Wednesday, February 28, 2007

Quest in Scottish Borders

Entry 25 Feb 2007:

Last weekend we spent 3 day visiting the Scottish Borders, the southern part of Scotland that borders on England. This is Elliott country, especially the Liddesdale and Teviotdale areas, that is, the valleys of the Liddel Water and the River Teviot.

Instead of going by way of Carlisle in Northern England, as we did last summer, this time we travelled by way of Edinburgh. Either way, it doesn’t seem to take much more than 2 hours to get there from Glasgow. Unlike America, you can go a long ways in a relatively small amount of time, because everything is on a smaller scale and somehow geographically and historically dense.

I love the soft, rolling hills of the Borders, which remind me of the California Coast Range in winter or autumn, after the rains have come. Windy roads, wide fields, livestock grazing (mostly sheep rather than cattle), small valleys with streams running through them. After Glasgow, the Borders feels peaceful and spacious, while at the same small-scale.

In Selkirk, we sought out the Elliot Woollen Mill, which we had visited 20 years ago. There we met Robin Elliot, with whom we had a very interesting discussion about the economic difficulties of Borders communities like Selkirk, which are off the main highway and train routes and now struggle to maintain themselves. Among other things, we came away with two boxes of Elliot tartan mugs for various family members and a toy fox in Elliot plaid trousers.

Hawick (pronounced Hoik by the locals) was our first major destination. My mom has daily dialogues with my dad, who as I have noted previously, died last year. This process has many possible interpretations, from spiritual/mediumship/shamanism to hallucination, but I prefer to see it as a special kind of Empty Chair Work, which has proven to be enormously important for her since over the past 11 months and which has helped her develop new direction in her life. (For more, see her blog at: http://murraycreek.net/blog/ .) Through this process, she developed a project of travelling to Elliott clan country in the Borders in order to try to heal a piece of the its violent, lawless history. Hawick was one of three points forming an equilaterial triangle that were the target of this work, where we placed a laminated medallion of the Murray Creek Labyrinth in a place overlooking the town.

Then, we went onto the eastern point of the triangle, in the Wauchope Forest, not far from the Burns Bothy. This is a pine plantation, really a big harvest crop of pine trees, with patches of dense mono-culture separated by barren wastes of tree stumps where the crop has been logged off. This land seem violated to us, Diane and I felt as we walked up into it on a muddy logging road, having left my mom and sister by the Bothy. After a couple of miles, we came to what we later determined was a ruin of a stone sheep shelter, about 60 feet in diameter, with walls maybe 4 feet tall. In the middle were tree stumps and boggy vegetation; it had been abandoned for a long time, but revealed that the land had been used for sheep herding before being turned into a forest plantation. We placed the second medallion inside the stone wall, and walked back to the car.

The next day, we drove down to Hermitage Castle, the southern point of the triangle. The castle, a ruin with a nasty history, is deep in Elliott territory, not far from Newcastleton. The castle was closed but Anna managed to leave the third medallion in a modern dry stone wall.

The fourth point was supposed to be on or near Wyndburgh Hill, located in the middle of the triangle, but turned out to be the most difficult to get to. We ended up building a tiny cairn by the side of a logging road in the forest, about 3 miles away (it would have been 7 kilometers each way), in sight of the Wig Knowe transmitter tower, which at the time we had mistaken for Wyndburgh Hill. We decided that this was good enough for now, but that Kenneth and I would have to try to tackle Wyndburgh Hill next summer, when we have more time and better weather.

Having completed the pattern, we returned the next day to the hill above Hawick to place our last medallion with the first. Then we drove down south to Burgh Hill (pronounced “Bruff” a local woman told us). After a vigorous climb in the rain and wind, we reached a small stone circle, about 60 feet across, with a marshy area in the middle. Further up the hill was an extensive megalithic hill fort, with walls and rampants crumbled and now covered smoothly with grass. We tried to imagine who lived here and how long. I loved the energy of this wild and desolate place.

Then we drove south along the River Teviot, stopping for lunch at Langholm, a quaint and quiet town on the river. There I sampled haggis pizza, which was interesting but rather more of both haggis and pizza than I wanted. At least I can say now that I have tried it!

We returned, tired and relieved to be home again, my mom’s task largely complete. She began this quest with only a general sense that something needed healing in the area we explored, but we ended up with a deeper understanding of the Borders. The past in which the Elliotts and the Armstrongs and other border clans fought each other and the English seem long gone to me, but what remains is the sense of economic dislocation from having been left out or behind, which I got from talking to Robin Elliot at the woollen mill in Selkirk, and the ecological injury brought about by the pine plantation system. While I appreciate the importance of her quest for my mom, for me the quest was to gain a better understanding of the people who still live in Scottish Borders. I’m looking forward to another visit and the opportunity to get to know this part of Scotland, the home of my ancestors, better.

Sunday, February 25, 2007

Seeing Kilmartin


Entry for 23 February 2007:

We love stone circles and Neolithic/bronze age sites. The year we lived in Sheffield we tracked down two nearby stone circles, the most impressive of which was Arbor Low, a circle of supine stones in a farmer’s field, surrounded by very large grazing horses. Not surprisingly, Scotland has a large number of ancient sites of various kinds, so I have been chomping at the bit to begin exploring them.

My mom’s main mission is to Scottish Borders, but she is also interested in sacred sites of all types, so when she found that Kilmartin (in Argyllshire, in Western Scotland) was on the itinerary of the Sacred Sites tour and involved stone circles, we quickly changed plans in order add a trip there to her and my sister Anna’s journey.

And so we set out on Tuesday morning, driving up along the west shore of Loch Lomond on a beautiful, uncharacteristically sunny February morning. I was startled to find that it only took us about an hour to get to Inverary, a charming town on the banks of Loch Fyne, where we ate lunch at the restaurant in a woollens store. Another hour and a bit saw us to Kilmartin, a wide glen chock-filled with bronze-age remnants.

Actually, it takes a while to develop an eye for ancient monuments. The standing stones are the easiest to see; it was only later that we realized that we had failed to see the line of five cairns that run down the valley, or the stone circle off to one side. As the day went on, we got better at ancient monument-sighting and were struck by how much had escaped us at first.

The first group we did see, a set of five standing stones, took our breath away. We parked in the small car park, crossed the burn (small stream), and followed the path to the field where they stood, forming a North-South line, with one large stone in the middle and two at either end, spaced so that when we stood in the 10-foot space between the southernmost pair, the middle stone sat between the northernmost pair. We circled around each lichen-covered stone, in particular standing against the middle one facing south, soaking up the warm sun. Sheep were grazing in the next field.

But where was the Temple Grove Circle, referred to by the road sign and in our literature? We proceeded up the valley, to the town of Kilmartin, only to find the Museum of Ancient Culture, next the Church of St. Martin, after which the town is named, closed until March. We were on our own to sort out the mystery of Kilmartin’s ancient monuments.

After looking at the medieval carved gravestones in the churchyard, glorifying dead local fighters, many killed in battles, we drove down the valley to look for more ancient and inspiring sites. We turned down a small lane, passing a school where parents were picking up their children. There off to the left was an ancient cairn of stones piled on each other, that we had missed before, although it was across a field from the standing stones we had first stopped at. Apparently, we had mistaken it for a random pile of stones, and the carefully laid out path leading to it as random fences. So much for our powers of observation!

The cairn consisted of a large and spread-out pile of smallish stones 4 to 8 inches in diameter, gradually mounting to a centre, 4-5 feet high, the whole thing about 60 ft across. In the centre was the burial chamber, covered with a large slab of stone on the top, an entrance on one side. I was surprised by how rocky the whole thing was, because I had always imagined megalithic sites, including burial cairns, to be made of a small number of large stones, set in the dirt or turf. This is possibly why I missed it the first time.

I had left the car in a passing place on a one-lane road, so I decided I’d better move it around the parking lot where we’d stopped the first time. Leaving Diane, Anna and my mom to finish their exploration and find their way back by way of the first set of 5 large standing stones, I drove on… and immediately encountered the missing Temple Grove Circle, on the opposite side of the road!

After getting the car parked properly, and I went to meet the others, and excitedly and triumphantly dragged them off to see the missing stone circle. It, too, consisted largely of a large pile of small rocks, centring on a burial chamber. However, it was surrounded by a circle of largish stones, 1 to 2 feet tall, two of them decorated with spiral patterns, the whole thing about 60 feet wide. In the centre was a smaller circle of low standing stones, defining a kind of inner sancrum; the inmost part was rectangular, uncovered burial chamber. To the east, two stones were turned outward to form a doorway, which was blocked by another stone. Not only that, but there was a second, older and smaller pile of stones to the immediate north, with the perimeter partly marked by cement pieces indicating where archeological evidence points to the placement of the original stones and wooden support beams.

According to our stone circle book, carbon 14 dating places the older circle at 3100 to 3500 BCE, and the newer, larger circle contained human remains dating as recently1050 BCE. This means that this complex of circles was in use for at least 2000 years, at first as some sort of ritual/observatory site, and later as a burial site. It was rediscovered in the 19th century and excavated and dated in the 20th century in two stages.

This was the high point of our visit to Kilmartin. We did make one more stop, further down the valley at another cairn, quite similar to the first one we saw, but with more standing stones (in a field full or suspicious sheep) and a set of flat ancient carved stones with cup and circle designs, in a field on the opposite side of the cairn. We missed the other 4 cairns, more carved stones and an ancient fort. Kilmartin Glen, as the book says, is a paradise of megalithic structures. It feels like a very holy place, incredibly ancient and powerful. It took us a while to learn how to see it, but in the end through persistent exploration we succeeded, and left feeling exhilarated and powerfully linked to the ancient past.

Tuesday, February 20, 2007

Counselling Skills as Emotion Schemes: Presentation to the EPS Scholarly Community

Entry for 19 February 20, 2007:

My mom and sister Anna arrived on Saturday for a two week visit. I was scheduled to present to the Department of Educational and Professional Studies Scholarly Community series on Monday, so my mom decided she wanted to come hear my presentation, and Diane and Anna thought it would be interesting also to hear what I had to say and to experience some of my other colleagues.

I selected a topic that I thought would be interesting and relevant to the other faculty and that would also push me in a new direction. For these reasons, I chose to talk about the relevance of the emotion scheme concept for training counsellors, and specifically as a conceptualization of the fundamental nature of counselling skills. I illustrated my proposal with an analysis of a brief segment of Empathic Attunement with one of my clients. The following is a typescript version of my Powerpoint slides for the talk:

1. Complexity of Counselling Skills
-When students learn counselling/therapy skills, what are they learning?
-Multi-faceted:
-Not just a matter of behavior/ technical skills (=doing)
-E.g., Hill equates “skill” with behavior
-Also involves who one is as human being (=being)
-E.g., “emotional labor” (Hochschild)

2. Problems in Design of Counselling/ Therapy Training Programs
-Training often focuses too much on one aspect of learning
-Conceptual: Focus on theory
-Experiential: Focus on practice
-More than two aspects
-Teaching aspects of learning separately, so students don’t learn to connect them
-E.g., teach conceptual first, then practice
-Leaving aspects of learning out altogether
-E.g., examples of practice

3. Political Pressures
-Development of National Occupational Standards for Psychological Therapies
-Skills for Health Initiative (2006)
-Currently in consultation process over draft document
-Complement standards in other areas of healthcare in the public, private and voluntary sectors
-Parallel process: Department of Health project re: statutory regulation of counsellors and psychotherapists

4. Need for a Conceptual Model for Counselling/Therapy Skills
-Guide training
-Provide guidance to government & professional bodies

5. Conceptual Analysis of “Skill”:
a. Definition (American Heritage Dictionary):
-Proficiency, facility, or dexterity that is acquired or developed through training or experience
-An art, trade, or technique, particularly one requiring use of the hands or body.
-A developed talent or ability: writing skills.
b. Etymology:
-Middle English: skil = discernment
-from Proto-Indoeuropean skel = to cut (cf. scalpel, school, shelf etc.)
c. Synonym analysis (AHD): Part of a family of words that refer to “qualities that enable a person to achieve or accomplish something”
-Ability = mental or physical power to do something [=parent word]
-Capacity = potential for acquiring that power
-Faculty or Talent = inherent or inborn ability
-Skill = ability acquired or developed through experience [relevant to training]
-Competence = ability to do something satisfactorily but not necessarily outstandingly
-Aptitude = inherent capacity for learning, understanding, or performing

6. Proposal: Apply Emotion Scheme Concept to Counselling Skills
-From Neo-Piagetian theory (Pascual-Leone)
-Scheme vs. schema
-Key concept in Process-Experiential (PE) therapy

7. Process-Experiential Therapy
-Developed by Greenberg, Rice & Elliott
-Integration of Person-Centred and Gestalt therapies Based on contemporary emotion theory
-Organized around key therapeutic tasks
-Also known as Emotion-Focused Therapy (EFT)
-Emotion scheme concept developed in Elliott, Watson, Goldman & Greenberg (2004)
-Therapeutic change understood as based on changes in emotion schemes (=outcome)
-Therapy typically involves explication of different aspects of emotion schemes (=process)

8. Emotion Scheme Concept
-Provide implicit higher-order organization for experiencing
-Both:
-a representation of experience
-and a plan of action
-Self-organizing processes, not things
-Consists of component/elements linked together in a network

9. Organization of Emotion Schemes
-Involved in implicit/automatic processing of experience
-Not available to awareness until activated and reflected upon
-Idiosyncratic and highly variable
-Complexity: Many operate simultaneously
-Not a bad description of how mastered skills operate!

10. Client Problem-Related Emotion Schemes: Structure
I. Experienced emotion: organizes other elements
II. Perceptual/Situational: context
A. Primary appraisal: eliciting cues
B. Episodic memory
III. Conceptual/Verbal: self-talk, identities, metaphors
IV. Bodily/Expressive: embodied experience
A. Body sensations
B. Nonverbal expression
V. Motivation/Action tendency: preparation for action
A. Wishes/needs
B. Actual or potential behaviors

11. Therapist Skill Emotion Scheme Structure
I. Experienced emotion: often subtle, complex
II. Perceptual/Situational: “when-then”
III. Conceptual/verbal
IV. Bodily/Expressive
V. Motivation/Action Tendency

12. Example: PE-111-1, Initial Empathy Segment-1 (2:15+)
C1: … No, it’s this, it’s this, fear, of, of,… getting across bridges of all things
T Settles into inquisitive, intent body position, looking at C, slouched slightly forward. Tilts head slightly to left during silence, as if trying enter client’s experience
T: I see, OK. [soft slightly thin voice]

C1.1 And height, oh my, I have terrible fear of height and it…
T: OK Deep head nods, bobbing upper body.
T1: And it- that interferes with your life? Intent, soft voice; gestures with right hand

C2.1: Oh, it does. We used to take great long road trips, and don’t do any of that any more.
C2.2: Funny thing is, I’m not afraid to fly, as long as it’s a jet plane and it’s multi-engined.
T: Right hand to mouth, then strong head nods I see.
T: Shifts head forward, slight nods.
T2: I see, OK, that doesn’t bother you Nodding, intent; soft voice

13. Therapist Skill Emotion Scheme Structure
I. Experienced emotion: often subtle, complex
II. Perceptual/Situational: Context, “when-then”
A. Marker/micro-marker
B. Memory of models/examples
III. Conceptual/verbal: Treatment principles
IV. Bodily/Expressive:
A. Body sensations
B. Nonverbal expression
V. Motivation/Action tendency:
A. Task/Goal
B. Verbal response mode

14. Empathic Attunement Scheme:
I. Experienced Emotion
Blend of:
Curiosity/interest
Emotional involvement
Internalized representation of client emotional state in narrative or session
II. Perceptual/Situational
A. Marker/Micro-markers
Marker: Client presents problem for first time
Micro-markers: Clients a piece of experience
B. Memory of models/examples
Examples: Carl Rogers, Gerry Goodman, Gene Gendlin
"(deeply embedded in practice as “voices”; cf. Bahktin, Stiles)
III. Conceptual/Verbal
A. Treatment Principles: Empathic Attunement (Principle #1): “Begin by entering the client’s experience”
B. Identities: “Process-experiential therapist”
C. Metaphors: “Empathic Attunement Is Entering The Other’s House” (cf. Lakoff & Johnson)
IV. Bodily/Expressive
A. Body sensations
Excited tension in upper chest, shoulders
B. Nonverbal expression
Forward body lean
Hunching down gesture
Intent, serious facial expression of concentration
Softened vocal quality
V. Motivation/Action Tendency
A. Task/Goal
Understand client’s experience
Connect emotionally with client
B. Verbal response mode
Minimal encouragers (“I see” “OK”)
Empathic reflections

15. How Do Students Learn this Kind of Skill?
-Have learn complex set of elements
-Broadly organized into 5 domains
-Design learning experiences to enhance each domain

16. Conceptual/Verbal Learning:
Cognitive/ didactic learning
-Content:
-general theory: function, dysfunction and change process
-treatment principles (rules)
-therapist response modes
-client tasks (markers, resolution stages, therapist operations)
-Media: main lectures & exercise mini-lectures, course readings; trainer commentary during workhops or supervision (“anchored instruction”)

17. Perceptual-situational Learning: Observation of examples/ modeling
-need both “successful” and “difficult” examples
-class: videotapes
-workshop: live demonstrations
-workshop: trainer modeling
-supervision: supervisor modeling

18. Motivational-Action Tendency
-Skills practice workshops w/ other students
-Supervised practice with real clients

19. Emotional Learning Processes
-Safe learning environment
-Personal therapy: Experience in client role
-Experience in consellor role
-Attention to emotional issues in supervision
-Workshop training on common counsellor emotional issues

20. Bodily Expressive Learning Processes
-Body learning methods: Awareness and expression
-Focusing (teaching attention to body)
-Movement, exercise
-Attention to health
-Experience in body-oriented therapies

21. Need for careful examination & study of training processes
-Planning systematic research on training processes and outcomes
-Use conceptual model

Saturday, February 17, 2007

Unpuzzling British Television

Entry for 16 February 2007:

Everyone in our family is a Dr. Who fan; I have been watching since the John Pertwee Doctor and Sarah Jane Smith in the 1970’s. After we moved house in Toledo in the early 80’s, we had a tower TV antenna (=aerial) installed in order to be able to pull in the signal from TV Ontario, a Canadian public television network broadcasting from Windsor, Ontario, across the river from Detroit. We were heartbroken when the old series stopped in the late 1980’s. After that, we lost touch, until our stay in Belgium about a year and a half ago. I was working in the bedroom one evening, when I heard the familiar sound of Daleks intoning, “Exterminate! Exterminate! Exterminate!” … Diane and Kenneth had accidentally tuned into the penultimate episode of new series 1.

So here we are living in the UK, ursprung of Dr. Who. In general, we are not impressed with British TV, which now seems even worse than American TV… But there is Dr. Who, and we have been holding out, waiting for series 3 to begin in March, before breaking down and buying a TV. Actually, we enjoyed the absence of informational clutter and slight feeling of moral superiority that comes with not owning one. Finally, about a week ago, I decided I was finally ready.

But what to buy? First, the UK is in the process of going to digital television (as well as high definition), with “switchover” (a euphemism for “switch-off” of analogue TV) set for Glasgow in 2010. In preparation for this, the BBC have set up what is called “Freeview” digital broadcast TV. What I hadn’t fully grasped is that as a semi-independent government corporation (sort of like the US Postal Service), the BBC are responsible for all “terrestial” or ground-based broadcasting in the UK, even when they aren’t content providers and allow commercials on the more or less independent TV channels such as ITV (STV for “Scottish TV” in Scotland, of course!). On Freeview, there are currently 46 TV channels and 27 radio channels (source: http://en.wikipedia.org/wiki/Freeview). We decided that Freeview would be nice to be able to get, if possible, which meant getting a set with an integrated digital tuner built in. This suggested that we should get a hybrid model, with both analogue and digital tuners.

Second, after our last place, we decided that CRTs are too big and clunky for Scotland, so we decided that a 26-inch LCD screen was what would best meet our needs.

Third, I wanted to be able to play NTSC videotapes recorded in North American, which meant a TV capable of diplaying both NTSC and PAL (UK/Australia) images.

Finally, it should have good ratings and reliability. This was getting pretty complicated! Using Amazon and other internet resources, I finally selected a Philips model that seemed to meet these requirements and wasn’t too outrageously expensive. (By UK standards; it was still 3 times the most we’d ever paid for a TV in the US!)

So we headed for the Currys to buy this piece of consumer hardware, feeling guilty for spending this much money on an entertainment appliance. Once there, I because paralyzed with worry over whether we’d be able to get the digital freeview channels with what I thought was communal aerial hook-up in the living room (=lounge in the UK). Finally, after further obsessing, we bought a cheap set-up aerial, just as an experiment.

We brought the TV home, set it up, and attached it to the cable in the living room to see what would happen. Its initial set-up scan detected no digital service whatsoever, but 14 analogue channels (actually 4.5 analogue channels repeated over and over again). Four of the analogue channels came in quite clearly. The set-top aerial, even tried in various configurations failed to detect the digital channels, but did pick up, not particularly well, the four basic channels. Then I stopped some neighbors from upstairs and asked them about Freeview; they get it just fine. This confused me, because I had thought we were all sharing a communal aerial. I did a lot of internet investigation of digital channels and antennas; finaly, I went outside and looked at our roof. Like practically all of the buildings around us, we appear to have multiple aerial sprouting from various chimneys; there is no communal aerial.

Disappointed, I explored various options, including satellite and cable. However, these turned out to even more confusing: They’ve all been eating each other up, while at the same time diversifying into each other’s territory. The much-heralded media convergence is upon us here in the UK, with the unexpectedly frustrating result that it now appears to be impossible to get cable television all by itself. Instead, all the cable/satellite options are now multimedia bundles: cable with telephone and broadband; telephone and broadband with cable. That might have been OK, except we’d purchased a broad band service with a 2 year contract; we couldn’t figure out a way to make this work! Finally, I went back to Plan A: trying to figure out what the story is with the current aerial.

Eventually, I found a website that maps the locations and relative distances of various transmitters, based on postal code. I discovered that the analogue signals are being broadcast from four transmitters locally, two of them only a mile away (one northeast, the other south); by contrast, the digital channels are broadcast from Black Hill, 16 miles away due east from us. Suddenly, many pieces fell into place. Conclusion: I had been assuming that the clear analogue signal emanated from Black Hill, but actually it appears to be from the West End, northeast of us; the other 10 or 12 versions of the basic channels come from more distance transmitters. We are plugged into a roof-top aerial, but it’s undoubtedly old, pointed the wrong direction, and lacks the hardware to pull in the digital Freeview channels. But then an informal survey, taken while I walked to work, revealed that most of the aerials in this part of Glasgow are also still aimed at the local transmitter.

After first, this seems like a disappointment, but actually it’s fine for now: It’s enough to get Dr. Who when the new season starts, but it’s also ready for switchover. It would be nice to get the other freeview channels, but they are mostly full of re-runs anyway, so for now we are sticking to the basic 4.5 (there is a channel 5, but it is pretty fuzzy, since it comes from Black Hill). Eventually, we may spring for a new rooftop aerial, but for now, it’s enough.

All this might sound a bit obsessive (and I recognize that it is), but on reflection, I realized that several issues have been involved in this for me: First, it’s part of a nesting process that I have been in since we moved to a flat that we have felt we could really settle into and make out own for now. The visit by my mom and sister have been a kind of informal deadline for finishing this process, at least for now. Second, I’ve always been fascinated by radio and TV signals, taking it as personal challenge to pull into difficult to get stations. (As a kid growing up in Northern California, I prided myself as being able to pick up, in the middle of the night, AM stations from as far away Mexico, Alberta, Canada; Seattle, Chicago, and once even Cleveland!) Third, I’m also fascinated by glimpses into the invisible infrastructure of everyday life, in this case, the existence of a network of little local urban transmitters all around us. It reminds me of when I realized in a very immediate, lived way about 10 years ago that the phases of the moon are the sun shining on the part of the moon facing us, while we changed position in relation to it. The Big Mysteries elude us, but sometimes little mysteries, like British Television, reveal themselves! Now if there was just something worth watching in addition to Dr. Who.

Tuesday, February 13, 2007

Comparing Notes: Consultation between Strathclyde and East Anglia Counselling Diploma Courses

Entry for 13 February 2007:

The person-centred postgraduate diploma courses at the Universities of Strathclyde (Glasgow) in and East Anglia (in Norwich) grew out of the partnership of Dave Mearns and Brian Thorne, who together organized the earliest PCA training courses in the UK, about 20 years ago. These early training courses developed at about the same time that Greenberg, Rice and I were developing the Process-Experiential (not also known as Emotion-Focused) therapy approach in the late 1980's. About 15 years ago, the two courses at Strathclyde and East Anglia were founded, and from this common source, have been developing in parallel ever since.

Tracey Saunders, director of our diploma courses, is a graduate of the East Anglia program and through her contacts with Judy Moore, the current Director of Counselling at East Anglia, arranged a joint consultation visit between the academic staff of the two programs. She and her colleague, Ian Draper, their diploma course director, thus flew up from Norwich this morning to spend the afternoon and evening comparing and contrasting the two programs and discussing issues, problems and ideas for improving our programs.

Over the past 15 years, starting from a similar place but reflecting the personalities and interests of their founders and responding to their local community and academic environments, the two program have evolved somewhat differently, to the point that we decided that it was time for a serious dialogue. Some of these differences are structural and less interesting (although still consequential), but others are quite obviously deserving of in-depth discussion; these include:

1. EAU has explicitly added an experiential (focusing and PE therapy) element to their training, including offering focusing training on a weekly basis throughout the training year. Such elements are only now beginning to creep into the curriculum of the courses here, so that the Strathclyde program as a whole remains fairly classical.

2. At Strathclyde, we have developed a network of possible placements or sites where students can seek counselling experience (unpaid); students are then supposed to go out and arrange to work at one of these sites. EAU has had a collection of captive sites for their students, but changes in the NHS have cost them most of these, so they are now looking for alternatives. We made suggestions for them to follow up, such as starting a research clinic and having students work with established solo counsellors or groups of counsellors in their practices.

3. East Anglia has more students continue on to take their MA degree (a large majority); at Strathclyde only about 10% of students continue on to the masters. We learned that the biggest difference was that students at East Anglia are accepted into a 2 years Diploma (which they can opt out of), while Strathclyde students have to actively and separately apply to the MSc course.

4. There is no research training in the first (diploma) year of the training at East Anglia; this is all done in year two, the MA year, to the tune of a 60 hour module. At Strathclyde, we begin research input in the first term of the diploma year (15 hours, roughly), but don’t provide much input during the MSc course. As we talked, it became clear that neither of these extremes is ideal. I suggested “an hour a week for research” throughout the diploma year, culminating in a research proposal assignment toward the during Term 3, and I expressed my desire for more systematic input on research during the MSc course, in addition to the emerging model of research group supervision/support that Brian Rodgers and I are developing.

And so on, pretty much all afternoon and much of dinner tonight. This visit was so interesting and inspiring that it makes me wonder (a) why we didn’t do this years ago; and (b) why there isn’t an organization of person-centred training organizations with yearly mini-conferences. Certainly a lot to think about!

Interpreting the Research Evidence: Further Comments on the Draft Report on Occupational Standards for Psychotherapy

Entry for 13 February 2007:

A government body called Skills for Health is planning to develop National Occupational Standards (NOS) for the practice of Psychological Therapies in 2007. This development will complement standards in other areas of healthcare in the public, private and voluntary (nonprofit) sectors. They have now produced a draft document for comment, which lays out the proposed framework and a basic model of psychotherapeutic skills. Many of us in the Counselling Unit are concerned by an apparent cognitive-behavioral tilt to the draft document. In addition, the document includes a listing of four types therapy: CBT, Psychodynamic therapy, Family systems therapy, and humanistic therapy and counselling. Perhaps we are being too sensitive, but we noticed that “humanistic therapy and counselling” was the only one (a) not capitalized and (b) listed as “therapy and counselling” and not just as “therapy.” At the end of January, we had a large, vocal and productive meeting that included both full time and part time Counselling Unit staff, which led to the drafting of a response/commentary on the National Occupational Standard draft, which we submitted last week.

However, Mick then talked to a contact at BACP (the British Association for Counselling and Psychoherapy), who gave us information that we interpreted as indicating that the division of psychotherapy and counselling into the four main types may be part of a strategy setting the stage for excluding humanistic/person-centred/ experiential approaches, as has been done in Germany. Last Thursday, after a quick consultation with Tracey and me, Mick drafted a further response, which I then extensively edited. In doing so, I came up with a formulation of the research evidence’s main conclusions, which I quite liked. Here, with Mick’s permission (since it is a joint effort), is the formulation:

While we believe that it is a useful heuristic, particularly for training purposes, to talk of different forms of psychological therapy, we think it is essential to emphasise that the scientific evidence from multiple lines of research overwhelmingly points to four overall findings:
(1) The different major approaches to therapy are all generally equivalent in their effectiveness (Lambert, 1992; Wampold, 2001). Indeed, in the largest comparative effectiveness study to date, Stiles, Barkham, Twigg, Mellor-Clark, & Cooper (2006), using the functional equivalent of a randomized controlled trial, found that cognitive-behavioral, person-centred, and psychodynamic therapies were virtually identical in their effectiveness for clients in primary and secondary care settings.

(2) The strongest, most consistent factors associated with improvement in the psychological therapies - such as the quality of the therapeutic relationship (Norcross, 2002) and clients' levels of engagement (Gonzales, 2002) - are common to all the major therapy approaches.

(3) There is very little evidence to indicate that any one approach is more effective or efficacious with any particular psychological difficulties than any other. (However, there are one or two exceptions to this, such as behavioural modification techniques for sexual difficulties; Anderson, & Lunnen, 1999).

(4) By far the strongest predictor of the results of comparative outcome trials is not type therapy but researcher allegiance (Luborsky et al., 1999).
On the basis of these and other lines of evidence, there is thus no basis for using the division of the talking therapies into the four approaches stated, in order to limit the therapies that can be accessed by particular groups of clients. While cognitive-behavioural researchers have conducted a larger number of studies demonstrating the efficacy of their therapies, this is largely a result of their history of greater access to research funding and overrepresentation in academic positions. It is a logical error to interpret differences in amount of evidence as evidence for differential effectiveness. That is, having more studies showing effectiveness does not equal greater effectiveness.

Monday, February 12, 2007

My Journey as a Therapist as a Symphony in Six Movements

Entry for 12 February 2007:

After I showed them a video clip from my client with panic/bridge phobia last term, the students in the Monday Part-time Diploma course requested that I come talk to them about what they called my Journey as a Therapist. Never having had such a request, I accepted, and last night put together a “multi-media” show, complete with poems, videos and Powerpoint slides… plus discussion of course!

Going in today after a very harried morning, I felt somewhat nervous, but was looking forward to seeing how it would go. I decided to frame the presentation with readings from several of my poems. The following is the outline of the presentation, including the information from the Powerpoint slides:

Prolog: Poems on why I became a therapist:
*Magic My Dad Taught Me (for his 75th birthday, available at: www.murraycreek.net/elliott/robert/dad75.htm )
*On Leaving the Shire (section 1; poem given at my retirement/going away party last August; available by request)

A. Training (1972-1980): Assembling the elements of the Process-Experiential approach
1. Basic therapy treatment: UCLA, Goodman - broad client-centered, community psych
2. At the same time: Liked the idea of early proto-CBT/behavioral self-control therapies (e.g., Mahoney): organized & systematic; but discovered this didn’t work for me and my clients
3. Psychodynamic/interpersonal training and clients; much creative work going on: research by psychodynamic process researchers: Luborsky: CCRTs; Sampson-Weiss: Control-mastery theory; current interest in empathic processes (therapy attunement/misattunement); short-term dynamic approaches
4. Through Society for Psychotherapy Research, met Laura Rice, Les Greenberg ("adopted"): added Experiential

B. Eclectic Experiential/psychodynamic phase (1980-85):
1. Base: Empathy, warmth, genuineness
2. Used psychodynamic formulation and interpretation
3. Plus experiential techniques: focusing, chair work
4. My research: phenomenological/experiential: Interpersonal Process Recall, qualitative methods

C. Return to pure experiential approach (1985)
1. Confronted by analyst in 1985: You interpret your client’s dream, but won’t interpret clients in your research. Isn’t that inconsistent?
2. Research approach was more important that therapy approach: decided to change practice
3. Other reasons: (a) worries about dangers of eclecticism (lack of grounding); (b) better research possible within a particular model.
4. What I eventually discovered: I felt more grounded and oriented as a therapist in a more purely experiential/person-centered approach
5. Laura Rice helped me stop interpreting my clients
6. Began collaborating with Rice & Greenberg to develop a new, integrative experiential therapy

D. Development of Process-Experiential (PE) Approach: 1985-1993
1. U Toledo Depression project; formulation of depression developed
2. Worked out main elements of practice: Treatment principles; Therapist experiential response modes; main tasks: Unfolding, Focusing, 2-Chair, Empty Chair, Prizing
3. Followed by York Depression Study (Greenberg, Rice, Watson)
4. Facilitating Emotional Change published in 1993

E. Emotion-Focused Therapy (EFT) Phase: 1993- 2005
1. Developed emotion theory: types of emotion response, emotion schemes, emotion regulation; emotion change principles
2. Application to Trauma (Paivio, Greenberg, Elliott)
3. Added tasks: Empathic Exploration, Space Clearing, Narrative Retelling, Alliance Repair
4. Clearer, student-friendly/training focus
5. Several books; Learning Emotion-Focused Therapy published in 2004
6. Videos: Greenberg
7. Depression research: York 2 project (Greenberg); U of Toronto CBT vs. PE (Watson)
8. PC/E outcome meta-analysis

Interlude: At this point, I showed two videos in which I helped clients do chairwork, one with client 31 in about 1986 (one of the case examples in Facilitating), and the other my client with panic/bridge phobia, from 2000.

F. Time of Turning: The Present Moment: 2006+
1. Anxiety (panic, GAD, social anxiety)
2. Severe problems (Borderline processes)
3. Dialogue with Person-Centred Approach (Strathclyde)
4. Dialogue with Pluralistic approach (Cooper, McLeod)
5. Political challenges
6. Personal challenges/issues: feeling that it's up to me to make something happen; getting caught up in clients' hopelessness; and dealing with clients who have great difficulty accessing their internal experience.

*Epilog: Poems: Where I am moving to now in my life:
*On Leaving the Shire (sections 2 & 3) (ran out of timefor this one)
*On Beginning Work at the Counselling Unit (available on this Blog for Octoberg 2006: pe-eft.blogspot.com/2006/10/poem-on-beginning-work-at-counselling.html )

References:
Elliott, R. (1999). The Origins of Process-Experiential Therapy: A Personal Case Study in Practice-Research Integration. In S. Soldz & L. McCullough Vaillant, Reconciling empirical knowledge and clinical experience: The art and science of psychotherapy (pp. 33-49) . Washington, D.C.: APA Books.
Short biographical summary; part of dropped material from Learning Emotion-Focused Therapy: www.process-experiential.org/learning/elliott.html

Saturday, February 03, 2007

Latha Fhèill Brìghde, The Beginning of Celtic Spring

Entry for Feb 3, 2007:

In the old Celtic calendar, the last day of January and the first day of February was a fire and healing festival called Imbolc, sacred to the Brigid, the goddess of poetry, healing, and fire/blacksmiths. In the Gaelic-speaking parts of Scotland, this festival is also known as Latha Fhèill Brìghde. This festival marks the beginning of Spring (in the same way that the 31st of October and the 1st of November celebrates the transition from Autumn to Winter). In Ireland, 31 Jan is St. Brigid’s Eve, a Time of Transition when it is customary to put out bowls of milk for the faeries (i.e., cats). Here in Scotland, St. Brigid is called St. Bride, presumably after the Irish Gaelic Bride.

Since I was a teenager, I have felt a special affinity for St. Brigid. For one thing, her feast-day marks the beginning of Spring, which in California meant that the almond trees in our back garden were soon to blossom, white flowers with delicate pink centers, raining down to the ground like snow. For another, she is the Christianized marker for the old Celtic Triple Goddess, Brigid. (World mythology is full of triple goddesses: maiden, mother, crone; the three Fates, etc.) It appears likely that there was an historical Brigid also, who was an early follow of St. Patrick, but presumably she was named after the Triple Goddess, and so made a handy replacement. So that makes 1 Feb a special day for the recognizing the Goddess aspect of the Divine. For years, I have marked St. Brigid’s Eve by phoning my mom, a Wise Woman and my personal expert on things to do with the Goddess. (This year was an exception, since I had had a long Skype session with her a couple days earlier and could not raise her on AIM.) And when I do phone her, my mom usually reminds me that the beginning of February also marks the cross-quarter day, that is, the midpoint between the Winter Solstice and the Vernal Equinox.

By one of those strange, synchronistic circumstances, Hyndland’s Scottish Episcopal Church, just 5 minutes walk from our new flat, is St. Bride’s. I checked their website for an indication of a service to mark their patron saint’s feast day, but found nothing, so instead we went to a lovely, small Celtic Connections concert of music from Ayrshire, at the Universal Folk Club, on Sauchiehall Lane. Three local singers from different parts of Ayrshire took turns singing songs in fairly broad Scots; we loved it! Diane talked to the woman singer, named Heather, for awhile, during which we were asked if we sang. It turns out that folk music here is not a spectator sport! So that was how we passed St. Brigid’s Eve this year. I think a Celtic Connections concert is a very good way to mark this time of turning!

The first of February is also my brother Conal’s birthday, and it felt good to drop him an email, a tentative feeler after a painful interaction last March after our dad died, to which he responded graciously and genuinely. This also is a good day to remember our families Irish heritage, since Conal is named after the fictional name given to our great-grandfather, William Mullen, in the books our grandmother wrote about her father. (This is an example of what our grandmother referred to as “the fictional treatment”, i.e., dressing up real facts in more fitting presentations to make them sound more real.) And it has been very good this year, here in Glasgow, to remember the Irish heritage in our family, which comes via our mother, is at least as strong as the Scottish, which comes from my father’s side and is carried also in the name Elliott. (The Elliotts were a bloody-minded lot of Borders reivers, whom mom hopes to sort in some way when she visits in a few weeks.) So I too carry the Scots-Irish, Protestant-Catholic split that is part of the historic and continuing pain of Glasgow and indeed Scotland, and St. Brigid/St. Bride’s day is a good time to recognize this duality.

Americans mark this festival every year without every realizing it, when they celebrate Groundhog’s Day on the 2nd of February. Groundhog’s Day makes the beginning of Celtic Spring into a tridium, a three-day holiday. A groundhog (also known as a woodchuck) is a large North American ground squirrel, a type of marmot. In Celtic Britain, the festival of St. Brigid was also a time for weather divination, when people looked for omens to indicate what kind of Spring was coming, so they looked for bears, badgers or marmots to come out of their dens. (I’m not making up the business about the badgers!) By one of those paradoxical reversals, a sunny day was taken as a bad omen. Living in Scotland, however, it is easy to imagine the critter being frightened not by the shadow itself but by how long it was, leading to it realize that the sun was still much too low in the south for any decent creature to stirring about this early in the year!

The 2nd of February is also Candlemas, 40 days after Christmas, in which candles are lit to celebrate the presentation of Jesus to Temple. When we lit candles for Candlemas last Sunday at St. Mary’s, I had no idea that we were participating in the Imbolc/ St. Brigid-Bride/ fire-healing festival, associated with this seasonal turning that I have been fascinated by for the past 40 years of my life. In Christian terms, this tridium resonates with and foreshadows the Great Tridium of Holy week: Maundy Thursday – Good Friday – Easter.

At a deeper level, in the end, it seems quite clear to me that Groundhog’s Day is also about whether we are living by the Roman calendar, in which spring does not begin until the Vernal Equinox (signalling Easter), another 6 weeks away, or by the Celtic calendar, in which Spring begins right now. I have always preferred to believe that Spring begins on the first of February, on my brother Conal’s birthday, the time when the pace by which each day grows longer and lighter than the last picks up and begins to rush toward the long Scottish Light is summer.

St. Brigid’s Eve + Day + Candlemas
= Latha Fhèill Brìghde
= Lousadzak, proposed Scottish-Armenian Festival of the Coming of the Light (see entry for January 10 2007).