Presentations – INTEGRA CPD

Enactments: are these to be welcomed or avoided? (CONFER 2016)

Sat, 24 Sep 2016 23:00:00 +0000

This is the presentation given CONFER at the conference entitled "Enactments: are these to be welcomed or avoided?" The main aim of the presentation is the following question: If I want the enactment to become transformative of deeply ingrained, unconscious characterological patterns (which, according to one definition, is what enactments are a manifestation of), what principles help us in practice? To prepare the ground, I establish some historical markers in terms of how the concept of enactment developed (Martha Stark's "Modes of Therapeutic Action" and my three relational revolutions). A central aspect of the presentation are two lists: different definitions and attitudes towards enactment; and different attitudes towards the recovery from rupture or enactment. This prepares the ground for the image that enactment is like being pulled down a vortex, and that in order to survive enactment transformatively, we need to surrender to it rather than struggle against it.

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The Diamond Model of Clarkson’s 5 Modalities of the Therapeutic Relationship (2014)

Sun, 06 Apr 2014 23:00:00 +0000

Whilst psychotherapy integration has been one of the most necessary, creative and productive developments in our field over the last 20 years, 'integrative' is in danger of becoming another meaningless sound-bite. What does our integration include, and what doesn't it? What holds it together? How broad and deep is the integration we are pursuing and therefore capable of offering to our clients? Many therapists quite rightly ask: does it do justice to the integrative principle to cherry-pick a couple of different approaches and call this 'integrative'? Are we not aiming at an integration that includes the strengths and gifts of the whole field, including all the theories and techniques? If this is your aim, or you feel confused or disjointed as an integrative therapist, or you have misgivings about the effectiveness of your integration, this day is for you. Many therapists do not feel sufficiently prepared to hold a robust, broad-spectrum, coherent integrative position. Too often integration is taught whilst disregarding the irreconcilable contradictions between the approaches in terms of underlying paradigms, theories, stances and assumptions. This inevitably leads to a too pragmatic attitude which reduces integration to an eclectic pick'n mix of techniques, with therapists switching between different approaches in ways that are confusing and uncontaining for the client. So how can we access the full wealth of therapeutic ways of working, without becoming everything to all people, diluting our therapeutic stance and losing coherence? Michael has been working on this conundrum for the last 20 years, and developed a formulation which he calls the 'diamond model of the modalities'. Based upon the different modalities of therapeutic relatedness (Clarkson/Stark), it can provide a framework for your own ongoing journey towards integration between the diverse approaches and polarities within the still fragmented psychotherapeutic field.

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Effective Ways of Relating to the Patient (2015)

Fri, 27 Sep 2013 23:00:00 +0000

This is the presentation given at public workshops in Lahore and Islamabad in August 2015, to a mixed group of the general public, psychology students, and helping professionals including psychiatrists. The overall idea is to understand the different kinds of psychological help that clients need, and to take our professional responses to those needs out of the realm of meaningless abstract descriptions in terms of different disciplines, paradigms and approaches down into the life experience of the client at different life transitions. This is based on the recognition that different kinds of change occur in cyclic, spirallic fashion in our development throughout the lifespan (an integral conception of evolution, with alternating phases of new structures emerging, being pre-eminent for a while, then breaking down and being in turn transcended by other new structures). A crucial stepping stone towards the client's lived reality is the recognition that different relational stances (on the part of the 'helper') underpin the different disciplines, approaches and paradigms. A simple spectrum between treatment by a doctor on the one hand and a friendly equal on the other, with most helping relationships ambiguously in the middle of this spectrum, is one way to conceptualise the different relational stances. When we see how different relational stances engender different ways of perceiving, reflecting and responding (or 'perception', 'understanding' and 'intervention'), it becomes possible to work towards an integration of the different disciplines and approaches based on an underlying embrace of the whole spectrum of relational stances rather than polarising them into mutually exclusive paradigms (‘medical modelâ€ as in classical psychoanalysis and behaviourism versus the ‘anti-medical modelâ€ as in the humanistic revolution). As a next step, this presentation would then lead to "Embracing the paradigm clash between the medical model and counselling" - a presentation I gave in 2008, which takes the topic further.

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The Wounding and the Wounded Healer (CONFER 2013)

Fri, 27 Sep 2013 23:00:00 +0000

Whatever therapeutic or philosophical language we use to become aware of, reflect on and articulate our own wounds - developmental, characterological, systemic or archetypal, for example - each tradition we train in and subscribe to has its own wounds. These reach back to our therapeutic ancestors and the conflicts and splits between them â€“ as people and as therapists and as writers/thinkers, and how they were wounded by each other. Whatever our position within the field, chances are that we have inherited an ambivalent and partial stance in relation to our woundedness, helpful, healing and revealing in some ways, exacerbating and occluding in others. Michael will bring an integrative, relational and embodied perspective to our woundedness and the protection mechanisms and dissociations we take refuge in. An integrative perspective can help us become aware how the therapeutic field reflects the psyche of both its clients and practitioners: each of the diverse therapeutic approaches which we are attracted to, reflects our own individual gifts and pathologies, as well as that of its founders. Therefore - rather than lamenting the fragmentation of our field into dogmatic tribes and the splits between them - we can use these conflicts and paradigm clashes to be drawn more deeply into the creative void of ‘intersubjective messâ€: when we can allow the contradictions between the approaches to de-construct and wound each other â€“ something they are inclined to do effortlessly - wounding and woundedness come together. If we can bear this coming together in an embodied way, a space is created in which healing and wholeness can emerge.

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Bodymind and Parallel Processes in Supervision (CONFER 2013)

Fri, 18 Jan 2013 00:00:00 +0000

This presentation was prepared as an introduction to a supervision masterclass organised by CONFER in January 2013. Here I spell out how bodymind principles might be applied to supervision, bringing attention to the actual non-verbal messages by which parallel process is communicated and carried from the client-therapist system into the therapist-supervisor system. It is a more elaborated form of the presentations I had given over the years at UKCP and BASPR supervision conferences on the 'Fractal Self' - an extended model of parallel process.

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The Therapist’s Embodied Presence in the Transformative Repair of Relational Breakdowns (CONFER 2012)

Mon, 19 Nov 2012 00:00:00 +0000

Enactments seem to occur suddenly, when we are caught unawares and plunged into them. But from outside the intersubjective entanglement it is apparent that they build up slowly, increasingly, over time. Before we become implicated in an obvious, explicit rupture, there have been implicit, unspoken, subliminal versions of the enactment which have passed unnoticed. Importantly, as we recognise with hindsight, our supposedly therapeutic responses have fed into and contributed to this build-up all along. Based on a multi-layered model of enactments, Michael will explore how the therapist's embodied presence, perception and self-awareness can make the difference between transformative repair of a rupture, or a destructive breakdown of the relationship.

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‘Using’ the Body or Engaging with Bodymind? (CAPPP 2012)

Fri, 29 Jun 2012 23:00:00 +0000

Embodiment as a paradoxical relational process Since its origins in Freud and the zeitgeist of the late 19th century, psychotherapy has struggled with and against the limitations arising from a mind-over-body paradigm and its traditional bias towards the verbal-reflective mind. The recent fashion in neuroscience and embodiment has spawned a wave of new approaches which attempt to graft the body onto established therapeutic practice. But how can we seriously imagine that bringing the body back into psychotherapy after 100 years of disembodied 'talking therapies' is just a question of a few new techniques? Many of the new body-based techniques and strategies, for example, fail to sufficiently engage the therapist's own bodymind, or re-introduce the reduction of therapy to simplistic reparative or medical model interventions, or exacerbate the client's disembodiment through the use of the body as an objectifying therapeutic tool. Other problems include the attempt to reverse disembodiment without addressing the underlying conflicts between body and mind, a solipsistic notion of the bodymind as bounded by one's skin, and the attempt to use mindfulness via a structurally disembodied and controlling mind. Without a more fundamental re-visioning of the body-mind relationship throughout our profession, potentially affecting all areas of theory and practice, many of these well-intentioned attempts to work with the body are bound to back-fire and remain ineffectual. Michael will try to address these problems by working towards a bodymind phenomenology of the therapeutic relationship that includes holistic, integral, systemic and relational perspectives and attends both to the possible integrations between spontaneous and reflective forces within the complex system of the bodymind, as well as their dis-integrations.

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The Bodymind Reality of Internal Objects in the Transference (CONFER 2011)

Sun, 11 Sep 2011 23:00:00 +0000

In the psychodynamic tradition we take it for granted that early relational dynamics are being replicated in the transference, often creating binds and dilemmas that in turn have a regressive effect on the therapist. This is such a powerful principle that we often do not stop to wonder: what actually are the subjective and interpersonal mechanisms that make this ‘transferâ€ possible? Object relations theory is capable of providing a crucial explanatory framework, and is therefore an essential pillar in a relational, integrative approach. However, object relations needs to be updated and brought into the 21st century, to fully manifest its potential to enhance psychodynamic practice and secure its continuing credibility in the wider field. Without understanding in some embodied detail how â€œthe repressed does not change over timeâ€ (Freud) and how the presenting past does get transferred from the original scenario into the consulting room, our options for responding therapeutically are limited. Using case material and role play, Michael will, therefore, try to demonstrate an embodied understanding of internal objects and their interrelationships, and how these are subliminally communicated and perceived. This can significantly widen our range of interventions, allowing for more creative and spontaneous practice, as well as helping us transform transferential impasses and enactments. ‘Internal Objectsâ€ in the Transference" href="http://www.integra-cpd.co.uk/wp-content/uploads/presentations/Soth2011_CONFER_Object_Relations.pdf" target="_blank">Download the presentation here as a

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The Therapeutic Potential of Broken Boundaries (CONFER 2011)

Mon, 24 Jan 2011 00:00:00 +0000

If the therapist's job is the steady provision of a safe, contained therapeutic framework, then breaks and transgressions of those clear and firm boundaries indicate a failure on the therapist's part - a mistake. However, every broken boundary is accompanied by the emergence of precious unconscious material, intensely relevant both to the client's inner world and to the dynamic in the therapeutic relationship. How can we perceive, understand and - most importantly - engage with such threats to the working alliance in a way which it turns 'the mistake' into a transformative deepening of the therapeutic process? Whilst not exactly predictable, neither do disturbing breaks in the boundaries occur out of the blue. There is usually a slow build-up, often noticeable in supervision over a period of weeks, that leads up to the eventual breaking of boundaries. This process happens largely subliminally and for many practitioners, unconsciously. But that does not mean it is necessarily beyond the reach of awareness. We can enhance our perception of the subtle dynamics that lead to boundary breaks by approaching them as relational body/mind processes. There are different kinds of boundaries on mental, emotional, physical and relational levels, with different clients, therapists and character types favouring some levels over others. As these dynamics rely on subliminal and non-verbal communication, we will explore these issues in an embodied, experiential fashion.

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Enactment as a Central Principle of Relational Therapy (BACP 2008)

Tue, 30 Sep 2008 23:00:00 +0000

Relational' is in danger of becoming another buzz-word, and this presentation is an attempt to formulate the substance, the essential principles of the relational paradigm shift. Theory is meant to support and enrich our practice rather than directing and legislating for it, by drawing our attention to what has been right under our noses all along. 'Enactment' is such a phenomenon which has been part of therapy all along, but has only been recognised and defined in the last decades. It is commonplace these days that all counsellors and therapists do indeed 'relate' to their clients and that therapy is indeed a 'relationship'. Beyond this simple given, which can be interpreted through the lens of almost every approach without any modification of its traditional assumptions, relational theory tries to establish a more precise and substantial phenomenology of what happens in a therapeutic relationship (including its dangers, impasses and counter-therapeutic dynamics), and I try to establish a holistic rather than dualistic version, by formulating 'enactment' as a bodymind process.

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