.... "the work of the therapist is not essentially concerned with dispensing wisdom or expertise or even with the deploying of skills. It is more about embodying values..."
from "On Becoming a Psychotherapist" - Routledge - Dryden & Spurling (eds)
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Infrequent musings and general comments on life, from the perspective of a UK psychotherapist.
Sunday, 7 November 2010
Sunday, 17 October 2010
The CBT surf-ride continues.... but for how long?
CBT (Cognitive Behavioural Therapy), on the platform of NICE, is riding the political wave of popularity... still.
I was interested, though, to listen to a segment on Radio 4 recently. A psychoanalyst took a rare opportunity to present a robust defence of non-CBT therapies. The fact is that the Evidence presented on CBT is matched by other therapies; additionally, the 'gold-standard' methodology of the randomised-controlled-trial is easily questioned by intelligent minds.
Why, then, do people still think of CBT as 'better' than other therapies?
Why do national services favour cognitively-based work (apart from the cost of short-term treatment, of course...!)
Think of the world of supermarkets. You can buy a product because you know it's what you need, or you can be told what you need by smart packaging, clever ad campaigns, and because everyone else says it's great.
Sooner or later, the hype might just wear off. Clients are smart, and will eventually vote with their feet.
I was interested, though, to listen to a segment on Radio 4 recently. A psychoanalyst took a rare opportunity to present a robust defence of non-CBT therapies. The fact is that the Evidence presented on CBT is matched by other therapies; additionally, the 'gold-standard' methodology of the randomised-controlled-trial is easily questioned by intelligent minds.
Why, then, do people still think of CBT as 'better' than other therapies?
Why do national services favour cognitively-based work (apart from the cost of short-term treatment, of course...!)
Think of the world of supermarkets. You can buy a product because you know it's what you need, or you can be told what you need by smart packaging, clever ad campaigns, and because everyone else says it's great.
Sooner or later, the hype might just wear off. Clients are smart, and will eventually vote with their feet.
Monday, 4 October 2010
Be This The Verse? ... Parents, Parenting, Families
Recently, for personal reasons, I've been revisiting the wonderful poem by Philip Larkin, "This Be The Verse". It's one that most psychotherapists are familiar with; we appreciate its truth and its irony.
It also makes me think about being a parent. I'm a little uncomfortable with Larkin's final rejoinder "And don't have any kids yourself", which to me speaks of Larkin's well-known glumness, his tendency towards polarized views, and a kind of lack of hope for humankind. He seems to suggest that the handing on of misery cannot be avoided.
This might be true in some ways; no parents are perfect, after all. But I wonder if it's also true that some of the misery can be turned into something else, or even quarantined, so that Larkin's dark outcome can be (at least partially) averted.
People can change. They can decide to do things differently, if they want to and realize they have the opportunity to do so. Otherwise, they may be able to achieve some of this in therapy.
I guess what I'm saying is, Mr Larkin made an astute observation, but I have more hope - for me as a parent, anyway, and for people who work on therapeutic change in themselves and others.
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It also makes me think about being a parent. I'm a little uncomfortable with Larkin's final rejoinder "And don't have any kids yourself", which to me speaks of Larkin's well-known glumness, his tendency towards polarized views, and a kind of lack of hope for humankind. He seems to suggest that the handing on of misery cannot be avoided.
This might be true in some ways; no parents are perfect, after all. But I wonder if it's also true that some of the misery can be turned into something else, or even quarantined, so that Larkin's dark outcome can be (at least partially) averted.
People can change. They can decide to do things differently, if they want to and realize they have the opportunity to do so. Otherwise, they may be able to achieve some of this in therapy.
I guess what I'm saying is, Mr Larkin made an astute observation, but I have more hope - for me as a parent, anyway, and for people who work on therapeutic change in themselves and others.
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Friday, 10 September 2010
Pastor Terry Jones - unbelievable
It's not my intention to get into religious matters on my blog. I'm certainly no expert.
However, I do know that the pastor in the US who is proposing to burn the Koran is offering a very weird form of Christianity.
As far as I recall, Christ preached acceptance, compassion, and forgiveness.
Hard-line Christians seem to forget that Jesus's commandment - "Love One Another" is poorly served by bigotry of any kind, be it anti-Islamic, homophobic, racist, whatever.
However, I do know that the pastor in the US who is proposing to burn the Koran is offering a very weird form of Christianity.
As far as I recall, Christ preached acceptance, compassion, and forgiveness.
Hard-line Christians seem to forget that Jesus's commandment - "Love One Another" is poorly served by bigotry of any kind, be it anti-Islamic, homophobic, racist, whatever.
Friday, 20 August 2010
"Look......" (that's an order!)
Listening to an interview recently on Radio 4, I noticed how frequently some of our politicians begin a reply with - "Look,..." and it made me angry.
Thinking back, I remember Gordon Brown using this intro, as did his predecessor Tony Blair.
Transactionally, it's interesting to note the two different levels of communication at play here. On the social level, "Look,..." is an invitation, and a plea for a kind of matey informality. 'Come on, I'll level with you....'
On the psychological level, though, there is a different message being delivered. A couple of possible interpretations -
"Look, (you clearly don't get it, so I'll have to explain it again)..."
"Look, (I have explained this before, so this is the last answer I will give to this question - don't ask it again thank you)..."
As Eric Berne suggested, the psychological-level communication determines the outcome of the transaction. So in their matey, friendly, I'm-just-like-you approach, these politicians are betraying a secret -
they really "look" down on other people.
Thinking back, I remember Gordon Brown using this intro, as did his predecessor Tony Blair.
Transactionally, it's interesting to note the two different levels of communication at play here. On the social level, "Look,..." is an invitation, and a plea for a kind of matey informality. 'Come on, I'll level with you....'
On the psychological level, though, there is a different message being delivered. A couple of possible interpretations -
"Look, (you clearly don't get it, so I'll have to explain it again)..."
"Look, (I have explained this before, so this is the last answer I will give to this question - don't ask it again thank you)..."
As Eric Berne suggested, the psychological-level communication determines the outcome of the transaction. So in their matey, friendly, I'm-just-like-you approach, these politicians are betraying a secret -
they really "look" down on other people.
Monday, 2 August 2010
Carl Gustav Jung
"Nobody, as long as he moves about among the chaotic currents of life, is without trouble"
Sunday, 16 May 2010
Cameron & Clegg - Relationships in Action
The recent coming-together of the Conservatives and LibDems in the UK has given us all a lot to think about. In particular, it highlights the difficulties of being together with someone (or some party of people) with whom you feel less-than-loving.
This is often the situation in the therapy room with a couple. When tempers flare or resentments run deep, there is a real threat to the bedrock of the relationship.
Cameron and Clegg have recently had to go through a tough process... they've had to put aside, at least temporarily, their resentments and differences - in favour of a new priority, "the national interest". Both parties must now realise that their selfish interests might not be best for the nation. This shared project, the nation's future, is now dependent on a relationship to which they must contribute.
This process is similar to what the behavioural-systems therapists call "Decentring"...that is, putting your resentment to one side, and accepting responsibility for your part in the relationship (and of course, your part of the problem).
So, Mr or Mrs X, who arrives saying "well, it's him/her over there who really needs sorting out....." has to finally own up to being part of the problem (transaction). It can be a very difficult first step, but it's the best way to start the journey of maintaining a good relationship.
Of course, it can still go wrong. Watch out in the future - if the new 'coalition' breaks up, it might be accompanied by lots of angry protests and finger pointing at the other side. The mutually responsible position is easily lost.
This is often the situation in the therapy room with a couple. When tempers flare or resentments run deep, there is a real threat to the bedrock of the relationship.
Cameron and Clegg have recently had to go through a tough process... they've had to put aside, at least temporarily, their resentments and differences - in favour of a new priority, "the national interest". Both parties must now realise that their selfish interests might not be best for the nation. This shared project, the nation's future, is now dependent on a relationship to which they must contribute.
This process is similar to what the behavioural-systems therapists call "Decentring"...that is, putting your resentment to one side, and accepting responsibility for your part in the relationship (and of course, your part of the problem).
So, Mr or Mrs X, who arrives saying "well, it's him/her over there who really needs sorting out....." has to finally own up to being part of the problem (transaction). It can be a very difficult first step, but it's the best way to start the journey of maintaining a good relationship.
Of course, it can still go wrong. Watch out in the future - if the new 'coalition' breaks up, it might be accompanied by lots of angry protests and finger pointing at the other side. The mutually responsible position is easily lost.
Tuesday, 16 March 2010
Tiger Woods - An Apology
The apology of Tiger Woods was hailed as one of the most powerful acts of contrition in recent history. Certainly, fewer people have apologized so profusely for quite so long, and in such a public way.
Equally surprising was the sharp volley of criticism from some media commentators.. "Does he mean it?" .... "Is it enough...?" et cetera. I found myself feeling a little sorry for Tiger - who, having been placed on the vertiginous platform of sports celebrity, got caught in the seductive narcissism of riches and global attention. Inevitably, he fell from grace. I had no doubts about his sincerity but many others did.
It reminds me that apologies aren't an event in and of themselves. Apologizing is a transaction. Someone says sorry, conveying an empathic understanding of the impact of their behaviour on the other. The other part of the transaction is that someone else has to accept (and maybe forgive if they can).
How come some people didn't forgive Tiger? I suspect there are many reasons; not least the kind of covert sadism of some towards successful people. In the UK particularly, we love to see people fall from grace; in fact we seem to build them up quite deliberately sometimes, just to tear them down.
As for me, I guess Tiger didn't hurt me much. He didn't disappoint me too much, as I never really paid much attention before.
There are other apologies, however, that I simply don't accept. Because the process of apology isn't complete for me. "National Express Trains would like to apologize for any inconvenience caused".
This one leaves me cold. National Express doesn't listen to or acknowledge my anger, fury, disappointment, and regret. They don't ask to hear it, they kind of pre-empt it with a blanket message intended to cover "any" inconvenience. This isn't a real apology - so why should I accept it??
Real healing happens when we listen to the hurt we've caused, and let the other person know that we really understand its impact. A true apology can be difficult because it involves acknowledging the experience of the other - and facing the reality that we may have done something wrong.
Equally surprising was the sharp volley of criticism from some media commentators.. "Does he mean it?" .... "Is it enough...?" et cetera. I found myself feeling a little sorry for Tiger - who, having been placed on the vertiginous platform of sports celebrity, got caught in the seductive narcissism of riches and global attention. Inevitably, he fell from grace. I had no doubts about his sincerity but many others did.
It reminds me that apologies aren't an event in and of themselves. Apologizing is a transaction. Someone says sorry, conveying an empathic understanding of the impact of their behaviour on the other. The other part of the transaction is that someone else has to accept (and maybe forgive if they can).
How come some people didn't forgive Tiger? I suspect there are many reasons; not least the kind of covert sadism of some towards successful people. In the UK particularly, we love to see people fall from grace; in fact we seem to build them up quite deliberately sometimes, just to tear them down.
As for me, I guess Tiger didn't hurt me much. He didn't disappoint me too much, as I never really paid much attention before.
There are other apologies, however, that I simply don't accept. Because the process of apology isn't complete for me. "National Express Trains would like to apologize for any inconvenience caused".
This one leaves me cold. National Express doesn't listen to or acknowledge my anger, fury, disappointment, and regret. They don't ask to hear it, they kind of pre-empt it with a blanket message intended to cover "any" inconvenience. This isn't a real apology - so why should I accept it??
Real healing happens when we listen to the hurt we've caused, and let the other person know that we really understand its impact. A true apology can be difficult because it involves acknowledging the experience of the other - and facing the reality that we may have done something wrong.
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