To give the reader an idea of my process below is a reflexive essay I wrote at the end of my training.
Assignment DPC C6: Personal Statement and Case Study - Final Written Assessment
Year 3 DPC Child and Adolescent 2020/2021
Mark James Hammond
Since first undertaking my DPC training I have worked in primary schools with children aged between 9 and 13 as and the charity sector working with adolescents aged 13 to 14 years old. I have worked with clients referred for various issues including anxiety, sleep hygiene, domestic violence, divorce, dissociation and bereavement. At the moment I have a placement at a charity that provides therapeutic interventions for children and adolescents based in South Shields.
The non-linearity of development in personal therapy makes reflection a task often clouded in ambiguity. I’ve found it to be a recurring challenge that just when I think I’ve resolved something it resurfaces some time later to (in my perception) invalidate an accomplishment. Some of my clients seem to have experienced the same, perhaps in parallel process. This has encouraged me to think of the process as working not so much by the metric of ‘accomplishments’; as if you have a pedestal to ascend, rung by rung and any falter is an undoing of every point you surmounted. It seems to me that the process involves a constant relationship with our environment, almost like weather. It is a living thing that interacts with our respective worlds and the only way to track this is to reflect on the relationship; figuratively, with regard to the therapeutic process and more literally with the relationship to our clients/therapists and the coinciding relationships that dot their/our lives. This relates to Winnicot’s ‘holding environment’ (1965).
’There is not one holding environment early in life, but a succession of holding environments, a life history of cultures of embeddedness (Kegan, 1987). With all these shifts, like weather, explaining the process or reflecting on it can sometimes prove incredibly foggy and difficult to articulate. I call to mind my child clients, who, not (yet) equipped with the verbal language to communicate their feelings, sit with me within a held space and communicate through foggier means such as play and metaphor.
My first reflective essay in year one of training described attending the open evening and how I wasn’t sure I could do the course. I went on to explain how I arrived at my decision to undertake the training despite this doubt. I now see that this was a kind of intuitive drive. I discussed my intersection of interests concerning various cognate, psychological themes (Spirituality, Mysticism, Jung) and those of a more personal nature, particularly Jung’s Wounded Healer (1961). It all felt like a synchronicity was at play and this is ultimately what brought me to my decision, despite not being wholly certain, to enrol on the course. One of the most profound realisations from my work so far is that no matter how you prepare yourself for any choice, whether you diligently research, question, analyse and explore a million avenues - along the way scrupulously gathering what you consider is as close to immutable fact as possible - the one fact that remains is that you will always depend upon an element of faith and intuition at the point just before you take the decision. This intuition, in the face of uncertainty is what underpins my approach to therapy and not just in a philosophical or psychological sense but in a physical and spiritual sense.
I think of Heinz Kohut when he says ‘Interpretations are not intellectual constructions. If they are they won’t work’ (1981). I think about this a good deal when working with clients and have indeed experienced the marked difference between coming to an intellectual explanation and an intuitive way of analysing and communicating an understanding of the client’s inner world. The potency of this intuition is predicated entirely on the potency of the relationship with the client. Transactional Analysis has equipped me with many tools with which to support my clients. Identifying Ego States within has offered clients a means of understanding why particular patterns of behaviour recur in their lives. Working with internal models in this way has also led to deeper considerations of script beliefs and in some instances, a better means of challenging these beliefs to the extent of changing them. Of course, transactions are fundamentally executed in relationship and all of the aforementioned tools work precisely within this context. I find most inspiration in Goulding’s writing (1976) and his work at the Western Institute which eschews ideas around the ‘power of the therapist’ and sees the child as ‘adapting to his environment’ and ‘making decisions in order to survive’ (p.377).
Judy Barr provides a conceptual framework for the therapeutic relationship - and as relationship underpins my personal philosophy so it is with Barr that I find my most helpful theoretical philosophy. The 5 relationship modes (1987) intersect with internal models from my TA modality, Attachment Theory, Object Relations Theory as well as other developmental theory such as Stern’s RIGs (1985). All of these ways of working seem to lead back to Winnicott’s holding environments; each appears to consider the primary relationship and how this is carried forward into subsequent relationships. What I like about Winnicott’s theory is that the holding environment isn’t fixed and I recognise the same sentiment in Barr’s relationship modes. It’s as if you can select the First Relationship Mode to work on the client’s original caretaking relationship and then carry this through the whole ‘model to demonstrate its effect on all relationship modes’ (Barr, 1987). This provides a clear framework to address the client’s development and most helpfully, brings the present relationship with the therapist into play, first in the Transference Relationship and ultimately in the Core Relationship. Rather than just studying historical patterns, in this way we are then applying them in a more empirical, active way upon what is going on in the here and now with the therapeutic relationship. As Thomas Hübl states, ‘Relation only happens in presence’ (2019). Relationship has proven to be the most fecund, rewarding aspect of my personal therapy as well as the most challenging. My therapist challenged me at one point during the training and a rupture occurred. I experienced my intrapsychic relationships externalised and in the transference with her as I withdrew. It was only through awareness of the relationship between us, in the present that I was able to engage again and repair. This was the most powerful moment of my process and it was entirely based on relationship.
Barr’s Therapeutic Relationship Model is an holistic approach that places emphasis on relationships and inspires congruence in how I engage in the therapeutic relationship. This adherence to Rogers’ Core Conditions (1957) can then in turn bolster my confidence in my intuition. My therapist often discourages my intellectualising of events and this I’ve worked on not just in personal therapy but how I approach my client work. Intersubjectivity plays a crucial role in all of this and harks back to Stern; ‘How do I know that you know that I know? And how do you know and how do I know that you feel that I feel?’ (2013). Of course, intuition is only ever that - as much as I trust in it, there is still a tremendous amount of uncertainty in the work. It is Keats who provides the most useful correlative to where I find myself in his concept of negative capability. ‘…that is when a man is capable of being in uncertainties, Mysteries, doubts without any irritable reaching for fact and reason’ (2020, British Library). I consider my therapeutic approach to be Pathic - a being grasped by the world of experience rather than grasping that is characteristic of the Gnostic approach. ‘The pathic mode involves an immediate communication with others and with things and evokes feelings as well as real and virtual movements. It is most characteristic of young children, who are open to change, flexible and tend to be flooded by ambiguities and possibilities’ (Mook, 1999). More succinct still is Irving Yalom, “…the capacity to tolerate uncertainty is a prerequisite for the profession’ (1989).
I’ve found myself feeling a lot less pressure to ‘know’ from an epistemological point of view and moreover I’ve felt a greater desire to explore how I know what I know (also encouraged by the research assignment in the final year). Derick Varn when talking about systemisations makes the bold assertion ‘You can’t have a model that completely explains everything within a system’ (2020). I’ve thought a lot about this with reference to psychotherapy and the multiple models long established. My integrative approach has been emboldened, particularly when I think of knowledge, certainty and Irvine Yalom’s thoughts on the matter. ‘The powerful temptation to achieve certainty through embracing an ideological school and a tight therapeutic system is treacherous: such belief may block the uncertain and spontaneous encounter necessary for effective therapy’ (1989). Spontaneous encounter, to me is the operative phrase here which relates wholly to the distinction I place on intuition. Realising that a lot of the work would not necessarily lead to any certainties was a relief and had me reconsider the role of psychotherapy; what my theoretical approach was; what my practical approach was and would be. Varn goes on to talk about the Ancient Greek notion of Theoria (contemplation) and the way in which Aristotle contrasts this with Praxis (theory practiced, enacted, realised, embodied). I find this powerfully relevant given that I have spent much time contemplating models and theories before putting them into practice and then spending considerable time trying to find the best way for that specific client. Much like it is good ethical practice to be self-reflexive as a therapist (privately and in a continued engagement with your supervisor) I think it is important to ‘theorise with a hammer’ as Varn puts it; ‘We are trying to remove the contemplation frameworks…that stop us from understanding things. We are not just trying to win debates here.’ (2020). To me this is of paramount importance; we cannot as therapists look for solutions; not least of all because so many times there aren’t any answers to be known. With uncertainty looming over the work this to me leads to questioning. This is a spur to a wider viewpoint that doesn’t simply shut its eyes when a single theory proffers a single (potential) answer. I am not looking for answers but I will ask questions; of the theory, of my practice, of myself, of my client in order to find what I am looking for and what clients will most benefit from - understanding. Knowing, being aware that you racketeer in transactions is only part of the work. Understanding this can lead to self-compassion and to growth. Answers can often be found in the back of school textbooks. What good is the answer without the workings - without the understanding? When you’re dealing with an unknown I find intuition is the best means of traversing it because intuition is more an innate process of shared understanding. A participant in a workshop called ‘Jung and TA’ remarked ‘Intuition is the language of the collective’ (2020).
Allowing yourself to be open to the unknown can lead to endless possibilities. A good deal of this will always be interpretation, which ‘in the sense relevant to hermeneutics, is an attempt to make clear, to make sense of an object of study. This object…in some way is confused, incomplete, cloudy, seemingly contradictory - in some way or another, unclear’ (Taylor, 1971: 3). I, of course, do not wish to sound crude in referring to the client’s internal world as an ‘object’ but what I find in the client work is a need to interpret the unclear and often contradictory in the people who I counsel. Alan Watts, in quoting Chuang-tzu not only speaks to the role spirituality plays in my work but references interpretation, knowing and intuition.
‘Regulate your body and unify your attention…If you integrate your awareness, and unify your thoughts…Your eyes will be like those of a new-born calf, which seeks not the wherefore’ (1957, p.42).
The words ‘awareness’ and ‘regulation’ in this context serve as the bridge from the conceptual frameworks of my personal philosophy to my more ‘concrete’ philosophy of how I ‘work’ as a therapist. Both words, of course appear throughout all considerations of embodiment, mindfulness and Polyvagal Theory (Porges, 1995) which have informed a good deal of my work. The mind, abstruse and difficult to define finds equivalence with my personal philosophy. The body, hardened - more literal whilst also based in feeling - akin to my more defined theoretical approach. The reciprocity of the mind and the body the perfect analogy for this integrative approach to psychotherapy.
Word Count: 2199
Bibliography
Barr, J., (1987), The Therapeutic Relationship Model: Perspectives on the Core of the Healing Process, Transactional Analysis Journal, 17:4, 134-140, DOI: 10.1177/036215378701700402
British Library, 2020, ‘Discovering Literature: Romantics and Victorians’, accessed via https://www.bl.uk/romantics-and-victorians/articles/john-keats-and-negative-capability on 10 December 2020
Hopper, G., (2020), ‘Jung and TA’, workshop via Online Events, accessed on 1/12/2020
Hübl and Maté, (2019), Working with Collective Trauma, accessed via https://www.youtube.com/watch?v=FhlVIhjZj4k&t=1194s on 11 January 2021
Jung, C. G., (1961), Memories, Dreams and Reflections, London: Fontana
Kohut, Heinz, (1981), ‘Heinz Kohut on Empathy in Psychotherapy’ accessed via https://www.psychotherapy.net/video/kohut-on-empathy?utm_source=ActiveCampaign&utm_medium=email&utm_content=Bowlby%2C+Frankl%2C+Kohut+Videos%2C+plus+Teletherapy+Across+Borders&utm_campaign=20201118+Newsletter+-+non+members on 7 December 2020
Mook, B., in Brookes, R., (1999), ‘Pathways into the Jungian World’, Chapter 13, ‘Phenomenology, Analytical Psychology, and Play Therapy’ Routledge
Porges, S., (1995)., ‘Orienting in a Defensive World: Mammalian Modifications of Our Evolutionary Heritage: A Polyvagal Theory. Psychophysiology. 1995;32:301–318.
Rogers, C., (1957), The Necessary and Sufficient Conditions of Therapeutic Personality Change, Journal of Consulting Psychology, Vol. 21(2), pp.95-103
Schama, S., 2020, ‘The Romantics and Us with Simon Schama’ Series 1:2. The Chambers of the Mind, accessed via https://www.bbc.co.uk/iplayer/episode/m000mmgx/the-romantics-and-us-with-simon-schama-series-1-2-the-chambers-of-the-mind on 20 November 2020
Stern, D., (1985), The Interpersonal World of the Infant, Basic Books and A Developmental Perspective on Intersubjectivity from Birth, (2013), accessed via https://www.youtube.com/watch?v=N_j4q45GHDY&t=10s on 20 January 2021
Varn, D., (2020), ‘The Ruthless Criticism of Everything Existing’, Zero Books, accessed via https://www.youtube.com/watch?v=pkAlTmSU6kQ&list=WL&index=135&t=433s n 15 December 2020
Watts, A., (1957), ‘The Way of Zen’, Vintage Books
Winnicott, D. W., (1965), The Maturational Processes and the Facilitating Environment, New York: International Universities Press
Yalom, I.D., (1989), ‘Love’s Executioner and Other Tales of Psychotherapy’
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