Appreciation (46) – Generator refit

Appreciation (46) – Generator refit

Torrey Orton

June 28, 2012

25 minutes for a decade of life

I went to the electronics repair shop a few weeks ago, sat around for 6 hours and had a 25 minute refit. My pacemaker was replaced. Two weeks later I'd hardly know it. There's no visible change in my behaviour or appearance. For the inexperienced (even my GP's nurse receptionist) I offer a touch of the soft but unyielding pad which is the "generator" sitting just below the skin on my left front shoulder. About 3cm square by 1 deep. Recently, I almost fell into a slightly competitive 'I'll show you mine if you show me yours' with a patient bearing babyhood scald scars he needed to share. It's that I don't really believe the generator is there unless I see it. Showing others is a validating experience in my reality stakes.

Things I learned: a pacemaker IS a generator; it produces pulses to prick the heart back into action if it forgets to beat here or there (which is my potential affliction; it only happened once in the last ten years, for which I have had the distinction of the generator ever since); I can sleep through many things, including this procedure for which anaesthesia was provided locally (I felt that); staff told me I snored throughout (perhaps because it was a valium assisted take off?). Wish I could sleep normally. Can't seem to learn that.

I walked out at the end of the six hours, fuelled up with a latte and a Danish (first eats in 18 hours apart from a single round of skinny sandwiches and some juice or tea immediately post insertion – and no seconds), stood around for a taxi and got home to remind myself not to wave my hands over my head in triumph. The generator leads in my heart might get loose. It takes a month to get them so organically enmeshed that the body around them will collapse before they do. Well, so a surgeon told me my first time around. He said a patient of his came back from a car accident where the pacemaker had borne the brunt of the impact without the slightest skip in performance. Rugged. What, me worry? I didn't bother to ask what else remained of said patient.

Unfortunately they haven't improved battery life, while allegedly 'improving' the guardian performance. A bit like laptops and such…ever improved and still unreliable. The generator's reliable enough but a bit short of breath one would think.

Maybe by writing this I'll understand why I think it's a bit of joke, this whole body decomposition thing that is advancing maturity. The fact doesn't get in the way when I'm doing things requiring the slightest bit of attention. But there's obviously a background discussion within me because it surfaces as a low grade wonder about my prospects of being here tomorrow when my attention is free. The generator is not likely to be a major player in the culmination of my maturity, but its presence is a reminder.

Back to the waiting room on the day: there were four or five generator insertion candidates lying around (it was pre-op after all, not a cafe) one of whom was a young woman I'd guess to have been 25 max. She was scared. Probably her first generator. Maybe I was/am, too, for my second.

Learner therapist (12)……and misses

Learner therapist (12)……and misses

Torrey Orton

June 25, 2012

 

Stories of my therapeutic errors

I am somewhat obsessively tuned to my mistakes, a commitment moderated by a fairly balanced level of professional self-regard. However, it seems that mistakes continue to occur in sufficient numbers and powers to guarantee the balance falls slightly towards the obsessive side. From my point of view, my reputation is better than my performance.

It is of course also the case that some of these may not be mistakes but effects of unreadiness… a condition afflicting both patient and therapist in unequal and differing measures. The patient is often not ready for certain lines of self-development. I may be unaware of the unreadiness because it has not surfaced clearly…and often does not until the patient decides not to show up anymore (though often, again, to return a year or two later when readiness has re-emerged!). Timeliness is near to all in effectiveness.

What follows are some examples which set mistakes in the context of the commanding injury which was the central object of therapy. Where obvious, I note my unreadiness. Theirs can only be guessed, if it was a factor at all.

A lost childhood

She was sent to me because she had seen another therapist unsuccessfully, had a powerful, wholly justifiable anger about her upbringing, had an Asian background I know the historical context for closely. She wanted to get over the anger – tools and techniques, please, for keeping the feelings at bay. I lost her after one session. So, another therapist failed her. I imagine she needed not to be lost more than I needed not to lose her.

I knew it at the end of the session. She sprang a surprise demand on me: Show her how she would get rid of her bad feelings fast. I'd spent a lot of the session listening to her story of separations – first her parents from each other, then she from her mother; then she from her grandmother who had brought her up in father and mother's absences: all perceived by her as abandonments, some of which she railed energetically against at the time they occurred, most notable of them that from her grandmother, the only real parent she'd known. The story was laced with appropriate venom, sadness, outrage and insight.

She signed up for another session and did not reappear.

A lost hope

A convicted paedophile who was trying to recover a workable social self. I felt I wasn't getting anywhere after 8 sessions and raised that with him – that he might want to see someone else. He didn't say no, just disappeared. My sense of not getting anywhere was real, but there wasn't anywhere to get to other than acceptance and support in the struggle to be…a role I have trouble with out of my own passivity? I have to constantly pay attention to the quiet depressed.

A lost trust

The engineer who should, but did not think he could, lead; always second guessing himself in a contest with chronic I'mnotgoodenoughitis…couldn't bear anything like a judgement because he judged himself to distraction. I, after 15 sessions, needed to make a judgment about his progress and he disappeared. I couldn't frame it right, though I had repeatedly worked on distinguishing 'evidence-based' judgments from judgmental ones. No evidence-based judgment, no progress. But there had been progress of concrete sorts, it seemed.

He was at that point going backwards for reasons we couldn't get a grip on. The triggers were not clear. And the pattern reiterated events of a year earlier which led to medication and time off work. An incipient anxiety I had not seen clearly, acknowledge clearly enough?

A lost bet

28 year old, under-employed, anxious single child of divorced parents with an injustice chip on his socially phobic shoulder…who desperately wanted me to validate his interpretation of a speeding infraction which he saw as the reason for his alienated social life, to agree that the authorities had been wrong in taking his right to drive away for 12 months (a fairly large speeding infraction).

This went on for 6 months until I finally suggested we stop, since I was not going to validate the causal chain he was using to contain his troubles; they just couldn't fit under the rubric of a miscarriage of road safety justice. He agreed, and was a little further ahead in his struggle with loneliness, injustice, physical complaints and dangling between his parents.

A next step

With many of these I imagine I would not lose them now, having improved my sensitivities in some of the faulty areas. But, now I will have other insensitivities, newly minted on the back of those improvements as my attention is preoccupied with their potentials and not their risks!

To get better at recognising unreadiness – mine or a patient's – and acting on it when the occasion arises is no simple matter. Unreadiness may be a cover for unwillingness, which in turn is a surrogate, possibly, for rejection, for not liking or approving of the other (going both ways, of course). And what my patients are here to see me for is almost always some rejected part(s) of themselves. These rejected parts involve some sense of rejection by others for those parts and therapy is meant to be a rejection free zone. That's pretty much recognised as a precondition (though not a permanently applicable one) for recovery of self.

Join me next Learner Therapist exploring this implication – the interpersonal politics of relationships.

Travel funnies 2012

Travel funnies 2012

Torrey Orton

June 15, 2012

 

The eyes of the beholder lose out again?

It's that time of year again. Travel time. Well, not quite for another month, but then we did have a small trial run to Magnetic Island, Queensland a week ago as a warm up for the main event in July, of which more later.

 

The Supervisory Loo

 

I realised shortly after this experience that I had had it before – 6 years ago in a restaurant in Shanghai's Xintiandi district. There I discovered that the men's urinal was mirrored in the hand basin wall out into the passageway through which men and women approached their respective loos. For all these years I've thought this was a peculiarly Chinese design. Now I think more broadly. It's a peculiarly loo designer fetish, maybe.

 

The supporting evidence is:

 

This time it was a restaurant loo in the somewhat less salubrious port of Townsville. Here the supervision was of pissers by same sex washers, sans the intrigue of multi-sex passers-by offered in Shanghai. This urinal ran down the wall alongside the doorway in, with the stalls arrayed at a 90 degree angle to it down the room and hand washing along the opposite wall. Here's the rub – the string of washing up basins were backed by a 1 meter by 3 meter mirror which gave the first hand basin an unavoidable line of sight enfilade of the action down the urinal.

 

Weird. Seen anything like it in your travels?? Or, maybe, of course, the only fetishistic designer here is my beholding of the facilities, a perspective strengthened by the multi-cultural evidence of my senses. Travel good; truth a wonder.

Learner therapist (19)…… systemic problem-solving improvement in relationships

Learner therapist (19)…… systemic problem-solving improvement in relationships
Torrey Orton
June 5, 2012

More tools for talk …and how therapists could help them do it.

 

Problem solving is hard to do

 

Daily life is full of stumbling efforts to fix things, the larger the system the bigger the stumbles…and yet we move on, even with sub-optimal solutions, or even solutions which aggravate the situation.


Striking when the iron is hot is good if you don't burn yourself or the other in the blow. Emotional and conceptual clarity are the key. Hot things cannot be cooled too much or they lose their energy, too hot and you lose your hand, or more. So, how to get started? If the start is wrong what follows will very likely get worse.


An overfull mouth
Problem solving is conceptually obvious and practically mind-bending because the feelings, issues and contexts to be handled are beyond presentation at once. So they have to be parcelled up both to make them accessible to the other and to get them organised for ourselves so they can stay organised under pressure from unexpected forces in ourselves, and the other!


Remember the overfull mouth of thought/feeling/action words which rush for exit at the moment you start opening a volatile issue. This is the everyday challenge of the damaged relationship, ending often in irradiating outbursts or cast-iron inhibitions. Such patterns can be improved a bit by a flexibly systematic approach. It has steps roughly as follows, which are straight out of rational problem solving handbooks. The order of steps matters, but the process should be recursive – doubling back on itself to keep the direction in view, because what we are seeking in such processes comes only fully to light as we go through them. The fullness of the task is seldom known from the start.
I like to think of problem solving as a process like a tumbleweed rolling along the slight inclines and divides of a Mallee farm on a windy day, picking up bits of this and that as it rolls, including other tumbleweeds, dropping off some same bits as well, and ending up in a mass of intertwined tumblers at the fence line where they begin to anchor, safe from the ploughing and reaping of daily farm life to provide the start for the next season. Not even a video of a tumbleweed rolling along can capture all the facets and phases of a problem-solving process, so I'm not too unhappy with my serial depiction below. Just remember to allow yourself to acknowledge all the associations which arise as you pass through it.


The problem solving sequence – an example

Step	Activity	Words / dialogue
Propose –getting something on the agenda; taking initiative	First, a proposal answers the question: 'what should we talk about?' - a statement of the issue of concern to one party, including a description of what it is, why it matters to you and what you want the other to do with it. This should also include an estimation of time required to deal with it and proposal for timing and location of the discussion. Proposal contents are often supplied by the issues chart developed in the first session. This also serves as the base for a shared running agenda and progress documentation. Flagging of volatile material is usually essential to progress with an issue. Start with simple issues which can be executed in one step if the relationship is in perilous condition.	(H) I want to get started on one of our issues. It's not too hot, but warm enough to make me focussed on it. It's our messy house problem. I'd like to get started tonite and have some solution(s) by next Monday. I expect it will take a few hours since we already understand it pretty well. We could start tonite just getting clear – maybe 30 minutes after the kids are in bed - and then follow up with options and decisions over the next nights. How's that strike you? (J) Yup, tonite at 9 say, but only ½ hour for starters. I've got a report to read for work, too. The recursive moment*
Acknowledge and clarify – ensuring joint ownership of the issue; being responsive	Second, acknowledgement and clarification answer the question; 'do we know what we are doing?' Three steps establish shared understanding of the proposal and a willingness to proceed with it: one, mirroring / paraphrasing back the proposal; two, adjusting it to confirm joint ownership; and three, deciding when to discuss it.	Later that day (J) So, I want to be really clear what you're proposing. What I got earlier is: you want to take up the "messy house" issue with the aim of having it fixed by Monday, right? (H) That's it. (J) OK, I want a little detail of what you think the issue is so I'm sure we're close enough to start. We've made that mistake before… (H) Well, I mean we've got a lot of stuff lying around and more coming in while we can't find last week's mags… (J) That's roughly what I think it is, too…so I'm ready to set a time (H) OK, let's agree a discussion schedule with next Monday as completion time, if possible. The recursive moment
Explore - establishing what matters to both – engaging with personal meanings	Third, exploration answers more precisely the question 'what's this all about?' by clarifying in detail why it should be important to both parties; this will involve especially establishing the meaning the issue has for both: its place in their personal and joint lives. This may result in a reformulation of the issue, usually more specific and actionable.	….. (J) …messy to me is not being able to find things…and you? (H) ...well, more finding every walk space cramped by piles of stuff and things looking just "messy"! (J) So what if it's messy..? (H)..Uhm, 'messy' I can't stand...feels like everything's out of control and then I feel out of control…you know what happens then. (J) Uh huh, things get messy between us and I begin to feel things are out of control… (H)..so in a funny way we're both bothered by messy – me first and then you following on as my bother bothers you!! (J) and that reminds me of another factor – when your mother's eagle eyes are cast over us each time she visits…!!! The recursive moment
Options –creating	Fourth, options answer the question 'now what's imaginable?' Usually there are already some options on the table, standing in clashing opposition to each other. The task is to turn them from positions into options. Trying to complete an options assessment in a single go will likely jam the creative, intuitive systems - throwing you back into clashing positions. Spread option finding over a couple of days at least. Provide a shared repository for potential options (e.g. a chart on the fridge). Follow the rules for issues charting: include everything and dispute nothing. Test for assumptions which limit the range/depth of possibilities. A good handle on restrictive assumptions is the word 'should'.	… (J) … remember, we're starting with an anything goes phase here… (H) Sure ...we already mentioned a few things we could do to reduce the 'messy' like: get an idea of what minimum mess is for us both, find some cleaners to organise the mess, and try out a holding pen for incoming stuff to corral the mess before it spreads .What else might be useful?? (J) For me it would be good try reducing my daily contributions to our mess… (H)…and maybe for me to reduce my complaining about that, too.. (J) And, then there's your mother: maybe we could agree on an approach to her expectations?? Maybe signalling how irritating her observations are…or inviting her to make some useful suggestions about how to deal with mess?? Scary thoughts, huh? The recursive moment
Decide	Fifth, decision(s) answer the question 'now what's possible, probable and practicable?' A decision should have an action set in a time framework with some mutually visible quantities attached to it. Start with simple decisions which can be executed in one step if the relationship is in perilous condition. Making effects of the solution testable is a way of ensuring commitment and the option of fine-tuning or changing the decision.	… (J) …so let's go with the cleaners first just to get the stuff neater, more packed, and we'll get a better feel for the shape of the next steps. (H) OK, and while we're at it we'll get them to price a more thorough solution – some storage options, some disposal options and so on. Does that follow? (J) Sure, but only if we have a way of keeping track of how these steps are unfolding, especially how we are managing variations to the solutions as they emerge…. (H) Well, that will probably be harder than agreeing and implementing these first steps… (J) Probably, so we shouldn't be too hard on ourselves if we're a bit slack now and then…. (H)…and here comes my mother again…How about this: we do some of what we've just suggested and then run the result by her for her observations??... (J)…and then modify our next steps somewhat. Sounds good…too good? Anyway, I'll get after the cleaners tomorrow and let you know when things are happening!!. The recursive moment, with special focus on how this solution(s) relates to other parts of your lives together, especially the problematic ones, as reinforcer or detractor from their progresses.

Notice that 3 out of the 5 steps are concerned with establishing the relationship focus of the problem-solving process. This is to ensure a good 'political' foundation for the detail work. This foundation is the basis for shared facts being created in the process – that is, each of you will get a fair go - speaking opportunities should be jointly monitored and adjusted (some things take more time than others, etc., especially if new aspects come into view like long term experience hooks which have blocked earlier work on this subject); and, there's a method for interrupting if hot things suddenly emerge.


The Options and Decisions steps can be unfolded in much greater detail, but technique will not replace bad 'politics'. The temptation to be too rational, too linear, which problem solving techniques usually offer, is often experienced as a power play if the process is failing. It may not be meant that way, especially if your personality is of the more rational, technical sort. Bridging a personality gap, or experience gap, or values gap is the job of interpersonal 'politics' not technique.




Afterword - Some matters of value(s)
Apart from the four 'theories' mentioned in the previous article, there are some other factors affecting relationship improvement out of relationship dysfunction. Here's a few:

Not all outcomes can be equal in the short term; sometimes not even the long term…

 

Not all needs are known at the start of any problem-solving effort, so unpredictable surprises will arise.

 

Not everything is within ones, or both's, power.

 

Doing heavy relationship lifting on a weak preparation is a self-fulfilling expectation of failure, a sign of unconscious pro-forma efforts at improvement. Do not try to do serious things when too tired or preoccupied to do them.

 

Small wins on small things are wins; they provide the whiff of success. Stopping yourselves from diminishing small wins is a critical move.

 

'It all depends' is the correct answer to any invitation to judge the rightness or wrongness of any action. Getting the dependencies right will largely answer the question of right or wrongness. Effectiveness is the most important standard.

 

The most important principle of relationship development is principled flexibility.

 

 

*So, what are the implications of this step for the one(s) which have come before? E.g. does our work at this point change the scale, scope, salience of the previous one(s)?
...and what are the implications for the next step(s)? E.g. what do we need to do to improve them? …what conditions or constraints should we apply to them?