The theory of the temporal contact rebus raises the issue of symptom tolerance. What can we accept of the client’s antisocial or hostile contact rebus in both inpatient and outpatient care? One conclusion we can draw from the theory is that we should avoid breaking contact with the client in the negative rebound and honor the contact contract that was entered into at the start.
If we discontinue our motivational efforts simply because we are unable to cope with the testing, it will confirm for the client, yet again, that no one cares about him, and leave him feeling betrayed and abandoned. The client will not receive enough life energy to enable him to continue the motivational process, and the demotivational process will recommence.
Since this will also give the client a non-contact rebus, this demotivational process will be maximal. On the other hand, if we can find a way to continue motivating him, it is important to do so as it will keep the client supplied with the life energy he needs to pursue the motivational process (Motivational Work, Part 1: Values and Theory, pages 536 – 548).
Insight into the demotivational and motivational processes gives the motivational worker a positive attitude towards his client’s destructiveness, which creates an opportunity for contact and thus confirms that the client’s motivation has become stronger. If the client is then to change, the motivational process must be able to accommodate the rebound polarity shifts. Similarly, the scope must be allowed for the rebounds of the demotivational process in order to keep opportunities open for connecting with the client.
Clients who, behaviourally, display no polarity shifts in their rebounds but who seem to change increasingly positively in the absence of negative rebounds (i.e. appear capable of looking after themselves) are a problem for the motivational worker. Such a client is using compliance tests in a prolonged positive rebound and has “put a lid on” his conflict-related emotions. The negative emotions thus mount up until they threaten to burst forth in a powerful explosion of hostility.
Case Study
Nils, 35, books himself into a treatment center to get help with his drinking problems. Nils stays at the center for the full nine months of the treatment and gradually improves. He raises his emotional problems during group therapy, where he is also helped to deal with his social problems. After a while, someone questions the authenticity of his addiction as he never seems to ‘crave’ a drink.
Shortly afterward he relapses and talks about how hard he has found it to resist his ‘craving’. When the nine months are up, he takes his leave of the other clients and the staff, who wish him luck in their belief that he has been an unusually ‘successful case’.
During his stint in the center, he attended an evening course, and this has given him a job to go to directly after his discharge. He has also met a woman, to whom he is engaged to be married. She is expecting their baby, and they soon, after some trials and tribulations, get a flat to move into.
Nils has also been working on his relationship with his mother, and they now get on much better. Now, a year after his discharge, he is sitting in his old local. He has started to drink more than he used to, has lost his job, his wife, and his home, and his relationship with his mother has deteriorated. Not only that, but he may only meet his son for brief supervised periods as the social services consider him unsuitable as a father.
Discussion
After his treatment, the client ends up back at square one. His change has been linear and devoid of rebounds, and in retrospect, we could say that he only superficially adapted to the center’s regimen with a positive rebound that remained unsolved.
The pressure within him gradually builds up until he finds himself unable to resist, and he feels compelled to ‘abuse away’ his concern. Nils does not receive enough life force from the staff and clients to enter a motivational process and remains in his demotivational process throughout his stay. Outwardly, he loses everything; inwardly, he has gained peace of mind and has eradicated his anxiety.
Nils tests the staff with his positive ‘compliant’ rebound. People only see the surface of the contact rebus and enable the demotivational process to continue. However, the commitment of the staff imbues him with extra life force, although only enough to retard, not reverse, the demotivational process.
The above case description is an example of how a superficial linear positive change only leads to an accumulation of emotions and anxiety, which must eventually be discharged. The client is still in his demotivational process and passes from the positive to the negative rebound. This is an example of self-destructiveness that in the end only harms the client himself.