to see it’s merely the intensity of the current emotion.  So instead of quantifying the intensity of the response, we mistakenly presume there is an intensity to the underlying anger trait.  Instead of seeing the intensity as proportionate to the provocation, we see it a measure of an underlying trait.  So we say “He has a lot of anger in him,” rather than “He was enraged over what happened.”

Again, we are viewing as a stable, quantifiable trait that which is a behavioral expression of an affect and a pattern of responding.

3.  Inter-individual Comparisons.  We also succumb to the tendency to compare the intensity of those responses amongst individuals.  So we may infer that Person A has more of the supposed anger trait than person B.  That is, we tend to see comparisons in this supposed and fictitious anger quantum between people – so one person has more “anger” than another. Actually, A may be more easily provoked, more vigilant, etc.  A may expresses angry affects more often than B.  We should not, however, reify that behavior and say A has a lot of anger inside.

4.  Arbitrary Inference.  A related fallacy ARBITRARY INFERENCE.  This is reasoning from a phenomenon to an unseen, unknown cause or from an event to an inferred, unseen motivation.  Applied to this essay, it refers to a leap of inference from someone’s behavior to a presumption about the person’s intention or to causation.  For example, “You were late, so I must not be important to you.”  “My feelings are hurt, so you wanted to hurt me.”  Assuming the outcome implies a cause is a step along the way to reification.  “If you hurt me and I know you wanted to, then you are a sadist [narcissist, thoughtless jerk, total disappointment, failure, etc].”  “I won’t accept your apology because in my opinion it’s not given out of sincere motives.”  “The fact that I had to ask ruins the fact that you did what I wanted.  Your heart isn’t in it.”  In other words, like Reification, Arbitrary thinking presumes some reality which goes beyond the observed.

At this point, we have been erroneously convinced of the reality of these supposed quantities of these supposed characteristics.  We have ABSTRACTED from the behaviors  themselves to a higher level in which we joined the observations together into the ABSTRACTION of ANGER as some kind of quantifiable thing.

This process of treating an abstraction as if it were a real thing is called REIFICATION.  This is a cognitive fallacy of assuming an abstract concept or theoretical construct is a real thing.  

Proper Usage

The word “anger” should be used only to refer to a particular emotion when we talk about human emotions in some general way, as in “Anger is one of the primary emotions.”  Or we could refer to specific emotion in a person, as in “You felt the emotion of anger when your feelings were hurt.” The word “angry” would be better to describe the presence of that emotion in a person, as in “I feel angry.”  The words hostile or angry, along with words which convey a sense of degree of hostile feelings, words such as irritated, annoyed, mad, irate, furious, represent specific feelings.  We could also use those words to refer to the quality of the resultant behavior.

So “How much anger you have!” is inappropriate and is less helpful than “How angry you feel and how you certainly do show it.”   Once we think of angry feelings rather than “anger,” it makes sense to quantify the intensity of the feeling, recognizing English has numerous words for expressing the quantity and type of angry feeling.  If we think of anger only as emotion and not a trait, then we have many words we can use to describe gradations of the emotion.

Furthermore, separating the emotion from the resultant behavior is crucial to therapeutic intervention.  Actually, separating the stimulus from the appraisal of that event from the subsequent emotions from the associated memories from the associated cognitions from the resultant behavior is all critical to change.

Intervention

As you will see below, telling a client he has a trait is unhelpful.  That kind of intervention is critical of the person, but gives little guidance on how to change.  It is no more helpful than telling a person who has OCD that he is “anxious” and “stop it.”

For example, telling the client he or she has an emotion and believes he or she can show it in a particular way is more likely to develop a helpful conversation.  Immediately, we think about how to help the person show it in a different way or react differently to a situation.  “You feel hurt and that makes you feel mortified, seeing the situation as one you should never have exposed yourself to, and then you go on the counter-attack.  Instead of saying you are hurt, you hurt the person back.”  We see that looking at the reaction in terms of emotions and reactions offers numerous intervention strategies.

A Range of Changes

The person could interpret the situation in a way which is not experienced as a hurt.  The person could see it as problem with the other person rather than a failing of self.  The person could consider how her self-concept amplifies the sense of mortification. The person could examine a range of coping strategies besides counter-attack.  The person could examine the beliefs behind retaliation.  Consider how limiting it is, by comparison, to tell the client, “Your anger is so great, it gets in the way of your relationships.”  How much less we and our client can do with that rather common type of mis-statement.  The statement seems almost critical, an indictment. Compare this statement, “You felt very angry and then you shouted.  It was because you felt hurt like when you were criticized as a child.  Then you used that belief that you should retaliate and you hurt your friend back.  It felt better to know someone hurt like you did.”  You can see when you spell out the dynamics that venting can’t really work very often – it leads to a sequence which often reinforces the underlying beliefs and may get some results, such as an apology, thereby reinforcing the hostile behavior.

People Pleasing

From the many such reifications we use, let’s take another example, People Pleasing.   We see a person make an effort to get her partner to be happy with her.  She may do this by ingratiating herself, helping in whatever ways she can determine may be helpful, agreeing with the other, giving in easily, enabling an undesirable behavior, failing to stand up for herself, tolerating mistreatment, or going out of her way to keep doing something the other person likes.  Rather than see these behaviors for their underlying motive, we see them for their surface value.  That is, on the face of it, they look like efforts to please others.  That may be so; but at a deeper level they may be efforts to feel safe, to feel loved, to feel accepted, or to feel approved of.  On the surface, we infer a persistent, pervasive tendency – the very definition of a trait – and say “You ARE a people pleaser.”  This equates the person with the behavior. [We are also being emotionally honest in that all too open way we discussed before and we expect the person to accept the critique graciously, that is, to please us for being so helpful.]

If we were to tell the person she is people-pleasing, but her motive for this behavior is self-protective, so why would she change behavior she has learned may be much safer than the alternative?  Also, criticism as a way to promote change seldom works!

But this is pejorative and critical.  As such, the patient may understand the reference and think of this as a PRESCRIPTIVE INTERVENTION.  A prescriptive intervention is one that implies “You are doing something wrong and you should stop doing it.”  But the patient is not doing anything wrong.  She is trying to meet important needs.  She may need more appropriate, adequate, or effective methods for doing so.  In other words, if we REIFY her behavior from an abstraction (an observation of a set of related behaviors) into a presumed thing, the thing being “People Pleasing,”  then just as the case with anger, we have missed the underlying processes, the deeper meaning of the behavior, the emotions involved, the pattern, and the patient’s motivation.  Then if change does not occur, it is faulty therapy, not faulty client.

Consequences of Reification

We can see that it is damaging enough that patients think of their own behavior in terms of reified abstractions such as “my anger,” “I am a people pleaser,” or “his ego.”  But it is more concerning when therapists reify patterns of behavior, affects, and needs.  When therapists reify, their thinking drifts away from helpful processes which are oriented toward change.  Instead, they direct the therapy to less helpful processes of LABELING the patient and expecting the implicit criticism to cause the patient to change.  In essence, this is a CRITICISM FALLACY, namely, that by telling the patient what her dysfunctional traits are that she will abandon them and somehow hit upon more effective behaviors.

The criticism fallacy is a cultural bias.  We see parents tell their children what they are doing wrong.  We see teachers tell students what they are doing wrong. We see husbands and wives telling one another who is wrong and expecting capitulation. We see psychotherapists telling clients what they are doing wrong.  In each case, the expectation is that the person will cease and desist.  In simple operant conditioning theory, Skinner long ago pointed out that punishment does not teach the desired response and certainly cannot increase the frequency of the desired response.  Only reinforcement can do that.  We can follow Bandura’s approach and have the person observe and identify with the desired behavior, then receive reinforcement or experience intrinsic reinforcement.  Beck did not tell people merely to observe their dysfunctional thinking, but also to hypothesize more functional thinking, then observe which type better fit the circumstances.  Systems therapists increase positive, low-frequency responses by the use of therapeutic compliments and finding positive connotations for behavior they want to re-shape.  So theories of change do not succumb to the Criticism Fallacy.  But therapists join their cultural cohorts in maintaining this fallacy.  And it goes hand in hand with reification.  The formula is something like this: “I am a helpful observer of your behavior.  Listen to my advice.  You have this trait.  That’s bad.  Stop showing it.”

REIFICATION presumes that something abstract actually has a concrete reality.  To cite a famous example, while Id, Ego, and Superego were meant to be metaphoric for organizations of personality FUNCTIONS, those terms have been treated as if they were meant as reifications and were thought to represent places in the psyche.  They never were intended to be reified.  Actually, Freud called them in German Es, Ich, and Uberich, namely, It, I, Over-I.  Clearly, in German, the terminology was meant to be loose, instructive, or metaphoric. It was an early English translator, James Strachey, who apparently wanted Freud to sound more scientific.  So he used Latin terms for these metaphors.

Reification is a common technique in rhetoric.  “Love” is often treated in poetry as a thing rather than a feeling.  But this device is understood by all readers as talking about the emotion behind the metaphor.  In psychotherapy, this is far from the case.  The patient hears the therapist as an expert; so the therapist’s wording and any fallacious comments are unconsciously heard as what is real.

Diagnosis

Let me comment on another reification.  We sometimes reify diagnoses.  We say this person IS schizophrenic.  This patient IS bipolar.  We sometimes refer to the client as “the borderline,” or “the bipolar.”  That is similar to a rhetorical devise known as METONYMY, identifying the person with one element.

Used to describe the entire person, some terms, such as mental retardation or autism, carry a stigma as if to say there is nothing more to know about the person!

The verb “to be” equates the subject, the person, with the object, that is, the diagnosis.  Actually, we professionals all understand the person displays a grouping of signs, symptoms, emotions, thoughts, and behaviors which we have learned appear together in the form of a syndrome (i.e., from the Greek for things ‘that run in unison’), namely, a recognizable pathological pattern.  These are patterns, not entities.  So of course you understand a person IS not the thing. I am not implying or denying that many diagnoses relate to actual brain-level dysfunctions.  But the person IS something far more vast than the condition he shows.  A person may be said to

*“have” a psychiatric disorder

*be suffering from a psychiatric disorder

*be displaying (manifesting) the syndrome or symptoms

John Nash, the subject of the movie A Beautiful Mind, is a mathematician who happens to suffer from a psychotic disorder.

I once worked on a psychiatric unit in a community hospital.  One morning I saw a patient, whose chart included the diagnosis of Paranoid Schizophrenia, sitting at a table with open books spread around him, writing on a legal pad.  He was a professor preparing his lecture notes.  He was to have a pass to give his lecture and then return to the unit to continue the treatment to stabilize him on new medication after an exacerbation of his symptoms.

I once treated a woman with hallucinations so intense and unremitting that they drowned out real voices speaking to her. I learned later that she did some very skilled craft work and she did volunteer medic work at concerts.  She also could drive safely.  The person is not to be described at the diagnosis.  One effect of making that error is to obscure our view of person’s the talents, skills, strengths, and abilities.

A few caveats are in order.  1) While we have found organic or genetic  substrates for some psychiatric disorders, in which case it may be more reasonable to say as person HAS a disorder, we have not found those substrates in most others.  In those cases, the disorders are pervasive action patterns.  A person displays or manifests them.   2) Because people relate psychiatric disorders to medical entities such as having an infection or a cancer, something organic which one HAS, patients hear borderline personality, depression, bipolar, and ADHD and the like as something one HAS in a tangible sense.  As long as we have a clear understanding that in some cases there is an organic substrate for the disorder but in many cases there is no THING or ESSENCE behind the diagnosis (rather the diagnosis is a label for a pattern), probably there is no harm in this type of usage amongst professionals.  But there is harm in reifying the diagnosis for the patient.  So, it’s preposterous to say one IS cancer the way we say one is a paranoid!   3) We are a long way from a final, definitive diagnostic manual.  For example, borderline personality can tilt toward paranoid, depressive, histrionic and other types.  Are these all manifestations of the same disorder?  Are they different?  In any case, this suggests it isn’t a thing one has, but a pattern.

In addition, from DSMII to DSMIII to DSMIV, a number of personality disorders have been subtracted or added.   The subtypes for schizophrenia changed quite a bit as well.  We are still discovering organic features which explain various disorders and we fine tune our understanding of those disorders and their relationships.  Therefore, all this shows that our understandings of diagnoses are far from representing things in themselves.

Better terminology is that the patient displays/shows/manifests the signs and symptoms of x disorder characterized by x1, x2, x3, etc., symptoms.  For example, “Joe shows symptoms of attention deficit hyperactivity disorder, characterized by distractibility, inattention, restlessness, and disorganization.”  When we write a report, we should use this terminology and format.  When we communicate about a patient, we should not use the verb ‘IS,” but we can say the person “HAS” a disorder, though I would prefer to say the person shows symptoms x1, x2 and x3 characteristic of disorder y.

Attention-Seeking

So now let’s look at another reification, the dismissive attribution about a person’s behavior that she is “attention-seeking.”  “She just wanted attention.”  “That behavior was attention-seeking.”  My students know that if I hear this term, I am likely to stop the presentation and give a mini-lecture about using buzzwords and attention-seeking is one of those I find particularly inappropriate.  The term is critical, dismissive of behavior which may be quite normal, and gives no guidance whatsoever.  It implies a trait and attributes a motive ascribed exogenously to the client.  But what is the internal meaning of the behavior?  By labeling it attention-seeking, we are only interested in shutting down the behavior, not in understanding it.   Such a presumption can indeed be thoughtless and, well, presumptuous.

First, humans crave and need attention, approval, and recognition.  We need them in order to establish attachment, self-concept, and self-esteem.  We need them in order to be socialized, to know what behavior is commendable, adaptive, or culturally sanctioned.  In our early years, attention is crucial for attachment, developing a sense of self, and supporting narcissistic development.  Without intensive attention in our early years , miasma, hospitalism, or failure to thrive are a result.

Second, the client may have a primary need for the therapist’s attention.  That would occur in a client who was deprived of meaningful attentiveness at an early age.  The client’s developmental needs have emerged in the transference.  This is not pathology.  This is a re-awakening of those needs in a safe environment where the therapist can observe and support developmental movement.  Is this not crucial to all therapies!

Third, the client may have a secondary need for the therapist’s attention.  That would occur in many ways, such as in a client who had learned to seek recognition in order to build self-worth, a client who experienced a loss or abandonment later than early childhood, or a client who felt ignored and unwanted and feels a need to dramatize her feelings in order to believe she is heard.

To dismiss any of these clients in severely pejorative words, such as “attention-seeking,” is to undermine the client’s way of meeting important needs.  More advisable is to get to the significance of the behavior in question.  “From what you have said in the past, we see how you could worry I may not truly hear your distress and so you felt you had to shout like when your parents (both of whom were alcoholic) did not hear and protect you.”

What Shall We Do: Action Language

Using Action Language

As examples of how to use language in a more appropriate way, let’s take closer look at anger, people pleasing, and id, ego, and superego.  If they should not be reified, how should we understand them.  What are we to say about behavior reflective of those concepts?

Be more aware of the abstractions you use.  Avoid treating a tendency, a group of actions, a pattern of behavior, a psychic organization of responses, or an emotion as if they are a thing or trait.  Treat them and talk about them as a pattern or action (behavior).  Patterns can change in frequency, location, duration, intensity, cues which elicit them, steps in the pattern, and outcomesIntervention can be designed to alter any one of those steps.

Emotions can be labeled and associated with memories which link to those emotions across time.  This is known as an AFFECT BRIDGE.

Reifying patterns or constructs into fictive structures makes them fixed and hard to change, so the message is “This is a bad thing. Change it.  But it will be difficult and the way is unclear.”  More appropriate language conveys the more hopeful message, “There are reasons you’ve come to do it this way.  Then you can find other ways to react.”

What we observe in a patient’s behavior should be identified by its pattern.  Patterns can be a set of repeated actions steps.  Patterns can occur often enough that the therapist can see correlations with causes or outcomes or can perceive in current behavior the repetition of a historical pattern.  So, for example, here is one possible analysis of a hostile act: “It seems that when something breaks or is difficult and not going well, you feel frustration and think it’s pretty disastrous, because it reminds you of your father scolding you and you think you are inadequate, and, when you feel that hurt, you often throw something.  Then you feel foolish, ashamed, and disappointed in yourself.  What comes to mind about that?”

On the other hand, a reified statement of this pattern could go something like this: “You’re so full of rage that when something breaks you have to blow off steam.  And you have no self-esteem.”  No one is full of rage, so no one can blow off steam.  This illogical statement almost feels hopeless.

Come back to the first statement.  Notice it correlates a series of observations or reports of the patient’s observations, beginning with a cue or stimulus.  That is, “when something breaks or is difficult.”  Then it identifies the patient’s emotional response, “frustration,” and cognitive response, “disastrous.” It brings in an un-mastered memory related to father.  These are ways of putting names to states both therapist and patient can identify.  Then it identifies the behavioral result of the underlying cognition and affect, “when you feel that way you often throw something.”  Lastly, it identifies the consequences of the behavior.  In other words, the statement, known as an INTERPRETATION, does not say, “Your anger is so strong,” which is reification.  It says you have a tendency to follow the emotion and the cognition with a certain behavior pattern.  This is an ACTION LANGUAGE.  Instead of a thing language, it abstracts behaviors into action patterns.  Action Language admits numerous intervention strategies.

When we reify behavior, it implies some inherent trait.  Action language, the language of patterns and tendencies, implies change is possible.

A thing is experienced as solid, stable, and unchanging.  But an action pattern is mutable.  So let’s go back to parsing the action statement.  It implies that a person could react to breaking an object with a different perception and, therefore, a different emotion.  It implies that a different cognition could follow from the emotion.  And lastly, it implies that a different action could be learned.  So a different consequence could occur.  It also suggests learning to separate the present from the past.  It suggests helping shift the person’s self-concept.  In other words, “So this last time, when something broke, you interpreted that as something that could happen to anyone at any time.  So you felt sad to lose the item, but you thought this is just one of those things, and you calmly cleaned it up.  As a result, you are proud of yourself for remaining peaceful and resisting any tendency to get mad.  What do you notice about yourself that enabled such a big change?”

It is more difficult to get to the roots of a non-existent, but reified, abstraction!  Where does the presumed pot of anger come from?  But an action pattern has been learned through experience, identification, or some other means, and one can often recall the origins of the pattern.  One might consider, ‘If I learned it then and I keep doing it now, perhaps I now can understand what I am doing and why I am doing it and what other behaviors I can perform in order to change it.’

Are therapists ever justified in reifying abstract notions during therapy?  Probably not.

Are therapists banned from using the language of traits? Of course not.  Trait language is a short-hand for communication between therapists.  When we say a person is depressive, manipulative, or narcissistic, those words convey in short-hand the description of a grouping of behaviors we psychotherapists all understand.  I still think our consultations would be more effective if we concentrated on avoiding trait language and worked hard to talk in the language of patterns and, therefore, the language of change.  Rather than “She is manipulative,” how about “We are working on her seeing the consequences of her manipulations and she is determined to stop behaving that way”?

Yes, in logic, those patterns we see in client behavior are abstractions too.  But we clearly are not thinking of them as things.  We are thinking of them as repeated steps in a family system or in an individual’s behavior.   Steps can change; other steps can be learned.

Put simply, the language of actions and patterns offers a richer path to the process of change.

© Don D Rosenberg, 2012

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