Understanding Psychological Distress: A 5-Stage Character-Analytic Theory

There are many different frameworks for understanding psychological distress and well-being. It is accepted by many that there is no “right way” of understanding or working with mental health issues. Rather, many find it more appropriate and more helpful to clients to recognise that each approach has their strong points and weak points. Furthermore, each individual is unique and suffers in their own way and responds to different approaches in their own manner. Therefore, it is best to look at each approach, and ask, “what can I take from this?”, “how beneficial is this theory to the situation at hand?”. In this blog post, I would like to introduce you to the very basics of a 5-stage process put forward by Stephen Johnson, a character-analytic theory which I think is a great framework for understanding the creation of an individual’s psychological distress.

Stage 1- Self Affirmation

Self-Affirmation is very simply the expression of an individual’s needs. There are many different instinctual and relational needs which each of us have. A simple example, one need is for a child to feel loved by their parents or care givers. If a child’s needs are met, they then have the opportunity to internalise the affirmation of the environment and build a healthy self-structure and relate the world in a more positive way.

Stage 2- The Negative Environmental Response

There will be many times when the child’s environment does not meet their needs appropriately. In some cases, unfortunately, they may not be met at all. This is stage 2. Continuing with the above example, the child needs to feel accepted, wanted and thought of as a worthy person. The parent doesn’t just need to show their positive thoughts of the child just by using words. But also body language, attitude, and behaviours toward the child. It is not just verbal but a displaying of love using the whole body, mind and personality of the parent. A parent may love their child, and say it often, but if it isn’t shown using the whole of the parent’s being, then the child may not be able to feel it- this can often be unnoticed by the parents and they may believe they are doing the right things. The child may hear the positive words, but may hear the contradictory attitude, body language and actions a lot louder. Thus, the need will not be met.

Stage 3- The Organismic Reaction

This is the child’s initial reaction to their needs not being met, the affect. This could be anxiety, anger, feeling bereft. It is the child’s natural, and individual response. There is no “set way” that people respond, each of us react differently. However, it is felt very intensely which is difficult to handle, especially for children who have not yet learnt how to manage their experiences. Additionally, the child may not even have sufficient knowledge or skills in language to be able symbolise their experiences in order to make sense of it. Due to this lack the understanding, an individual may grow up not knowing the cause of their troubles and be confused or, even worse, self-blaming telling themselves “I have no reason to be like this”. Which is a scary and difficult position to be in.

Before proceeding to stage 4, it was worth noting that the first 3 stages are common experiences to all of us. Parents naturally ‘fail’ at times- it is impossible to meet all of a child’s needs all of the time, it just cannot happen and the child will find it tough at times. That’s life. Many believe, myself included, that parents must fail us at times, because if not, we will not be prepared to cope with what life throws at us in later life. Stages 4 and 5 however, occur when a child’s needs are unmet repeatedly or even less frequently but more severely- a ‘one off’ act of abuse for example. The repetition, or severity of unmet needs is essentially what pushes someone into stages 4 and 5 and create psychological distress.

Stage 4- Self Negation

This is the child imitating the environments blocking of the need. S/he responds by denying the initial need, believing that there is no need to be met. Not only does the individual block the need, but also blocks out their original, organismic response. Now, it is not only the environment denying the child of their basic needs, but blocking is now internalised and the child can continue to identify with the environment in a complex act of turning against themselves. Despite the individual blocking their own needs, they are irrepressible, in some way the individual will be crying out for their needs to be met on an unconscious level. This inner-conflict can last throughout the person’s life.

Stage 5- The Adjustment Process

This stage involves the individual doing the best they can, making the best of the situation and creating their own way of compromising. In other words, the individual may act in in accordance to stage 4. A very simple example, the child may unconsciously believe that: “no-one loves me, I do not need to be loved, in-fact I am unlovable” and the child can then act in ways that support this belief: rejecting affection, behaving badly to push people away and to confirm that they are a bad person. Not fully engaging socially, being unable to connect with people, act in self-destructive ways to ruin opportunities as they do not deserve them, the list could go on. Again, different people will react in different ways, partly influenced by which need was unmet, the manner in which it was unmet, and individual differences in personality structures, beliefs and way of responding. The examples given are not the only types of compromising, some people may over-compromise: “I do not need prizing of another because I keep on achieving and meeting my own standards”- which may be high, unrealistic and the goal posts can keep shifting because “I need to keep proving this to myself”. Reaching the goal posts may create satisfaction, but it can only be temporary, and the anxiety returns when the goal posts are moved further.

Concluding Comments

I find that this framework is great way to understand how distress can occur and hope I have stressed enough that each individuals experiences and way of coping will be unique. However, whatever the need that was blocked, whichever way the individual may respond, the individual’s aim in stage 4 is to avoid the pain of stages 2-3 via a complex denial of stage 1. Stage 5 however, is how the individual over-exaggerates as a result of this process, in order to get through the internal conflict and can lead to a plethora of unhealthy behaviours and the creation of a false-self. This false-self can be difficult to change due to the extreme internalisation of the whole process. However, if the individual is successful in their life tasks, healing the original wound and making changes can become a lot harder.