Many of you know that I am planning to take off the spring term of 2017 in order to start writing a book. There are several books I have in my mind which I think deserve to be written. But as I have previously struggled when writing longer pieces like that, for my first book I have decided to go for a project where the structure is fairly self-evident, and I am hopefully less likely to get lost in endless cycles of re-structuring.
The basic idea is that I’ll be writing a textbook, (or training manual) outlining in fairly sequential fashion the possible curriculum for a 21st century integrative-integral-embodied-relational therapy course, and designed for students and tutors as an accompaniment to integrative learning and training.
Inspired by my recent visits to Pakistan, where I have been teaching on an integrative counselling course, I have been wondering about traditional counselling and psychotherapy training and how it is organised and how effective and productive it is. I call it ‘traditional’ because although my own original training was fairly experiential and there is an experiential tradition throughout the humanistic field, since the 1990s much counselling and psychotherapy training has become increasingly academic and less experiential. And in my opinion it is debatable whether - inspite of other beneficial developments in therapy (around trauma therapies, neuroscience, psychotherapy integration, the relational turn) - this has really served our discipline and improved the standard of therapy which the public ultimately receives. Arguably, our trainings are still stuck in the therapy principles of the 20th century - in their left-brain academic educational paradigms, their NVQ-like skill sets and assessment criteria, in their underlying assumptions about role of the therapist in the predominantly ‘talking therapies’, with some lingering sense of the ‘modality wars’ even in integrative trainings.
In the light of what we have learnt over the last 20 years in terms of the embodied, intersubjective and relational foundations of therapy, and what makes therapy work, we can wonder: what are the most important skills, qualities and competencies that prepare a student for the ‘impossible profession’? How would we prepare a trainee - the averagely wounded person coming into training as a student - and how would we allocate the few precious training hours we have realistically available? What kind of learning environment do we think is most suited to maximise attention to the crucial developmental processes that will make a difference to the kind of therapist they will become?
How do we help students reflect on the wounded subjectivity they are bringing to the intersubjective encounter, including their own tendencies for over-identifying or dissociating, for example? How do we facilitate the development of their implicit relational knowing, their right-brain capacities for attunement and attachment, the otherwise subliminal functioning of their mirror neurons, their investment in their own habitual relational positions? How do we help students deepen and enhance their innate emotional intelligence and life experiences, and turn them into resources for the therapeutic position? And how do we help them become aware of their own tendencies, mechanisms and patterns of avoiding or demanding intimacy, or breaking or forcing intensity, their inclinations for surrender versus submission, and their own investments in or abhorrence of therapeutic authority and power – all of these factors are crucial in maintaining awareness in the roller coaster ups-and-downs of the working alliance and its ruptures and repairs.
To access my imaginings about the kind of training textbook that would be needed in the future, I first asked myself the question: if counselling and therapy had not been invented about 100 years ago, but we were to discover and develop these disciplines now, during the first fifth of the 21st-century, based upon …
1. what we now know about primary intersubjectivity, attachment, the neuroscience of empathy and emotion, non-linearity and complexity;
2. what we now consider the baseline post-imperialist values of pluralism and diversity regarding culture and the politics of difference;
3. understanding - as we do with hindsight - the diversity of relational modalities practiced across our field, as well as …
4. the significance of the bodymind connection, embodiment, ‘right-brain-to-right-brain’ attunement and implicit relational knowing, ...
what kind of counselling and psychotherapy practice would we come up with? And what kind of training and learning environment would we consider most suitable and productive towards developing such a practice?
Any such kind of training would necessarily have to be integrative, drawing from all the branches of the field, not cherry-picking a couple of approaches to integrate, but aiming at a broad-spectrum integration that covers all the bases. It would have to be based upon an appreciation of pluralistic diversity, both in terms of culture and in terms of therapeutic approaches. It would have to include pre- and non-verbal communication and some question how to tackle the Cartesian dualism that is still rife across the collective as well as the profession, although it is a paradigm that is widely considered inadequate, unrealistic and unhelpful.
These ideas take me back to 2005, when it was decided that we would slowly wind down the Chiron training and not invite any further intakes of students. We were then involved in writing the Chiron book, generating a snapshot of 30 years of Body Psychotherapy training and where we had got to at that point.
It then occurred to me for the first time that - rather than modelling the process which a student goes through during training on some linear idea of academic learning (or -as we did at Chiron - on childhood development, with the 1st year being considered the kindergarden, the 2nd year primary school and the 3rd year the teenage and separation phase towards adulthood as an independent practitioner) - it would make more sense to model any psychotherapeutic training on the therapeutic process itself.
Based on an integrative, embodied, relational perspective, what is the shape that the therapeutic process takes? Overall, we would think of it as a developmental process at the “intimate edge”, which - like primal attachment - goes through rupture-and-repair cycles of enactment and recovery from enactment, in deepening spirals of descent and transformation, integration, dis-integration and re-integration.
Relationally, such a process starts from the beginning with the negotiation of difference: in order to meet the client where they are (one of our essential principles), we cannot just assume that they know what kind of therapy they need, want or are signing up for - they come with their own conscious demands and unconscious construction, their longings and ambivalences. We want to meet them as the complex fullness of bodymind being they are – the multi-dimensional mysterious psyche of psychology. What we are meant to do together is not at all clear or understood, nor is it - the more we actually take unconscious processes into account - easily clarifiable by customer information, negotiation or clear contracting. On the contrary: we must not presume our own frame of reference as the fundamental terms of engagement.
In order to provide a relational space and container, we want to be immediately sensitive to the client’s habits in the contact, their relational patterns, e.g. in terms of controlling the space and/or being used to having things imposed upon them. Immediately, we are confronted with the self-other dilemma and the vicissitudes of difference. Like Schopenhauer’s hedgehogs, we have the urge to huddle close for comfort, but our defensive spikes impinge on the other the closer we get. In terms of forming a working alliance and working together productively, the only advantage we have over other professions is that we have available a psychologically profound grasp of just how different these constructions of our supposedly joint task may be.
It is through daring to encounter each other - through hurting each other and continuing to risk hurting each other - in an ongoing commitment that the mutual fault lines and dissociations (which we both have brought into the relationship in the first place as degrees of habitual unreflectedness) serve to bring awareness to each other’s sense of self and subjective identity (Bromberg’s theory of therapeutic action). To facilitate this deepening process, to keep making ourselves available to be “used as an object” by the client and to keep providing the relational space when our own “hard, dumb and blind spots” (these are phrases used by Jim Mc Loughlin, an American analyst whose work is mentioned by Bill Cornell in his book "Somatic Experience in Psychoanalysis and Psychotherapy", which Morit and I are currently reviewing) are touched, a therapist needs to deepen their own capacities for such exploration consciously, developing awareness of being both the wounded and the wounding healer.
When we recognise the kind of edges we come up against in ourselves in such a process, what would be the kind of learning experience needed in training which would maximise a student’s readiness to travel to such places in their practice?
As students, partly depending upon our own previous experience of being clients and our resulting understanding of the therapeutic process, we go through a series of common thresholds in our capacity to engage with the our client’s conflicts and pain, our willingness to be drawn into these conflicts, our ability to learn from within these conflict zones, and then how to make all of that useful to the client’s process.
These thresholds resemble the steps which I formulated in 2005 when I wrote about how the client’s wound enters the consulting room (today I would prefer to formulate it as: client’s wounding enters the consulting room).
The client’s wounding comes into the consulting room and enters the ...
... client’s ‘here & now’ experience as non-verbal process
... client’s perception of the therapist ( = transference)
... client’s bodymind experience of the therapist ( = embodied transference)
... therapist’s awareness ( = situational countertransference)
... therapist’s bodymind experience ( = embodied countertransference)
... supervisor’s experience ( = ‘parallel process’)
At around the same time I also worked out a possible curriculum for a training (which might have become the blueprint for a successor of the Chiron training after its closure). And a couple of years later I proposed the associated idea of the three relational revolutions (treatment -> transference -> countertransference -> enactment). My plan for the book is to combine these various proposals now – more than 10 years later - with the benefit of further development and a lot more teaching experience, which gives me some sense how therapists can make use of these ideas in their continuing professional development.
So my intention is to write the integrative, integral, relational, embodied textbook for 21st-century psychotherapy, mainly focused not so much on establishing the validity of these principles (which many others have done by now), but mostly on how we apply them in practice, and how we would maximise our learning as students in those domains.
One of the things I am worried about most is my capacity to make these ideas and my writing accessible, especially to beginners. If you’re willing to help me by reading and commenting upon draft chapter of the book, please let me know.
- one book on working with psychosomatic symptoms, the psychological meaning of illness, the psyche-soma connection (from a non-dualistic ‘Reichian-functionalist’ holistic embodied-relational perspective) – this would be on the “8 ways of relating to the symptom”
- another book on the history of Body Psychotherapy and its evolution (similar to Stark’s ‘one-person psychology’ towards ‘two-person psychology’, but specifically applied to embodied ways of working and including a critique of ‘traditional Body Psychotherapy and how to evolve beyond it)
- another book on the ‘Fractal Self’ and the multi-dimensional nature of parallel process – based upon my extended model of parallel process
- another book on the complex notion of the ego as ‘internal therapist’ and the dilemmas which arise from that for the ‘external therapist’
- and another book on working with regression, how to access early, pre-verbal states in a variety of ways, but specifically using the mattress and breathwork