System, Method and Experience in Psychotherapy and Consultation

Therapists and teachers often describe their approach to psychotherapy as a system or method, such as cognitive-behavioral or psychoanalytic.  Many other approaches, when you look into them, are some sort of inspired hybrid, such as Emotion-Focused Therapy, Internal Family Systems or Acceptance and Commitment Therapy.  My approach to therapy, like my approach to consultation with therapists, doesn’t rely on a system or a method, although it is methodical and systematic in its own way.  It places experience, and the observation of experience by client and therapist, first.  In my work with each client in psychotherapy, and each therapist in consultation, I am focused on exploring the experience of the client, the experience of the therapist, and the experience of the therapeutic pair.  This is a highly reflective process, and it includes the exploration of behavior and its meaning.  Psychologist George Kelly–a teacher of one of my teachers–said, “Experience is not what happens to us, it’s what we do with what happens to us.”

I had a very unusual introduction to psychotherapy, because of coincidences (or, if you prefer, luck, or grace) in my life.  While still an undergraduate at Goddard College, in Plainfield, Vermont, I met, and became an apprentice to, Eugene Eliasoph, MSW, LCSW, co-founder and co-director of the New Haven Center for Human Relations.  Gene was a therapist, psychodramatist and leader of therapy and personal growth groups.  For a year, II was able to participate in Gene’s groups, along with licensed therapists and Yale post-docs, and receive undergraduate credit for an off-campus field experience.  Goddard’s educational philosophy, influenced by John Dewey, prioritized experiential learning and the role of students in pursuing what they wanted to learn, on campus and off.  Even then, I was finding my own way.  

Psychodrama, for readers unfamiliar with it, is a way of exploring situations in our lives, in groups, by acting them out rather than talking about them.  The person whose situation is being explored is the “protagonist,” the leader is the “director,” and group members play the various people involved in the situation.  There is a role in psychodrama called “auxiliary ego,” which Gene often asked me to play.  The auxiliary ego, also called a “double,” is sent by the director to join with the protagonist (or other member of the psychodrama) and express what the person might be thinking or feeling, but not saying.  This was part of my introduction to psychotherapy.  The experience of the person I was doubling with was more important than any theory, method, concept or system.  My task wasn’t to label what the person was struggling with, or analyze how they were doing it, it was to find my way into the person’s experience and express it in a way that helped move the exploration forward.

In his other therapy and personal growth groups, Gene included me as a “model member,” who was there to learn and participate authentically.  Gene had a lot of knowledge and experience about facilitating therapeutic and personal learning in groups, and later became President of the American Society for Group Psychotherapy and Psychodrama.  His focus was always on the experience of the people he was working with, and he had a way of being and working with them that helped them feel encouraged and secure enough to explore issues that might otherwise have felt too vulnerable and disorienting to get into.  He had psychoanalytic training, at both Austin Riggs and William Alanson White, as well as psychodramatic training with J. L. Moreno, the creator of psychodrama; all of which informed his work.  But he also bought his own life experience to his work.  Among other experiences, as a soldier in W.W. II, he had been captured and escaped, and this contributed to a deeply existential view of human nature.  He had also been influenced by the writings of Harry Stack Sullivan, which he had studied at William Alanson White (which Sullivan had helped found), on the importance of interpersonal relationships.  Gene was also a jazz musician, as I was at the time–he on clarinet and me on guitar–and we shared a love of improvising together within a structure.  This is similar, in some ways, with the experience of psychodynamic psychotherapy (for a unique consideration of this dimension of therapy, see “The Musical Edge of Therapeutic Dialog,” by Steven Knoblauch, https://www.amazon.com/Musical-Edge-Therapeutic-Dialogue/dp/088163297X).     

I later came to understand part of Gene’s systematic approach in the psychoanalytic concept of the “frame” of psychotherapy.  The frame is the set of mutual roles and responsibilities of client and therapist, which creates a safe relational space, at least compared with most other relationships in our lives, within which clients can let down their guard and accept help in exploring intimate and difficult issues.

Later on in my academic and professional education, I was exposed to lots of theories, methods, and systems of therapy.  They all seemed to me to have some truth, mixed up with expressions of the personalities of the founders and their followers, and their attempts to achieve stature and the appearance of theoretical consistency.  This is a problem that started with Freud and continues to this day.  I’ve worked around it by studying neuropsychology and neurocognitive science, as well as spiritual psychology, and developing a model of how psychotherapy works.  That model, under continuous revision, is based on brain structure and function, neural networks and their interaction, the experience and behavior of multiple self-states, the social and economic dynamics of human communities past and present, the dynamics of identity and meaning, and how all those processes are instantiated in the client’s issues and the psychotherapeutic relationship.  (See my review of Pat Williams’ “Which You Are You?” https://psychatlarge.com/a-review-of-which-you-are-you-by-pat-williams/).  I call it an “expanded psychodynamic” model, and it easily incorporates what I find useful in psychoanalytic, cognitive, and other therapeutic approaches.  It enables me to be methodical and systematic without being confined within any method or system.

For more on consultation to refine therapists’ perceptions and skills, see my earlier blog post at https://psychatlarge.com/consultation-to-refine-therapists-perceptions-and-skills/

 

“We now live in a nation…”

A FB friend posted this:

chris_hedges

Here’s my commentary:

There is truth in this, but also dishonesty.  All these institutions both support and undermine the values and qualities of life which they are instituted to support and cultivate.  Repairing and redirecting existing institutions is much harder to get to grips with than overturning them.  Getting them to work like they are supposed to is a huge challenge.  They are all parts of a society in which dishonesty plays too large a part.  Getting the various parts of our culture to work as they should calls for an increase in honesty that the culture may not be prepared to acknowledge or undertake.  Posters like this one do very little to move us in the necessary direction, and might actually move us backward while claiming to move us forward, or to want to.

For example, the claim–“We now live in a nation…”–suggests that there was a former time and place in which institutions did not undermine, to greater or lesser extents, their purposes.  But if there is such a time and place in the U.S.A., or even anywhere in the world at any time in human history, I haven’t read or heard about it.

Yes, our institutions–which means the people who make them up and how they do their work–are often insipid, stupid, self-serving, blinkered and even corrupt in various ways (there’s more than one way to be corrupt).  And its hard to really look at that: disillusionment is painful.  Part of that pain comes from realizing that our original impression of how things were was itself not true.  Psychotherapy and genuine social improvement both share the need for a top-down reorganization of how life is perceived.  Because how we change who we are, and open up new possibilities of how we can be, can involve changing our perception of who we were.  The psychoanalyst Arnold Modell uses the term “retranscription” to refer to this process.

But it’s easier to feel that things were perfect and then ruined, usually by others whom we can resent.  There is a spiritual piece to this.  In spiritual traditions, the human condition is described as having “fallen from grace,” “lost contact with our origins,” etc.  And it does map onto the situation of institutions which have lost contact with their origins; so, for example, we get law instead of justice, medicine instead of health care, wild bank speculation instead of stewardship of funds underpinning the economy, etc.  Nor is my own field of psychology, which tends to produce successive fads that dominate its versions of human nature and how science and treatment should be done, instead of understanding in depth, immune from this kind of process.

In fact, many of the most effective emotion-arousing appeals in politics and religion claim that we have lost a perfect state of being which we formerly had and need to mobilize ourselves and prepare to sacrifice to regain.  Hitler, no less, was well aware of this, and used it quite deliberately.  He was able to invoke the loss of German-speaking lands in the remapping of Germany after W.W.I as a geographic example of a nation having lost its original integrity and needing to restore it by taking its destiny into its hands.  The fact that the “original” Germany he recalled was itself a relatively recent creation somehow didn’t make it into the story.

Of course, the self-promotion of the individual who highlights the deficiencies of social systems is always worth considering.  Students at Goddard College, where I later went to school, said to Stokley Charmichael, when he gave his fiery presentation against racism in America during the 1960s, “What’s in it for you?”  (If you don’t know who Stokely Charmichael was, look it up.  Though having to write this does make me feel old!)  His answer, as it was reported to me, was to the effect that this was a different kind of place than he was used to speaking at.