American Psychotherapy Association

Learning Objectives
After studying this article, the reader should be able to:

1. Understand the psychological significance and meaning of the components of physical environment (PhE) of the client.

2. Deal with components of PhE as metaphors that represent significant others or experiences.

3. Apply Dwairy’s model of metaphor therapy (1997b) on PhE.

4. Be aware of the various actions and manipulations that could be taken on PhE that may affect, consciously or unconsciously, the biopsychosocial experience of the client.

Abstract
The meaning and use of the physical environment (PhE) in psychotherapy is undervalued as compared to the social environment. In infancy and childhood children interact with their PhE not less than they do with their parents and family members. Objects and places become associated with emotional experiences and then with significant memories. Talking about these objects in therapy yields significant information about the client, such as relationships, memories and emotions. Components of PhE may be considered as metaphors and symbols for the significant relationships and experiences of the client. Therefore, changes in the PhE of the client and/or her relationship to significant items in PhE will affect her real experience.

Keywords: Metaphor, therapy, physical environment

The importance of the social environment in determining the psychological development, personality and psychological disorders is well documented in psychology. Projection, introjection, identification, transference, object-relations (Freud, 1946; Klein, 1955; Mahler, Pine, & Bergman, 1975), attachment (Bowlby, 1960), mirroring and empathy (Kohut, 1982; Rogers, 1961) are some terms that describe the relationship between the person and his social environment. On the other hand, the role of the physical environment (PhE) is undervalued if not neglected. Transitional object seems to be the only term in psychology that addresses the psychological relationship with the physical environment (Galligan, 1994; Passman, 1987; Shafii, 1986).

In infancy and childhood, children interact with their PhE no less than they do with their parents and family members. Directed by their need for pleasure, satisfaction and/or security, they struggle for property and territory and, accordingly, they are attracted to certain items and places and avoid others. Besides their understanding of the nature of PhE, children develop emotions toward certain objects during their experience with it. Objects and places become associated with emotional experiences and then with significant memories.

The relationship with the physical environment (PhE) develops along with the developmental stages of the individual. Besides satisfaction and security, PhE in adulthood has to do with social relationships, identity and status. Some people invest most of their money in owning or controlling their physical environment in the form of houses, furniture, decorations, cars, jewels and ornaments. People’s exchange of PhE items, such as gifts, expresses the emotions and attitudes that exist between them.

People in collective societies (e.g., Arabs) have a special psychological relationship with their physical environment – from the land and house to animals and other goods, including household tools (Dwairy, 1997a). Unlike those who live in Europe and North America who are often individuated from their families, traditional people are still attached to their families and their physical environment (Dwairy, 1998). The self among them is the collective one that is not detached from family and PhE. Traditional people are affected deeply by what is happening within family and PhE (Dwairy, 2002). Selling family land or a house may be considered as a betrayal that causes guilt and shame. It is almost impossible to discuss personal issues with these people except in relation to the family and PhE. In fact, talking about family and PhE puts personal issues in a context that helps one to understand the person (Dwairy, 1997a; 2001).

Physical environment in therapy
In play therapy with children (Axline, 1969; Brems, 1993; Kohut, 1982; O’Conner, 1991; Semrud-Clikeman, 1995), the child is exposed to items that represent her real or imaginative PhE. Items in the therapy room can represent significant figures, experiences and conflicts. The therapist employs these items to facilitate the child’s acting out of her conflicts in order to accomplish therapeutic change. This significant relationship with objects in the PhE does not cease in adulthood. It could, therefore, be employed in therapy with adults too, regardless of the disorder from which they may suffer.

The importance of PhE in therapy is quite clear in cases of trauma and loss. Post traumatic stress disorder (PTSD) clients avoid places and stimuli that are related to the trauma. Therapists are aware of the significance of PhE with regard to these clients and implement interventions such as desensitization that addresses stimuli related to the trauma (Schwartz, 1984; Van-Der-Kolk, McFarlane, & Weisaeth, 1996). People who have lost loved ones develop a special relationship with certain items or places that are associated with them, since these items and places are charged with memories and emotions. They become attached to some of the items and/or avoid others. Therapists discuss the relationship between their clients and items or places that are associated with their lost loved ones. They work together on the relationship between the client and the PhE that is associated with the loss. It has been suggested that incorporating the PhE in therapy may facilitate change and development (Dwairy, 2001). Metaphoric or ritualistic actions may be helpful in some cases of loss. For instance, Jeffrey Zeig had a client who complained about a stone-like sensation on his chest after the death of his father. To help the client work through his loss, Dr. Zeig suggested that he take a stone from his yard to the cemetery, holding it against his chest and then placing it on the grave site (1995).

The components of PhE surrounded by which all people grow or live are not inanimate, but rather have personal meanings and are charged with memories and emotions that are related to significant experiences in the past and present. Based on this assumption I suggested the use of significant objects in therapy (Dwairy, 2001). Talking about a significant object (TASO) is a five-stage process in which the client is asked to bring an object from his PhE to talk about in the therapeutic session. The therapist encourages the client to address the meaning of the object and memories and emotions associated to it. Talking about these objects in therapy yields significant information about the client’s relationships, memories and emotions and puts her experience in a larger context. Typically, the content that is disclosed by talking about an object has to do with a core conflict in the client’s life (Dwairy, 2001).

Generally speaking, components of PhE may be considered as metaphors and symbols for the significant relationships and experiences of the client. Besides understanding these relationships and experiences when talking about items that were brought to therapy, these items, as metaphors, may be employed as such in therapy. Based on my model of metaphor therapy (Dwairy, 1997b) metaphorical changes are reflected in real changes in three other domains: the biological, psychological and social domains.

Assuming that components of PhE may be metaphors for significant others or symbols of them or of certain experiences with them, therefore, changes in the PhE of the client and/or her relationship to significant items in PhE will be reflected in these three domains. Control over components of the PhE gives a feeling of control over what they represent. Control over items that represent a significant other or a traumatic event will give the feeling of control over the relationship with that other or that trauma.

After discussing the meaning, emotions and memories associated to a significant object, client may be asked what she is going to do with it. Clients have several options how to operate on significant objects in their PhE. They may change their position (take items out of the drawer and put them in a prominent position), give an item to or take one from a significant other (return a gift to a mother or request an item from a sister), start or stop using an item (start smoking the father’s pipe) or destroy it (to destroy pictures or gifts that represent an abusive parent). Based on the ability of the client to handle and deal with unconscious contents, therapists may decide whether to discuss the psychological meaning of the change.

Here are some examples:
Example 1: One of my clients who suffered from an abusive father was distressed by the fact that after his marriage he was living in a house his father owned. After we discussed his feelings toward his economic dependency on his father, he decided to move to another house that he leased and paid for. For the client, this was a necessary step to actualize his independence from his abusive father. Afterwards, he was able to establish a new relationship with his father founded on new bases.

Example 2: A married client who suffered from tension in his relationship with his controlling wife, decided to rearrange the furniture in the house in a new way according to his taste. This act on his PhE symbolized, for him, a need to actualize his freedom of choice within his relationship with his wife.

Example 3: A woman who suffered from somatoform symptoms was upset about feeling indifferent, and even relieved, after she lost a ring that her mother had given her as a wedding gift. Only after several sessions was she ready to talk about her oppression in childhood that resulted from the control her mother wielded over her. When she was asked if these feelings had anything to do with her feeling of indifference and relief concerning the ring, she continued to deny any connection. In the last stage of therapy she became able to understand how her unconscious anger towards her mother had made her indifferent.

Example 4: A client who had difficulties in developing an independent identity because of an authoritarian father, decided, five years after his father’s death, to remove the portrait of his father from the family guest room. Despite the clear meaning of this act, he was not ready to acknowledge his negative feelings toward his dead father. He claimed he removed the picture because it did not fit the colors of the furniture.

According to my model of metaphor therapy, changes in the position of significant items in PhE represent, metaphorically, significant bio-psycho-social processes. The effect on the bio-psycho-social domain is made even when the meaning of the change still not consciously known to the client.

In many cases, such as among clients from a traditional and collective cultural background, expressing unconscious content is typically forbidden. Revealing unconscious feelings, drives and wishes may lead to a difficult confrontation with the family and expose the client to serious punishment that would abort therapy (Dwairy, 1997c). In these cases, manipulating the PhE itself may have the same effect even without the client being made aware of the real psychological meaning of that manipulation.

In summary, people are psychologically attached to their PhE as well as to their social environment. Discussing the meanings, emotions and memories associated to significant items from their PhE reveals significant experiences and conflicts. Operating on these items affects the bio-psycho-social experience of the client, whether the meaning of the action becomes conscious or remains unconscious. Based on the ability of the client to handle unconscious contents, and on his cultural background, therapists may decide whether to reveal the unconscious meaning of the actions and changes made in PhE.

References
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About the Author
Marwan Dwairy, D.Sc. completed his B.A. and M.A. in psychology at Haifa University, Israel, and his doctoral degree in 1990 at the Institute of Technology of Israel (TECHNION). His dissertation topic was about the manifestation of denial in brain evoked potential. He has four areas of expertise in psychology: Clinical, Educational, Developmental and Medical. Dr. Dwairy established the first Psychological Services Center among the Palestinian-Arab citizens in Nazareth, Israel, in 1978. He published several books and articles in cross-cultural psychology in which he suggested new models and theories concerning people from collective cultures. In 1995-1997 he served as visiting professor in the Center of Graduate Studies in Psychology for Nova Southeastern University, Florida. Currently, he is directing a private clinic and is teaching cross-cultural psychology at Haifa University.