The Use of Self

19 Oct. 2018  The Fells & Dales group of counsellors & psychotherapists met today to discuss two papers:  ‘Interview with Carl Rogers on the Use of Self in Therapy’ – chapter 2 in ‘The use of Self in Therapy’ ed. Michele Baldwin, Haworth Press, 2013, and ‘The Use of Self of the Therapist’ by Wendy Lum, Contemporary Family Therapy, March 2002.

We discussed in some detail what ‘use of self’ means:  the in-the-moment awareness of felt sense, experienced when with our clients;  allowing ourselves to be impacted by our clients, and trusting both ourselves to find a way of conveying, and them to be able to receive, what we are experiencing.

Yet this can feel risky at times, as the outcome of such an expression is unknown at the time.  In the very act of reaching out to the client, there is the risk of alienating or confusing them, but hopefully our intention to honour them with our honesty, genuineness and integrity will be received and reflected upon.  Indeed, it can model to the client the value of transparency and self-awareness.  It might be easier to ‘play safe’ and not make the effort or take the risk, thereby depriving the client of what could be a significant learning opportunity to reflect and grow.

Perhaps no one has been able to improve on Carl Rogers’ own descriptions of this process:

Perhaps it is something around the edges of those [core] conditions that is really the most important element of therapy – when my self is very clearly, obviously present.

The important thing is to be aware of this feeling, and then you can decide whether it needs to be expressed or is appropriate to express.

I want to be as present to this person as possible.  I want to really listen to what is going on.

At those moments, it seems that my inner spirit has reached out and touched the inner spirit of the other.  Our relationship transcends itself, and had become part of something larger.

To be congruent means that I am aware of and willing to represent the feelings I have at the moment.

We acknowledged how difficult it is for this level of congruence, or ‘use of self’ to be taught within counselling training courses, and how the (necessary) breaking it down into teachable and observable units somehow diminishes it and misses the point, as perhaps is a danger in Virginia Satir’s model described by Wendy Lum.

Despite the threats of the medical model dominating the helping professions, and despite our kind of work being at times extremely demanding and exhausting as we give of ourselves, we agreed that it is a tremendous privilege to be able to relate to others at such depth and intensity  –  to experience what some might describe as a ‘meeting of souls’.  Where else can clients be met with such realness, at the same time as being held in such deep respect and trust?!

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The Use of Self

Emotions and the Brain: the origins of values?

The meeting of the Fells and Dales Counsellors on Friday August 24th 2018, met, through the medium of TED and UTube talks, Professor Mark Solms and Dr Jaak Panskepp, the latter now sadly deceased.

The input stemmed from a visit by one member in July to South Africa. He had been reading a book The Brain and  the Inner World written by Profesor Solms. Noting that Professor Soms was at Cape Town University he discovered that this Vineyard was located ten minutes away from where the holiday accommodation was situated, a visit was therefore possible. Mark Solms is Professor of Neuropsychology at the University of Cape Town. He is also a psychoanalyst and the owner of a Vineyard in Franschhoek.

The relationship to that Vineyard, Solms and Delta Vineyard, is  complicated and offers a fascinating insight into the political and cultural situation in South Africa. The insight of a psychoanalyst to that situation illuminated by the mind of a neuropsychologist is rich indeed. One possible reference to hear about the sociological dynamics can be found at: https://youtu.be/C_Aao_8XOAI       Mark Soms giving his land back to farmers.

The focus then was switched to hearing Professor Solms, the academic, speaking of a fundamental theory concerning ethics. He understands and has been able to demonstrate that all mammas have the same brain structure and deep level of emotional response. We share our emotional brain responses with 500 million years of mammalian evolution. Our fundamental emotional responses concern survival and reproduction. All mammals feel the enthusiasm for seeking and finding that which keeps the physical body in being and harmony. When it is not in harmony, the emotional response is such that that balance must be restored. 500 million years ago then, the concept of values was being played out in terms of that which is ‘good’ and achieves physiological balance and that which is ‘bad’ and upsets or destroys that balance. all of which is routed to the inner brain emotionally. Thus our value system was born as was consciousness itself, in an awareness of what our emotions were conveying, namely, ‘how am I doing?’

Professor Solms refers to the work of Jaak Pansksepp, Estonian neuroscientist, and known for his work now into affective neuroscience whose book The Archeology ofthe Mind details his resesarch into those primary and ancient emotions that we share in common with all mamanals. His identification of seven fundamental primary affects is becoming better known. There are several TED videos which feature Jaak Panskepp such as that seen during this meeting at: https://www.youtube.com/watch?v=65e2qScV_K8

Discussion visited the origins of ethics in use today in our professional bodies and curiosity about the tendency towards the apparent doctrinal even dogmatic assertion of our professional ethical boundary statements. Perhaps education in affective neuroscience may help practitioners understanding of their emotional lives that sometimes lead to unwise behaviours.

We were reminded of the association of Sandra Paulsen to Jaak Panskepp and her EMDR workshops inviting participants to consider the existence of these fundamental primary emotional circuits. She proposes that these, due to innumerable forces no doubt, can be ‘damaged’ or ‘distorted’ and not fulfilling their evolved purposes. She teaches EMDR protocols for their ‘resetting’. A member of the group who has benefitted from her workshop and had the privilege of working with some clients in this mode, told of his awareness of and fascination with clients’ processes and work that led to an apparent amelioration of their emotional lives.

All felt that a world of new reading had been offered!

 

 

Emotions and the Brain: the origins of values?

Fat Lady by Irvin Yalom

We used this chapter from ‘Love’s Executioner’ to consider out personal responses to obesity. While we had varied experience of obesity in clients, we agreed that it is vital to find a way to talk about it. We acknowledged that it may take courage to broach such a potentially sensitive aspect of a client’s body image but that it was imperative to create  the space to  explore it.

A member of F and D with professional experience of disordered eating pointed out that many overweight people are blind to their size. She thought there would invariably be a reason for a person’s weight to be out of control and therapy is an opportunity to try and find the reason. Emotional emptiness seemed to be a common feature .

We considered the effect of gender on our responses to obesity and decided that social and cultural expectations were harsher on women than men.

Fat Lady by Irvin Yalom

“Real” differences between twins and identity development

 

 

The groupm meeting on June 6th 2018, discussed a chapter entitled “ “real” differences between twins and identity development” from Barbara Klein’s book on twins in therapy: “Alone in the Mirror” (Routledge,2012).

 

This chapter raised a number of interesting issues for our work as therapists:

 

  • Who mirrors the twin as the twin is often not looking at mother but at their twin and what is the impact of this? (i.e. the essential formative relationship is with the twin rather than the mother)

 

  • What is the effect of shared experience in the womb, particularly if one twin dies in utero?

 

 

  • Effect of a merged and dependent relationship with the other twin as in the clinical example of Chuck

 

  • The effect of twins being seen as a unit by the parents rather than as separate individuals

 

 

  • Impact of a twin’s expectation of others that their feelings and thoughts will be known and understood without the need to express them due to the shared communication with their twin as the imprint

We agreed that the book was thought-provoking and merited further reading and one of the group has already recommended it to a client who is a twin which is sufficient validation!

 

Rosemary pitt

28/6/18

“Real” differences between twins and identity development

The True Nature of Jealousy

The papers for discussion this month were on the subject of Jealousy, by popular request.  Both articles are from Psychology Today: ‘Listening to Jealousy’ by Sara Eckel, and ‘The True Nature of Jealousy’ by Berit Brogaard.  It was acknowledged that jealousy stems from insecurity, sometimes relating to suspicion (which could be unfounded), though it could represent a genuine fear based on past experience.  It is symptomatic of attachment issues, with relationship difficulties becoming a metaphor for early life scripting.

Jealousy can be an escape or distraction from facing one’s own guilt and responsibility.  We discussed the difference between jealousy and envy, one possible pair of definitions being:  envy is wanting what someone else has;  jealousy is not wanting someone else to have what you have, and what you consider is rightfully yours, and resenting them if they’ve got it!  Jealousy is associated with possessiveness, a fear of loss, a sense of injustice, a threat (usually to a relationship), being made to feel inadequate or inferior.  Preoccupation or obsessive thoughts that a partner is being unfaithful, with no real evidence, can result in ‘morbid jealousy’.  Its origin could be a deep underlying fear of being abandoned and left alone.

In the words of Esther Perel, quoted in the Ekel article, ‘The feeling itself [jealousy] is taboo…..[and yet] it’s a universal human condition, one of many that is part of the multilayered experience of love.’

The True Nature of Jealousy

Should we talk to ‘parts’?

The group met 20th April 2018 and used the article ‘Should I talk to Parts?’ by Rob Spring (Multiple Parts (2015) Volume 5, Issue 3, Pages 12-17.) as a departure point for our discussion about working with multiple parts & dissociation.

The article starts from the position that there is no ‘YES or NO’ point, but rather it depends on the context.  The article continues to talk through 7 arguments that include;

  • whether the parts are created by clients for personal gain,
  • whether therapists help or harm clients by engaging with parts,
    • such as the impact of approaching some parts and not others possibly due to bias of therapeutic approach (e.g. to only address adult parts) or personal views of the therapist around what parts represent (e.g. there may be a perceived risk around further dissociation when engaging with some parts over others or in somehow enabling parts to become more individuated from the ‘host’ rather than working towards integration of parts into a ‘whole-person’ identity.
    • Whether therapy may align more with the therapist’s agenda of what is helpful or contain certain bias that do not help clients,
    • whether working with parts is a form of avoidance of processing the trauma or helping clients to avoid taking personal responsibility for clinical improvement,
    • whether therapists may inadvertently re-active trauma, whether working with parts.

 

We discussed a few different subjects over the course of the meeting.

We asked whether expertise was important in this area and how it was possible to gain appropriate skills.  A key text ‘Looking through the eyes of Trauma by Sandra Paulsen’ was discussed and referred to by several group members who had found this to be a useful and thought-provoking body of work around how to engage in therapeutic dialogue with parts.

One of the difficulties with this subject is defining reality.  We discussed the reality of the therapist vs the reality of the client and as we discussed this one emerging theme was that the therapeutic alliance between therapist and client set up a language of its own through which clients and therapists learnt how to position reality and work with parts.

Dissociation although written about and assessable through various means was also felt to be something hard to experientially define and again seemed to be something that was recognised between the therapist and clients at moments of incongruence – each experience being context-dependent and somehow related to how ‘in-contact’ it feels in the moment with clients. Although experience of the therapist in this arena was felt to be helpful in working with dissociation there was a dominant feel that the relationship between client and therapist seemed to be something we all felt would support therapeutic progress.

PB shared work by Knipe (CIPOS Method – constant installation of present orientation and safety, which had some useful theory and approaches around helping dissociative clients to engage with the present and gradually resource clients with ways of making greater contact with their own experiences.

We also asked the question of the difference between amnesia and a ‘split-off’ part? This lead to a discussion of childhood trauma and attachment style and how these contributed within this area of work.  We also referred to Sandra Paulsen’s work again here and some work by Michael Patterson on Ego State therapy and the relationship to dissociation which identifies different types of dissociation (primary – being nightmares and flashbacks, secondary being depersonalisation and derealisation and the third type associated with more complex states that have amnesic barriers).

 

Should we talk to ‘parts’?

Self Harm

Our meeting on March 23rd looked at several papers on self harm, with particular emphasis on self harm in adolescents. We learned something about the on line presence of websites and chat rooms dedicated to self harm and frequented by young people. The positive side being a source of support for young people in unbearable pain.  The negative being a peer group which might encourage self harm and could even promote it.

Chapter 3 of Antonia Murphy’s book ‘Out of This World’ discussed the relationship between self harm and suicide. She sees a difference in intentionality though they are both acts of self aggression. People harming themselves generally want to feel more alive whilst those who are suicidal wish to die. We quickly saw a blurred area where the two acts overlap where long term self harm can lead to ‘acquired capability’ of suicide. Both behaviours come, of course,  from psychic pain and we discussed the importance of investigating the pain and its origins by empathic atunement in therapy. Barent Walsh’s paper on Clinical Assessment of Self Injury concentrates on extracting the details of the client’s harmful behaviour in what he calls  ‘respectful curiosity’ , a term which did not sit well with all of us as it implies therapist distance rather than involvement. We were however agreed that seeking detail might make the behaviour feel more real for the client and conveys a willingness to bear this reality collaboratively. The client’s prior experience of other people is likely to have been avoidant or squeamish.

We came up with a very interesting new idea (for most of us) that morbid jealousy is itself a form of self harm stemming from early inadequate attachment –  the pain of feeling unloved  at the same time as feeling unworthy to be loved and re creating this distress in the self inflicted pain of jealousy.

 

Self Harm