This week’s lecture was on “acting out”. It is tempting to view the term “acting out” as a throw back to the hippy culture of coolness. In fact Freud talked a lot about “acting out” saying that patients do not remember their repressed feelings but reproduce them not as memory but as an action. The action is repeated in a unconsious manner. For the therapist it is important to try to understand what is bring communicated. The most overt resistance is the “doing”, like when children “act out” with tantrums. The tantrums could be seen as a unconsious way of communicating attitudes to authority and compliance. Children’s feelings are invariably unmediated. The greater the resistance the greater the level of “acting out”. Indeed when a child falls over there is invariably a delayed reaction and then there are loud bursts of howling. Perhaps the child is making an unconscious attempt to get attention and sympathy for all the previous hurts. Transference and “acting out” are at one when the client is acting in a way that repeats “the cycle” with the therapist, thereby exploring the core issues. A lot of the material with a client is pre verbal and pre conscious.
The types of clients more likely to act out
Unable to sufficiently distinguish between present and past
Rigid defences, fear and terror of feelings leads to dis associate behaviour – when the clients get close to feelings they act out in a big way
Pre verbal levels of development
Kinds of acting out
Self destructive acts
Splitting – seeing more than one therapist at the same time
Bringing gifts and presents to the therapist
Setting conditions on the therapy
Imitating the therapist
Forgetting to pay
How to deal with acting out?
As with all therapy don’t let the “acting out” get personal. The “acting out” is not directed at you. Keep your boundaries and be consistent with whatever you do. Therapy is a two-handed affair. On the one hand you are offering strategies to help the client cope but on the other hand you are helping them to untangle the mess.
The job of the therapist is to recognise when something unconscious is beginning to surface in the sessions. We need to view “acting out” as a form of remembering. Empathy and compassion can create a safe environment in order to allow difficult issues rise to the surface. What are the fantasies? They will be your guide.
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