I had a stark reminder the other night of how ubiquitous conflict between different wants and desires is, and also how distressing it can be.
My seven (nearly eight) year old son was getting out of the bath and was looking rather despondent. That’s an unusual look for him. He was also starting to get dressed without drying himself first which was similarly out of the ordinary.
I asked him if anything was bothering him and he replied “It’s just not perfect when I get dressed and I want it to be perfect and it’s impossible.” I was a bit taken aback at first because he’d never expressed this kind of passion for dressing before. I asked him what he meant by “perfect” and he said “I don’t know how else to explain it.” So, taking another approach, I asked him what was wrong with the way he was getting dressed.
By this stage he was sitting on my lap and was sobbing. Through his tears he held out his right hand, palm up, and said “I want to get dressed in the bath but I don’t want to get dressed in the bath” and then, he held out his left hand, palm up, and said, “And I want to get dressed in my bedroom and I don’t want to get dressed in my bedroom. I can’t decide which one to do and that’s why it’s impossible.”
Since the entire basis of my therapeutic approach is the identification and resolution of internal conflict (The Method of Levels) I suspected some kind of conflict might be the source of his angst but I was stunned to hear such a clear and eloquent description of it by a 7 year old.
We chatted about this for just a few minutes with me asking him about both sides of the conflict.
Me: “So you want to get dressed in the bath and you don’t want to get dressed in the bath?”
Me: “And you want to get dressed in your bedroom and you don’t want to get dressed in your bedroom?”
Son: “Yes, I know. And I can’t decide. It’s just impossible.”
I asked him what was important about getting dressed in the bath and he told me that he wanted to get dressed in the bath so that he could stay warm because he gets cold when he gets out of the bath. And he wanted to get dressed in his bedroom because that’s where he saw Bruce Wayne get dressed in the Batman movie and he wanted to be like Bruce Wayne only he didn’t want to be too much like Bruce Wayne so he wanted to get dressed on his bunks not just at the wardrobe.
We talked about this for a little bit longer and then, foolishly, despite all that I know about the folly of giving advice, I made a couple of suggestions. I suggested we could leave the heat light on in the bathroom but my son pointed out that the heat light doesn’t work well enough. Then I wondered if he could wear a dressing gown from the bathroom to the bedroom, but this wouldn’t work either. Thankfully, my son was wise enough to treat this advice with the contempt it deserved because, although my suggestions were well meaning enough, they were offered from my perspective and showed no respect for my son’s own conflict-solving propensities.
Since he was dressed by this stage (in wettish clothes) we agreed to think about the problem some more and talk about it later.
The next day I asked him what he was thinking about his bath that night and he said “Oh it won’t be a problem.” When I asked “Why not?” he explained “Well, I’m not getting dressed in special clothes tonight so I don’t need to get dressed like Bruce Wayne. I’m only putting on my pyjamas and pyjamas area no big deal.”
This was a great illustration of how environmentally specific conflicts can make. People can live very functional, mostly satisfying lives, in almost all areas, but they can also have one particular area that harbours a raging, debilitating conflict.
So, the next morning, I checked in with him again to find out how he was thinking about getting dressed after his bath. We had talked about going out to a restaurant for dinner so I was wondering how he might be travelling with his dilemma. He told me that he was trying to think that it doesn’t matter. I’ve heard lots of people in conflict say they are “trying” various strategies and, whenever there’s a sense of “trying” involved, I suspect the conflict is still lurking in the background. Unconflicted activity doesn’t usually have a sense of trying to make yourself act or think in a particular way.
We decided not to go out that night but later in the day I checked in with him again.
Me: “Have you had any more thoughts about the getting dressed in special clothes problem?”
Son: “Well, I could get dressed with you.”
Me: “Oh, OK sure. Would that solve the problem.”
Son: “Yes, because getting dressed with you is more important than getting dressed in the bath and getting dressed like Bruce Wayne.”
This extended conversation between my son and me is a great example of some of the general principles of conflict. Firstly, conflict can be unpleasant. The conflict of wanting to stay warm and wanting to get dressed like Bruce Wayne was distressing to this 7 year old youngster. Secondly, advice and suggestions from someone else not experiencing the conflict are usually of little help and, finally, conflicts are eventually resolved by finding something more important than both of the conflicted goals.
Conflict is a pervasive human phenomenon that is at the heart of much distress and misery. Unfortunately, it is also seldom recognised; obscured by categories of disorder spelled out in systems such as the DSM, or brushed aside by other, fancier (but less accurate) ways of describing psychological turmoil and discontent.
There are many, many examples of the conflict that people experience in day-to-day living.
Emily Troscianko has a terrific article on her Psychology Today blog called “The Fast Diet: A Fast Route to Disordered Eating?” in which she explains that “to succeed in this diet, you have to draw up very explicit battle lines between your mind and your body, between hunger you feel on fast days and your natural instinct to act on it on one side and the 5:2 doctrine that forbids eating on the other. This dynamic is at the heart of all restrictive eating disorders.” Later in the article she describes the 5:2 perspective as “yo-yoing between extremes of self-denial and self-indulgence.”
Thus, Troscianko seems to be implicitly subscribing to a conflict model of dieting and eating disorders. In another article on her blog she explains that “Liking food but not wanting it may be at the heart of anorexia.” With regard to the experience of hunger for people who might attract a diagnosis of “Anorexia,” Troscianko explains that “Hunger can be the ultimate enemy or the point of everything, or both at once.” These are palpable descriptions of a conflicted mind.
Another excellent example is provided by Bruce Alexander in his marvellous book “The Globalization of Addiction: A Study in Poverty of the Spirit.” The book describes the dislocation theory of addiction. In this theory Alexander explains that the breakdown of psychosocial integration leads to dislocation and it is in the context of dislocation that addiction arises. Alexander suggests that we have motivations concerned with personal autonomy and also motivations concerned with social acceptance. Psychosocial integration is the successful balancing of these different, and sometimes incompatible, goals.
Again, psychosocial integration and dislocation seem to be inherently about conflict and its successful resolution. According to the thesis of Alexander’s book some cultures and societies are more conducive to the simultaneous pursuit of personal autonomy and social acceptance whereas other social contexts are organised such that the pursuit of one entails compromising the other.
In yet another example, I recently published an article with some colleagues in which we suggested that the basis for persistent and distressing trauma may be conflict. It seems that two people can experience the same or similar events and experiences and have very different reactions. One person might become chronically traumatised while the other does not. We hypothesised that conflict might account for this differential responding. There may be aspects of the incident that one person cannot reconcile but the other person can (Carey, T. A., Mansell, W., Tai, S. J., & Turkington, D. (2014). Conflicted control systems: The neural architecture of trauma. Lancet Psychiatry, 1, 316-318.).
The source of psychological distress is not an ill, a disordered, or a dysfunctional mind but a conflicted one. I have written at length about the psychological havoc that conflicted control systems can wreak (see www.methodoflevels.com.au for papers and books) and I have also developed an iPhone app called MindSurf that may go some way to helping people get themselves above their conflict for a better view of life.
The more that conflicted control systems can become a part of our understanding of psychological distress the more humane, efficient, and effective our treatments might be.
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I certainly agree that a better understanding of internal conflict is required to develop more humane, efficient and effective treatments. External conflict is another matter.
I came across you video on Youtube on the Method of Levels and Medication Noncompliance. Funny because I was looking for a John Lee Hooker track lol
I was wondering if you believe that psychiatric drugs are really ‘medications’? Just that after watching Dr Moncrieff’s video on the myth of the chemical imbalance I’m not convinced that they are really ‘medications’.
Thanks for your comments. It’s amazing how the internet works isn’t it?
Yes, I’m a big fan of Joanna Moncrieff’s work. Her book, The Myth of the Chemical Cure, is terrific.
I very much subscribe to her reasoning including the way in which she thinks psychiatric drugs should be used in clinical practice.
Thanks Tim for this very insightful piece. It is very encouraging for me to look at my son’s distress as being rooted in internal conflict. This seems to me to explain the real cause of what has looked like irrational fear/anxiety/paranoia. Many writers refer to distress as being caused by trauma, but since my son has never really been traumatized, I could never really understand where the extreme distress was rooted. Looking at it as internal conflict makes so much more sense to me. Thank you!
Thanks for taking the time to let me know how this landed for you. I’m really glad it struck a chord with you. I think we really underestimate just how pervasive internal conflict is and how distressing it can be.
On a related (I think?) note: psychiatrists tend to point to the so-called cognitive dissonance as a sort of pathology and a sign of disorganised thinking. Personally I think that it is a completely normal state which can even be positive. The conflict between different ideas does not always have to be resolved or forgotten: it can be simply kept in mind. I think it is the fallacy of psychiatry that it prescribes to behaviourism like someones actions or words mirror his/her internal reasoning which I know is not true for me and by extension I don’t believe is true for others. I can have a conflict between two positive idea and only act on or express one but keep the other one in mind as equally valid and maybe express it another day. I think this kind of “dissonance” is the only way not to get crazy in a complex and in-understandable world without oversimplifying it or becoming helplessly lost.
I think you’re really ‘on the money’ with these comments. Conflict goes by different names – ‘dissonance’ is one of them, ‘ambivalence’ might be another. Even concepts such as ‘willpower’ and ‘self-control’ are really issues of conflict I think. I’ve written about self-control as conflict in my Psychology Today blog. You can read it here: http://www.psychologytoday.com/blog/in-control/201412/the-difficulty-self-control-is-conflict
One of the things I like about the ‘distress as conflict’ idea is that it doesn’t mean anyone is sick or broken or disordered. They’re just chronically conflicted. Conflict is very common. Essentially, every choice situation is a conflict so, clearly, we’re ordinarily very good at resolving internal conflicts. As you say, sometimes people don’t even resolve conflicted ideas; they just keep them in mind and focus on one rather than the other.
At times, however, conflict can become chronic and distressing. Helping people explore and understand conflict can be very useful in enabling people to function as they would like in a world that is, often, as you put it, “in-understandable”.