One hour’s reflection is worth seventy years’ pious worship.
Bahá’u'lláh: quoting a hadith in the Kitáb-i-Íqán
Some years ago I posted a series of attempts to describe my work in the NHS as I experienced it. Since then I have been also attempting to use poems to approach the same experiences from a different angle. Because my poems tend to come from a darker place than my prose it seemed only right to publish the poems alongside the more positive feel of the republished mind-work posts. It felt as though that would be more balanced, more true to the experience as a whole. So, what I am doing is following up a prose post with a poem after a day or two, but they need to be read together to get a more complete picture of what was involved in the work I did. Above all else I would hope to convey the reality of this area of experience more completely by tackling it this way, and do more justice to the courage of those who suffered. They are stronger than we realise for bearing the unbearable so bravely.
Three Crucial Factors
There are at least three other crucial factors in the mind-work process over and above what we have dealt with in the previous posts: Reflection, Relatedness and Relativity. They are qualities that the mind-worker must have from the start. The names for these qualities are used in an existential model of mind-work. (Reflection is also a core quality of the Bahá’í spiritual process and has been discussed at length in other posts on this site, as has consultation which can be fairly described as a process of group reflection.)
Reflection, relativity and relatedness as discussed here are the antidotes to three forces of fixity – drowning, dogmatism and disowning — which I discussed in detail in the article on Collaborative Conversation (a term I borrowed at the time from Anderson and Swim) in Madness Explained mentioned in a previous post. The forces of fixity are common when we function in survival mode. Psychotic experiences in people who need help from Mental Health Services are very threatening. Being in survival mode is therefore very much the norm for many of them. Creating a situation that feels safe is of paramount importance. Otherwise it can be very difficult to mobilise the forces of flexibility.
Reflection, Relatedness and Relativity are the core of the mind-work process. They will need some further explanation. They are what the mind-worker models and what the client can either develop further or discover how to use. If the mind-worker lacks them the process of mind-work is likely to remain locked in unproductive disputes that tend to drive the client further into his private world. The client may or may not demonstrate them at the beginning but should increasingly do so as the mind-work progresses. The better the mind-worker models them the more likely it is that the client will begin to use them too. These qualities are what consolidate and generalise the process of change. They ensure that the process of mind-work becomes a permanently transformative one. If the client does not develop these abilities there is likely to be no real sustainable progress.
These three capacities combine with the relationship aspects in different ways – trust, containment and authenticity – each of which contributes something special and important to the therapeutic process. They may have an order of importance which is discussed later in that without Trust it may be impossible to develop Containment and without Trust and Containment Authenticity may be impossible. Eventually the client will certainly need to acquire and evince Reflection, Relatedness and Relativity, without which he will never make his own any clarity that comes from the mind-worker.
What, in the Relationship, Makes Change Possible?
The Plane of Authenticity
Clarification and Congruence (see earlier posts) are two sides of a square mind-space, so to speak, which is completed by Reflection and Relativity, two concepts which are also related. The combination constitutes what we might call Authenticity.
Let’s take reflection first. Reflection is the capacity to separate consciousness from its contents (Koestenbaum: 1979). We can step back, inspect and think about our experiences. We become capable of changing our relationship with them and altering their meanings for us. We may have been trapped in a mindset. Through using and acquiring the power of reflection, we do not then replace one “fixation” with another: we are provisional and somewhat tentative in our new commitments which remain fluid in their turn. Just as a mirror is not what it reflects we are not what we think, feel and plan but the capacity to do all those things. Knowing this and being able to act on it frees us up: we are no longer prisoners of our assumptions, models and maps.
The principal focus of reflection in mind-work is often upon our models of reality and upon the experiences which give rise to them and to which they give rise in return. This is especially true of “psychosis.” The capacity to reflect increases the flexibility of our models in the face of conflict and opens us up to new experiences: the adaptation and change that this makes possible enhances the potential usefulness of our models and their connected experiences. It is the antithesis of drowning where we are engulfed in our experiences and sink beneath them.
The ability to reflect, one part of our repertoire of tools for transformation, enables us to achieve our own clarification without depending upon another mind-worker. If a mind-worker does all the reflecting she is just giving people fish: if she can help someone discover how to reflect, she has taught him to fish. In combination with its sister quality, relativity, it becomes a powerful tool indeed. The antidote to chronic dogmatism, another of the forces of fixity, is relativity. Being dogmatic seals us off from new evidence which makes it hard to change our minds even when we are wrong.
It is not surprising that Reflection and Relativity are interconnected. By placing our models and assumptions mentally in brackets or inverted commas, which is a necessary first step towards reflecting upon them, we inevitably acknowledge, at least implicitly, that we have no monopoly on the truth, that we understand and experience the world at best imperfectly from a particular viewpoint or perspective which is only relatively true. This is not the same as saying there is no truth out there and any viewpoint is as good as any other. We refine the usefulness and accuracy of our simulations of reality partly at least through a process of comparing notes with others in consultation or, as I call it here, collaborative conversation.
We can, and as mind-workers we must, become almost as sceptical of our own position as we tend to be of other people’s. Any other posture is unhelpfully dogmatic in this context. The extent to which I should then explicitly endorse the client’s position is still an issue of debate. Peter Chadwick, for instance, in his book Schizophrenia: a positive perspective, contends that it would not have been at all helpful to him to have staff endorse his beliefs in supernatural influences at the time he was experiencing extreme psychotic phenomena, even though he still holds those beliefs to be valid now that he is well: had they been endorsed by staff at the time he might have killed himself.
Authenticity matters because without it the clarity necessary for effective action and coping is unlikely to become possible. Client and mind-worker could well remain in a warm and sympathetic muddle that leads nowhere. As we will see in a moment though, without the warmth of an accepting relationship, authenticity and its resulting clarity can seem far too dangerous to risk.
Without a clear sense of uncertainty about absolute truth radical authenticity of the kind required here may prove impossible. An example from my own work serves to illustrate this well. A client was convinced the devil had a purpose for him. He was very concerned about whether I believed in the devil or not. He pressed me in almost every session for an answer. In the end, concerned to be congruent, I told him I did not. He broke off mindwork. I reflected on this afterwards. It became apparent to me that I had spoken from a position of dogmatic and unreflecting identification with my views about the devil. It would have been more authentic to acknowledge that, as a fellow human being struggling to make sense of the world, I couldn’t know for sure whether the devil existed or not. I could have shared with him, if he had pushed me further, that I had chosen to operate in my own life on the assumption that the devil did not exist. This would not, I think, have broken the relationship in a way that made further work I possible.
The Plane of Trust
Relativity shares a space with Relatedness. This term was chosen because it began with an ‘r’! Perhaps openness is a better word. Ernesto Spinelli (1st Edition: 1994) uses the expression “ownership.” Either way, along with Warmth, Encouragement (both discussed in earlier posts) and Relativity, it helps develop Trust, a crucial component that the client must eventually bring to the therapeutic process, and along with Empathy, Solidarity and Reflection it helps the client develop the ability to contain, rather than disown or act out, his inner experiences. The relation between Trust and Containment we will return to in a moment.
First of all we need to know what Relatedness is. Relatedness, in this context, is the capacity to consciously acknowledge and relate to what we are experiencing. It is the antidote to disowning, the last of the forces of fixity. It makes us sufficiently accessible to relationships with people and things to learn to accommodate to as well as assimilate experiences, to make appropriate adjustments to our selves or to our circumstances. If we disown parts of experience we become a prey to it, just as Ian was a prey to his repressed pain which turned into hostile or destructive voices. Anything we disown controls us while eluding our influence to change it in any way. What we are open to we can affect even though it may also affect us directly in its turn.
Trust comes first. We need to trust someone sufficiently to feel the strength flow into us from her Solidarity, to be able to know that she understands how we feel but will not therefore dump us or summon undermining and unwanted help, and to see how she feels confident enough to open up to what she feels about us and subject it to careful Reflection. This is what gives us the opportunity to learn that we can contain our experiences and change our relationship with and understanding of them.
How do we develop Trust?
First of all, we need to feel the warmth of the mind-worker, her unwavering and unconditional valuing of us. Next, we need to sense her relativity, that she knows the incompleteness and inadequacy of her understanding and can suspend judgement and criticism indefinitely until it is really constructive to share (not impose) it. Then, we need to experience her encouragement, which unfailingly rewards our efforts to apply what we have discovered to our problems. Last but by no means least, we need to see her relatedness, her unthreatened openness to all experience, which allows us to become more aware of other dimensions of our own experience. These things together make it possible for us to trust other people, our experience and ourselves. Without this making and sustaining change becomes almost impossible.
The Plane of Containment
This mind-space comprises empathy, solidarity (both discussed in an earlier post), relatedness and reflection. If someone is standing beside us in our struggles, giving us comfort, understanding what we are going through, and showing an open and reflective attitude to the revelations we share, it helps us to contain what might otherwise be too scary and/or disturbing to contemplate. What we cannot contain, we find it almost impossible to reflect on and process. Containment therefore plays a central role in the therapeutic process.
In our culture we are all too prone to either repression (convincing ourselves we’re not experiencing something when we are) or acting out (expressing whatever we are currently experiencing and ignoring the consequences until it is too late). Containment is the creative third way and a key to change.
An inability to contain experiences of a disturbing nature accounts for much substance abuse, self-harm and dependency on mind-altering subscription drugs. Containment is often not possible outside a set of supportive relationships of the kind I am attempting to describe.
Furthermore, if we cannot trust anyone, and perhaps least of all ourselves, we cannot contain what frightens us or threatens to overwhelm us. So perhaps without Trust there is no Containment. And without Trust and Containment, Authenticity will be impossible, I suspect. Any life-lie will seem a tempting port in the storm of life if distrust and disowning rule the mind.
In the next post I will attempt to pull this all together.
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