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Posts Tagged ‘Clinical Psychology’

It seems a good idea to republish this sequence from almost six years ago to complement the current sequence on transcending the crocodile within and providing more detailed background to its thinking. This is the first of six.

Some Background Thinking

I thought it was about time I tried to do a post on the work I did for most of my professional life. It could be tricky and might not work out at all.

I have been struggling for ages — at least ten years —  to capture in words the work I used to do. Words like therapist and therapy make me uncomfortable. Even the word counseling implies unequal distributions of wisdom. She who gives counsel is somehow superior to him who receives!

I have come to believe that what I did is best called mind-work. It includes mood-work, belief work and will-work: it should have included ‘soul-care’ but that would have been a step too far for a clinical psychologist’s job description even though ‘psyche’ means ‘soul’ to the Greeks.

Everyone does mind-work up to a point. It’s a bit like cooking though. Almost everyone prepares food at some point in his life but not everyone’s a chef. As a professional mind-worker I was a bit like the chef. I was an expert at the work at the same time as the people who worked with me as clients were experts about their own minds.

Because, to do mind-work, I drew on lots of other disciplines and traditions, including philosophy, psychology, biology, religion (especially Buddhism and the Bahá’í Faith) and the arts, I could sometimes feel like giving myself a fancy title such as psy-culturalist. This captures the richness of the traditions I could draw on and also captures the essential purpose of mind-work which is growth. It also meant I didn’t have to label myself a psychologist with its one-sided implication that I study the mind but don’t work with it, nor did I have to call myself a Clinical Psychologist with its implications of illness and therapy, which are insulting to the client.

Psy-culturalist, as a term, has a similar problem to Clinical Psychology. If we think about gardening, it’s a one-way street. Plants, as a general rule, don’t grow people. Mind-work, though, is both reciprocal and reflexive. I grow you and you grow me and we grow ourselves as well!

In the end then mind-work is a perfectly good description.

Mind-work for the most part involves forming a relationship (much more on that later) that allows words to be used in a process of collaborative conversation (the title of a book chapter I contributed to This Is Madness) to enhance meanings in a way that enables all participants to grow. As I see it every human interaction is an opportunity for mind-work and as many interactions as possible should be used as such. Even the groups of people who traditionally have been seen as experiencing meaningless lives, such as those with a diagnosis of schizophrenia or dementia, are not to be excluded from this meaning-making growth process. My work has mostly been with the former group and what follows discusses some implications of that. For me though, everybody means something and to deny that is to dehumanize us.

Perhaps it is important to clarify something. I use the word mind to cover a wide variety of possibilities. Consciousness is only one of them. Many important processes take place outside the circle of light shed by conscious attention. Mind is also where the body is experienced and shares a two-way relationship with the brain, so the realms of the physical are not excluded. The mind is a node in a sociocultural network and is affected by many wider systems which it maps and responds to in a variety of ways. No mind is an island! There is also strong evidence that the mind can operate independently of the body/brain (See Jenny Wade’s Changes of Mind, Ken Ring’s Lessons from the Light and David Fontana’s Is There an Afterlife? as well as posts on this site about the afterlife hypothesis for more detail about that.)

There are differences that should not be obscured. A psychologist is paid for her mind-work: her client is not. That is one difference which can create an undesirable power-differential if great care is not taken to counteract that tendency. Another difference lies in the fact that the client is the expert, as I have said, in his own mind: the psychologist is the expert when it comes to the nature of the work in some of its aspects. That is the only other difference. Both can grow as a result of the mind-work they do together.

That should be enough to set the scene for the exploration of my way of working that follows.

The Client’s Perspective

In 1996 I interviewed someone who had gone through a series of conversations with me about his voices. He was a former miner and an ex-army man from the Welsh valleys. He was articulate but down-to-earth. What he told me enriched my way of doing things considerably and shed a great deal of light into previously dark places. We made a video together, from which the photo  below is extracted but without showing his face, and he was very keen that it be used to help others understand this kind of problem better. At the time of the videoed interview we had been working together for about six months. There was still a long way to go but much of interest had happened. I will call him Ian to protect his identity.

Perhaps most importantly, he emphasised the role of trust.

P.: And it was in November that we first met, wasn’t it?

I.: Yeh. Jenny [his residential social worker not the author of the book recommended above!] had started talking about you, you know? And it was coming up to the meeting with you. And I can remember going to the meeting with you that first time. And I can remember thinking who’s this bloke asking me all these questions, you know? And I didn’t trust you. But Jen was persistent that I could trust you, so I decided to trust Jenny and to talk to you.

P.: And you actually asked if Jenny could come to sessions, didn’t you?BM & PH

I.: Yeh, I asked if Jenny could come, yeh.

P.: Right. And I think she came about the second or third time you came.

I.: Yeh.

P.: And did you feel more comfortable with her there?

I.: I did, yeh.

P.: And did that make you feel more able to begin to trust me at least personally if not what I was doing?

I.: It took about a month to start to trust you. And that was with Jenny backing you up.

This cannot be stressed too much. Trust takes a long time to build and is easily lost. In Ian’s case Jenny who had worked with him for years and vouched for me assisted the development of trust. In a “delusion” exercise I use in workshops we can see how a period of unsympathetic and confrontational treatment at the hands of other people makes it harder for someone to believe we are not going to be the same. We need to prove our trustworthiness over a period of time. We need to be prepared for hostility at worst and the cold shoulder or evasion at best in the early stages of our relationship. We would be wise not to assume that such behaviour is the result of “paranoia.” It is at least as likely, if not more so, to be a natural reaction to months if not years of other people’s outspoken incredulity.

What also was important to the success of my work with Ian was all the effort Jenny put in in-between times.

I.: It took about a month to start to trust you. And that was with Jenny backing you up.

P.: And that was by being there in the sessions and by talking to you between whiles wasn’t it? You used to have meetings and discussions with her between times.

I.: Inbetweentimes, yeh. And we’d talk about what we’d talked about, you know? And she supported you in what she said.

She helped him remember what I had said or correct his distortions of it. She encouraged him to make use of the suggestions we had come up with. She helped him make sense of what was happening to him in the terms I had described it. Isolated mind-work sessions will achieve little if they are not reinforced and supported by a lot of work in-between.

We will hear much more from Ian in the next post.

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Heart to heart

Humanity’s crying need . . . . . calls, rather, for a fundamental change of consciousness, for a wholehearted embrace of Bahá’u’lláh’s teaching that the time has come when each human being on earth must learn to accept responsibility for the welfare of the entire human family.

(From a message of the Universal House of Justice to all those gathered on Mount Carmel to mark the completion of the project there on 24th May 2001)

This seems worth republishing at this point, given its relevance to nature as an issue in the current sequence.

I had a recent deep discussion with an old friend (of course, I mean old in the sense of ‘known a long time.’) We are close in many ways. We share a similar sense of humour and many core values. However, we are hugely different in our interests – hers practical, mine theoretical – and temperament – she, extravert: me, introvert.

She was completely unable to understand how I could combine a deep love of nature with a completely passive attitude to gardening.

I gave into the temptation to react, which generally involves treading on dangerous ground and attempted to point out that she similarly fails to understand why I spend so much time and energy reading and writing, even though she values some of the ideas that come out of all that effort.

I referred to her passion as horticulture. It’s then that the concept of ‘hearticulture’ came to me in a flash, as a good way of contrasting our intense enthusiasms.

This idea has had a long gestation period though.

First of all there was the slogan used many years ago in the Bahá’í community ‘Uniting the World: one heart at a time’ with the logo that accompanied it (see picture at the head of this post). I used to joke that this meant we were involved in heart-to-heart resuscitation.

Then there was the idea of ‘psy-culturalist’ which I coined in my discussion of my approach to mind-work, more specifically working with those who were experiencing distressing and abusive voices and the delusions that sometimes accompanied them. I wrote:

Because, to do mind-work, I drew on lots of other disciplines and traditions, including philosophy, psychology, biology, religion (especially Buddhism and the Bahá’í Faith) and the arts, I could sometimes feel like giving myself a fancy title such as psy-culturalist. This captures the richness of the traditions I could draw on and also captures the essential purpose of mind-work which is growth. It also meant I didn’t have to label myself a psychologist with its one-sided implication that I study the mind but don’t work with it, nor did I have to call myself a Clinical Psychologist with its implications of illness and therapy, which are insulting to the client.

Psy-culturalist, as a term, has a similar problem to Clinical Psychology. If we think about gardening, it’s a one-way street. Plants, as a general rule, don’t grow people. Mind-work, though, is both reciprocal and reflexive. I grow you and you grow me and we grow ourselves as well!

Flowers near the Shrine

Flowers near the Shrine of the Báb

Thirdly, there was all my pondering on the issue of the ‘understanding heart.’ In that process I attempted to unpack some of the implications of a key image in the Bahá’í Writings: the heart as a garden. I wrote:

The garden image implies that many of the processes that promote spiritual development have a far slower pace than either light or fire would suggest. The image is also powerfully suggestive of how the processes of spiritual growth are an interaction between what we do and what is accomplished by infinitely greater powers that work invisibly on the garden of the heart over long periods of time. It takes only a few seconds to plant a seed, it takes some degree of patience then to nurture and protect it, but by far the greater determinants of what happens in the end come from the soil, the weather and the sun.

When, for example, I read a passage of Scripture I am sowing seeds. When I perform acts of kindness as a result I water that seed. My heart’s garden then benefits with flowers and fruit because of the rich nutrients of the spiritual soil and the energising power of the divine sun. By analogy, these fruits yield further seeds that I can plant if I have the wisdom and caring to do so, and my heart will benefit even further.

I know that the term ‘hearticulture’ could still be seen as one-sided. I’m the gardener and you’re the garden. But in terms of the Bahá’í perspective that would be missing a crucial point: I need to tend my heart, you need to tend yours and we can both help each other in this process. We both can help each other develop a growth mindset, to borrow Carol Dweck’s terminology.

Once we begin to see what this means, every interaction with another human being, or even with an animal, insect or plant, becomes an opportunity to facilitate our growth and the growth of the being with whom we are interacting. And, what’s just as or even more important, they can facilitate ours.

That heart is an anagram of earth just makes the metaphor even more appealing. I have come to realize that hearticulture is my true passion. Everything I do is influenced, perhaps even entirely reducible, to that purpose. I want to understand myself and others better, that’s true, but not just for its own sake, but for the purpose of growth. And if our hearts grow, so will the earth as a whole benefit. When our hearts shrink, the world dies a little. If all our hearts should shrivel completely, the world as we know it would be utterly destroyed. We would wreak such havoc that Hiroshima and Nagasaki would be utterly dwarfed by the consequences.

Basically, I have to learn how to expand my heartfelt sense of connectedness so that it embraces the whole earth. I believe that’s what we all need to learn. I want to learn it too, and as fast as I can, but I have discovered over the years that the metaphor of gardening applies here also in a way. I cannot grow faster than the laws of nature and the limitations of my own being allow. To paraphrase a Bahá’í pamphlet on making the equality of men and women a reality, hearticulture will also take love, patience and the passage of frustratingly long spans of time.

But that is not a reason not to persist in the attempt.

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bss

Three people whom I know well went to boarding school. None of them has much positive to say about the experience. It’s no surprise then really that I should be drawn to a book on the subject. It was far more rewarding than I thought it would be though.

Reading Boarding School Syndrome by Joy Schaverian was like coming home in terms of my sense of vocation at least.

Psychology is close to home. Clinical Psychology is my foster home. Only purely therapeutic psychology is my real home. I left it because I had to if I was to be able to work with experiencers of psychosis independently of psychiatry in the NHS. So, I ended up boarding all my professional life in an institution that allowed me to live as close to my vocation as it was possible for me to get.

How did that happen?

As I came to the end of my degree course I had to begin considering my next step. Emotionally, I was clear. I passionately wanted to become a psychotherapist. I wasn’t sure what kind of psychotherapist I wanted to become, but was swinging between two options: Existential Psychotherapy or Psychosynthesis.

I decided to consult with my tutor. I explained my dilemma and also added that ultimately I wanted to work in the NHS not in private practice. I was stunned by the advice I got.

She said, ‘If you go into the NHS as a psychotherapist you will have to work under the direction of a psychiatrist.’

My extreme scepticism about the medical model made this option completely unacceptable.

‘What should I do then if I want to work within the NHS?’

‘I think the best option,’ she said, ‘is to become a clinical psychologist.’

I went off in a state of frustration and shock to explore this idea. In the end I went with it, thinking that when I’d got my clinical qualification I could always do my psychotherapy training. For reasons I explain elsewhere this never worked out.

It’s ironic then that a Jungian text on boarding schools should have reminded me now so movingly of what I had had to leave behind all those years ago.

This will be a very personal review therefore of what more objectively speaking is an extremely important book in terms of what it says about our society, as well as about the lives of those who have suffered from its collective blindness, as it consigns its children to a childhood of bereavement and virtual imprisonment in the illusory hope of giving them a ‘good education,’ a positive start in life and a leg up the competitive ladder.

All the way through this book I was moved to discover echoes of my own or my clients’ experiences in life.

Laura

One of the first examples that I came across was on page 50:

Those whose experience of boarding schools was traumatic may not take their own stories seriously; even as adults they may disregard their own suffering. As children there were no words to articulate the abuses they suffered and they were unable to tell their parents. There was no adult witness to confirm that the treatment they received was wrong.… A child usually assumes his or her experience to be the norm, especially when it was shared with others who took their suffering with apparent stoicism and without complaint. Therefore, it is often difficult for the adults in psychotherapy to recognise that the treatment they received was wrong. This may also explain why parents, themselves ex-borders, may not have ‘known’ what their children where enduring.

This reminded me strongly of Laura’s experience, a lady I worked with for a number of years. Her diagnosis was endogenous depression (ie deep sadness with no obvious cause).

She initially had no sense that life had given her any reason to be depressed. She was an articulate lady who gave clear descriptions of her history, which included a basically contented childhood, and of her current feelings, which were often suicidal, though she did not understand why.

However, some part of her mind knew perfectly well where the problem really lay and recognized its exact nature. This awareness broke through in the metaphorical form of her dreams, a psychotic experience we all share at night whether we remember them or not.

An Interrogation Room

An Interrogation Room

One day, she spoke of a recurrent dream she was having. With variations, it was of being in a room with Hitler’s SS. They wanted information from her and were preparing to torture her.  Before the torture could begin she invariably woke in terror. Following the model I used for my own dreams I asked her to give me a full description of every aspect of her situation in the dream. She described not only the people, but also the size and shape of the room and the kind of furniture that was in it.

Naturally, we focused at first on the people, but, apart from the obvious link of her having been brought up in the aftermath of World War Two, there were no links with the SS officers who were threatening her. The room did not trigger any useful insights either. We were beginning to wonder whether this was simply a childhood nightmare of the war come back to haunt her, when I asked about her associations to the furniture. We were both instantly shocked by her first answer. It was exactly the same as the furniture in the kitchen of the house in which she had grown up.

It would not be right for me to go into any detail about where this led. I imagine everyone can see that the picture she had persuaded herself was real, of a contented childhood, was very wide of the mark. That she had no vivid memory of any one dramatically traumatic incident was because there were none to remember: her whole childhood, as we then gradually came to understand it, had been a subtle form of emotional starvation and neglect successfully disguised for her at least as normal parenting.

god-help-me

Theo

Over a series of chapters Schaverian gives a detailed description of her work with a man she calls Theo, not his real name. Her description of his struggle highlights amongst other things some aspects of the nature of this difficulty (page 81):

It is common for those who have suffered trauma to disbelieve the extent of their own suffering and so it may be difficult for the analyst to believe it. Moreover, the client may feel culpable and so responsible for the abuse. Theo seemed to recognise my compassion for his suffering and gradually some compassion for his own anguish emerged.… He gradually came to accept that these really were abuses and they should never have happened.

Another echo in the text was closer to home. In the previous session he had described a particularly traumatic incident in which the boys in the dormitory could hear a seriously injured man crying for help in the courtyard below, but were too afraid to move or call for help for fear of the beating that might follow if they did. He came to the next session (page 55):

I acknowledged the previous session and how dreadful was the incident with the kitchen staff that he had described. He appeared shocked that I remembered it and reacted physically. It was as if I had physically hit him with something terrifying. Perhaps this is because he had reverted to the way he had survived in the past by repressing and so forgetting the traumatic experiences.

This was just one of many of occasions that he was unable to remember, without prompting, having already disclosed a traumatic experience.

I will move onto where this leads next time.

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Dream GameAs I hinted at the end of the previous post, I don’t think the Transactional Analysis model goes far enough. It helps us develop a reasonable sense of part of the mind’s layout, but it lacks any contour lines to give us a real feeling of its depth.

One of the problems with TA is that it privileges the intellect – our head to use the everyday expression. In a way it has the same weakness as Kahneman’s model, discussed in detail elsewhere. Yes, we can clearly see the importance of distancing ourselves from our gut reactions, which Kahneman in my view mistakenly terms intuition. But, we have only our head to rely on in both these models. I don’t deny that this is far better at making wise decisions than our guts, particularly when complex situations are involved.

The TA psychotherapist who led the group I was in recognised that this emphasis on intellect was a weakness which is why she also drew on Gestalt therapy techniques and dream work in her approach. In fact, when I started to write this sequence of posts I had forgotten that and it was only as I thumbed through a journal I wrote at the time that I saw references to both techniques.

Even with the inclusion of both those methods, and I have given a vivid example in another post of how I used them to powerful effect many years later, TA still did not go far enough, as we will now see.

Star-diagramAn Encounter with Psychosynthesis

There are models that suggest we can and should go one step further at least. We need to be as suspicious about all our thoughts not just some of them. All our thinking is infected or at least influenced by ideas we have never questioned. We need to step back from our thoughts in their entirety just as I had been trying to step outside the prison of my conditioned reactions. Even positive thoughts may not be reliable.

While I was studying for my psychology degree at Birkbeck, I lived in Hendon, not far from the Psychosynthesis Institute. I’m not sure whether that’s what triggered my interest in that particular form of therapy. It may not have been, given the similarity between certain aspects of Psychosynthesis and TA, namely the exploration of subpersonalities. Jean Hardy, in her book on Psychosynthesis – A Psychology with a Soul – explains that (page 38) ‘the concept of subpersonality is a means of approaching… hidden and often seemingly forbidden areas.’

That may have been what drew me to Psychosynthesis, but it was not the main idea I derived from my reading about it.

In the end what captured my attention was the psychosynthesis idea of disidentification. That it presupposes a transcendent dimension including a Higher Self, with which we can get in touch, might have been expected to put me off, given my agnosticism at the time, but it did not seem to. This approach also emphasises the importance of values, which we need to connect with in order to guide our use of will power (yes, Assagioli believes that discredited faculty does exist), but I don’t think that’s what hooked me at the time either.

Assagioli explains (Psychosynthesis – page 22):

We are dominated by everything with which our self becomes identified. We can dominate and control everything from which we disidentify ourselves.

Hardy quotes Assagioli on this issue (page 24):

. . . . the ‘man in the street’ and even many well-educated people do not take the trouble to observe themselves and to discriminate; they drift on the surface of the mind-stream and identify themselves with its successive waves, with the changing contents of their consciousness.

Psychosynthesis places great emphasis on practising disidentification exercises (see image below for an adapted example) so that we can learn how to step back from the contents of our consciousness and operate more calmly and wisely from a more grounded sense of ourselves. This of course immediately appealed to me, given that I was operating in a bit of a cauldron at work and needed to learn how to maintain my composure and presence of mind under pressure.

disidentification-exercise

Existential Psychotherapy

However, this was not the end of his influence. Assagioli himself, in the opening pages of Psychosynthesis, prompted me also to look at Existential Psychotherapy. At first I was only really aware of the importance this approach attached to meaning and choice: the perspective changing insight from existentialism came much later as I will explain in the next post. At this point in the development of my thinking I could see the importance of both meaning and choice, but somehow the existential approach to meaning seemed to ring a bit hollow.

Ernesto Spinelli’s valuable exploration of existential therapy – Demystifying Therapy – contains a passage that highlights what was the problem for me (page 294):

. . . . we are confronted with the meaningless of it all. The meaninglessness refers to the idea that nothing – not you, nor I, nor any ‘thing’ – has intrinsic or independent or static meaning. If things are ‘meaningful,’ then they are so only because they have been interpreted as being so. . . . . . Each of us, if we follow this line of argument, does not inhabit an independently ‘meaningful’ world – rather, we, as a species, as cultures, and as individuals in relation to one another, shape or create the various expressions of meaningfulness that we experience and believe in.

This sounds rather like Don Juan, the Yaqui Indian, in Carlos Castaneda’s series of books: in explaining the way of the warrior, he argued that the best we can do is achieve a kind of ‘controlled folly’ by investing meaning in the meaningless.

A warrior must know first that his acts are useless, and yet, he must proceed as if he didn’t know it. In other words, a warrior must know he is unimportant, but act as if he is important.

A Moment of Choice

I was struggling to discover where I stood on this for the whole time I was earning my BSc degree. Does life have a meaning or doesn’t it?

As I came to the end of my degree course I had to begin considering my next step. Emotionally, I was clear. I wanted to become a psychotherapist. I wasn’t sure what kind of psychotherapist I wanted to become, but was swinging between two options: Existential Psychotherapy or Psychosynthesis.

I decided to consult with my tutor. I explained my dilemma and also added that ultimately I wanted to work in the NHS not in private practice. I was stunned by the advice I got.

She said, ‘If you go into the NHS as a psychotherapist you will have to work under the direction of a psychiatrist.’

My extreme scepticism about the medical model made this option completely unacceptable.

‘What should I do then if I want to work within the NHS?’

‘I think the best option,’ she said, ‘is to become a clinical psychologist.’

I went off in a state of frustration and shock to explore this idea. In the end I went with it, thinking that when I’d got my clinical qualification I could always do my psychotherapy training.

Spirituality

In re-examining my diaries of the period in which I was doing my Clinical Psychology training, I came to realise that my world-view was fundamentally changing in a way I had failed to remember. I thought I was still resolutely agnostic at least if not downright atheist during all this time. It seems that this was simply not the case: my reality was slightly more complicated. I find the word ‘spirit’ occurring far more often in my journals of this period than I would have expected. The reason for that seems to have been my exploration of Buddhism.

Osho-Buddha-MAJJHIM-NIKAYAI can still remember the day I stood in front of the Surrey University library shelves and took down a book on Buddhism. Memory says I did this because I’d had a heads up about how sophisticated the Buddhist model of the human mind was. This may have been the case. It may have been more complicated than that at the unconscious level, in that my aunt, by then in her late 80s, had asked me to investigate Roman Catholicism again and, refusing to see a priest, I had agreed to look at a book on the subject, pulled down from shelves in the same section of the library.

Whatever the reason, I not only read about Buddhism, I also visited the Buddhist Centre in London and attended classes on meditation. I can locate this accurately in time as I was in the first year of the course doing my child specialism placement. By the 11 January 1981 I was taking detailed notes from Alan WattsThe Way of Zen. My comment on my reading up to that point may be revealing:

That reading stemmed from my need for some moral or value focus in my life. Interesting that in 1792 the Retreat in York was founded by Tuke, a Quaker, on moral principles not knowledge, and yet achieved so much so far ahead of its time for ‘lunatics.’ And yet so much harm has been done by fanatics in the name of various moralities. Only a life-centred rather than idea-centred morality will serve. Buddhism comes closer than any I know.

A fortnight later, while reading Christmas Humphreys‘ book, my thinking has moved on:

Even being committed to the “right” side in a battle… blinds my mind to the transcendent realisation that both sides are in the last analysis one. Best to tend the wounded of both sides than fight, even for freedom!

I was already showing strong reservations about the limits of psychology and responding strongly to Buddhism:

I will continue to think about Buddhism. It’s shedding an unbelievably clear light on my problems and giving me the strength to cope with them.…. People and their welfare are more important than the sterile ideas peddled on the course, more important than any ideas at all in fact. I can at least use the experience of the course better to understand my fellow human beings and myself under stress – it won’t be wasted.

A year later I seem to have achieved a more harmonious perspective:

My life is slowly becoming simpler, more integrated, less fearful. I can see how poetry, psychotherapy and Buddhism fit together. And perhaps how they all cohere with my personal life.

More on my struggles to learn how to meditate next time and on one of the epiphanies that helped shift my perspective radically.

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It seems a good idea to republish this sequence from almost four years ago to complement the current new sequence on collaborative conversation. This is the first of six.

Some Background Thinking

I thought it was about time I tried to do a post on the work I did for most of my professional life. It could be tricky and might not work out at all.

I have been struggling for ages — at least ten years —  to capture in words the work I used to do. Words like therapist and therapy make me uncomfortable. Even the word counseling implies unequal distributions of wisdom. She who gives counsel is somehow superior to him who receives!

I have come to believe that what I did is best called mind-work. It includes mood-work, belief work and will-work: it should have included ‘soul-care’ but that would have been a step too far for a clinical psychologist’s job description even though ‘psyche’ means ‘soul’ to the Greeks.

Everyone does mind-work up to a point. It’s a bit like cooking though. Almost everyone prepares food at some point in his life but not everyone’s a chef. As a professional mind-worker I was a bit like the chef. I was an expert at the work at the same time as the people who worked with me as clients were experts about their own minds.

Because, to do mind-work, I drew on lots of other disciplines and traditions, including philosophy, psychology, biology, religion (especially Buddhism and the Bahá’í Faith) and the arts, I could sometimes feel like giving myself a fancy title such as psy-culturalist. This captures the richness of the traditions I could draw on and also captures the essential purpose of mind-work which is growth. It also meant I didn’t have to label myself a psychologist with its one-sided implication that I study the mind but don’t work with it, nor did I have to call myself a Clinical Psychologist with its implications of illness and therapy, which are insulting to the client.

Psy-culturalist, as a term, has a similar problem to Clinical Psychology. If we think about gardening, it’s a one-way street. Plants, as a general rule, don’t grow people. Mind-work, though, is both reciprocal and reflexive. I grow you and you grow me and we grow ourselves as well!

In the end then mind-work is a perfectly good description.

Mind-work for the most part involves forming a relationship (much more on that later) that allows words to be used in a process of collaborative conversation (the title of a book chapter I contributed to This Is Madness) to enhance meanings in a way that enables all participants to grow. As I see it every human interaction is an opportunity for mind-work and as many interactions as possible should be used as such. Even the groups of people who traditionally have been seen as experiencing meaningless lives, such as those with a diagnosis of schizophrenia or dementia, are not to be excluded from this meaning-making growth process. My work has mostly been with the former group and what follows discusses some implications of that. For me though, everybody means something and to deny that is to dehumanize us.

Perhaps it is important to clarify something. I use the word mind to cover a wide variety of possibilities. Consciousness is only one of them. Many important processes take place outside the circle of light shed by conscious attention. Mind is also where the body is experienced and shares a two-way relationship with the brain, so the realms of the physical are not excluded. The mind is a node in a sociocultural network and is affected by many wider systems which it maps and responds to in a variety of ways. No mind is an island! There is also strong evidence that the mind can operate independently of the body/brain (See Jenny Wade’s Changes of Mind, Ken Ring’s Lessons from the Light and David Fontana’s Is There an Afterlife? as well as posts on this site about the afterlife hypothesis for more detail about that.)

There are differences that should not be obscured. A psychologist is paid for her mind-work: her client is not. That is one difference which can create an undesirable power-differential if great care is not taken to counteract that tendency. Another difference lies in the fact that the client is the expert, as I have said, in his own mind: the psychologist is the expert when it comes to the nature of the work in some of its aspects. That is the only other difference. Both can grow as a result of the mind-work they do together.

That should be enough to set the scene for the exploration of my way of working that follows.

The Client’s Perspective

In 1996 I interviewed someone who had gone through a series of conversations with me about his voices. He was a former miner and an ex-army man from the Welsh valleys. He was articulate but down-to-earth. What he told me enriched my way of doing things considerably and shed a great deal of light into previously dark places. We made a video together, from which the photo  below is extracted but without showing his face, and he was very keen that it be used to help others understand this kind of problem better. At the time of the videoed interview we had been working together for about six months. There was still a long way to go but much of interest had happened. I will call him Ian to protect his identity.

Perhaps most importantly, he emphasised the role of trust.

P.: And it was in November that we first met, wasn’t it?

I.: Yeh. Jenny [his residential social worker not the author of the book recommended above!] had started talking about you, you know? And it was coming up to the meeting with you. And I can remember going to the meeting with you that first time. And I can remember thinking who’s this bloke asking me all these questions, you know? And I didn’t trust you. But Jen was persistent that I could trust you, so I decided to trust Jenny and to talk to you.

P.: And you actually asked if Jenny could come to sessions, didn’t you?BM & PH

I.: Yeh, I asked if Jenny could come, yeh.

P.: Right. And I think she came about the second or third time you came.

I.: Yeh.

P.: And did you feel more comfortable with her there?

I.: I did, yeh.

P.: And did that make you feel more able to begin to trust me at least personally if not what I was doing?

I.: It took about a month to start to trust you. And that was with Jenny backing you up.

This cannot be stressed too much. Trust takes a long time to build and is easily lost. In Ian’s case Jenny who had worked with him for years and vouched for me assisted the development of trust. In a “delusion” exercise I use in workshops we can see how a period of unsympathetic and confrontational treatment at the hands of other people makes it harder for someone to believe we are not going to be the same. We need to prove our trustworthiness over a period of time. We need to be prepared for hostility at worst and the cold shoulder or evasion at best in the early stages of our relationship. We would be wise not to assume that such behaviour is the result of “paranoia.” It is at least as likely, if not more so, to be a natural reaction to months if not years of other people’s outspoken incredulity.

What also was important to the success of my work with Ian was all the effort Jenny put in in-between times.

I.: It took about a month to start to trust you. And that was with Jenny backing you up.

P.: And that was by being there in the sessions and by talking to you between whiles wasn’t it? You used to have meetings and discussions with her between times.

I.: Inbetweentimes, yeh. And we’d talk about what we’d talked about, you know? And she supported you in what she said.

She helped him remember what I had said or correct his distortions of it. She encouraged him to make use of the suggestions we had come up with. She helped him make sense of what was happening to him in the terms I had described it. Isolated mind-work sessions will achieve little if they are not reinforced and supported by a lot of work in-between.

We will hear much more from Ian in the next post.

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Heart to heart

Humanity’s crying need . . . . . calls, rather, for a fundamental change of consciousness, for a wholehearted embrace of Bahá’u’lláh’s teaching that the time has come when each human being on earth must learn to accept responsibility for the welfare of the entire human family.

(From a message of the Universal House of Justice to all those gathered on Mount Carmel to mark the completion of the project there on 24th May 2001)

I had a recent deep discussion with an old friend (of course, I mean old in the sense of ‘known a long time.’) We are close in many ways. We share a similar sense of humour and many core values. However, we are hugely different in our interests – hers practical, mine theoretical – and temperament – she, extravert: me, introvert.

She was completely unable to understand how I could combine a deep love of nature with a completely passive attitude to gardening.

I gave into the temptation to react, which generally involves treading on dangerous ground and attempted to point out that she similarly fails to understand why I spend so much time and energy reading and writing, even though she values some of the ideas that come out of all that effort.

I referred to her passion as horticulture. It’s then that the concept of ‘hearticulture’ came to me in a flash, as a good way of contrasting our intense enthusiasms.

This idea has had a long gestation period though.

First of all there was the slogan used many years ago in the Bahá’í community ‘Uniting the World: one heart at a time’ with the logo that accompanied it (see picture at the head of this post). I used to joke that this meant we were involved in heart-to-heart resuscitation.

Then there was the idea of ‘psy-culturalist’ which I coined in my discussion of my approach to mind-work, more specifically working with those who were experiencing distressing and abusive voices and the delusions that sometimes accompanied them. I wrote:

Because, to do mind-work, I drew on lots of other disciplines and traditions, including philosophy, psychology, biology, religion (especially Buddhism and the Bahá’í Faith) and the arts, I could sometimes feel like giving myself a fancy title such as psy-culturalist. This captures the richness of the traditions I could draw on and also captures the essential purpose of mind-work which is growth. It also meant I didn’t have to label myself a psychologist with its one-sided implication that I study the mind but don’t work with it, nor did I have to call myself a Clinical Psychologist with its implications of illness and therapy, which are insulting to the client.

Psy-culturalist, as a term, has a similar problem to Clinical Psychology. If we think about gardening, it’s a one-way street. Plants, as a general rule, don’t grow people. Mind-work, though, is both reciprocal and reflexive. I grow you and you grow me and we grow ourselves as well!

Flowers near the Shrine

Flowers near the Shrine of the Báb

Thirdly, there was all my pondering on the issue of the ‘understanding heart.’ In that process I attempted to unpack some of the implications of a key image in the Bahá’í Writings: the heart as a garden. I wrote:

The garden image implies that many of the processes that promote spiritual development have a far slower pace than either light or fire would suggest. The image is also powerfully suggestive of how the processes of spiritual growth are an interaction between what we do and what is accomplished by infinitely greater powers that work invisibly on the garden of the heart over long periods of time. It takes only a few seconds to plant a seed, it takes some degree of patience then to nurture and protect it, but by far the greater determinants of what happens in the end come from the soil, the weather and the sun.

When, for example, I read a passage of Scripture I am sowing seeds. When I perform acts of kindness as a result I water that seed. My heart’s garden then benefits with flowers and fruit because of the rich nutrients of the spiritual soil and the energising power of the divine sun. By analogy, these fruits yield further seeds that I can plant if I have the wisdom and caring to do so, and my heart will benefit even further.

I know that the term ‘hearticulture’ could still be seen as one-sided. I’m the gardener and you’re the garden. But in terms of the Bahá’í perspective that would be missing a crucial point: I need to tend my heart, you need to tend yours and we can both help each other in this process. We both can help each other develop a growth mindset, to borrow Carol Dweck’s terminology.

Once we begin to see what this means, every interaction with another human being, or even with an animal, insect or plant, becomes an opportunity to facilitate our growth and the growth of the being with whom we are interacting. And, what’s just as or even more important, they can facilitate ours.

That heart is an anagram of earth just makes the metaphor even more appealing. I have come to realize that hearticulture is my true passion. Everything I do is influenced, perhaps even entirely reducible, to that purpose. I want to understand myself and others better, that’s true, but not just for its own sake, but for the purpose of growth. And if our hearts grow, so will the earth as a whole benefit. When our hearts shrink, the world dies a little. If all our hearts should shrivel completely, the world as we know it would be utterly destroyed. We would wreak such havoc that Hiroshima and Nagasaki would be utterly dwarfed by the consequences.

Basically, I have to learn how to expand my heartfelt sense of connectedness so that it embraces the whole earth. I believe that’s what we all need to learn. I want to learn it too, and as fast as I can, but I have discovered over the years that the metaphor of gardening applies here also in a way. I cannot grow faster than the laws of nature and the limitations of my own being allow. To paraphrase a Bahá’í pamphlet on making the equality of men and women a reality, hearticulture will also take love, patience and the passage of frustratingly long spans of time.

But that is not a reason not to persist in the attempt.

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My story diag 1

As I’ve said in an earlier post, I was asked if I had prepared an account of how I came to join the Bahá’í community. I’ve now completed the story at least in draft. I was planning only to send it quietly to the Bahá’í Histories website and leave it at that, in the hope that very few would read it outside the Bahá’í community. But then I wondered why I should be so quiet about it. Yes, I think it’s a fairly ordinary story about a fairly ordinary person, and to that extent, why go public? But then also it is just about the most important thing that ever happened to me and connects very closely to two of the other most important events in my life. So, I thought, ‘Share it and see what happens.’ It might do some good and probably won’t do any harm. So here goes.

Religious conversion runs in my family and from childhood I was familiar with its potential consequences, all of which tended to inoculate me against religion rather than draw me towards it. This is one of many threads in my life linking to my decision to join the Bahá’í community. For anyone who gets lost as I unravel the tangled knot they create into a narrative of sorts, there is always a slowly evolving diagram at the top of the post to convey some sense of where we’re up to!

My mother, who came from a family of Catholic converts, had married a man from a staunch low church Protestant family, most of whom promptly disowned him. I never met two of his sisters until they came to our house for the funeral after my father died. This contributed to my disillusioned view of religion, which had begun to develop at a very early age.

In the year prior to my declaration in 1982 my deceased mother’s last surviving sibling, my Aunt Anne, urged me to talk to a Roman Catholic priest. She hoped that I would at last return to the one true church as she saw it.

AA

Aunt Anne

I told her, I hope gently, that I was not prepared to talk to a priest but that I would read about Catholicism again. My strongest association with the priesthood from my early years was, possibly unfairly, with the eschatological preachers I had heard, ranting after the manner of the hell-fire sermoniser in James Joyce’s Portrait of the Artist as a Young Man. The one I remember best had been a boxer in his younger days and was reputed to visit the homes of his less enthusiastic parishioners and drag them out of bed to Mass. Both these details could well have been apocryphal but they influenced my attitude strongly at the time. Apart from such stereotypes I had not internalised a clear sense of what a priest might be as all that remained in memory of all the other priests I had come across was a blurred palimpsest of mildly authoritarian impressions. I’d certainly few if any positive experiences to draw on and none had stuck in my memory, not even from my confirmation classes.

What I had read later of the way the church treated its unorthodox members such as Gerard Manley Hopkins, Teilhard de Chardin and Hans Kung did not encourage me, a self-styled rebel at the time, to feel I would get much joy out a conversation with someone from the Catholic mainstream.

My aunt was saddened with my answer. Their parents, hers and my mother’s, had converted to Catholicism in the Nineteenth Century as a result of what was called the Oxford Movement under Cardinal Newman’s influence. They had been quietly passionate about their faith, and my aunt was their eldest daughter and loyal to their memory to the last.

As I had promised, I read a book about the faith I had left behind at the age of sixteen and remained as unimpressed as ever. Even earlier than sixteen my doubts had been aroused about the reliability of the Church’s teachings. My first communion in my early teens, for example, was a great disappointment to the part of me that wanted to believe, and compelling reinforcement of the case being made by the sceptic within, who had been steadily gaining ground as adolescence progressed. It was a decisive experiment in a way: would the host taste of bread or flesh? It was definitely a raw dough flavour.

Another time, when I was much younger, possibly marks one of the earliest roots of my doubt. It was an experience in church when I was very young – maybe five years old or so. Everyone was bowing down at the same point in the Mass and I asked my mother in a whisper why they were doing this and she replied, in a way which she thought fitting for my age and degree of understanding, ‘Because it’s too beautiful to look at.’

This was a challenge too difficult to resist. Something that beautiful and I couldn’t look! This I must see.

And I looked up and I looked round everywhere. The only objects I could see were the same old altar, the same old pictures of the stations of the cross, the same old man in a funny dress standing in front of the altar.

The only difference was this big round golden thing he was holding above his head. This seemed to be the object everyone was bowing to, but I didn’t get it. It was quite pretty but definitely not too beautiful to look at.

In any event my faith was possibly not of the strongest, as I had not gone to a Catholic school, as was usually the case, perhaps because my parents were of different views about the wisdom of that, though I never really knew why my mother had departed from tradition in this way. So, it was not too difficult to undermine more or less permanently the ambivalent faith I had developed by this impressionable age.

By the time I was in the second term of my clinical psychology MSc in early 1981 at the age of 38, which was when my aunt had made her request, my sceptical antipathy to any kind of church had a long history and very deep roots.

Even so, I did take a further step that summer and read a book on the world’s religions by Trevor Ling, honouring the spirit of my aunt’s request if not the letter. I stopped when I had almost finished a Chapter on Islam in the modern era and before I had read the section on the Bahá’í Faith. I only read the book through to the end after I had declared my intention of trying to become a Bahá’í. This was fortunate in that, if I had read that version of the Bahá’í religion before I read the book that drew me to the Faith, I might never have bothered to investigate any further. It felt almost as though I had been steered away from what would put me off. I reverted to reading about Buddhist psychology and practising meditation, neither of which confronted me with the need to believe in a god – but more of my relationship with Buddhism later.

There were two other curious facts worth mentioning here before we reach the critical point.

First of all, there was another way in which I appear to have been steered away from a possibly off-putting encounter with the Bahá’í Faith. My clinical training was at Surrey University. One of the clinical tutor’s was a Bahá’í. However, my cohort of trainees was not impressed with some of the ways in which the course was being run and we were all rather disillusioned with the staff who were defending it, of whom this Bahá’í was one. I never discovered, in the whole two years I was there, that he was a Bahá’í. This only became apparent to me when I joined the Bahá’í community after I had qualified and left the course.

Secondly, much of my second year from late 1981 onwards was a very testing time. I was undergoing significant upheavals in my personal life and, perhaps as a result of the distress I was feeling, had also made at least one very poor decision, which impacted adversely on others as well as on myself. I was extremely distressed by all this, particularly because I had brought some of this on myself and could also see how others were suffering too. By Christmas, I knew I needed help to sort the situation out and rectify what I could in terms of damage done, but I couldn’t see where to turn.

To my astonishment, in early January 1982, I found myself alone in a snow-bound cottage in the middle of Sussex, a complete unbeliever as I thought, on my knees in tears saying, ‘God, if you exist, please help me now.’ It was a short prayer, if prayer it really was, but it was undoubtedly intensely felt. I was on my knees a lot longer than it took to say those improbable words.

I set about putting the situation right and found the means to do so, working at rectifying it over a period of many months. I qualified as a Clinical Psychologist that September. I started looking energetically for work. During this period of unemployment I read a lot and, as my interests were wide and I lived halfway between two massive libraries, one in Hendon and the other in Swiss Cottage, I was never short of reading matter.

Books had always been my most reliable and supportive companions in times of stress, illness, loneliness and boredom. This dated back to childhood when long absences from school were made bearable by Rider Haggard, G A Henty, Baroness Orczy, Conan Doyle, G K Chesterton and many others. Not surprisingly, books helped me through the frustrations of job-seeking.

I had no idea quite where this lifelong passion was about to lead me.

Hendon library

Hendon Library in the snow

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