Because such work is concrete and definite in contrast to more general or abstract discussions of thoughts and feelings, clients often have an easier time using it. When basic trust has been established and the client is functioning consistently at predetermined, baseline levels, such work can be gently introduced to receptive clients. In a supportive, caring fashion, client and therapist can then examine together the gamut of subpersonality identifications: the part that "acts out," that withdraws, that is self-hating, that feels anxious and insatiably needy.
Should the client show signs of being upset by this work, either during or following the session, it should cease. When used sparingly, and with discrimination, however, such discussions can add freshness and humor to what, for the client, is the arduous process of reconnecting with himself and the external environment.
In this context, humor itself, when used with compassion and clarity, can have an almost magical effect in strengthening the therapeutic bond; simultaneously, humor aids the client in stepping back and taking less seriously the various attitudes, behaviors, and emotions which are the substance of his or her subpersonality identifications. Such a therapist may be said to be aiding the client toward "dis-identification through conversation." What follows is the next step in aiding a client rebuild and re-identify with a more mature aspect of self, his "own inner nurturing parent" or her "responsible adult part."
Work with the subpersonality known as "the inner critic" can be of particular value to the long-term mentally ill client. Clients face the stigma of mental illness, as well as their own subjectively based difficulties in coping. Shame is very often coupled with blame in the form of pejorative self-judgment. This often is projected onto others with whom the mentally ill individual then struggles. A vicious cycle can be set up whereby professionals place further limits on the diagnosed individual - restricting him to a ward or supervised housing, for example. The client who can get to know and dis-identify from his inner critic gains back much energy and will to use on his journey toward health.
A crucial aspect of psychosynthesis counseling is the therapist's ability to relate to the client as a Self - a center of both awareness and will. The basic understanding one wishes the client to receive is, as Alberti states, "I have an illness, but I am not my illness." This attitude on the part of the therapist consists of relating to the client in the context of his essential nature and his potential for health while acknowledging his current identifications and disabilities. Anne Yeomans describes this attitude in writing about Roberto Assagioli:
"He had the remarkable capacity to read through the layers of self-doubt, of anxiety and tension, of fears and insecurities, of false pride, to reach through these false identifications to the very core of a person - to one's essence - and recognize and greet and affirm it. He seemed to be able to see through the pain and the chaos of those who came to him, to their positive and creative inner core, and say to them both with and without words, 'This is who you are.' We have often said he spoke to the highest in us and we rose to meet him."
This ability is most available to the therapist who has himself learned to disidentify from the various thoughts, emotions, and perceptual vantage points of his own psyche, returning to the observing, willing center, the Self.
Of major help in aiding clients to re-identify with more mature or life-enhancing aspects of themselves is the principle of identification -that is: whatever one gives energy and attention to grows in power and intensity. This is stated as Law Six of Assagioli's Ten Psychological Laws: attention, interest, affirmations, and repetitions reinforce the ideas, images, and psychological formulations on which they are centered.
For many clients, this means moving attention away from images of defeat and substituting in their place a realistic goal they desire to accomplish. One client who had recently found success living in the community after 20 years of hospitalization failed the written permit test necessary for getting his driver's license. All childhood experiences of test taking were failures, except for one incident in grammar school where he had passed a difficult test and had been lauded before the entire class. It was suggested that he concentrate on and recall this memory for five minutes each night, stating to himself the affirmation: "I am going to pass that permit test." Within a month, he passed the test with a perfect score.
In a related context, the psychosynthesis exercise known as "the ideal model" can be adapted for work with this population. The therapist can ask such questions as, "If you were able to nurture and take care of yourself, what would that be like?" The client is then encouraged to flesh out a realistic vision in words, describing the details as carefully as possible. Within attainable limits, the client can be invited to imagine himself possessing an ideal skill or life state. Such a focus of attention when combined with sincere desire can do much, as Hyde states, to "touch the inner core of hopelessness with a firm helping hand." This, Hyde notes, is key for rehabilitation of schizophrenics.
The client's will to grow (or will to health) is a crucial determining factor in successful rehabilitation. Yet, as Peck states, it is a factor not at all understood or even recognized by contemporary psychiatric theory. He notes that it is possible for an individual to be extremely ill, psychiatrically - and yet at the same time possess an extremely strong "will to grow," in which case, some healing will occur. A person who is only mildly ill, on the other hand, but who lacks the will to grow, "will not budge an inch from an unhealthy position."
Hyde has shown that success, even for very ill psychiatric patients, is based mainly on persistence, hard work, and learning to handle setbacks. But, as Alberti asserted, the will to health is intimately connected with the will to meaning - the client's ability to give meaning to the prospect of greater health. Frankl has said that it was this will to meaning which enabled concentration camp victims to survive their horrific conditions. With schizophrenic clients, the therapist often finds the need to appeal to the client's will to meaning, which takes the form of acceptance of life through trust and faith in life itself.
Assagioli was known to speak of the blessing of obstacles, pointing out their function in drawing out latent will and permitting us to develop transpersonal qualities in the struggle to overcome difficulties. From this point of view, the difficulties life presents can be seen as opportunities for growth, and obstacles as challenges or stepping stones. In addition to freeing a vast reserve of will, such a reframed perspective can provide great comfort to the schizophrenic client.
While action in the outer world may follow, there occurs, just as often, a more relaxed acceptance of the realities of one's current existence. As Crampton points out, dealing with an obstacle at times simply means accepting a situation which cannot be changed and learning to develop patience and forbearance. This, too, is an act of will, for as Frankl wrote: "What matters most when one confronts an unavoidable situation is the attitude chosen toward the suffering."
While certain aspects of the will, such as concentration and organization, appear to be seriously damaged by mental illness, these losses are often matched by the strengthening of other qualities in the very act of facing each day amidst psychic pain, confusion, and economic deprivation. These are important assets of which the mentally ill client is often unaware and which frequently go unacknowledged by mental health professionals. The therapist who is alert to the appearance of such strengths should consistently feed this information back to clients, reminding them of their patience, endurance, and courage.
Other aspects of will are often visible in the all- too-common control struggles of mentally ill clients with the mental health professionals in charge of planning and executing their treatment plans. Ineffective and painful past encounters with the mental health system coupled with the client's own urge for self-determination may emerge as sullen stubbornness and willful lack of compliance.
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