Scripts People Live

by Claude Steiner

  It makes perfect sense to me that people should ask such questions, and evaluate the responses of their prospective therapist, and that the time and opportunity for doing this be offered free of charge. It further makes sense that therapists who won’t agree to be freely interviewed are suspect of being less than open and candid. It makes no more sense that the client should pay to interview the therapist, than that the therapist should pay the client for interviewing him.

  The Myth of Mental Illness and the Relevance of Medicine to Therapy

  The notion that emotional disturbances are in some way similar to physical illnesses is another important widely held myth in psychotherapy. This myth has been thoroughly and adequately exposed by Thomas Szasz.1 Suffice it to say here that there is no justification whatsoever for thinking of the banal or extreme forms of tragic scripts, whether they be depression, madness, or drug abuse, as having any relationship to physical illness. As has been pointed out, the course of scripts parallels to some extent the course of illnesses in that they have an onset, a course, and an outcome. Yet none of the tragic scripts conform to the definition of an illness which requires that there be some “interruption or perversion of function of any of the organs, an acquired morbid change in any tissue of an organism, or throughout an organism, with characteristic symptoms caused by specific micro-organismic alterations.”2 Because such micro-organismic alterations are not detectable in any of the so-called “mental illnesses,” it is not proper to regard them as such, nor is it reasonable to expect that drugs could have a curative effect on them. At present no drug has proven effective to cure depression, madness, or drug abuse, and no drug is likely to ever have that effect, since these tragic scripts are not the result of chemical or micro-organismic changes in the body but the result of the scripted interactions between people.

  Some readers might argue that people who are afflicted by the extreme forms of the tragic scripts are often sick and in need of medical attention, and this is indeed the case. However, it is important to distinguish malnutrition, liver damage, arthritis, ulcers, or any of the other illnesses which develop as a result of the neglect of the body and anxiety to which people in extreme scripts are subjected, from the actual script. Thus, alcoholism is not an illness, although the excessive consumption of alcohol over a long period of time can lead to liver damage and other medical illnesses which require the assistance of a physician. The same is true of extreme depression and madness; they can over a period of time cause a physical illness, but they are not in themselves illnesses.

  Since neither physical medicine nor drugs are directly relevant to emotional disturbance or unhappiness, it also follows that physicians are in no way uniquely qualified to be therapists and that when they attempt to exclude other capable therapists from helping people they are usurping for themselves a function which is not theirs. Competence as a therapist depends on training and experience in therapy, and medical training is of no particular relevance. People wishing to see a physician’s documentation of this claim might read Allen Mariner, M.D., on the subject of the irrelevance of medical training to therapy.1

  19

  How to Avoid Rescue

  Therapists who are paid for helping others (ministers, probation officers, social workers, psychologists, doctors, psychiatrists, therapists), as well as other people who are simply devoted to other human beings, often come to experience their “helping” activities in a basically negative way.

  After the initial enthusiasm and pleasure of the first months or years of helping work they begin to experience frustration at having to work against difficult odds, a sense of bottomless responsibility, and heartbreak over failure.

  The widespread occurrence of this unpleasant experience causes “helping” workers to accept it as being reasonable for them, and one that they teach their trainees to expect.

  Working under such circumstances eventually fosters negative, persecutory attitudes about the people being helped; namely, that they are helpless and hopeless, or that they are lazy and unmotivated, or even that they are incurably ill.

  Since persons in need of help come to be seen as helpless, hopeless, and unmotivated, helpers tend to assume the complete burden of caring and helping, responding to and dealing with every problem that presents itself, and expecting no effort in return from the people they help.

  When a person enters into a helping situation with the attitude that the endless numbers of those being helped are helpless and yet that they all, somehow, must be helped, the burden becomes increasingly large until, soon, it is overwhelming and likely to crush the helper who will eventually feel powerless and victimized too. This is the plight of many mental health workers who work for public clinics where they are expected to take care of the emotional casualties of a whole city, county, or state.

  The attitudes described above are the expression of the game of Rescue in the work of therapists.

  The Rescue Triangle in Therapy

  Once pointed out, the Rescue Triangle becomes quite apparent to therapists. For instance, in the psychotherapy of alcoholics, it is common for the alcoholic to present himself as a powerless Victim. The therapist accepts this presentation and proceeds to “do therapy” without insuring a commitment of any sort from the alcoholic. Without any assurances of interest and willingness to participate from the alcoholic, he begins to act in the role of a Rescuer in which he does more than half of the work because the alcoholic has not really manifested any interest in stopping drinking or doing anything at all other than, maybe, come to therapy sessions. The alcoholic “makes progress” for a while, but eventually, just when everybody thinks he is really getting better, he goes back to drinking. Part of his reason is often a gesture of resentment and a retaliation to the therapist’s one-up stance. This is an instance of the Victim turning Persecutor as the Rescuer turns Victim. After the alcoholic persecutes the therapist by his “failure,” laced possibly with midnight calls and excessive demands for help, the therapist switches to the role of Persecutor and begins to act in vindictive ways. She may begin to think of him as a “schizophrenic,” may discount him, be angry with him because he is no longer being a good little Victim but is being instead a bad little Victim. At this point the Rescuer has turned into Persecutor and the alcoholic is back in the Victim position.

  Most therapists have worked enthusiastically in behalf of persons who eventually proved to have been not only disinterested in their help but actually disdainful of it. Most of us have had the experience of becoming more and more concerned and active with someone who subtly became more and more passive until it seemed that his welfare concerned us more than it did him. Most of us have, at one time or another, been lured into a false sense of accomplishment as therapists only to suddenly fall from our pedestals as our star “patient” got drunk, attempted suicide, or got arrested for shoplifting.

  Most of us have, after “working hard” with a person, and having no success, gotten angry and subtly (or overtly) persecuted her.

  These experiences are heartbreaking to therapists. I wish to present some ideas and approaches which will be helpful in avoiding the Game of Rescue in therapy.

  Therapy is a situation in which the three triangle roles have a tendency to occur, especially Rescuer and Victim. Some therapy groups which use attack therapy methods, as pioneered by Synanon, encourage the Persecutor role as well.

  For good therapy to take place, it is essential, however, that the persons seeking help be seen as complete human beings capable of taking power over their lives, and this is impossible as long as the therapist is willing to play the Rescuer role. The Persecuting role is completely without therapeutic merit as well, in my estimation. To be sure, when used, it does away with Rescuing tendencies in the group. But it adds nothing of value; and the kind of Persecution used in so-called “attack therapy” is often terrifying and inhumane, frequently causing people to become hardened and insensitive rather than better, happier human beings.

  In short, to avoid
the Rescue Triangle the therapist needs to adopt an “I’m O.K., you’re O.K.” position with respect to the person seeking help. (See page 22 for elaboration on this point.)

  How Not to Play the Rescue Game

  It is fairly evident that some people, some relationships, and some organizations operate almost completely within the framework of the Rescue Triangle. In these situations a person is denied the freedom to act in any way other than that which fits one of the three roles. Relating to one of these persons, relationships or organizations almost requires that a person participate in the game. For instance, relating to a person who is an alcoholic and who almost constantly displays the role of Victim in search of a Rescuer may be impossible unless one is willing to play the role of Rescuer or Persecutor. That is to say, if one is not willing to Rescue or Persecute the alcoholic, the alcoholic will simply not be interested. The same is true of certain individuals who demand to be Rescued or who demand to be Rescuers in relationships.

  There are some organizations in which, unless one is playing the role of Victim or the role of Rescuer, one cannot participate in the interactions. A psychiatric clinic is often this kind of organization in which there are only two slots for people: 1) the role of patient or Victim, in which one is treated as having no power and no choice; and 2) the role of therapist or Rescuer, in which one is required to treat people either as powerless good Victims, that is, people in need of help, or powerless bad Victims, that is, people in need of Persecution.

  Relationships with such people and such organizations are personally stressful if one does not want to play the Rescue game. It may be impossible to do, in fact, because one might be Persecuted for not wanting to play, so that staying in the situation at all is a case of being willingly Victimized and not getting out.

  In every case in which one person Rescues another, whether by going along with something she doesn’t want to do, by doing more than 50% of the work, or by not asking for what is wanted, there is always the assumption in the Rescuer that the person is in some way powerless, unable to take care of himself, or in some other way one-down. In every case, the act of Rescuing another person reaffirms and maintains the power imbalance between the Rescuer and the Victim and prevents the possibility of people becoming equals in the relationship. In order to eliminate Rescues one has to believe that people are O.K. and capable. Giving up one’s one-up assumptions and giving up the belief that some people are just unable to take power over their lives is difficult to do, but it is the only path to cooperative, helping relationships.

  Example: A young woman, disheveled and haggard-looking, appeared at the Radical Psychiatry Center Action Rap one afternoon (Figure 13). She slumped into a chair in the corner of the room looking desperate and ashen. Everyone noticed her and saw that she was in great need. Eventually, she looked up and got a greeting from a couple of the people in the room. As usual, after a round of self-introductions, the Action Rap Worker asked: “Who wants to work?”

  Several people said they did, but Carol (that was the woman’s name) said nothing. Everyone noticed; and somebody in the room, not the Worker, said: “How about you, Carol?”

  Carol answered, “Oh, I don’t know.…”

  The Worker let a few moments pass, turned to someone else and said, “I guess you want to work, Fred. Let’s go ahead and let Carol decide if she wants to work later.” This was a very self-conscious effort not to Rescue. Carol looked disappointed but said nothing.

  Fred worked for twenty minutes and when he ended by saying, “Thanks, I got what I wanted …,” Mary jumped right in and reported on some work she had done during the week. Everyone in the room was aware of Carol’s inaction and when Mary was done a silence followed.

  The Worker turned to Carol and said, “You look like you need something. I would like you to ask for it so that we can see if we can help.” Carol burst into tears. Jack, sitting next to her, put his arm around her but she cringed and he, hurt and upset, took his arm back lightning fast.

  Figure 12

  By now some people in the room seemed annoyed with Carol while others seemed taken by her pain, which was very real at the moment. The Worker, after letting her cry for about a minute, said, “Carol, it seems you feel quite powerless and without hope to do anything about it. Am I right?”

  Carol looked up, taken by the word “powerless.” She said, “That’s right, powerless. There is nothing I can do, I am such a mess.”

  The Worker answered, “The way we work here is that we want to do what we can to help you but we need you to use all of your energy or it won’t feel good to us.”

  “I told you I can’t do anything,” answered Carol.

  “You can start to take your power to act by asking for something….”

  “That’s not being powerful, that’s being weak!” answered Carol.

  “I don’t think so but, anyway, I want to help you to ask for something….”

  At this point Jack said, “I want something…,” and we worked with him for awhile, leaving Carol to decide what to do.

  The above example illustrates how not to Rescue an active Victim. Eventually, within that afternoon, Carol did ask for something. She wanted to be hugged by several of the women in the room, cried in one of their laps, and eventually spoke of her troubles. She got some helpful suggestions that day, but the main point is that when she left she felt better, she walked taller, and when she returned next day she said, “I have a lot to do but I feel good about yesterday. I got the point; I can do it!”

  The following points may be useful to further understand and avoid the game of Rescue.

  1. Every situation in which one person needs help from another is potentially also a situation in which one person can become a Rescuer and another person can become a Victim. The role of Rescuer is a role in which one person, in a one-up position, denies to or diminishes in another person, the Victim, the power of helping himself by accepting a request for help without making demands for equal participation or by imposing help without a request for it. Therefore:

  A. Don’t help without a contract.

  B. Don’t ever believe that a person is helpless (unless he is unconscious).

  C. Help people who are feeling helpless to find the ways in which they can apply the power they have.

  D. Don’t do more than 50% of the work in therapy; demand that people do at least 50% of the work at all times.

  E. Don’t do anything you don’t really want to do.

  2. The role of Rescuer is a role of power and superiority in relation to the Victim. The role of Victim is the role of powerlessness and inferiority in relation to the Rescuer. Behaving in either of these two roles inevitably leads to accumulated feelings of resentment which will turn both of these roles into the Persecutor role.

  Persecution, the inevitable result of playing the role of Rescuer or playing the role of Victim, will be proportional in intensity to the intensity of the Rescue or Victim role having been played. Therefore:

  A. Avoid behavior which unneccesarily places you in a one-up position.

  —Don’t use a special chair.

  —Don’t answer the phone during group sessions.

  —Don’t dress more expensively than the people you work for.

  —Don’t take the center of the group’s attention unless you have to for therapeutic purposes.

  —Don’t interrupt people.

  —Don’t accept one-down statements or “Gee, you’re wonderful” strokes from group members.

  —Maintain equality in all spheres except where you are understood to be one-up, namely as an expert in therapy. Strive to reduce this inequality by teaching group members everything you know about therapy.

  —Don’t have an unlisted phone (unless you also have one listed).

  B. If you feel anger toward a group member, assume that you have. Rescued by either

  (i) having done more than 50% of the work or by

  (ii) having done something you didn’t want to do and having fail
ed to do something about it for fear of hurting the person. Examples of this are: listening to people when you are bored, doing therapy when it feels unproductive, having sessions when you don’t want to, either because you don’t like the person, or she bores you, or you are tired.

  The responsibility is half yours. The angrier you are at a group member or the angrier he is at you, the more you are likely to have Rescued or Persecuted him. Remember, there is no such thing as a group member playing a game with you without your being a full partner in it. If you get angry at members of your contractual therapy group often (more than once every six months), get yourself into a therapy group and work on your problem.

  C. Don’t allow feelings of resentment to accumulate in you or group members. Unload stamps or held resentments in the group and encourage people to give Adult, critical feedback to each other and you.

  D. Don’t allow yourself to invite Persecution or Rescue from your group members. Some therapists, in order not to be one-up, try to come on one-down. This can be done by dressing sloppily, being sick a lot, being late to meetings, being hungover, smoking incessantly, alluding to or talking about one’s problems, or simply being an incompetent, fumbling therapist who cops out by saying once in a while, “Don’t look at me, I’m just one of the group …,” and forgetting that if that were the case he would have to refund his fees to the group members.

  Avoiding the Rescue game is a large measure of a therapist’s effectiveness.

  To summarize, we are rescuing another person when:

  1. We do something for someone else which we don’t really want to do.