The Power of Intimacy: Nurturing Connection in Relationships

Intimacy is the foundation upon which strong and fulfilling relationships are built. It goes beyond the physical aspects and delves into the emotional, psychological, and spiritual realms of our connection with a partner. As psychotherapists, we understand the significance of intimacy and its role in fostering healthier and more satisfying relationships.

Richard G. Erskine, a renowned psychotherapist, once said, "Intimacy is not purely physical. It's the act of connecting with someone so deeply, you feel like you can see into their soul." This profound insight captures the essence of intimacy - a deep connection that transcends the surface and touches the core of our being. It's about truly seeing and understanding our partners on a level that goes beyond words.

In the words of Eric Berne, the father of Transactional Analysis, "Intimacy is the capacity to be rather weird with someone - and finding that that's ok with them." Berne's perspective emphasizes the importance of authenticity in intimacy. It's about being our true selves, even in our quirks and vulnerabilities, and finding acceptance and love from our partners.

Understanding Intimacy: Intimacy is the deep sense of closeness and vulnerability shared between two individuals. It is about being open, honest, and authentic with one another, creating a safe space where both partners can express their true selves without fear of judgment. As Erskine noted, "Intimacy requires courage because risk is inescapable."

I will at this point state that intimacy can be very challenging and uncomfortable. All of our buried self-concepts get in the way and sabotage our attempts and strivings for true love and intimacy.

Claud Steiner (1974), referred to the Life Script (which he delineated into three types See notes) as ‘Basic Training in Life’ This involves a systematic attack on Three Primary Human Potentials:

Intimacy – Giving and receiving of human love (Negative modelling or injunctions etc around closeness and love)

Awareness – Capacity to understand the world and it’s people. (You are not angry, this is how things are)

Sponteneity – The capacity for joy and free expression. (Behave yourself/ don’t make a fuss)

The Different Dimensions of Intimacy:

Berne's concept of "strokes" aligns with the different dimensions of intimacy. Physical intimacy involves nurturing touches and affectionate gestures that communicate love and care. Emotional intimacy, as Berne put it, is "when two people say, 'I love you' and mean it." This type of intimacy involves sharing feelings and creating a deep emotional connection.

Building Intimacy: Cultivating intimacy requires effort and commitment from both partners. Effective communication, as Erskine highlighted, is the bridge to intimacy. It involves active listening, empathy, and vulnerability. Sharing our innermost thoughts and feelings, as Berne suggested, leads to a richer connection: "The moment a little boy is concerned with which is a jay and which is a sparrow, he can no longer see the birds or hear them sing."

Overcoming Barriers to Intimacy:

Both Erskine and Berne acknowledge that past experiences can hinder intimacy. Berne's concept of "life scripts" underscores how our past influences our present relationships. Overcoming these barriers requires introspection, as Erskine states, "True intimacy is based on a solid sense of self."

The Benefits of Intimacy:

Intimacy brings an array of benefits, resonating with Berne's idea that "we are born princes and the civilizing process makes us frogs." It transforms us, offering emotional security, improved communication skills, and a deep bond. As Erskine eloquently puts it, "Intimacy develops through shared experience and then sustained through ongoing relationship."

Seeking Professional Support:

Both Erskine and Berne advocate seeking professional help when needed. Berne's encouragement to "gather strokes" emphasizes the importance of seeking support and connection. Psychotherapy, in line with Erskine's view, provides a structured environment to explore barriers and develop deeper intimacy.

In conclusion, intimacy, is about authentic connection, vulnerability, and acceptance. I encourage couples to embrace the wisdom of these insights, nurturing their intimacy and building relationships that thrive on genuine connection. Remember, true intimacy is a journey of growth and self-discovery that leads to profound emotional fulfilment.

There are indefinitely growing pains along the way as we can experience repressed parts of ourselves mirrored back to us by our partner(s).

Intimacy has both light and dark shades. The most intimate experience can be in a heated argument or fight and winning and responsible relationship will show interest in this opportunity for deeper relating and expanding the depth of contact, vulnerability and fully knowing of the self and other.

It isn’t easy, takes time and above all, kindness, with the courage to be vulnerable and IN the relationship.

Notes

Steiner (1974) defined scripts as Joyless, Loveless and Mindless.

Joyless – Has no joy, and is often involved in drug addiction. There is a reliance on drugs for the production of desired bodily feelings and well-being. Injunctions prevent experience of bodies and emotions (e.g. with a headache will ask  “where is the aspirin?” not “why have I got a headache?). Sensations are medicated away or passively tolerated. Good sensations are not indulged in. They are disconnected from their bodies, out of touch with good and bad, and live in head.
They know what is good/bad for them but block their core selves, they are scripted to ignore their own counsel and shut off from body. Yet this is not completely so (e.g. will notice if they burn their hand). Many people completely ignore their bodies sometimes even feeling burdened by them.
Drugs restore the connection with body and needs for a short period of time. Yet the side effects are they then need more of the drug to connect again.
Shut off from pleasure and pain, can be exploited by business (e.g. stressful work situations or the tobacco industry), learning  to bear pain without complaint, with bodies adapted to pain, splitting the body from the head.
 

Loveless – Often depressed (Steiner suggests this is seen more in women). A lack of strokes lead to chronic stroke hunger and varying degrees of depression - suicide is the extreme form. Early injunctions cripple the child’s skill for getting strokes – they feel unloved or unlovable. They need to learn about how they discount strokes and allow them in – the stroke economy
Stroke satisfaction is the antidote

Mindless – This person fears going crazy, and in extreme cases does. They have no capacity to cope with the world, and feel that they have no control over their lives, have no will power, are lazy, indecisive, and are stupid or crazy. Early injunctions attack child’s capacity to think and figure things out in the world – thus they developed a discounted adult.
They were told they can’t understand, or that they do not know what they know – i.e. that their intuition is wrong. Intuition is often discounted in men and logic discounted in woman.
They can also discount emotions, and rationality.
The antidote is not to discount and allow rational thinking.

Some thoughts on Understanding Addiction its Psychological Underpinnings and Treatment

I recently had a conversation with a colleague about the subtleties of how addiction can manifest and take hold.

I remembered Gabor Maté’s writing on addiction, “Children who suffer disruptions in their attachment relationships will not have the same biochemical milieu in their brains as their well attached, well nurtured peers. As a result, their experience and interpretations of their environment, and their responses to it, will be less flexible, less adaptive, and less conducive to health and maturity. Their vulnerability will increase, both to the mood enhancing effect of drugs and to becoming drug dependent.” (Maté 2018).

There are multiple reasons people become addicted to something, and one of the most significant are experiences of heightened stress.

Developmental traumas and repeated traumatic incidents all have stress in common.

“Stress has everything to do with addiction.” (Matè 2018). Maté describes how stress is an attempt to maintain an organism’s homeostasis both physiologically, biologically, neurochemically and psychologically. From a Transactional Analysis perspective, I would interpret this as maintaining the Script (Berne 1974). - The Script is a life plan made in early childhood, which is ultimately our innate ability to adapt and survive in response to the environment.

My hypothesis is therefore that when trauma is/was present, humans either have an appropriate or adverse multi levelled reaction (stress response) to attempt to maintain their Script, for better or worse, which reminds me of the adage, “Better the Devil you know, that the Devil you don’t…”

This becomes a repetitive and self-fulfilling prophecy as Freud describes as Repetition Compulsion in his 1920 book, “Beyond the Pleasure Principle” (Freud, 1920).

Maté writes about the commonality of major stressors, “Ultimately, they all represent the absence of something that the organism perceives as necessary for survival – or its threatened loss. The threat itself can be real or perceived. The threatened loss of food supply is a major stressor. So is the threatened loss of love – for human beings.” (Maté 2018). Gabor Maté, cites the following quote to emphasize his point further, “It may be said without hesitation that for man the most important stressors are emotional”. (Hans Selye 1956).

With regards to working with addiction, my thoughts are to pay due attention to what sits in internal and interpersonal deficit, conflict or is confused together with what is unexpressed or suppressed by the addiction. Attention to what the addiction serves and to give due credit to this mal-adapted coping strategy.

There are of course many perspectives to look at and work with addiction. Object relations is another area to consider when looking at addiction. From reading Catherine Stuart’s “Addiction from an Object Relations Perspective, Contemporary Psychoanalysis” (1996), she explains how object relations best explain the aetiology of the more compulsive drug user. Addicts have suffered different degrees and manifestations of object loss and therefore are driven to find ways to alter the internalised object representations.

Due to early disruption from parent figures, confusion in the developing psyche can take hold and manifest with addiction to balance the lack of affect (emotions or feelings) regulation.

Addiction to alcohol, sex, drugs, or gambling etc are either compensation for the lost good object. The “Good Object” can be understood in simple terms as a good attuned care giver. A “Bad Object” are experiences of pain, frustration and disappointment etc from the primary caregivers, which become internalised.

Object constancy was never achieved because of environmental and relational disruption, addicts are unable to integrate Good and Bad object representations, and so are unable to adequately tolerate anxiety, aggression, frustration, and the dysphoria that results from a harsh ar­chaic Superego/Parent Ego State (aka the potentially punitive internal critic).

Treatment, therefore, should not reinforce punitive internal voices but rather facilitate the expression of authentic emotional expression. This can promote healthy resolution of the split between good and bad object representa­tions that formed to protect the idealized good object rep­resentation.

In the notes I have included a useful diagram of Carlo Moiso’s Projective Transference model (1985): For the purpose of this diagram, the therapist represents the Good/Bad Object

An addiction has a function to distract from inner pain and turmoil. Confusion and fixation of the Good Object, lessening the Bad Object… but the cycle flips and repeats as the Good Object becomes the bad. The cycle continues until broken with appropriate intervention and holding to provide a “Good Enough” relationship. (See further in notes on Good Enough relationship).

Providing a space where the client can experience safety in contact with their therapist in the therapeutic space.

This can be achieved by paying appropriate attention to meeting the clients unmet archaic Relational Needs for example (Erskine 1999, 2003).

Over time accounting for and recognising the clients Relational needs, they can begin experience more of themselves, in what is also known as “The Needed Relationship” (Clarkson 1992).

The presence and consistency of this new therapeutic relationship can create new internal Nurturing Parent voice in the client as it is modelled by the therapist. As this Nurturing Parent takes continual presence and progressive dominance in the psyche, addicted clients develop a sense of internal comforting self-regulation. The inner turmoil’s or splits begin to integrate and resolve.

To conclude my thoughts today on this subject, presence and contact with the client are paramount. To sit in the moment, recognising and accepting their struggle. To respond to clients compassionately and empathically, validating their internal experience, which therefore can recognise un-met archaic relational needs.

Only when this contact in the therapeutic relationship is made, the work can begin the journey of an effective psychotherapy.

References: 

Berne, E., 1975. What do you say after you say hello?: The psychology of human destiny. Random House.

Erskine, R.G. and O'Reilly-Knapp, M., 2003. Core concepts of an integrative transactional analysis. Transactional Analysis Journal, 33(2), pp.168-177. (p169)

Freud, S. (1920). Beyond the Pleasure Principle (Standard Edition, Vol. 18, pp. 7-64). London: Hogarth.

Moiso, C., 1985. Ego states and transference. Transactional Analysis Journal, 15(3), pp.194-201.

Clarkson, P. and Pokorny, M., 2013. The handbook of psychotherapy. Routledge.

Catherine Stuart , Ph.D. Published online: 28 Oct 2013. Addiction from an Object Relations Perspective

Pages 486-488 |

Notes

·      Donald Winnicott, a renowned paediatrician and psychoanalyst, introduced the concept of "good enough parenting" in his work. The idea is discussed in several of his publications, particularly in his book titled "Playing and Reality" published in 1971. In this book, Winnicott explores various aspects of child development, emphasizing the significance of parental care and the environment in fostering healthy emotional growth in children. His concept of "good enough parenting" suggests that parents don't need to be perfect; instead, they should provide a "good enough" level of care and responsiveness to support a child's development.

·      Erskine’s 8 Relational Needs (1999).

(these are not an instruction manual but a fluid relationship informing tool)

• The need for - Security.

• The need for - Validation, affirmation and significance.

• The need  for - Acceptance by a stable and dependable other.

• The need  for - Confirmation of personal experience.

• The need  for - Self-definition.

• The need  for - Having an impact on the other.

• The need  to - have the other Initiate.

• The need to - Express love.

·      Carlo Moiso’s Projective Transference model (1985):

Understanding the Neuroscience of Addiction

How Addiction Works: Understanding the Ventral Tegmental Area (VTA) and the Brain’s Reward System

The Ventral Tegmental Area (VTA) plays a critical role in the brain's reward system, directly impacting pleasure, motivation, and addiction. Understanding how the VTA works and how it interacts with other brain structures is essential to grasping the science behind addiction and how habits are formed.

What is the Ventral Tegmental Area (VTA)?

The Ventral Tegmental Area (VTA) is a small region in the midbrain rich in dopamine-producing neurons. Dopamine is often referred to as the "feel-good" neurotransmitter because it plays a crucial role in reward, motivation, and pleasure. The VTA is part of the mesolimbic dopamine pathway, the brain's primary reward circuit.

When we engage in pleasurable activities—such as eating, socialising, or accomplishing goals—the VTA releases dopamine into the Nucleus Accumbens, another brain structure heavily involved in the reward system. This release creates feelings of pleasure and reinforces beneficial or enjoyable behaviours.

The Role of Dopamine in Addiction

Dopamine release isn't just about feeling good; it's about reinforcing behaviours. When we experience something pleasurable, the brain remembers it, and we’re motivated to repeat that behaviour. Unfortunately, this system can be hijacked by substances like drugs and alcohol.

Drugs artificially spike dopamine levels, causing intense feelings of euphoria. Over time, this overstimulation leads to the brain’s reward system being rewired, making it more difficult to experience pleasure from natural rewards, like spending time with loved ones or eating a good meal. This is how addiction begins.

How the Globus Pallidus Forms Habits

The Globus Pallidus, part of the Basal Ganglia, plays a significant role in habit formation and automatic behaviours. When certain behaviours are repeated enough, the Globus Pallidus helps encode these actions into the brain so they become automatic.

In the context of addiction, the Globus Pallidus reinforces drug-taking behaviours, turning them into ingrained habits. Once these behaviours are stored as habits, they become difficult to break, even if the individual no longer finds the experience pleasurable.

The Prefrontal Cortex (PFC) and Decision-Making

The Prefrontal Cortex (PFC) is responsible for higher-order cognitive functions, such as decision-making, impulse control, and planning. Usually, the PFC helps regulate the brain’s lower regions, including the Nucleus Accumbens, to keep impulses in check.

However, drugs weaken this control. As drug use increases, the PFC's ability to inhibit the Nucleus Accumbens diminishes. This leads to a breakdown in self-control, which is characteristic of the binge and intoxication stage of addiction. The PFC's weakened state makes it harder to resist cravings or make sound decisions, perpetuating the cycle of addiction.

The Withdrawal and Negative Effects Stage

As drug use continues, the brain responds by lowering its natural dopamine production. This creates a cycle of withdrawal and negative affect, where the person feels worse and worse without the drug. Dopamine levels drop, and feelings of depression, anxiety, and irritability set in.

During withdrawal, other brain regions like the extended amygdala, including the Bed Nucleus of the Stria Terminalis and Basolateral Amygdala, become activated. This triggers the release of stress hormones such as cortisol, which further worsens mood and increases the discomfort of withdrawal. This is why people often feel "shitty" after stopping drug use abruptly.

Anticipation and Craving: Why It’s Hard to Quit

The final stage of addiction is the anticipation and craving stage, where cravings for the substance become almost uncontrollable. By this point, the PFC's ability to regulate behaviour has been severely weakened.

Glutamate signalling—which is critical for memory and learning—plays a significant role here. The large dopamine surges during drug use prompt the release of glutamate in the brain, which helps solidify memories of the drug experience. Over time, the brain's plasticity adapts, creating new neural pathways that prioritise drug use.

These drug-related memories are stored in the hippocampus, which is responsible for long-term memory. Additionally, the Basolateral Amygdala becomes involved, creating conditioned responses to cues associated with drug use. This means that even seeing something related to the drug can trigger intense cravings.

The brain has essentially been rewired to prioritise drug use over everything else, making it extremely difficult to break free from addiction.

Overcoming Addiction: Rewiring the Brain

Understanding the brain’s reward system and how drugs reshape it is crucial for overcoming addiction. By targeting the brain regions involved in pleasure, habits, and cravings, treatments like behavioural therapy, medication, and support networks can help reverse some of the damage done by drug use.

Addiction takes advantage of the brain’s ability to learn and adapt, but recovery is possible. Reversing the process involves creating new habits, strengthening the Prefrontal Cortex's control, and reducing the brain's reliance on drug-related rewards. From a therapeutic perspective, bringing our awareness of what the pain is that the addiction is suppressing is key.

Conclusion

The Ventral Tegmental Area (VTA) and other brain regions, such as the Globus Pallidus, Prefrontal Cortex, and Nucleus Accumbens, play a fundamental role in how addiction develops. By understanding how these areas work together to reinforce drug use, we can better understand the challenges of breaking free from addiction.

If you or someone you know is struggling with addiction, learning about the brain’s reward system can be an important step toward recovery. For more insights into addiction, mental health, and the brain, visit [Talk to Ralph](www.talktoralph.co.uk) for professional support and guidance.