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Re:CBT for people who believe they've done something unforgivable
Linda Nauth · 07/16/03 at 10:03 PM ET
Since I work with people who have truely done unforgiveable actions like sexually assaulted someone or killed someone, I have used Ellis's distinction between the act and the person. Because I act "like a jerk" does not mean I am a total jerk of a person. The person's behavior is not them. Their worth is not defined by what they have done. Guilt for their actions is appropriate, shame for them as people is not appropriate (from Burn's "Feeling Good, the new mood therapy.)
The most difficult is when an individual feels pleasure at causing others pain. The first person I met with this problem was a Vietnam Vet who had to shoot people in his combat assignment. He felt shame at the adrenalin rush he had experienced. This man resisted working on the problem.
I actually am working with 2 offenders at this time who have a history of violence and both who have experienced pleasure during their violence. One is dealing with the shame of this pleasure, and the other is simply trying to avoid the addictive nature of this pleasure. the second man who does not experience shame regarding his violence has to see the pleasure of violent revenge fantasies and behaviors as the PIG, the problem of immediate behavior. He has to be reminded that he "wants to be a better person" and the short-term pleasure is not worth screwing up the progress he has already made. The first man is just revealing his shame so I'm not sure how we'll get through it yet.
I interpret the feeling of pleasure as a learned counterattacking coping style for their Mistrust/abuse schema. Again I am using Young's schema therapy which I know Jim won't like. But for both of these men who have experienced terrible childhood physical abuse, their violence appears as a counterattack or compensation. Being abused and helpless as a child, they found that they could feel powerful and in control through fantasies of violence against their perpetrator. They feel even more pleasure acting out violently and hurting others. the man with shame has significant Borderline Personality Disorder traits. The man without shame is just an antisocial PD. But both are making progress in reducing their violence. I've worked with both for approximately 10 years.
I can keep you all informed of the outcome with these men. But probably no one is interested in these men because of the terrible things they have done. But I, like Ellis and Burns (and I thought all cognitive therapists) separate the men from their actions.
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