Thursday, November 30, 2006

Modes of Engagement 2: An Interpersonal Contact Work Exercise

Entry for November 29, 2006 (Back in Glasgow):

Part 1. Introduction

We continued training in different client modes of engagement today. Last time, we did exercises on Attending and Experiential Search, using elaborations of the old Gestalt Zones of Awareness exercise.

Tonight we did an exercise on Interpersonal Contact, defined as: Working in the therapeutic relationship by revealing to the therapist hidden or private aspects of experiencing (memories of previously untold events, here & now bodily sensations or emotions, private or secret thoughts, feelings or wishes, including about therapist); trusting, opening up to therapist; being present/transparent/ real/vulnerable to the therapist; (“Here’s what is difficult for me to say to you…”).

Part 2. Exercise: Interpersonal Contact/Secret Sharing. [The following write-up is a revision of the original instructions based on what actually happened:] The point of this exercise is to reveal hidden, private, embarrassing or tender aspects of yourself by trusting or opening up to therapist or the group. As far as feels safe to you, try to be present/transparent/real/ vulnerable to the therapist or group. Here are the instructions:

a. Take out a piece of paper, and write at the top of it, “Here’s what is difficult for me to say to you…”. Then take about 5 minutes to write down any or all of the following that come to you and that you feel safe enough to possibly share.

-Previously untold events: Things that have happened to you or that you’ve done, that you’ve few people, or maybe even nobody. (Perceptual/Situational)
-Here and now body sensations: Sensations you’re aware of in your body right now that you wouldn’t necessarily tell most people. (Bodily/Expressive)
-Here & now feelings about therapist/other group members: Hard-to-share emotions you are feeling right now about the therapist/ other group members, or yourself in relationship to them. (Experienced Emotion)
-Private thoughts: Things you’re thinking to yourself (words, ideas, images) about the therapist/group members, or yourself in relationship to them, especially things that are hard to share. (Conceptual)
-Secret wishes: Secret desires, aspiration, dreams, ambitions that you generally protect by keeping them to yourself. (Motivational/Behavioral)

After you have written down your secret topics, review each one, asking yourself, “Do I feel safe enough to share this with this person/group of people tonight?” Put a star by the topics that feel safe enough to share, then pick one to share with the group/other person (you can share more than one if you want and the group decided to do that).

b. Select a format to use:
-One-to-one: Take turns sharing one or more of your secrets.
-Small groups of 5-6 people: Take turns sharing in a group.
-Group secret pooling exercise for 5-6 people: Fold your secret list twice, in quarters. Put it into a hat or other container. Mix the secret lists up. Take turns drawing one secret list. When it’s your turn, share one of the secrets with the group as if it was your own.
-Alternative one-to-one exercise: For those who do not feel comfortable with one of the above exercises, form small groups of 2 –3 and take turns exploring your sense of boundaries in therapy and other relationships: what kinds of things you feel safe sharing, what you don’t, etc.

c. In the client role: When it’s your turn, experiment with sharing one of your secrets. Pay attention to what it feels like to reveal the secret you’ve chosen to share; also, pay attention to your experience of not sharing the other secrets.

d. In the therapist/other group member role: Respond to the client in two ways: (a) By reflecting their secret back to the client in an accepting way, or (b) if you wish, by giving a self-disclosure of your own (that is, of a similar experience, of a personal reaction to what the client has said, or a personal reaction to the interaction). Note: If you choose to share a different perspective that is at variance with your client’s experience, make sure that you finish your response by adding a solid empathic response of their experience. This reduces the possibility that the client will feel judged or invalidated.

e. Take turns sharing secrets for 30 – 60 minutes, depending on the size of the group.

f. Afterwards, process the experience by discussing what it felt like to share or not share secrets. What issues came up in doing so? What did you learn from the process? How did the process unfold over time?

Part 3: Issues that may be raised by doing the Interpersonal Contact Work Exercise:

Spoiler Alert: In this part of the entry, I describe a few of the issues that may come up in doing the Interpersonal Contact exercise described in the previous blog entry. If you are planning to do this exercise in the near future, it might be best to wait until after you do so before reading this entry, in order to experience the exercise in a fresh way.

* * *

In fact, this exercise allows participants to experience what we ask clients to do in every session. Therefore, it can enhance empathy for the client’s immediate in-session experience.

The exercise also promotes experimentation with different kinds of appropriate therapist self-disclosure, including (a) Therapist Life Disclosure (also known as “me-too self-disclosure, cf. Goodman), (b) Client Content Reaction Disclosure (to the client’s story or content), or (c) Interaction Reaction Disclosure. (I am indebted to Jutta Schnellbacher at KU Leuven for formulating these kinds of therapist disclosure, including one other: Personal Clarity Disclosure about therapist intentions, limitations and therapeutic processes.)

Participants are also likely to learn more about their personal boundaries from doing the exercise, what is OK to share in each role, and what is not. Both things said and things not said are important.

Participants described a spiral process of deepening disclosure within groups. This process requires adequate time to unfold.

It is important for participants to have choices in how to participate in this exercise. In fact, participants who find that their boundaries don’t allow them to participate can get just as much from the exercise by exploring their process and experiencing the empowerment of being able to say no. For this reason, it is important to honor and support such hesitation.

The exercise does a good job of helping participants access different forms of shame. Shame is a basic, biologically significant, emotion, and can occur in a variety of forms: primary adaptive (related to maintaining connections to one’s community), primary maladaptive (overgeneralization of past humiliation to present nonevaluative situations), secondary reactive (reacting to other emotions such as anger with shame), and instrumental (deliberately displaying embarrassment in order to impress others of one’s moral character).

1 comment:

Anonymous said...

Hi Robert,
Looks like an interesting exercise. I'll try it with the student therapy groups.
Sorry I couldn't say goodbye to you on tuesday.
Take care!
Groetjes uit Belgiƫ,