Learner therapist (44)…… A first session strategy

Torrey Orton

May 28, 2014

Making contact – aims and methods of the first therapy session

My objectives in Session One: to provide my patients with …

…experience of recognition and acceptance                                                                             

…increased understanding of presenting issue(s)

…hope that change is possible and that some directions towards it exist

…relief of pressure(s) by live exposure and containment of them

…a live model of the therapy experience which will follow

…an appreciation of their existing competences relevant to handling presenting issue(s)

…a sense of personal wholeness

Stages in Session One (and most others) – a collection of conscious processes

Coming into our ‘house ‘– arrival ritual(s)

·         Arriving, paying, waiting, being called up

·         Hello’s, handshakes, seating, name checking?

Opening

·         Blank slate assumption – getting them to start ASAP (prompted by questions like What are you here for? What do you need? What can I do for you? if necessary)

·         Listening for key players, key feeling(s), key theme(s)

·         Initial validations - ‘Noticing’ feelings, themes and players; remarking these as they emerge.

• Initial feedback – summaries of story chunks for disconfirmation, capturing themes, feelings and players; relevant therapist self-disclosure(s).

Engagement - Joining their story

·         Perspectives – framing their story, similar stories, psych facts conceptualising the ‘problem’

·         Implications – extending their story – how it affects whole life?

·         Objectives – what outcomes wanted; sharpen the focus

·         Work processes – through feelings to truths and new actions, as we are doing here now

·         “Am I crazy?” – a common question to be grasped directly as early as possible.

Closing

·         Summary of overall session tone, topics and tendencies

·         Check fit of my style with their needs

·         Therapeutic prediction – time and labour to ‘recovery’

·         Home works

Leaving our ‘house’ – departure ritual(s)

·         Walk to gate

·         Encouraging word(s)

·         Handshake

·          C u next week…

(Some of) my therapeutic assumptions…

·         Feeling is the pathway to resolutions

·         The pathway to feeling is non-verbal, assisted by feeling language and concrete expression

·         Resolution requires acceptance of the injured self

·         Skills for resolution are mostly present in non-injured self, but inaccessible to the injured at the moment

·         Change emerges from the unconscious and reveals itself in little steps of which a first is starting therapy

·         Many issues arise from misshapen or over-developed life habits based on normal functions and needs.

·         Awareness is the key tool for shifting ineffective habits

·         Getting back own power and defending against others’ power is usually a major covert outcome in depression /anxiety spectrum disorders

·         Our times are net stressors for everyone

·         Sharing secrets w/ significant others reduces internal stressors

·         Families matter cultures matter gender matters age/life-stage matters…

·         Therapeutic progress must occur at thought, feeling and action levels to be resilient and resistant to backsliding.

 

 

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

 

 

Learning to act right (17)… Matters of love

Learning to act right (17)… Matters of love


Torrey Orton
Nov 8, 2010



Matters of love provide daily opportunities for practicing ethical behaviour. Intimate relationships are among our most desired and needed life foundations. In and through them we achieve or seek a large range of other needs. Wherever modernity passes, these relationships are endangered by powerful internal and external forces.


So, 1/2 marriages will have the experience of total relationship breakdown and starting over again (or not – also a decision). This involves, among other things, a delicate dance of hope and pragmatism played out to the music of our needs asserted and acknowledged, engaged and resisted – all for a good reason: no one other can wholly meet our needs. That doesn't stop us hoping they will! This hope is fuelled by the process of negotiating the unequal quantities of dominance and submission required to construct a workable whole for both parties – this thing called an intimate relationship.


The story below catches many of the conflicting needs that pave the way to relationship development and sustainability, or not. It is the effort that offers the learning for us. The honesty of the description provides the material.


Learning to do the right thing: Matters of love
I met my husband when I went to university at the age of 17. With all the enthusiasm of the young we had sex, fell in love, lived together, got engaged and at 22 I was married. This was a marriage based on sex and good food. We had nothing else in common and at the age of 27 with a 2 year old and a 6 week old baby I found myself a single mother. For the past 25 years my life has consisted of work, study and raising children. Early in my single life I had thought I could find love but I was bitter, angry, and distrustful - not attractive features.


So at 52 I fell in love. I had known this man for a number of years through my work. We met on occasion for breakfast and to talk work and usually ended up talking of all manner of things. Though the relationship had always been professional the rapport was comfortable. Then he asked me to dinner. His invitation and insistence told me this was more than a professional rendezvous. The dinner went for 4½
hours. When I think back to that night all I can remember is him and me, I have no recollection of anything else in the restaurant. The conversation was easy and varied and none work related. Here was an intelligent, attractive man who was interested in me at all levels.


I knew he was married, but I let myself believe his marriage was over and that all he needed to do was "sort out the logistics". How SMS and e-mail has changed the face of romance. What in the past took weeks of furtive phone calls and dates to say seems to be said in days. Things that you would never say out loud can be typed and sent with ease. It was exciting and sexually arousing in a way that I had never experienced.


Then the relationship moved to the physical. How nervous do you think I was? The last time I had a lover I was in my early 40s and though fit and healthy things are not where they used to be. I know love is just a cocktail of hormones that combine to make you form an attachment, but I will always remember how caring and considerate he was of me. I don't believe any man has treated me with such respect or tenderness.


Through all the excitement of the past weeks sitting heavily in the back of my mind has been his wife. When I separated, my husband had had an affair with his secretary and for years I have been able to say "he left me for the secretary"; he was the wrong doer, which gave me a sense of righteousness. In fact, we divorced because we had a bad marriage that made neither of us happy. We communicated on the most basic level, had differing values and life expectations. We used sex as a bargaining tool. My life is richer and happier for not being married to my ex- husband and my children more enlightened and happy people.


I find a man I feel worthy to love and who I think could love me and he is married. I have never wanted to be the other woman, partly because of my own experience but also I believe women shouldn't do that to other women. I could continue to have an illicit affair ignoring the consequences to his family, and my own dignity to satisfy a lost need for intimacy but I know it is not right. I don't want to be the cause of his wife's heartache and I want a relationship that is open, honest and conducted in the open light of day. I want him make the right decision about his marriage because he is unhappy, not because of me. I have been conflicted because I am 52, and it has taken me 25 years to fall in love again; will I miss an opportunity that may never occur for me again and end up a lonely old cat woman. Is it right to do what I know is wrong in the pursuit of intimacy long forgotten. I know it is not.


Here is the rub! I fall in love with a man battling the same dilemma. He wants to do the right thing and while I struggle with my own impasse, he has the courage to articulate what is right thing to do and I know he is right. So he is going to sort out his "shit", whatever that means. I don't know what I am expected to do. Will I wait? Does he want me to wait? Will I try to find love on the internet now I have experienced it and will I lose this desperate feeling knowing the right decision has been made?


Today I wish I could be unethical with ease but I know I won't respect myself. Any relationship we may have had will be doomed if it starts this way. That doesn't make me feel any better.


Note – the author remarked that it had taken about 40 minutes to write this story once she allowed herself to see she had a live ethical learning in her heart. The search for a topic had gone on for weeks til that moment.