Learner Therapist (67) … My enduring ignorance and patient progress

Torrey Orton

Dec. 9, 2015

Wholes and bits

The whole person is the object of therapy, as is the case for all kinds of learning. What comes broken into pieces is therapeutic techniques, learning contents and learning processes, as if readied for piecemeal consumption. Our learning theories tell us things must be chunked, parcelled and presented.

What’s hard to preserve in the passage of the bits is the wholes. The whole person, the whole of the subject, the whole of the practice… anything whole in the moment perhaps. A first challenge to my deeper engaging this situation is my ignorance across many domains and levels of human activity. There are so many things relevant to effective living which I do not and never will know deeply. These ignorances spring from aspects of myself which were never strong – the mathematical arena for example, the related natural sciences and their associated engineering applications.

I know they exist and that they matter, but I am constitutionally unsuited to engaging them with any hope of a real grasp arising from the effort. And, I don’t have that much time anyway.

Action for a change

What I can, and do, do is this:

·         Pay attention to those domains and levels which are clearly both important to whole persons and beyond me (and perhaps beyond them, too, in varying configurations).

·         Choose a few of them to pay persistent attention to – follow them at different levels of presentation: daily news, monthly news and annual review level (but in standard educated reader publications - the best of X for year 2016).

·         Be on the lookout for signs of the chosen domains in everyday life. This should occur unconsciously as a result of the persistent attention chosen interests.

·         Develop specialty interests in the domains which you follow closely enough to be able to lead a conversation among non-experts about the nature of that enterprise / issue / domain and its importance for you, us, and them now and into the near future, but especially how it feels important to you – the kinds of feelings it elicits.

·         Find and maintain a suite of colleagues with specialisations in those areas of interest to me that are beyond my likely competence. Engage on the periphery of activities and projects which are driven by specialists. For example follow target domains in different cultures, easy to do these days by subscribing to web versions of major papers daily and get notifications of preferred subjects direct. Many foreign language majors have English editions – e.g. Le Monde, China Daily, etc.

(I learned this technique living and teaching in Beijing in the early ‘80’s when wanting to learn to read Chinese and understand their view of education. I discovered that the Guangming Ribao (the ‘intellectuals’ daily) carried a regular column of matters educational. I stayed with that pretty much for two years. I could read the then current education commentary by the end, though very little about specific subjects or courses.)

Domains and levels of interest for action

So, what are some candidates for must-know domains and levels for the next 5-10 years with testably high impact on the lives of our patients (and ourselves!)? Try these for now:

Domains of action:

 

1-      The Artificial Intelligence / Enhanced Performance* industries

2-      The life extension business – to the century as normal and the planets as possible by artificial starts (IVF, etc.) and hangings on (replacement parts, etc.)

3-      Climate changes and other acts of gods

4-      Macro (the degradation of democratic practices in the chief democracies) and micro (local violences) political disintegrations

5-      Loss of concrete public language* for expressing and discussing experience (the prominence of spin across everyday life)

6-      The commercialisation of everyday life and the sanctification of productivity. (The only measure of worth is money and its surrogates (stuff)

 

Levels of understanding:

 

7-      What’s normal now? (from the impacts of the preceding,  and their interactions)

8-      Dilemmas / paradoxes* (gains are losses and losses are gains?)

9-      Boundaries – defining the spaces which domains occupy exclusively

10-   Evidences* – the ‘facts’ and ‘values’ which constitute the substance of life.

These domains and levels can also be seen as the context for everyday persons’ lives which provide perspective on their purposes, conduct and achievements. Elsewhere I will offer some approaches to checking for their influences in the course of therapy. One implication of these domains and levels is that some parts of much therapy will have to be concerned with “tools and skills” for helping patients get their power back in domains and levels which are inescapably present to us all.

*These are my current favourites.

Learner Therapist (64) … Test myself, test my patients

Torrey Orton

Oct. 06, 2015

Feedback Informed Therapy (FIT)

It is claimed, with reason, that the most effective therapists are those who seek constant and consistent feedback on patient experience of their therapy provision. The International Centre for Clinical Excellence offers research backing for this claim and tools for feedback informed practice. I find them sensible but unremarkable, being an obsessive self-doubter about my therapeutic effectiveness, which springs a little from my tendency to self-denigration and a lot from my constitutional scepticism.

My skill at feedback seeking and giving has been fashioned and refined during years spent in various educational roles ranging from teacher to instructor, coach and, drawing up last, therapist. I became accustomed to checking if things were working well enough from both my and the other’s viewpoint. During my first two years’ high school teaching in 1966 to ‘68 I kept a teaching diary daily for five classes a day assessing the appropriateness of my teaching plan and implementation over year levels 9 through 12 in English and year 12 in philosophy. For the latter course, I invented a student reflection process which has flowed on into later life teaching/learning settings. Both have a life today when patients take up diary keeping as a path to self-clarification.

As a result of these sources, I am inclined to see my therapy skills as applicable in a wide range of learning settings and roles, though most obviously in therapy, coaching and teaching. The process of testing patient / participant purposes or needs morphs naturally into testing learning processes and outcomes, and shifts emphasis from testing me to testing them – testing their confidence in their grip on themselves in whatever ways they are seeking in our work. One could say competent confidence in one’s ability to self-correct is the signal attribute of a professional or high performing amateur of any kind.

8 critical feedback opportunities

 

There are at least eight critical junctures for testing what patients / participants are working on, whether in therapy or training group:

1.      Preferably first, some kind of pre-session needs assessment before the moment of first entry, which may be a proforma tick-a-box, open-ended questions or a quick inquiry by phone at the initial contact for an appointment like “what’s your concern?” or similar.

2.      On arrival for the first session, the opening test is reconfirmed in this hello: ‘What are you here for?’ or its slightly more pointed sib ‘What can I do for you?’ In a group this is usually formalised in a group needs chart cobbled out of individual contributions.

3.      A little way into the first session (and many sessions thereafter), I propose this: ‘So, what concerns you is…? Am I right?’ This is a test of me, not the patient / participant, though they often hear it as a test of them.

4.      One step beyond mirroring is framing a chunk of patient / participant input into slightly different language and at a slightly higher (or lower!) level of generalisation, which does double duty of checking my grasp of their material and testing their capacity to generalise or concretise it.

5.      I pretty consistently check progress in session by inviting patient / participant assessment of the clarity and relevance of almost anything I offer beyond mirroring their contributions: “Is that clear?” “Does that make sense?”

6.      Towards the end of a session I seek a general assessment from the patient / participant like: ‘Are we on the right track for you here?’

7.      Over multiple sessions I check how the work is fitting their original and emerging objectives’ prediction of its direction and process, sometimes pointing out a new candidate for objective of the day, or week, for which I have evidence in their behaviour. Such “pointings” are raised as queries with explicit room for patient disagreement. Almost no patient / participant arrives at the end of therapy without discovering some learning objectives they did not start with.

8.      And, at the end of the learning process (in therapy there seldom is a complete closure, just as there is no closure to learning in life except the closure of life itself) we may look back by looking forward to see what new pathways have been unveiled by the work and what vulnerabilities have now been raised to the level of self-correcting consciousness.

5 in-session reflection ‘tests’

1.      Phrase completion test – there are a number of ways to signal I am paying attention to a patient / participant: This is a normal conversational move not just a therapeutic one and has the same effect – the person feels attended to, recognised, understood and shows this by continuing their conversational flow. For example,

a)      Add the word which comes next in a run of expression when the person pauses

b)      Punctuate chunks of expression with ‘Uh huh’, etc.

c)      Ask the patient to repeat what they’ve just said in other words, or give an example

d)     Encourage them to stay on a track they’re on with a rolling hand signal, not words.

e)      Stay silent when they reach a natural pause in their talk to make space for them to continue

2.      Feeling awareness tests, often repeated especially early in the work to authorise using feelings and help discover them.

a)      Mirror back a non-verbal, usually embodied, or say back a particularly striking expression

b)      Invite reflection on where in body they are feeling something: ‘’what body feeling is happening with this experience you are describing?’

c)      Invite an example / trigger of a particular feeling.

3.      Conflict engagement test

a)      Suggest an alternative perspective for a situation they are exploring – ‘I imagine you could look at this matter in other ways. For instance…’

b)      Propose an alternative interpretation for a situation – e.g. ‘Another way you could interpret at this is…’

c)      Assert they are wrong about a perspective or interpretation of theirs, with an appropriate degree of certainty in the truth claim involved. Use ‘perhaps’, ‘probably’, ‘possibly’, ‘certainly’ (as appropriate) to show your level of confidence in your assertion.

4.      Emerging theme identification test

a)      Repeat back a word in their conversation which suggests the patient / participant is evaluating something, especially them self – words like ‘value’, ‘care’, ‘like’, ‘avoid’, ‘worth’, etc.

b)      Invite an example of a particular evaluation, especially those where ‘could’ can easily replace ’should’ or ‘must’ in their speech.

5.      Objective description test – have they covered the what, who, when, where, how and why of their concern concretely?

NB – all of these ‘tests’ are feedback opportunities for both patient/participant and therapist/coach.

Learning to learn is the primary objective of therapy (and training and coaching!!)

A useful model for thinking and acting about adult learning is experiential action learning which comes out of workplace development needs arising from unexpected circumstances which out-date existing business operating constructs and competences.

 http://www.leeds.ac.uk/educol/documents/00001260.htm

I roughly work with this kind of framework in all learning settings where local design is necessary to fit specific conditions - a typical therapeutic requirement. The above ‘tests’ of both patient / participant and facilitator / therapist can be applied (should be applied) in any such setting for optimum effectiveness.

Learner Therapist (59) … Learning by small steps

Torrey Orton

April 19, 2015

What are we thinking patients and students are doing when they are learning a new scheme, a new move, a new thought…? Roughly, they are trying it out. We have lots of experience of trying things out as children. Doing so as adults may be inhibited by self-censoring our playfulness.

The main point is that learning is a cycle of choosing an object of study, imagining it as a whole, attempting it in progressively greater precision and integration, appreciating the closeness of fit between today’s attempt and the imagined whole and re-attempting until inner and outer perceptions match well enough. This inner cycle sits in a larger cycle of a particular learning object’s place in a competent practice (football, music making, etc.), and where that practice sits in a life – and specifically in the life of the learner, both now and in some imagined future of theirs.

Along the way, what’s to be learned changes as the attempts get closer to it!! All together this is a practice cycle, repeated consciously and then unconsciously as long as the object and its user has a life. As therapist and coach we can help at each step.

Here’s a variety of tryouts to contemplate.

Mimic’s delight

Imagine this: you are struck by some person’s manner, style, feeling of being in your world and you want to mimic that style. Your reason for doing so may be to honour it by copying or to mock it – also by copying.  Anything can be modelled.

So how do you do it? Possibly by adopting their posture, then their gait and finally their flow – all embodiments of the person (now reduced to a stereotype in our minds!). Or you can start with their voice and a characteristic statement and expression. In any case, you eventually try a sound and get it right or not. Usually you are getting it partly right, and you know that’s what you’ve done. You have it fully right when all aspects of an action are integrated: volume, tone, pace, posture, breathing, movement…

Now, how do you know that? Because you have a memory of their performance in mind… but the memory may be incomplete, distorted in some way, partial like your performance of their performance. So you go back to the original, often easily because they sit next to you in school, church, pub or playground and you don’t tell them you are refuelling your memory.

And you try it again and again…until it’s good enough to be mistaken for them…but it isn’t them, wherein lies the particular joy of a successful mimicry.

40 years ago this process of modelling was commercially formalised in The Inner Game of Tennis (Tim Gallwey, 1974) including the rehearsal and visualisation processes - inner and outer – which I’ve just described in mimicry. It was the beginning of a grand coaching career for Gallwey. Its psychological career is a bit older.

The artist’s self-training at drawing and …

Now let’s shift to a different form of learning – drawing. It is the cheapest form of visualisation, barring drawing lines in the sand. And it draws on the same learning dynamic: a need to represent things visually, the sight of something which asks to be drawn, the step by step creation of the object out of the difference between a line and the paper holding it. This, if you watch a drawer at work, involves repeated looks at the thing, putting pencil to paper for a while, then looking at the thing again and around and around… sometimes they get stuck on a single line because they know from looking that it does not correctly catch the location of the thing in space, to say nothing of not looking like it at all (except to an artistic eye’s look).

….then painting to see what is imagined

But the original of the imagined object, say a flower, has never been seen in that way until the painter is producing it. Here the model …intrinsically ‘unreal’, fake, imaginary… is brought into reality by the brush. Painters I know talk of seeing the image they have in mind by putting their brush to paper. This assumes they already have skill in brush use, colour selection, paint density, paper porosity and so on. They just have to get a stroke of it right to get started and in part they cannot see what’s in mind until they apply the brush.

If they don’t have those precursors then they start with them. Naturally gifted artists start early feeling things, looking, splashing them around…just as the engineering gifted deconstruct and reconstruct their little worlds… and the musical give voice and tap rhythm…. Use of skill cannot be separated from expression of the self in its use.

Writing in the dark…

Or, try this: write a three word note on a small post-it on your night table with no light on, preferably when you’ve awoken naturally in midsleep with a thought on your suddenly conscious mind. This is a fun exercise in your inner sense of space which you can test yourself on immediately. On the way, notice that to write you actually have to think the words letter by letter to get the spacing right, and then you’ll probably get it wrong. Try it printed and in script for comparative purposes. Then repeat until your performance is reliable for data gathering, or just correctly reminding you of what you want reminded next morning!

The writer’s search for the right word…

Writers have stories in mind - their versions of pictures - and editing is the final word!  Writers spend more time editing than they do writing, which means writing is more a reflective art than an inspired one and that the editing process is like the painter’s comparing her brush stroke with her inner vision. Notice that the written word is more powerful than the imagined words of an inner dialogue and the spoken word in public more powerful yet. The inner dialogue (rehearsal) is in a safe place and can be worked through with less stress than a public work out. This editing effect is visible even in the most ordinary writing. Try withholding your next email for 6 hours and then re-reading before sending. What do you need to change to get it right?

Aikido 31 kata again!

On my continuing effort to get the aikido 31 kata right, after 10 years of trying…and keep it that way from one session to the next! It is an interplay each training session (approx. 4 times a week) between recalling the correct form in mind and following the body’s lead to it from its previous years of instruction, with a closing reflective pause over the entire sequence before shifting into the next repetition. About 6 monthly I revisit videos of the Sensei performing the kata, as individual bits and integrated series. I imagine that it will take me another 20 years to get to the 30 year performance he produces. And then I remember that he too probably critiques his own performance to this day.

 

Learning to act right (49)… learning, unlearning, relearning cycle

Torrey Orton
Feb. 10, 2015

Is that a signal you’re making, or just a wandering wiper?

 

There’s an empty place feeding my feeling of disorientation, of not being in the world which I am in at that moment, when I shift from left hand drive to right hand drive and back again. This has been a relatively regular occurrence over the last five months as I’ve adjusted to a new car while occasionally revisiting the old one. It’s interest for me here, apart from the fact of repeatedly being seen to turn on and off headlights then on and off windscreen wipers and cleaning cycles totally inappropriately – e.g. wipers when turning left at a T junction; lights when the rains came down! – is that I am exposing myself to a very sharply focused example of learning, unlearning and relearning. This is the stuff of neuro-scientific phantasy – the plastic brain and all that.

Driving for 55 years

But there’s more. It’s the left right, right left confusion. My new car has its steering column mounted tools on the wrong side. That is, for a right hand drive car the turn indicators and lights are operated from the right hand side in Australia, regardless of manufacturing origin, but the new car has retained its European positioning, trading its firm market position for an excuse not to do the engineering required to shift them to the right along with everything and everyone else??

 

I’ve been 95% driving the new car for five months with very occasional forays in the old one. Each time I have the experience of revisiting the old car I have the following challenge: approaching a turn of choice my left hand goes for the turn indicator (new car position) before I notice it. This is a classic automatic, habitual function which sets off before we know it, as a good habit should do (that’s how you know a habit is ‘good’ – if it ‘works’ by pre-empting the need to consciously choose an action). But I’m driving the wrong car and I ping the windscreen cleaning system instead with the above mentioned “wandering wiper” effect, if there’s anyone to notice it apart from me.

Just describing this is difficult because everything has to be turned around and around to give the proper impression – a video would do better but who wants to see a video of the wandering wiper syndrome?? And, how could it be made except by a dash cam cued to the lights / wipers complex??

I’m noticing as a write this that a background factor may be that this manufacturer’s (Audi) arrogance triggers a deeper level of driving learning – those first 14 years I spent driving in Massachusetts, never interrupted by functional wrong-sidedness!! On some standard neuro-scientific understandings, specific types of learning are produced in specific brain compartments. My driving compartment, so to speak, may have a residue of these original learnings clagging up my system, given the small chance to do so which a dysfunctional trigger might provoke. No wonder I feel so disoriented by these small moments. They may be taking me back to my teendom. Perhaps I’m doing the learning/ unlearning/ relearning cycle on historically discrete competences held together in the package that is me, which has to produce a recognizable action sequence out of the range available and match it with a real world in the now. Maybe? If so, a good opportunity for a performance clag-up.

 

 

 

 

Learning to act right (47)… Repetition revisited… a comforting failure??

Torrey Orton
Jan. 27, 2015

Learning to park, again

 

For five months I’ve been learning to park again! That’s on the back of 55 years’ experience on three continents in two modalities (left and right), and 5 months of rear video and audio assist. The new car was measured for fit with our off-street parking space, passing by about four inches greater width than its predecessor. Length about equal. The space in question is like an on-street parking space, but behind an automatic sliding gate parallel to the street and about 1 car’s width wide by two cars’ lengths long.

 

It’s that four inches I’ve been learning to command with quite intermittent success. Here’s the achievement standard: when I get the angle of entry correct and the closeness of passage bearably delicate (i.e. – failure to rub off door panel paint on the driver’s side gate post and front fender paint on its opposite number) a best of class single-go entry to the parking space with no back and fill moves will result. This I have managed about five times in these five months. The rest (almost one go a day) have been variations on two or three back-and-fills to be able to close the gate with me and the car inside it.

 

…but I’m not getting it right

 

Now I might have thought I would get this right, since I’ve always been a high performance parker, till now. And this is why I’m writing. I’m not getting it right but by chance almost. I’m not finding the right path and then repeating it, I’m just repeating the looking for it! Weird.

 

Why not trial and error the path, as any sensible person including me does when learning something new? Why not notice the front and rear markers for the right place to start the approach to the gate? Why not notice the point at which the turn to enter the gate has to begin to optimise the entry space for backing in?

 

I don’t know why not for all these except that I started trying to park here with the assumption that I would progressively get it right and that would include the implicit signals for the required moves. This assumption, in turn, involves an implicit assumption that the learning will occur without trying, so to speak, which is often enough true when an action has to be repeated, whether we learn it or not. This is not, therefore, a short term memory problem, which I have plenty of and reliably expect. For them there is a treatment: conscious repetition of the prospective memory item by doing it over a couple of times, or even better by writing it in the pocket notepad I always carry for such events.

 

This is a mistaken assumption problem supercharged by my resistance to the facts above – namely I keep getting it wrong way above what normal evidence-based practice should allow. I could say I’m enjoying the potluck approach I’m taking and the evidence for that is I don’t get irritated about messing it up. And so, I could say I should get irritated and there’s something wrong with me that I don’t. But I’m not irritated and any reader of my blog posts can tell when I’m irritated about something.

 

A comforting failure??

 

Maybe there’s something comforting in the repetition of my approach, which is wrong about 90% of the time on the above numbers? The comfort being the promise of a small challenge which has a high failure rate and low salience. Much less than an expected change of street lights when I’m close to the end of a cycle on a normal progress on a normal street. At those I get a small charge of disappointment that the fates of timing have corralled me again.

 

Not so the pathway to the safety of my home. I can say now that maybe this is a presence exercise undertaken without intent, but under the thumb of necessity, as the best are. Evidence in search of a theory is also a scientific process. Hmmm.

 

 

Learning to act right (44)… consulting conception or deception – 2 or 3 bombs going off

Torrey Orton

Oct 27, 2014

 

In his mind the performance target is 2 or 3 bombs going off on the way to the solution.

In the assignment where “I am making it up as I’m going” I find myself sort of promising something I can’t really promise. That is, my interventions claim to do something with the agreed problem(s) I’ve been hired to engage, but the unfolding nature of the circumstances, their complexity and fluidity, often compromise the conditions and assumptions of intervention design which were operating at the moments of my last promise.

When I undertook the assignment or near the beginning when I had a first grasp of it, I suggested that often such situations can only be moved by a few bombs going off. Failing the bombs, the participants can sustain their existing muddling through strategies, motivated by a mutually sustained conviction that anything else than the muddle will be an unrecoverable disaster. The bombs would be wholly typical on reflection, yet unpredictable. They would just be exaggerated versions of the existing disturbances which frame much of everyday interactions in the place.

The first bomb happened near the end of the first month of engagements and was loud and clear enough to be heard down the hall of the head office space. Neither participants nor others stakeholders (non-family employees) could doubt that something tumultuous had occurred. No one died from that and some air clearing had occurred. That bomb was engineered by one participant “dragging” another, reluctant, participant out of his office and into the meeting with the explicit rationale that everyone else needed him involved for progress to be made. She drew on her powers of motherhood for her successful intervention.

And so it was a few weeks ago (4 months later) that another client threw a hissy around the type of issue they all could have predicted, but for failure to pay attention they did not notice they were invoking his rage again, and so they were thrown into blame attribution mode conducted over some days in the murky waters of indirect dealing with the rage in question. And all of which sustained the entire dynamic with increased energy. Non family stakeholders - trusted advisors and executives – flushed my phone lines with wondrous queries and hopes someone had the situation under control…and hoping that my work with the hissy one had not prompted the perceived outrage. The situation is still not under control. Like all previous bombs before and since my time on the job it remains a vivid memory, perhaps this time to be turned into leverage for a change of habit(s)?

The concept of “bombs” is self-explanatory, except in the clinical interventions practice where expectations are high that previously long colluded undiscussables implicitly in play will be engaged without imagined terrors overwhelming everyone. A “bomb” in this sense is a high energy event which typifies the secrets and can no longer be avoided. Sometimes 2 or 3 are necessary. We have evidence in public life where “bombs” in this sense can be contained within the collusive secrets process (GFC, WMD in Iraq…) which is also evidence that the containment is an instrument of the denial, of the making undiscussable of such matters.

That bombs were in my clients’ expectation sets makes it somewhat more easy to bear them when they arrive because they can be seen as necessary markers of change. No bombs; no change. Just a bit unpredictable for a consulting assignment.

Learning to act right (42)… building stereotypes from nothing

Torrey Orton

July 21, 2014

 Once more again with feeling…

Repetition is the heart of learning almost anything. Noticing that one is repeating certain experiences is the heart of capturing unconscious learning in motion. Until captured by awareness the unconscious process unfolds with certainty and produces actions assumed to be right automatically…which is what a habit does.

Repeated experiences are based on sufficient uniformity of actions, circumstances and purposes to survive generalising over time. That is, an effective habitual response requires a consistent experience base. The test of an effective habit is it works for me, and maybe others.

 Once more, the Fertility Control Clinic

So, back to the frontline at the Fertility Control Clinic. My colleague T., the regular security guard, with more than a year’s experience 6 days a week at the Clinic, has acquired an unscratchable itch about certain classes of arriving patients. The itch is their perceived resistance to him executing his security role to his standards of adequacy (which independent observers class as high).

The routine is supposed to go like this: for each arrival at the Clinic (an action sequence of about 3-5 minutes duration depending on how far down the street they come into view, repeated at unpredictable intervals about 15-18 times a morning over a 90 minute period) he walks towards them to escort them past the Catholic anti-abortionists and then up the pathway into the Clinic*. At the Clinic front door he unlocks the door and admits them to reception, turns around and leaves, closing the door (and so relocking it again). Patients usually come in pairs – a patient and her partner, family member, friend, etc. – which makes a small crowd at the door.

 Unintended injuries
 

Here’s where the stereotyping begins to be built, and then reinforced and embedded. A proportion of arrivals do not notice T. is getting out keys while walking towards the door and saying, “I’ll open the door”. They may miss his call because their English is weak, because they are apprehensive about being there in the first place, because his English is accented, because they do not know his role though he’s clearly marked as Security, and so on….with the overall consequence that he is unable to effectively, from his viewpoint, play his role correctly – to care for patients until they are safely inside!! This is seriously angering. The people he’s supposed to protect unwittingly make it difficult for him to do so to his standards of service!! A classic unintended injury.

The backwash of this injury to his professional self-regard has hardened into stereotypes, the effect of which is to raise his blood pressure well beyond appropriate levels, while not affecting his presence  and conduct to all patients. When he sees suspect patients (from his developed stereotype viewpoint) on the street horizon he’s already expecting trouble for him which he cannot, so far, prevent because the situational variables reduce everyone’s capacity to respond ‘rationally’. There are few patients, or protestors, arriving at the Clinic who are not in a heightened state of some kind.

 

There is very little room for altering the context to allow new perspectives and awareness to arise. There is no relationship with the patients other than offering a kindly reception, including obstructing their harassers (an emotion priming activity). There is no room (?) for engaging the patients about their potentially, from T’s viewpoint, injurious behaviour towards him because the relationship is too fraught with implicit intent and brevity of exposure. So, the injury is incorrigible, unmitigatable…the very stuff of hardened emotional arteries set in permanent ineffective defence for T. Micro-traumas recurring persistently. Perhaps this kind of pattern is why few Clinic security staff last very long at full exposure.

 

I have raised my perception outlined above w/ T. in various less complete forms over recent months, prompted by his slowly increasing expressions of exasperation with his least favourite types.  This is the beginning of creating a space for reflection and change, I expect.

 

*the over full richness of this sentence somewhat captures the emotion and content density of the experience it describes.

Learner therapist (45)…… Beating the "BLOCKS"

Torrey Orton

May 23, 2014

Beating the "BLOCKS" *

An icebreaker to bring some unspoken rules above sea-level

Précis

            "Blocks" is a tool for eliciting training group members' apprehensions about the activity they are about to enter. It focuses on expectations which will (in their view!) constrain their participation in the activity.  These, typically, are concerns about the likely attitudes and behaviour of others in the group towards them, with themes of minority difference, power hierarchy, influence of external events/concerns and the like prominent in participant contributions.

            A "Blocks" exercise also serves to legitimate practical Equal Opportunity principles in the process of training. In addition, it provides markers for the group to measure its own gains in process competence during the training experience, in terms of issues it perceived to be important from the start. And, finally it contributes to setting the climate for participation by inviting members to identify the conditions under which it can occur for them now.

            The process has been used with intact work groups, short (1 day) and long (5 day residential) programs, with staff from all levels and specializations.  It has been used as a preface to courses ranging from basic counselling skills, negotiation skills and consultant training to job redesign and collaborative decision-making, in groups from 8 to 100+.

Rationale

The purposes of the exercise are to:

            1- increase the potential for participation of all present;

            2- provide mutually agreed indicators of dysfunctional behaviours;

            3- engage participants from the very start with the fact that the sessions will deal                           in the here-and-now; and,

            4- legitimate discussing normally undiscussable matters of group dynamics which              are central to effective learning in groups.

The "Blocks" Process

Step 1: Having done basic program housekeeping and introductions -

Invite participants to reflect on the kinds of things which are likely to block their participation in the coming activity; suggest they make a few notes about these things. (2 mins.)

Step 2:

Say you are going to give everyone a chance to speak, but no one will be forced to do so. If they don't want to speak they just say 'pass' when their turn comes. It is often worthwhile asking 

Then, record on butcher’s paper all contributions, one at a time, going around the group and taking one from each participant until all are up.  If one says their idea is already there, have them say it anyway, since they often differ significantly in detail. Note duplications by starring, etc. (10-15 mins)

Step 3: (optional)

 If appropriate, add the idea of stigmatizing differences, like those of colour/race, language, national origin, sex, physical or other disability, etc., if these have not arisen naturally. Note that they are the most common level of noticeable difference in groups, and that they are the normal grounds on which majority and minority subgroups informally occur. Add that there is much evidence that being a minority member of a group makes it much harder to participate. (5 mins)

Step 4:

Invite participants to comment on any patterns or features of the "blocks" listed; if appropriate, offer the stigmatizing potential of one's own (the trainer's) characteristics to concretize the issue and bring it into the here-and-now (e.g. - I talk about my unavoidable foreignness - a US accent - and my awareness of how that touches (understandably) some stereotypes). (3-5 mins)

Step 5: (optional)

Challenge them to consider the likely effect of any contribution they make to the group's activities on increasing or decreasing the participation of others in the group. Note that the items cited suggest particular areas for this group to pay attention to (whatever they may be).

            Then, get on with the program.

Outcomes

            The kinds of issues raised in more than 100 applications of this technique include -

1- fear of negative reaction to one's input by others

2- fear of being looked down on for being foreign

3- concern about confidentiality of the activities

4- external thoughts - work pressure outside; pressing personal concerns

5- not being used to sitting in one room all day

6- unsure what this course is about and what I'll gain

7- a perceived physical shortcoming - eg. stuttering

8- fear of not knowing enough to contribute meaningfully

9- feeling intimidated by superiors

10- lacking personal credibility due to a history in the organization as office clown, etc.

11- doing something new is scary

12- not really wanting to be here; 'I'm a don't know why I was sent'.

            As an opener, "Blocks" clearly establishes we are all somewhat apprehensive about what's coming and that it is O.K. to talk about it here. Just saying these things has the effect of reducing the blocking effect of many of them.

 

*Originally published in: Training & Development in Australia

Vol. 17, No.3 September 1990; pg. 39-40

Revised 23/7/1996 and 10/10/2007 by the author