Tuesday, March 13, 2007

UK-SPR and the Origins of Process-Experiential Therapy

Entry written 13 March 13, 2007 while returning from UK-SPR/Ravenscar-2007:

We first attended the annual meeting of the UK Chapter of the Society for Psychotherapy Research (UK-SPR) in 1985, while we were living in Sheffield, England during my first sabbatical. The meeting was small and intimate, less than 100. The setting was Raven Hall, a dramatic, windswept country hotel on a rocky promontory overlooking the North Sea. Legend has it that during his spells of madness King George III was kept in asylum at Raven Hall; and indeed the main meeting room was the George III Room. At that conference, Bill Stiles and I gave presentations, and it appears that that may have started a tradition of bringing in one or preferably two international psychotherapy researchers each year. (In fact, they had me back some years later, in 1996, when the other international guest was Jackie Persons, developer of a personalized approach to cognitive therapy.)

This year’s conference brought back strongly to me memories of my first Ravenscar meeting. I have written in a book chapter (Elliott, 1999) about how the 1985 UK-SPR meeting turned out to be a turning point in my professional career, which led to my involvement in what became Process-Experiential therapy. Prior to that time, I practiced in an eclectic psychodynamic-experiential mix (with occasional bits of CBT thrown in). At the Ravenscar meeting in 1985, I presented a significant event in which I interpreted my client’s dream, including my client’s account of her moment-by-moment experiences during the event, gathered through the use of Interpersonal Process Recall:

As I presented these data to the audience of primarily psychodynamically-oriented therapists, one of them offered a psychodynamic interpretation of something the client had reported to the researcher in the IPR interview. In response, I told the audience that one should not make such high-level inferences about phenomenological data. The analyst who had made the interpretation then pointed out that I had obviously felt no such compunction against interpreting my client’s dream in the therapy session. Wasn’t I being inconsistent, he said, if I refused to do in my research what I did in my practice as a therapist? I agreed that it was inconsistent, but that research and therapy were very different enterprises. In qualitative research, I answered, it is very important to stay close to the research informant’s meanings and not to impose the researcher’s meanings. This argument did not impress the analyst, but we were forced to leave the issue there. (Elliott, 1999)

Nevertheless, I went away from this confrontation deeply troubled. I knew that the analyst was correct in his observation. However, as I reflected on the contradiction, I realized that my commitment to understanding the client’s experience in his or her own terms – as I had developed it in my research - was more important to me than the pleasure I took in interpreting my clients. I had to admit my use of interpretations was more about being clever than really helping clients, since over the years I had gradually lost my faith in the mutative power of interpretations, at least as I practiced them, and had become disturbed by the work of Strupp and others on their potentially harmful effects. If something had to give, it was going to have to be my therapeutic orientation!

The rest is history, as the saying goes: We returned to Ohio, with me determined to carry out the kind of process-outcome research I had seen being done by David Shapiro and his team at the University of Sheffield. I began working with Laura Rice and Les Greenberg to develop the therapy to be delivered, which eventually became known as the Process-Experiential approach, and still later Emotion-Focused Therapy. And that all started at Ravenscar!

Reference: 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.

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