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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Nature of Evidence – After the day

Nearly two months after the Nature of Evidence seminar, the buzz of the day has passed and I periodically return to the sound-file. Such richness and diversity of material!

Thirteen people assembled for the day. Each had prepared a brief presentation, and these were delivered in groups throughout the day, separated by open discussion.

I am listening to the sound-file in order to extract themes, but what I am reflecting on right now is the way that people are affected by each other’s positions. There is a quality of respect and attention that contrasts so starkly with what I see so often on Twitter.

Of course this was a group of people who were likely to be respectful of one another’s opinions and sensitivities, but what I particularly notice today is what is said by someone AFTER they have listened to and taken on board other opinions. There is often a softness or slight circumspection that marks these utterances. For example, “This may not apply so much in some of the areas you are working in, but I think that…

So this day was informative through process as well as content. People took care of one another, which is heartening. But I find myself wondering if the validation that opinion can receive from agreement may be less that that which it receives from its ability to demonstrate that it emerges from a process of reflection. For agreement, the message is often simplified, rather as the outcome measures of a quantitative study are simplified. The devil remains hidden in the detail, and the detail has been effaced by the process. Perhaps we are agreeing over that-which-can-be-agreed-upon instead of that-which-needs-to-be-debated.

In this discussion about evidence, there is a difference between the statement “this is about power” and the statement “context is important” (both of which, incidentally, I agree with). It is not that one is convergent and the other divergent, but more that they invite differing qualities of convergence-divergence.

It calls to mind Leonard Cohen’s lyric “There is a war between the ones who say there is a war and the ones who say there isn’t“. If those two groups can work together, then we are really getting somewhere!

When presented with “evidence”, I inspect it for evidence of some reflective process that has been able to listen to contradictory positions and that continues to take them seriously.

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