Therapeutic Alliteration

Therapeutic Alliteration

Every argument worth making, it seems, can be summarised in a limited number of words all beginning with the same letter. So here are the Four Ps of Therapeutic Attitude. The last one is A, so I made the middle two either P/A to balance it out.

By the way, the “you” addressed here may be a therapist, but not necessarily. Everyone can bring some therapeutic attitude to the table in whatever relationship they are in. If you are in a position of professional responsibility, then I believe you have a duty to do so. Oh, and first check out Attitude

So here are the four Ps: Position, Posture, Purpose, and Appreciation. That’s P for ‘preciation.

Position

Are you visible? Accessible? Are you in a place in your own life that enables you to park your issues and engage fully in the therapeutic relationship for the allotted time? There is little point in having all the other attributes of a therapist if you are hidden away or beset constantly by other demands. Position can also refer to your “position on issues”. Where are your red lines? I suggest, very simply, “Support the other if you can do so without harming anyone”. If you have read much else of what I have written you will know that I have other red lines; I will not serve the machine, for example. Red lines are relatively static and provide the channels through which Purpose (see below) is directed.

Posture/Appearance

Body posture is both a useful metaphor, and a way to evidence and influence a more internal posture. You need to be upright without being rigid; relaxed without being slumped; alert without being rapacious; responsive without jumping to conclusions or into action. Some aspects of your posture will become evident from your responses. To maintain therapeutic attitude, you need to be located in the real world, but not too subservient to it. Stable, yet poised for movement. How you appear will hopefully inform others as to your position and likely style.

Purpose/ Approach

The purpose of therapy is to enable positive developmental change; enable and encourage, but never force or demand. The agenda arises in – is set and owned by – the other person. Any other would-be influences can be considered part of the environment. If the client has been sent or brought by a third party – then the agenda of that third party is something that you and your patient or client can look at with interest. Someone may come to you with an agenda and that is fine, but you will be curious towards it, and ready for it to change.

Appreciation

Appreciation of the other includes warmth, greeting, acknowledgement (that they are real and valid), acclaim, and humour. There are two keys to appreciation. One is Sensitivity. There is no merit to acclaim, for example, if it is insensitive. Some people are not rewarded by a fanfare, but rather a shy nod. Others will only notice a fanfare and will experience a shy nod as a brush-off or will not notice it at all. The other key to appreciation is genuineness, and it is at the point of appreciation that genuineness is most crucial. It is possible to manufacture Position, Posture, and Purpose and act them out – possibly against the grain, though this will require a good deal of effort – but genuineness must be genuine. Fake genuineness, when detected, simply results in disengagement; if undetected, fake genuineness can be toxic. Therapeutic work, therefore, is a vocation. You do it because you really want to, and because it really matters to you.

TA = P + P(A) + P(A) + A(P)SG . What could be simpler?

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Compass Bearings

Compass Bearings

A compass needle will point towards magnetic north, as long as there is not too much metal around, but typically when travelling we want to get to a geographic location, so it is geographic north that is the more useful reference in deciding our direction.

We often use the compass as a metaphor to evoke those bearings we use (or ignore) to varying degrees when deciding our values and actions. Individual politicians or business-people, for example, are occasionally criticised for their lack of “moral compass”.

Retiring from a post I have worked in for seventeen years has given me a new perspective on what I was doing and some of my strengths and weaknesses. This reflection is in its very early stages. I am two weeks retired and still disorientated by my sudden de-institutionalisation. I have decided to dig out that old compass.

And so it was, in conversation with a friend, that I found myself owning up to a relative lack of attention to what he and I came to call the “pragmatic compass”.

I have spent a fair bit of my time kicking against the pricks (a brilliant phrase that offers in its archaic imagery scope for serious irreverence). This has not achieved as much as I always hoped at the time. Early on, my optimism could have been put down to naivete but later, with greyer hair, one has to wonder at my lack of pragmatism. If I had a pragmatic compass I was not following it very closely.

Needless to say, I had some colleagues who were following theirs and, whilst they were doing so, I accumulated accolades for “standing up for people”. I am proud of that, of course, but I have wondered if I had the balance right and if I might have been able to achieve more if I had adjusted things a little.

My friend and I agreed that in the world – and perhaps especially in the workplace – we need to set our course somewhere between two bearings; those of the moral compass, on the one hand, and those of the pragmatic compass, on the other. If they coincide, then we are truly lucky. If on the other hand they point in opposite directions which, sometimes, they do – we have a particularly thorny problem to resolve. Sometimes, the pragmatic action is in the opposite direction to the moral one.

Anyway, this has got me musing on various situations in which “pragmatic north” and “moral north” diverge by differing angles and, in each case, which course I have chosen – or might in the future choose. I am not a great one for regret, but I think it is worth learning from experience.

Why “Normal”

Why “Normal”

Strolling through woods, my friend asked me “is that normal?” and seemed astonished when I replied, “Is that question even relevant?” We were talking about thoughts, feelings, experience – I can’t remember, now, exactly which. In any case, I have been asked that question, or variants of it, so often. We seem to be obsessed with normality; strange when in so many areas of life we are busy deconstructing the notion.

So here is my theory. Normality is an idea that stems from the herd. Herd behaviour is a primitive, instinct-driven behaviour designed to ensure survival of the group at the expense of the outliers. The slowest, or those on the fringes, can sacrificed to the group cause; picked off by predators or extreme conditions.

Two things follow.

  1. The individual, when the group is operating at this primitive level, becomes anxious if they find themselves at the back, or off too far to one side. “Am I normal?” becomes a proxy for “am I safe?”
  2. The group, when under pressure, will expend less energy supporting individuals on the fringes, since their value to the group lies chiefly in their expendability.

There is another angle which is the stigma attached to being at the rim of the bell-shaped curve. I suspect that this is a little more complex. We are generally placid as long as things continue as they always have (and provided our basic needs, at least, are met). If something out-of-the-ordinary arrives, though, we are challenged, and the degree of challenge depends on the extent to which we feel insecure. If something unfamiliar turns up in my experience (a skin blemish, or an unusual sensation, for example), or in my group, I may welcome it if I am feeling secure, or be suspicious of it, if not.

Because, in the latter instance, novelty is unwelcome, I do not want to be associated with it. If I run next to this individual, then I may be sacrificed by the herd along with them, or by association. They, by definition, are at the fringes and expendable – a target for predation, or a low priority for succour – so the further I am from them the better.

My conclusions are several:

  1. An insecure group will tolerate difference less; will stigmatise it more; will be happier to see it suffer and disappear.
  2. To decrease stigmatisation of minorities, we need not to attack the perpetrator more, but somehow reduce their sense of insecurity.
  3. When we find ourselves asking “is it normal?” we are operating from a primitive and insecure position. The better question might be “is it dangerous?” At least, then, we allow ourselves the possibility of higher-level existence: welcoming and experiencing novelty, and providing succour to the needy.

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Pebbles and People

Pebbles and People

Whenever let loose on a beach I immediately find myself looking at the ground around me, stooping, and picking up objects for closer examination. Sometimes it is shells or driftwood. Occasionally it is a useful piece of nylon string. But what I find fascinates me most frequently are pebbles.

On the beach at Filey in Yorkshire, about ten years ago it occurred to me that, although I was exercising great discrimination in selecting pebbles, I might just as well shut my eyes and pick up the first one I stumbled across and that single pebble would give me as much satisfaction.

This observation troubled me slightly, and bided its time, quietly fizzing in the very back of my mind until a few months ago on a beach in Pembrokeshire. That idea about “any old pebble” popped up to greet a new niggling observation. I was noticing in myself a sense of affection bordering on love and nostalgia towards the stones I was picking up and, with some reluctance, releasing again to the wild.

Suddenly these were people. Indeed, they were my patients! Do I have a favourite? No, of course not. Is any one not worthy of love? No. Is any of them perfect? No. Do they share features, and yet retain, each of them, a uniqueness? Yes. Do I take a particular interest in some over others, for a time? Yes. Does each of them accompany me for a time and then leave? Yes. And do I have a sense of the number that I can safely carry, and the number that I can examine closely, at any one time? Yes.

Of course the analogy has its limits. Any analogy that is total or complete ceases to be an analogy or of any interest. I do not see myself as of any use to these stones. I don’t expect any of them to be in any kind of predicament that I might be able to help them through. In fact the roles are somewhat reversed. It is more likely that they can help me with my predicament.

But do they talk to me? Yes.

What makes these pebbles like people to me? What is it they share?

A pebble’s character is shaped by two things: their inherent material, and their experience. Each stone is made of a material which may be soft, hard, brittle, porous. These features, in turn, have their distant origin in constituent and experience – their chemical makeup and the terrible forces that gave birth. There may also be a fault line, or a sheering plane due to differing materials joining. And then there is the tossing and churning, the action of water, and jostling with their fellows which has brought them to their current shape. The interaction of these two broad sets of influences is important. Some will have been more or less resilient to this abrasion. Others may have seemed impenetrable until they split after a sharp tap, to reveal a hollow interior. And then this, in turn, was smoothed and adapted. And some may have been brought here from elsewhere, finding themselves in the company of other shapes and colours.

I found myself moved by the stories of these stones. And by the fact that, yes, some of them caught my eye – bright colours or a wet shine – but that I could pick any one of them, take an equal interest in it and enjoy its company – for a time.

Ultimately, of course, the analogy relaxes its grip and we fall back into our respective places. I turn to my human companion, perhaps compare notes, and move on.

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