Getting Sick - Like The Emergency Hatch

2024 Author: Harry Day | [email protected]. Last modified: 2023-12-17 15:43

When a person is under unbearable stress, the escape hatch acts as an outlet for relief. The “diversion channels” relieve the stress accumulated as a result of not turning to sources of irritation in search of ways to solve the problem. Liberation can be active, as in the case of suicide or murder, or passively, as in the case of (psychosomatic) illness or insanity.

Somatic illness ("Get sick") is an analogue of mental illness ("Go crazy") and also an emergency hatch. Due to their passive nature, illness and insanity create the illusion of a lack of responsibility. Thus, the therapist and client need to recognize the passive process and redirect energy towards healing.

Initially, five alternatives to the fate scenario were proposed:

(1) "Get better", (2) "Run away from people", (3) Go Crazy, (4) Kill Yourself, (5) “Continue to play old games” (Heiberg, Sefness and Bern, 1963).

Holloway (1973) later condenses these alternatives and links them to attitudes within Corral's OK:

1) (I) OK + (You) OK + Change, 2) OK - OK + Kill yourself, 3) OK - OK - Go crazy, 4) OK + OK- Kill others.

Scenario decisions set the course in which energy is channeled into the formation of destiny - to commit suicide, commit murder, and go to a hospital or special institution. - Acts of aggression, which alleviate the pent-up tension and actively lead to destruction. Illness or madness is the result of acts of inhibition, which lead to the accumulation of tension and passively lead to destruction. The main benefit of redirecting energy into braking is avoiding anticipated disaster by gaining autonomy.

Due to the ignorance that accompanies such scenario behavior, a client with an illness as an escape hatch does not pay attention to it at his own risk.

One of the positions here is to be an innocent victim or a passive recipient of illness or injury. Meanwhile, illness serves as a racketeering, reinforced by secondary benefits of care and attention, which is achieved by intimidation (Persecutor), pleasing (Rescuer) and being in a deplorable state (Victim).

Cowles-Boyd writes, “Escape doors, no matter how tragic, are designed by Child (P2) as solutions to unbearable problems. When these options are blocked by Adult Decisions, the Child experiences heightened shock and stress with no potential outlet. The result of the stress that builds up in the Child is most often confirmed later by the manifestation of a psychosomatic disorder (1980).

Here Cowles-Boyd describes the effect that occurs when the Sick escape hatch is left open with other hatches closed, even before the customer has the freedom and skill to address needs directly. Clients can close the Get Sick hatch as well as Go Crazy, Kill Yourself, and Kill Others and channel the energy directly into Get Well (Health). Techniques that redirect energy from escape routes into the therapeutic process have been described. Drew (Drye), Gouldings (1973) refer to anti-suicidal decision at the Adult level: "No matter what happens, I will never kill myself, either accidentally or intentionally."

Holloway (1973) suggests using a similar Adult level solution to close other escape hatches. Boyds (1980) ask clients to repeat the following sentence for each of the above escape hatches: "I might want to (kill myself, go crazy, kill someone else) and I won't." They then check for congruence by asking, "Do you want this statement to be true for you?"Mellor (1979) expands on such statements of intent with the following sentence: "I will not base it on someone else doing it for me." He describes 4 steps to a "life-affirming" decision: "I will live a healthy, fulfilling life and encourage others to do the same."

These techniques seem to be most appropriate for aggressive behavior, where the responsibility for the action belongs to the subject himself, and can be controlled through a decision. In a passive process in which responsibility for inhibition is outside awareness, the client needs information to shift the focus away from survival by meeting the survival need of the external caregiver by meeting needs with direct self-care. Early Decisions, made with the hope (Glenda, 1981) to maintain symbiosis, channel energy into inhibition. The result is a reduced "awareness" of the body and a reduced response to requests for relief from bodily tension. This manifests itself in the inability to defend oneself. Hope here fuels illusion and the passive process leads to illness and despair.

Redirecting focus to the inner Parent allows the client to let go of this illusion. True hope is gained through inner Resolution and Protection in a process of expression that relieves bodily tension and effectively solves problems. Activating the parenting aspects of the Parent allows you to risk release from inhibition for the sake of freedom.

This idea can be effectively represented with the five chair model (Caring Parent, Controlling Parent, Adult, Adaptive Child, Natural Child). The therapist can induce a dialogue between the Nurturing Parent and the Natural Child. Of particular importance is the following message: “I will be here, no matter what happens”, “I am part of you, so I will be with you all the time you live”, “Since you exist, you have needs, and this is absolutely OK - to satisfy them "and" Your feelings are a signal that you need something, and I take them seriously."

Any permissions or statements that seem appropriate to the identity of the client can be added. After each statement, or one after another, the client is asked to respond from the Natural Child's chair. When the answers demonstrate that the inner Parent can be trusted, the following formulation of the solution is congruent: “No matter how afraid I may be, I will speak loudly and clearly to protect myself (Natural Child is willing to take risks in order to feel) and stand up for myself (position Caring Parent).

With this, the urge to inhibition is released and the client seeks to recognize and respond to feelings. Health is a personal commitment to protecting and enjoying life.

Nancy H. Glenda, Registered Nurse, MS in Nursing, MS in Private Practice in Highland Heights, Ohio. ok literature:

Boyd, H. C. and Cowles-Boyd, L. Blocking Tragic Scenarios, Journal of Transactional Analysis, 1980

Cowles-Boyd, L. Psychosomatic Disorders and Tragic Scenario Paybacks, Journal of Transactional Analysis, 198, 10 (3), 230-231

Dre, S., Goulding, R. L., Goulding, M. B. "Anti-suicidal solutions: monitoring patients at risk of suicide." American Journal of Psychotherapy, 1973

Glenda, N. H. The Essence and Illusion of Hope. Journal of Transactional Analysis, 1981, 11 (2), 118-121

Khyberg, G. Sefness, W. R., and Berne, E. "Fate and Scenario Choices" Transactional Analysis Bulletin

Holloway, W. H. Close the escape hatch. Monograph 4, V. Kh. Holloway, M. D., 1973

Mellor, K. "Suicide: being killed, killing and dying." Journal of Transactional Analysis, 1979 9 (3), 182-188

Journal of Transactional Analysis, Issue 12, # 3, July 1982