Tuesday, May 31, 2011

Late May Update: Quantum Change?

Entry for 31 May 2011 (61st Birthday):

After a quiet few weeks in April, things got very busy again and May has flown by with many trips and activities. I can’t believe that it’s been five months since my last update on the state of my recovery and how my life is going generally, but there you have it.

I saw the surgeon and his team at the end of April: They liked what I told them about my functioning, and were particularly impressed that I was once again running my full distance. Then the important thing: they had me tested for PSA again, and eventually, after a couple of weeks, I got a letter saying that my PSA score was still undetectable. This is a great relief.

I've been back to work full time since January, trying not to work too hard while still keeping reasonably on top of things. My colleagues, and indeed all my fellow academic staff members whom I’ve talked to, have also been struggling to stay on top of our workloads in an ever-changing, under-resourced work environment. After deliberately avoiding much in the way of travel during January and February, while we tried to sort out what to do about our immigration status, I over-did things in March, although April was more reasonable. I'd been running regularly, 3 times a week, gradually increasing how much of my course I ran as opposed to walking. As the weather improved and the days got longer, I began riding my bike to work, which turned out to be no problem at all.

My energy has been good and has continued to improve. At this point, it feels like I've got 95% of my life back. I made a big improvement in the incontinence at the beginning of January, but after that I didn’t see much change until early May. I was doing well enough to mostly function, but couldn’t handle standing for long periods of time, so all my teaching and presenting at conferences has had to be done sitting down. Walking quickly in particular was difficult, and I’ve found that overwork and sleep deprivation make it worse.

This was the situation at the end of April. Then, we had old friends from Australia, George and Joy, come for a visit, and we made a trip back to the Kilmartin valley, with its dramatic standing stones, cairns and stone circles, challenging me with hours of walking around and scarce toilets. I didn’t do so well, but got frustrated with my lack of progress … and made another big improvement.

In both instances, there was a moment of insight about how to handle my body: I suddenly saw that the muscles I’d been exercising and trying to use weren’t exactly the right ones but that if I just did it… this way, it worked much better. It’s hard to explain; my granddaughter Mizuki probably understands exactly what I’m trying to say, although she wouldn’t be able to put it into words it either. (She has a good excuse: She can’t really talk yet.) The closest analogy I’ve been able to come up with is the old game/puzzle we had as kids, called Roll-Up, where you had to a roll a metal ball uphill by squeezing it between two metal rods. When I was about 10, we got this for Christmas, and I spent hours and hours trying unsuccessfully to do it. Then one day, it just worked: there is something to it about using just the right pressure – not too much -- to keep the ball rolling up hill, but it is impossible to put into words. Anyway, this is very like that: just the right amount tensing of the just the right muscles, and voila’, I can stand and walk for 30 minutes or even an hour with little problem. Of course, it takes continuous effort and some degree of concentration, so over time it’s pretty tiring to do this, and it gets harder as I get more tired. But still: another big improvement. Quantum change!

This is of course a great relief, and I continue to feel extremely grateful for my situation. Nevertheless, I am determined not to take this lightly and will continue to act as though the cancer is still present but at very low levels. In other words, I plan to continue to take care of myself, take most of my nutritional supplements, get at least 7 hrs of sleep a night, exercise regularly, and generally avoid stressing myself out.

In general, though, I’ve been feeling pretty happy for the past few months. It feels like I have a new lease on life. I find myself whistling. Yesterday I ran 10K and saw a whole row of new 4-story flats along the canal near Firhill Stadium, built since I last ran that far, last summer. Diane and I enjoy hanging out with each other. Absurdly, we are studying to take a UK citizenship test this Thursday in order to renew our visa, and this has turned into a kind of adventure in itself, as we try to memorize ridiculous facts about life in the UK (example: Q: How many people under 19 in the UK in the 2001 census? A: 15 million). The EFT one-day taster workshops I’ve been doing all over the UK have been fun, as have the EFT Level 2 workshops in the Netherlands. The research here continues to be stimulating and interesting. It feels so good to be doing actual process research with recordings of sessions rather than always working with self-report. For example, one of my MSc students, Sarah Shaffner, has done a descriptive study of the characteristics of six carefully-identified Relational Depth events; she’s found that intense emotional contact between client and therapist appears to be the key to these events, but also that therapists and clients don't seem to be able to stay with them.

So the work is good, and so is the living. There is, of course, too much to do. I’ve given up trying to answer all my email, opting instead for a system of prioritizing it and letting the rest pile up. Some things will have to slide. I can only do my best within my limits. Trying to do more than that seems to make it all unpleasant and to take the life out of what I do. None of us knows exactly how much time we have, so it’s really important to take each day as a gift, to do the best with that I can. To quote TS Eliot: “The rest is not our business”.

Sunday, May 29, 2011

Saturday Adventure: Sharmanka, Friends, and St. Andrew’s Catholic Cathedral

Entry for 28 May 2011:

I’ve been travelling a lot the past few weeks, so it was a relief to be able to get back to a proper Saturday Adventure this week. After a slow morning, we set off for the Glasgow city centre, to see St Andrews Roman Catholic Cathedral, recently reopened after extensive renovations. However, after various delays and wading through the Saturday afternoon crowds on Argyle Street, we got to the Cathedral just as people were going in to the 1pm mass.

Instead of going in and having an hour or so to kill before a scheduled visit to Diane’s friend Juli’s, we wandered back up away from the river. ending up at the art space at 103 Trongate for something completely different, which a friend had told us about a couple of days earlier:

The Sharmanka Kinetic Theatre is one of the strangest, most eccentric, evocative and enthralling art exhibits I’ve even seen. It features 20-plus separate mechanical sculptures-cum-theatre-pieces, by Eduard Bersudsky, a Russian wood-carver, junk-collector, gadgeteer, and allegorist. We arrived, by accident, just in time for the 1pm show. We paid our entrance fee, the lights went down, and for the next 35 minutes one piece after another lit up and different bits – cables, chains, wooden figures, bicycle wheels, sewing machine treadles, old fashioned typewriters, pieces of pipe etc etc -- began moving up and down, back and forth, round and round, while appropriately evocative music played. Each piece is a world of its own, evoking a set of emotions, and often unfolded a narrative: a leave-taking, a painful episode in Russian history, a journey, a fantasy novel, an old movie, and so on. The pieces mix sacred and profane, mechanical and organic, and humor and tragedy. What a find! Who knew such a thing existed, right here in Glasgow. For more (including videos), go to http://www.sharmanka.com/

After this, we took the train south of the river to see Juli and Tony. Tony injured his leg and is currently stuck at home, with Julie looking after him. We took a bunch of flowers and the Sharmanka flyer to cheer them up. After tea and cake, Juli gave me the Tour of the house, which is an Alexander “Greek” Thomson property, dating from about 1860, quite spacious, with lovely fire place fittings and has a great view over south Glasgow.

After that we thought we’d try St Andrew’s Cathedral again, this time arriving by accident about 15 minutes into their 5.15pm Saturday evening mass. This time, we went in and sat down in one of the pews, listening and joining in with the service while we absorbed the renovated interior. No more heavy, dark nave: They’ve lightened the walls, which are now a honey colour, and run broad spiraling ribbons of gold-leaf and trefoil up the inside columns; the bosses in the ceiling have been painted green, blue, red, again with gold leaf. There is now lots of natural light and in the left aisle there is a striking, El Greco-like painting, by Peter Howson, of Roman Catholic Glasgow martyr St. John Ogilve. It was lovely just to sit there in this new-old, clean-feeling sacred space, listening to the words and music and absorbing the feel of the place. Afterwards, we wandered for a bit through the brand-new cloister space, in the centre of which is an installation consisting of a set of tightly spaced stainless steel reflecting plinths, with a small channel of water running among them, like a small forest of space-age standing stones.

Afterwards, walking back to Central Station and on the train back to Hyndland, I let the feeling the day wash over me This was one of our best Saturday Adventures ever: blending curiosity/wonder, the pleasure of company, and the peaceful/sacred.

Sunday, May 22, 2011

Orkney Wedding, but First a History of the World

Entry for 14 May 2010

For Louisa and Steve

1. A Brief History of the World as a Search for the Master Motive

Jesus, Plato, Augustine, Bowlby,
And latterly, Lennon all proclaimed,
Love is the force that rules the world.
Freud, at first, reframed this as Sex,
But later, depressed and dying of cancer,
Joined medieval painters of murals,
And early Bergman in the Dance of Death.

In the face of this, the Buddha said,
All is suffering and sought release,
While Greenberg grasped for emotion regulation,
And Nietzsche, Adler, Machiavelli willed
A pecking order of Power and Self.

Others followed: We competed
For Money, and Market; we told ourselves
Everything is Story and Language;
The fruit of the One Tree is bits and bytes,
Knowledge, Reason; Information and Code:
Binary, decimal, genetic, semantic.

Thus we architected the great Archetypes
Of human thought, type-cast ourselves
And others, as players in a theatre of the mind.

Louisa and Steve, what say you to this?
On which of these is your marriage based?

2. Orkney Wedding Journey

Maes Howe, sunrise, the first of May:
Entrance in shadow, cross-quarter day,
Family and friends gather around.
Bending low, you enter the narrow way,
Bury yourselves under the mound.

In central chamber, you strike flint:
Light the flame, reflections glint,
Shadows wave from rooms either side.
Together, you say the old, old words,
Greet old ghosts, barely heard,
People loved and gone before.
Prepare to leave your old life behind!

* * *

Quarter of an hour, which seems a century,
Then we see you emerge, reborn from the cairn,
Hoist you on litters, monarchs of the May,
And carry you on to Ring of Brodgar.

There you lead us, dancing from stone
To standing stone, and weaving between.
Glancing over shoulder we see all around
The ancestors dancing, circling, tall
In our long early morning shadows.

Three times we dance around the Ring:
Once for Death, all of us sing;
Twice for Rebirth, returning again,
And thrice for your Joining, birds on the wing.

* * *

It’s a long journey then, to the Brough of Birsay,
In the far northwest, hours away.
But the tide is out when we arrive,
The two of you lead us by the narrow way:
We carefully walk, rock to rock,
And safely cross to the sacred isle.

There at the foot of the windswept hill,
We gather together by the ancient shrine.
In the afternoon sun, the oldest of all,
The old Father Druid recites the lines
Of Life and Death, Leaving and Joining.

Then hand in hand, Louisa and Steve,
You walk the steep path, ascend the hill,
Silhouetted by sun, blown by wind.

We don’t know yet what adventures wait,
Deepening love, family and friends,
Travel and work, beginnings and ends.

But we do know this: From the top of that place,
High cliffs above the crashing waves,
There you can see… Eternity.

-Robert Elliott, 14 May 2011

Emotion-Focused Therapy and the Person-Centred Approach: Past, Present & Future

Reference: Elliott, R. (May, 2011). Emotion-Focused Therapy and the Person-Centred Approach: Past, Present, Future. Paper presented at Counselling Unit Twentieth Anniversary Conference, University of Strathclyde, Glasgow, Scotland.

1. A Personal Journey…
1.1. Five years ago: Invited to join the Counselling Unit
1.1.1. Walked into a place with a deep sense of culture and history built up over many years; but also, deeply counter-cultural
1.1.2. Complex web of: Courses and projects; relationships and traditions; large team of talented trainers and counselors; highly committed students, past and present
1.1.3. Fear & trembling: Questions raised:
• Will I be able to do meaningful work in this new setting?
• Will I be accepted?
• Is there space for my way of working with clients here?
• Will I change it?
• Will it change me?

1.2. Crucial Issue: What is the relationship between Process-Experiential/Emotion-Focused Therapy and the Person-Centred Approach?
1.2.1. In the early 1990’s, Barbara Brodley and John Shlien had both said to me: (Process)-Experiential therapy, Focusing, Emotion-Focused Therapy is not Person-centred
1.2.2. But Laura Rice, Les Greenberg & I had all started from a Person-Centred base, and felt we were Person-Centred
1.2.3. So, coming here, I began a five-year Evolving Dialogue with colleagues: •Classical/nondirective Person-Centred Therapy (PCT)
• Broadly relational PCT
• Pluralistic
1.2.4. My position has varied: Curiosity & puzzlement; awe & skepticism; frustration & excitement
1.2.5. Will present what I’ve learned so far from this dialogue: Past, Present & Future

2. The Past: A Brief History of Person-Centred-Experiential (PCE) Therapy
2.1. PCE Time-line:
• Roots/Sources: Humanism (The Renaissance, The Enlightenment, existentialism, Third force Humanistic psychology)
• 1940’s: Nondirective therapy: Rogers
• 1950’s: Classical approach: Chicago: Relationship conditions: unconditional positive regard, empathy, genuineness
• 1960’s: Focus on client process: Wisconsin; Late Rogers, Gendlin. The dialogue begins…
• 1970’s: Experiential therapy: Gendlin: Focusing; Rice, Greenberg: task analysis
• 1980’s: Partial eclipse period: Dismissed in North America; Further development of PCA in Europe
• 1990’s: Beginning of PCE revival; Training centres established: Counselling Unit; Process-Experiential (PE)/Emotion-Focused Therapy (EFT); explosion of research
• 2000’s: World Association founded; Journal: Person-Centered and Experiential Psychotherapies; Struggles for recognition; Research continues rapid development; EFT books & training emerge

2.2. Legacy of this Past: The Great Divide:
2.2.1. Continuing dialogue between different parts of the tradition, especially from 1970 on
• One end: “Classical” approaches: Emphasize Nondirectivity, Unconditional Positive Regard, the centrality of the relationship
• Other end: Emotion-Focused Therapy: Emphasize client process, process guiding, the work of therapy
2.2.2. “Pluralistic Approach” fits in there somewhere… perhaps at a 90 degree to the Great Divide

2.3. Examining the Legacy: Dialoging Across the Great Divide
2.3.1. Counselling Unit: One of few places in the world where it would have been possible to carry out this dialogue: Over an extended period of time; and with reference to actual practice
2.3.2. Most importantly, this has allowed exploration of the deeper issues of personal and professional identity:
•Need to hang onto what is essential vs. need to escape oppressive restrictions
•Need to establish self vs. feeling threatened or excluded
2.3.2. Which takes us to …

3. The Present: Have PCT vs EFT differences been exaggerated?
•As a result of recent history of dialogue over our differences, can now ask this question.
Two recent efforts to look at this…

3.1. The EFT Translation Project
3.1.1. EFT jargon can put PCT therapists off: Makes it sound like EFT therapists are pulling levers and controlling clients
• Have been trying to translate into PCT Friendly language; many discussions with Beth Freire, Brian Rodgers, Graham Westwell, and others
• Example: The Six EFT Therapy Principles
3.1.2. PCT-Friendly EFT Principles
• Research Clinic therapists examined the 6 EFT principles; decided the following 3 need no translation: Empathic Attunement: Always start by entering, attending to & tracking the client’s immediate experiencing Therapeutic Bond: Offer genuine, empathic, caring presence to client Self-development: Foster client growth, empowerment & choice
•Three EFT Principles Need Translation into PCT Language; involve different kinds of therapeutic work (=“tasks”) “Task Collaboration”:
•EFT: Offer and facilitate involvement in therapeutic work
•PCT Translation:
(a) Listen for and engage with what client wants to work on
(b) Offer orienting information about nature of therapy and particular ways of working in the session, particularly when the client asks or is puzzled “Task Completion/Emotional Change”:
• EFT: Facilitate reorganization of core maladaptive emotion schemes by helping client resolve key therapeutic tasks
• PCT Translation:
(a) Listen for and engage with key issues clearly or repeatedly presented by client
(b) Help client contact, explore and clarify core, growth-oriented emotions and views of self/others
(c) Keep helping client work on their key issues until they feel they have resolved these or decide they want to stop
(d) … and the client decides what is key, core, or resolved “Process Guiding”:
• EFT: Help client work in different ways at different times; foster relevant client micro-processes/ modes of engagement (e.g., experiential search, active expression)
• PCT Translation:
(a) Be aware of and respond helpfully to common kinds of client experiences and process
(b) E.g, Empathic Refocusing response: allow C to step back from difficult emotions before offering opportunity to return to them
(c) Respond to client-presented issues by offering opportunities for potentially useful kinds of therapeutic work
(d) Always accept client’s decision about whether or not to accept a process offer

3.2. Comparing PCT & EFT: The PCEPS study (Freire, Elliott & Westwell, 2011)
3.2.1. Developed quantitative process rating measure of PCE therapist adherence/competence: Person-Centred and Experiential Psychotherapy Scale (PCEPS) Two subscales:
• Person-Centred (PC): 10 items (Eg Client frame of reference; content nondirectiveness)
• Experiential Process (Exp): 5 items (Eg Experiential specificity, emotion focus
1 – 6 descriptively-anchored scales) Passing = 3.5+
3.2.2. The PCEPS study – Method: Just finished test of measure on 120 segments:
• Research Clinic data
• 10-15 min segments
• 60 sessions, 20 clients, 10 therapists
• 5 student therapists (general client sample)
•5 post-training therapists (clients with social anxiety): 2 PCT, 3 EFT (2 fully trained)
3.2.3. The PCEPS study: Summary PCEPS is reliable (across items and raters) In general, PC and Exp items correlate very highly with each other We also found a Nondirectiveness factor: Empowering Presence, Content Nondirectiveness, Clarity/brevity Student therapists scored lower on all items No difference between fully trained PCT and EFT therapists on: PC, Exp, and nondirectiveness subscales Conclusion: Therapist and training effects much more important than PCT vs EFT differences

4. The Future: Some concluding thoughts about avenues for continuing the dialogue & an agenda for the future
•Where does this leave us?
4.1. Beyond ideology, Or: Back to the Process Itself
• Is it worth continuing to argue at an ideological level over nondirectivity and process guiding?
• Like Psychology, we have been neglecting study of concrete behavior in favor of the ease of self-report data: Both quantitative questionnaires & qualitative interviews
• PCEPS study illustrates value of following the example of early Carl Rogers and colleagues: We need to return to the study of therapy process

4.2. A Pluralistic community of practice: Using our different strengths as therapists to complement each other
4.2.1. Most of us are never going to be effective therapists across a range of different therapy approaches
4.2.2. But: We can do a better job of listening to and learning from each other within the PCE tradition:
• Classical, nondirective therapists
• Broadly relational person-centred therapists
• Focusers and EFT therapists
• Person-centred-based pluralistic experimenters in other approaches
• Near neighbors in 4th generation CBT (eg Schema therapy) and contemporary relational psychodynamic therapy

4.3. Toward a deeper understanding of nondirectivity via Task Analysis
•Here in the Counselling Unit, I have found myself fascinated by rigorous nondirectivity in therapy
•Personally, I could never adopt a sustained, rigorously nondirective stance
• Nevertheless, it is clear to me that there are clients and moments when this is absolutely the best thing to do
• I want to know:
(a) What are these moments? (=client markers)
(b) How can I maintain nondirectivity at these moments? (=therapist processes)
(c) What are the immediate and ongoing effects of these moments? (=micro-outcomes)

4.4. Conclusion: Living with the creative tension between nondirectivity and process guiding
4.4.1. It’s so difficult to live in the middle: Between dichotomies/unresolved differences/ ambiguity/ complexity (David Rennie’s “rocky middle road”)
4.4.2. However, I strongly suspect: Nondirectivity and Process Guiding might actually need each other: Can be a source of moderation and creativity for each other
4.4.3. My dream for the next 20 years of the CU: That as a community, we learn how to effectively live with and grow from from the creative tension between Nondirectivity and Process Guiding

5. Coda: And by the way…
• Those questions I asked five years when I walked into this place…
• About doing meaningful work, being accepted, finding space, changing things, and being changed…
• The Answer is … Yes

Saturday, May 07, 2011

The Transcendent Witch Emerita of Oz

The Transcendent Witch Emerita of Oz

Entry for April 30, 2011:
Poem for Jeanne Brockmyer on her retirement
Video at: http://www.youtube.com/watch?v=GG8TSlOOIy0

No, I can’t imagine you in blue gingham,
But still I picture you setting out,
A young woman, blond hair flying,
Like Dorothy in the Wizard of Oz.

Travelling through strange lands --
Pennsylvania, North Carolina, Illinois, Ohio --
Collecting loyal companions along the way,
It’s a long journey, and it doesn’t always
Go according to the Book:
One dog isn’t enough, and
Your tin woodman loses heart along the way.

But there are plenty of flying monkeys,
Wicked Witches, little people;
Betrayals and acts of courage,
Partings, and reunions;
Many adventures.

At some point we realize
There’s been a career progression:
Instead of staying stuck in the same role,
Like Dorothy in book after book,
You get promoted to Distinguished Senior
Research Witch --
Jean, Good Witch of the Main Campus.

Teacher and mentor for generations
Of apprentice witches and wizards,
We, your travelling companions,
Witness your fierce loyalty,
How you take up your magic notebook
Against the abuse of the weak,
The hypnosis of mindless violence.

Now you’ve been promoted again:
Hail, Jean,
Transcendent Witch Emerita of Oz!

What’s next for you?
What further journeys,
Promotions, transformations?

As TWE, you are now able to travel
Anywhere you want
Using the silver shoes
That came with your promotion.

Deadly Deserts? Clashing rocks?
No problem!
As TWE, you can practically be everywhere.

But I’ve a hunch that most of the time
We’ll know where to find you:
In your backyard, with your dogs,
And your Magic Book;
There’s no place like home!

Somewhat belated report on Holiday Weekend Adventure

Our old friends George Wills and Joy Norton spent last weekend with us. I met up with them at Euston Station on Thursday night. We were all just a bit older and grayer than we’d been when we’d last seen each other in Melbourne, Australia, in 1999, but it was wonderful to see them again, and also brought back fond recollections of the memorable six weeks we’d spent there.

Over the next three days, we caught up with each other as we watched the royal wedding together; went to Hill House in Helensburgh (signature Charles Rennie MacIntosh house); walked through the West End by way of the Royal Botanic Garden; helped George buy a mandolin at a music store at Kelvinbridge; did a mini-tour of Provand’s Lordship House, St. Mungo’s Museum of Religious Life and Art and Glasgow Cathedral; had dinner at our favourite Scottish restaurant, The Sisters – Jordanhill; and watched Dr. Who together. Finally, we spent a day traipsing around the Kilmartin Valley, revisiting burial cairns, standing stones, stone circles, and rock carvings. Joy and George managed to locate a henge that we’d missed on our previous visit; and on our way out of the valley we hiked up to the Achnabreck rock carving site, consisting of a large collection of cup and ring carvings, some looking uncannily like primitive Cretan-style labyrinths.

So it was that, with some sadness and quite a bit of exhaustion, we walked Joy and George down to the Hyndland Train station on Monday morning to see them off back down to London. We’d had a lovely visit and revisited many of our favourite Scottish places. I don’t know when I’ll see them next but I’m hoping we’ll be back to Australia again before too many years have passed.