What’s a Therapy Group Like?

Never, it’s not for me, I don’t have the confidence for a therapy group.

Probably just a few of the responses you might have to the idea of being in a therapy group with people you have never met before. And sometimes it can be the very fact that you do not know the other members of the therapy group that be so helpful.  These people most likely do not know you. They are not in a previous relationship with you:  a colleague, friend, sibling or parent, a partner.  They can give you feedback in a way that is not influenced by their history with you.   They may choose to share their responses to the issues you may be facing in your life. You will most probably find out that they have faced something similar themselves. You are not alone in your experience.

A therapy group can be an opportunity to gain support, to explore yourself and your relationships, to have a shared experience of connectedness.  There are different types of therapy groups and different configurations. Some meet regularly, often fortnightly or weekly for a couple of hours or so.  Some groups meet a three or four times a year for longer. Others meet as a one off for a weekend or longer.

As a therapist who runs a variety of different groups, I am often struck by the potency of the group experience for people.  Taking the step to join a therapy  group, to share intimate moments from your life can be a big decision for some people, one that I think reaps its rewards. Add to this of course, is the fact that I like running groups. I enjoy the interaction, the sharing and contact I see between people, the willingness to be open and support each other. I like the fact we nearly always find something to laugh about together. We enjoy ourselves and have some fun too.

I read recently that we are born into relationship – it seems to me that engaging in therapy with others is a natural way to learn about ourselves through relationship.

Information on my next therapy group can be found at Group Therapy

Inspired

Two people whose writing inspires me. I really enjoy the personal, reflective approach taken by Barbara Clarkson and Martha Crawford.  Barbara’s blog is new and very much reflects her personal style and interests and I’m looking forward to seeing what she has to day as the weeks go on.

http://www.barbaraclarksoncounselling.co.uk/blog/

And then there’s Martha Crawford.  whose writing I have been following for a while.  I find her intellect and ideas fascinating.

http://whatashrinkthinks.com/2015/02/22/if-there-be-none/

I hope you enjoy both of these too. Let me know what you think,  I’d love to hear any recommendations you may have.

Creativity in Supervision

Art and Supervision

I’m really interested in the question of creativity in supervision. As a part time artist, creativity is something I frequently reflect on. In writing this piece I want to draw on my experiences both as artist and a supervisor and therapist to share some of those reflections and thoughts about creativity in supervision and psychotherapy.

How to Define Creativity?

When I was originally asked by Robin Hobbes to write an article for The Transactional Analyst (magazine of UKATA) I thought about how I define creativity, and then I did some reading. I looked at how creativity has been defined historically.  Some of the early ideas of creativity are that it is God given or from something beyond our understanding.  More recently Picciuto and Carruthers (forthcoming) write that “most theorists assume that creativity requires ideas, behaviour or products that are both novel and valuable.”  They also reference Boden (2004) who draws a distinction between “historical creativity” where “the novelty is relative to an entire society or tradition”, so for example, new movements in art and science where ideas are radical and new; and psychological creativity where an idea is new to a person in some way.  For example a new thought, emotion, way of doing, or process. I like how Edwards (1986) neatly summarises the conundrum of creativity, does it require innate talent or can it be learnt, she goes on to reference various thinkers’ ideas on the steps in the creative process.  I’m going to use this model to look at the activity of supervision and how it is a psychologically creative process for the supervisee.

Five Stage Model 

The model identifies five stages in the creative process:

First insight – a term that covers both solving existing problems and problem finding in the form of asking new and searching questions.

Saturation – the research stages

Incubation – period of reflection.

Illumination (The Ah Ha) – the sudden solution as a result of the integration of the previous stages nearly always brief.

Verification – putting the solution into concrete form and checking it for effectiveness.

IMG_20141009_152238

Pencil sketch

In my painting I’m faced with “problems” all the time. How to capture the light in a particular scene, how to use a selection of colours in a pleasing way. Most recently I have been faced with the problem of drawing buildings. I’ve felt dissatisfied with what I have drawn for quite some time, the first insight stage, the problem being how to draw buildings in a loose style and still be accurate. Alongside this I have been engaged in research, the saturation stage, practicing drawing buildings and reflecting on the results for a few months. Most recently, whilst spending time away where I was sketching every day I decided to undertake a more detailed pencil sketch en plein air (outside from life).  In using a pencil I was able to erase my mistakes and keep working on the drawing until I was satisfied I had the perspective correct. The sudden solution. Not that radical and new, but new to me in terms of process and what I had been engaged in recently.  I followed this by undertaking another painting using pen and watercolour, my preferred medium for plein air work.  I’d learnt a lot about how to draw buildings more effectively from my earlier attempts in pencil, about the quality of the lines, planning and composition, how to approach the drawing. The result was much more satisfying.

A more satisfying result

A more satisfying result

So how is this relevant to supervision?

I think that the relevance is in the process, one of problem solving creatively. I see part of my role as supervisor is to facilitate the supervisee accessing their creativity in problem solving with their clients and developing skill in being creative in the field of psychotherapy.

At the stage of first insight I will be contracting with my supervisee as to what “problem” they are seeking to solve. With some supervisees the work at this stage is often supporting them in the area of developing new and searching questions to ask. I have sometimes felt that adopting a contracting approach that seeks to define the problem too early can miss this extremely important part of the creative process, that of developing thinking around new questions to as.  By focussing too soon on what is immediately presented, then evolving questions through exploration may be missed.

Saturation, the research stages.  This takes place on an ongoing basis between client and supervisee and then in the supervision session between myself and supervisee as we discuss the client case presented. Assessment, transactional analysis, script analysis, the moment by moment, session by session experience of being with the client is part of the research process.  In the supervision one of my biggest areas of research is the parallel process.  I find it an invaluable indicator of the relational dynamics in the therapeutic relationship that exists between my supervisee and their client. I also like to be “creative” in how I facilitate supervisees in their research, looking again for new ways to ask questions. So for example using two chair work, or through encouraging movement and role play.

Incubation can take place between supervision sessions and is also part of the activity of supervision where we are reflecting on the experience of my supervisees’ relationships and work with their clients. Sometimes the period of incubation is rapid, where a supervisee may very quickly experience a sudden insight into a client. Other times incubation is much longer and takes place between sessions and the supervisee may be more reliant on the supervisor to provide solutions. Which brings me on to Illumination.  Another part of my focus is that of facilitating growth in the supervisee in confidence in generating their own solutions. That growth might mean encouraging them to undertake more research, or it might be about the first insight stage of asking different questions or more reflection time either with me or on their own.

Verification takes place when supervisees test out solutions through treatment direction and specific interventions with their clients. Reflecting on the impact of those interventions and bringing back for further discussion in supervision.

Ultimately I find thinking about the supervision process as one of creative problem solving very useful,  both in terms of what I am doing in the supervision with my supervisees, how am I being creative and when working with supervisees to facilitate them in developing their own thinking and solutions to client work.

This piece originally appeared as an article in the Transactional Analyst 2014.

Edwards, Betty. Drawing on the artist within. Simon and Schuster, 2008.

Carruthers, Peter & Picciuto, Elizabeth (forthcoming). The Origins of Creativity. In E. Paul & S. Kaufman (eds.), The Philosophy of Creativity. Oxford University Press.

On Being 50

Aging

It was my 50th birthday about 10 days ago. In the run up to the big day I had been feeling pretty ambivalent about being 50. In the last ten years or so I’ve noticed physical changes.  Fitness is not as easy, I get stiff after unaccustomed exercise and my recovery time is longer, I get tired more easily, it’s not as easy to keep my weight at a healthy level etc etc. I’ve also noticed a few grey hairs (actually more than a few) and some wrinkles.

Fear of Death

And perhaps most importantly I’ve been having what I’ve been “calling existential panics.” I will be engaged in doing something, not necessarily thinking deeply about anything in particular and I will find that somewhere in my thought process my mind has turned to the idea of dying.  Then I experience a cold panic at the idea of no longer being here. A sense of what it might mean to no longer have a sense of my own consciousness, of there being no more me. Alongside this is a feel of the magnitude of history, the endless stretch of time flowing backwards and forwards.  I feel completely insignificant. My time on this earth has been but a blink of an eye. It’s uncomfortable and unsettling and pretty scary.

So in the run up to being 50 I’d been thinking about this experience I’d been having. What it will mean to have lived 50 years of my life. That I’ve almost certainly got less years ahead of me than I’ve lived. I was worried how I might feel.

Being Peacful

What a surprise.  I woke up on my birthday and it felt like a good birthday. Friends and relatives coming to a party to celebrate. It was about lunchtime as I was sipping on a celebratory glass of champagne when I had a very reassuring insight. I was reflecting on my life and what I’d felt like at 40, and 30 and at 20, Then I thought that I’d probably got about another 30 years or so ahead of me.  In that moment it felt like it might be enough. That another 30 years was a long time and that in that time I might very well  be ok with the idea of not being here anymore.  So, whilst I’m not ready yet and  I love my life I  also for the first time  had a sense that it might be possible to make my peace with death, dying and leaving.

A serious subject and something that faces us all in end. Have you anything you would like to share about your experience of aging and living?

The Drama Triangle

I thought I would write another post about an aspect of TA theory I really like, that I use with my clients and they tell me they find really helpful..

Relationship Patterns

The Drama Triangle, originated by Steve Karpman, is a way of understanding the repeating patterns we can sometimes get into in our relationships, that result in uncomfortable feelings.  How often have you found yourself getting into a familiar discussion with your partner or a family member, where both of you end up feeling a bit rubbish?  Karpman’s idea suggests that this is because we often take up one of three roles in our interactions with people.  The roles are Rescuer, Persecutor and Victim, and the defining characteristic of each of these roles is the view of self in relation to others.  This draws on the idea of life positions, developed by Eric Berne.  He proposed 4 life positions, where people take up one of the four positions listed below and live their lives according to it.

I’m OK You’re Ok –  This is where I see both myself and others as OK with appropriate levels of self esteem, I am able to trust in others and the in world.

I’m OK, You’re not Ok – this is very often the position of the person who bullies, persecutes or rescues. Someone who sees themselves as OK, and others as not OK in some way, they operate from a one up position.

I’m not OK You’re Ok – this can often be the position of the Victim.  The person who has low self esteem and views others as having more power than them and consequently behaves towards them in that fashion, they operate from a one down position.

I’m not OK, You’re not Ok – this is a life position of futility as self and others are viewed as not being ok and able to get on with life.  It may be perceived as futile and full of despair.

Looking again at the roles of the Drama Triangle,  both the Rescuer and the Persecutor operate from a one up position, from the I’m OK You’re not OK life position and the Victim operates from one down.  Here’s an example to illustrate this more fully.

Your colleague is preparing some figures for her boss and she has looked pretty stressed all morning.  She heaves a huge sigh, pushes her chair away from her desk and puts her head in her hands, saying, “I’m never going to get this done in time, I hate excel, I just can’t make sense of this at all.”  Immediately you rush over and take a look at what she is doing.  You think you have spotted the mistake she is making and correct it for her.  Saying “there you are, that’s sorted now”.

She takes a look at what you have done and tells you that it wasn’t the problem at all and now she’s probably going to have to start all over again and she wishes you would mind your own damn business.

You go back to your desk feeling awful saying to yourself  – “But I was only trying to help.”

Uncomfortable Feelings

If we take a look at this little episode again, this time putting in the Drama triangle roles, some commentary and identifying that switch in roles which so often results in uncomfortable feelings.

Your colleague is preparing some figures for her boss and she has looked pretty stressed all morning.  She heaves a huge sigh, pushes her chair away from her desk and puts her head in her hands, saying. I’m never going to get this done in time, I hate excel, I just can’t make sense of this at all.”

Your colleague is probably in Victim, the words she is using and her body language are pretty big clues.  She is could be issuing an invitation to be Rescued or Persecuted.

 Immediately you rush over and take a look at what she is doing.  You think you have spotted the mistake she is making and correct it for her.  Saying “there you are, that’s sorted now”. 

Your response is definitely one of Rescuing. At this point you have not been asked to help and in fact are operating in the dark doing what you think is best, rather than what the other person wants.  Thinking that you know best for someone, whether it is how solve an excel problem or what might make them happy is very much part of the Rescuer role.

She takes a look at what you have done and tells you that it wasn’t the problem at all and now she’s probably going to have to start all over again and she wishes you would mind your own damn business for once.

Your colleague has moved roles into Persecutor.  Part of the way the Drama Triangle plays out is for the participants to switch roles.

You go back to your desk feeling awful saying to yourself – I was only trying to help.

And you have now moved into Victim feeling bad because of getting it wrong.

Any of this familiar?  The good news is that once identify what it is we are doing then we can, if we wish, change. And how do we change this?  Firstly be becoming aware of our own behaviours and the roles we might more often take up. Then by moving from one of the Drama Triangle roles where someone is always in a not OK life position to the I’m OK You’re OK life position.

Here’s an exercise you might find useful to do as a piece of persona reflection.

Can you recall a situation where you were caught in the Drama Triangle?  What role did you take on, what role did the person you were with take on, what occurred in this situation and what was the final outcome?  How might you have got a different result?

The Importance of Hope

What a lovely Bank Holiday weekend we had in Chesterfield. The weather was great, sunny and warm with lovely blue skies.  I was fortunate in being able to escape out into the countryside and go for a lovely long walk with my dogs along the Monsal Trail.

Monsal Head

Monsal Head

It was while I was out walking that I remembered a time a few years ago when I had a very similar experience of peacefulness, contentment and joy. Again I was out with my dogs for a walk, probably at a similar time of year and in similar weather. That time the walk was at Calke Abbey down near Derby. I have a very clear recollection of sitting on a wall by the reservoir, sharing an ice cream with my dogs and feeling sense of peacefulness and hope for the first time for months.

Relationship Break Up.
At that time this experience was hugely significant as I had recently separated from my first husband.  I was engaged in a some personal therapy to help me deal with the break up and in fact, probably more importantly, help me understand myself better.  I had been feeling pretty low for a number of months, I was finding the break up difficult, relationships with family were strained at best and I did not know how to make things different for myself, or what to do to help myself deal with the feelings I was experiencing. However, I remember very clearly sitting on the wall on that day and having what was probably one of the first experiences of hope after months of difficulty. In that moment I felt at peace, I felt happiness and I had a sense that things could be different. I knew I had a long journey ahead of me, but I also had a sense of potential and possibilities and that how I approached my life could change.  I did not have to continue to think, feel and act in the way I had in the past.

Therapeutic Support
These days, as a therapist I think that one important aspect of my role is to hold that sense of potential and hope for people when they cannot see it for themselves. Often when someone I am seeing is in the depths of their distress it is very difficult for them to see beyond what they are experiencing in the moment. To think that they can create a different life for themselves. That’s where I think a therapist has a hugely important task to hold that hope for them. To use a metaphor, it is almost like we are with them in a dark tunnel where they cannot see the light and we can.  We need to let them know that the light is there and to help them find it for themselves.

Change
I suppose this is, in part, what I am doing in writing this post. You may recognise some of what I am describing, have been in a place of despair yourself and recognise how difficult it was to believe that things could change. You may be there now – I hope you are not. What I do know from my own experience and from the people I have worked with over the years is that people are capable of making significant personal and emotional developments in ways that enable them to live more with more peace and satisfaction in their lives.

Adult Ego State

Ego State Model

Ego State Model

Here’s the final post on explaining ego states;  one of the ideas in TA I use widely with my clients and that I find really helpful in understanding ourselves and why we think,  feel and behave in the ways that we do sometimes.

It was Eric Berne, the founder of Transactional Analysis who originally described an ego state as “a consistent pattern of feeling and experience directly related to a corresponding consistent pattern of behaviour”.  I have written about the other two egos states, Parent and Child in previous posts. Today I’m going to write about Adult.  Where Parent, Adult or Child is capitalised I am referring to the concept of ego state, where lower case I am referring to real parents, adults or children.

Adult. 

When we are in our Adult ego state we are using thinking, feeling and behaviour in response to the “here and now”.  So being in my  Adult ego state means that I am in the present and will respond to a situation or stimulus using my capacity as an adult for solving problems,   reality testing situations, being honest,  direct and open about what I am thinking and feeling and being spontaneous.

Problem Solving

I’m going to look again the examples I gave you in my posts about Child ego state and Parent ego state to explain this further.  I want to talk about what the Adult response might be in those same scenarios as a way of demonstrating what I mean by a here and now response that uses all our resources for problem solving and reality testing.  In the example of getting an answer wrong in a training course,  I used this to demonstrate being in the Child ego state where the person re-experienced  an uncomfortable feeling from childhood when getting an answer wrong.  The Adult response might be to feel ok about not knowing an answer and then to reflect on what you have not understood and what additional information might needed to give the correct answer.  So I am engaging my problem-solving skills as an adult to solve the “problem” of not knowing an answer.

Anger

Thinking about the Parent example of being cut up by a car driving too fast on the motorway, in this scenario I talked about the person getting  angry and swearing  like their Dad had done.  The key point about this is, once again,  that the response to the stimulus of being cut up by another driver does not look at problem solving.  A response from Adult might be to check my own speed and see if I going too slow, I might move over out of the way of other drivers who want to get past. I might also think about my own driving behaviour and if I am driving safely and appropriately for road conditions.

Being Resourceful

How is this useful to us?  Being in our Adult opens all up all of our resources to be used;   so that we not using out-moded strategies that we have taken in from our parents into our Parent ego state that are not applicable to the lives we are leading.  It also means not re-experiencing a child response to a situation and using old ways to get our needs met.  The examples I have used are about taking action and problem solving.  Other scenarios might involve being how you are in a relationship with your partner, how you parent your children, how you relax and have fun.

Are there certain situations that stimulate a Child or Parent response from you?  What would be an Adult response?  Would this be more useful?

Child Ego State

Here’s the second of my posts on ego states.  A piece of Transactional Analysis theory that I think is a useful way of understanding ourselves and something that many of my clients have found helpful.  First, a quick recap on ego states:

Eric Berne, founder of Transactional Analysis described an ego state as “a consistent pattern of feeling and experience directly related to a corresponding consistent pattern of behaviour”.  He identified that we each have three ego states, which he named Parent, Adult and Child.

Childhood

In this post I’m going to write a little about the Child ego state, described as archaic thoughts, feelings and behaviours replayed from childhood.  This is description is one of an internal experience based on early emotional experiences.  So, what do I mean by this?  Here’s a simple example.

You are at school maybe 4 or 5 years old.  The teacher asks a question, you think you know the answer so you put up your hand.  The teacher asks for your response, which, when you give your answer, is wrong.  As you get it wrong someone at the back of the class sniggers, and you feel really embarrassed at not knowing the correct answer.  And think “it’s not a good idea to answer questions in case you get it wrong.”

Thirty years later you are attending a one day training course as part of your job.  The trainer asks a question, you answer and get it wrong and in that moment you revisit the experience you had when you were 4 and answered incorrectly in class,  you feel the same embarrassment and shame and again think,  “it’s not good idea to answer questions. ”

Being a Child

So,  as with  Parent  Ego State when I am in my Child Ego state I am responding to a situation or stimulus using thoughts, feelings and behaviours from the past.  Now some of our experiences that we use from Child can allow us to revisit and enjoy the free and uncensored joy that was part of being a child. For example, when I am out walking with my dogs and it’s wet, muddy and raining there are times when I find myself enjoying splashing through the puddles.  I was walking on Birchen Edge last weekend and thoroughly enjoyed the feel of the sticky mud sucking on my boots in just the same way I have since I was 8 years old.

Update Strategies

How is it useful to know this about our personalities?  When I am in my Child ego state I am likely to be responding to a situation or stimulus using thoughts, feelings and behaviours from the past and this response just may not be relevant or appropriate to the present.  I may also be using the strategies I developed as a child in response to the past, to a present situation an adult.  It is likely therefore, that those strategies will not be an effective way of problem solving.

I invite you reflect on a time when you think you might have responded to someone from Child ego state and to consider how else might you have responded.

Anxiety

Quite a few people have come to me for help because they feel anxious.  One of the first things I want to say is that nearly everyone will have experiences in their life that they worry, or feel some degree of stress or anxiety about, this is normal.  How we then deal with these feelings can be really important in whether or not they are something which we experience in passing, in response to one off events, or become a pattern of thinking and feeling that stops us from enjoying our lives, because we are almost constantly anxious, or worrying about something.

Physical Symptoms of Anxiety

The physical symptoms of anxiety are pretty common: dry mouth, elevated breathing and heart rate, butterflies in the stomach, upset stomach, sweating, trembling, unable to concentrate, sleep disturbances to name but a few.  This reaction is what is known as the “flight or fight mechanism”, it is an instinctive physical response to danger, that is designed to help us get away from a threat.  What is  happening in the body is that chemicals are being released to enable us to literally take flight, that is,  run away or to fight, to protect ourselves physically.  Now, as a response to a genuine danger, for example, enabling us to leap out of the way of a car, as we are about to cross a busy road, it  is appropriate and helpful.  If it is in response to an upcoming social situation or a presentation at work it may not be helpful at all,  but in fact get in our way and stop us from enjoying the experience.

Significant Factors

There are a number of significant factors that I think play a large part in why some people experience high levels of anxiety on a regular basis.  Here are two of them:

Firstly they have great difficulty in soothing themselves when they do feel nervous, anxious or stressed so do not easily return to a state of calmness.

Secondly, they are often have experienced one of more of the following –

  • A recent event that may have triggered feelings of stress and anxiety.
  • A traumatic, frightening or distressing event when they were a child that they have been unable to come to terms with.
  • One of more of their parents or caregivers often used to worry about them, or were themselves someone who often got anxious.

Self-Help Strategies for Anxiety

So, what can anyone who gets anxious do to help themselves. Here are five suggestions that you may find helpful:

1) Put in place a regime to improve your general health and well-being. For example cut down on stimulants – reduce how much tea and coffee you drink, particularly in the evenings.  Take regular exercise. Eat healthily.

2) Learn how to relax.  Make time at least once a day to undertake a relaxation exercise or activity.

3) Develop a series of activities that occupy your mind and provide an interesting distraction for times when you are stressed.

4) Talk about what is worrying you to someone you trust.

5) Challenge your thinking and your worries by reality testing your fears.

Do you often feel anxious?  Have you experienced anxiety in your life and learned how to deal with the feelings differently? I’d like to hear your stories.

Valentine’s Day

As it’s only a few days away I’ve been thinking about Valentine’s Day and how for some couples it will be a lovely experience full of closeness and affirmation of their love for each and for others a disappointment and possibly a day of sadness and anger.  How many of us have dreams of a romantic evening with a loved one doing all the things we most enjoy?  And how many of us have ended up with a bunch of wilting flowers from the local petrol station and a box of your least favourite chocolates bought as a last minute gesture.  Well I think a little planning and discussion before hand can make a difference so here are some simple tips that may help you make this year’s Valentines Day one that you enjoy.

 

Negotiate and compromise.

Firstly it can be helpful to begin by checking out that your loved one wants to celebrate St Valentines Day.  Then let them know why it is important to you to celebrate.  Next decide on something that you would both like to do.  If their ideas are very different from yours you may need to negotiate a compromise around this. For example you may decide to go with your preferences this year and theirs next.   Acknowledging and recognising the compromises you are both making is an important part of the process.

What is romance?

What do you expect from your partner or loved one and yourself?  Are your expectations realistic?  The place of romantic love in a relationship can vary tremendously depending on the background, upbringing and culture of the people involved.  One person’s idea of romance is not the same as anothers.  Find out from your partner or loved one exactly what their idea of romance is and what they would like to do.  Make sure they know what you want too.  Respect their right to want something different from you.

There is no mind reading!

Listen to their ideas and wants.  See if you can really understand their point of view, test out seeing the world through their eyes.  And remember, most people cannot read minds nor are they telepathic, we only learn how to please people from experience.  So, no matter how long you have been in a relationship the chances are that unless you tell your partner what you want they will not know.  So be specific.  If you want flowers or chocolates, tell them what sort, how many, the colour.  If you want a hug, let them know how you like to be held and how long for.

For some people asking for what they want or letting people know they have a need can be difficult.  They may have learnt at some point that it is not okay to ask, or feel scared and vulnerable in letting others know they have needs too.  Well, it is okay to ask and it is okay to have needs, this Valentine’s Day go ahead and ask for the romantic day you want.

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