DIVING DEEPER
•Seeing, Listening, Feeling
•Embodiment
•Immersion
•Intuition
•Empathy
•Tacit knowledge
•Humour
•Warmth
In many ways this set of streams is the core toolkit we need with us on our journey to mastery. We sometimes call them the ‘avenues of immersion’, ways of allowing ourselves to delve ever deeper and more completely into the terrain. When applied to working with clients in therapy they are vital skills to bring with you each time you sit down in the therapist’s chair. This set of streams enables us to delve deeper once we have been able to enter the space and dialogue, the play and exploration, opened up the stories and metaphors encountered in the ‘Jumping In’ chapter. It is worth repeating here that it would be ridiculous to try to follow these streams in some sort of sequential order – that would be totally contrary to the spirit of situated practice. We weave with multiple strands of thread simultaneously once our feet touch down in real-world territory (as the later stream Juggling explores) or as our head goes beneath the waves and we allow ourselves to get wet.
However, it is useful to conceptualise this group together as they all focus on getting under the skin, beneath the surface and entering into the core of another person’s heart and mind – employing as much situated skill as we own to get inside this person’s way of being in the world and seeing the world.
STREAM 11: SEEING, LISTENING, FEELING
Seeing with the eyes of another, listening with the ears of another, and feeling with the heart of another.
Alfred Adler
In our reflective practice work at university we begin by asking our students to explore what we call the ‘avenues of immersion’. These are ways in which the therapist can become fully immersed in the intersubjective space between themselves and their client. The avenues allow us to get inside the internal world of the person we are working with, trying to experience the world from their perspective. These tasks represent the root of all empathy: and for the client, in feeling your attempts to be with them and understand their world, the seeds of trust, feeling heard and contained, can be planted. The three key ways of immersing ourselves are seeing, listening and feeling.
I have placed this stream first in the ‘Diving Deeper’ chapter as the six streams that follow: embodiment, immersion, intuition, empathy, tacit knowledge, humour and warmth are tributaries of this stream. It is hard to use humour sensitively and appropriately or to feel genuine warmth if we have not really entered this person’s world. I would argue that empathy, immersion and intuition are severely hampered in practice if we haven’t opened up our channels of seeing, listening and feeling.
Our students often ask: in what way are these streams different from the seeing, listening and feeling we do in everyday life? This turns out to be the very best question.
Much of our visual system as humans is shared with all animals (even worms) – it allows us to react to light and to take in and process visual information from our environment. The lens in the eye focuses an image onto the retina, which converts patterns of light into neuronal signals to send to the brain’s central ganglia. It’s a fascinating process and one which is fairly mechanical. Far more interesting from the lived experience viewpoint is what we end up focusing on and its emotional impact on us. The vast majority of visual information is only selectively attended to, yet if we see our child’s face looking sad or richly coloured flowers or a traffic accident our attention is gripped. I can still form the visual image in my mind’s eye of watching the sun rise over the Grand Canyon, or the smile on the face of the first person I fell in love with – some imagery sticks around. More distressing imagery we tend to block out: a shard of glass sticking out of my arm during bar work 20 years ago, photographs of bodies following post-mortems when I worked in the law courts – for some people the sight of a father beating a mother, seeing a partner acting sexually with someone else yet unaware of your presence, the vision of a wife during the end stages of breast cancer.
Years ago a firefighter I was working with said, ‘When a building is on fire most people run away; we have to run towards.’ For therapists it is similar, although not as physically dangerous. We must look deeply into people’s anger, pain, loneliness, existential terror, grief or self-loathing without flinching or turning away yet without becoming so hard and immune that we cannot be deeply moved any more.
The Streams in the Consulting Room
SEEING, LISTENING, FEELING
To be truly open to these avenues of immersion – you have to get out of the way. Your ego, fears, narcissistic tendencies, needing to be liked or be clever, your hunger, the lingering anger from the row with your partner last night – all have to give way (temporarily) to the journey into this other person’s unique inner world.
This involves effort and some sacrifice – yet it is also wonderful. The chance to flee the bonds of self-hood (and all its associated trials and heaviness) for a while is marvellously freeing. At times when life has been truly awful therapy space has acted as a small holiday from personal pain and has re-opened me to the world outside of self.
Our everyday version of seeing: half paying attention to thousands of competing images, and jumping to rapid, judgemental conclusions about what we see, will not work well in therapy space. That trait (of rushing to quick judgement) is necessary for animals to survive in the wild (or for humans in modern settings). Stopping to contemplate the internal motivation of that tiger hurtling towards you is hardly a sensible survival strategy. The trouble is that the automatic process of uber-fast decision making hampers us if we wish to build intimacy and increase trust – it can become problematic in the context of relationship making. Part of the reason for Slowing Down is to gradually allow things to take form, to revise first impressions and to really pay attention to detail. Seeing into (or in-sight) is the polar opposite of stereotyping (putting things into neat categories or boxes) or prejudice (pre-judgement). It is attempting to freshly encounter things as they actually are – which lies at the heart of phenomenology.
Listening is much the same: we tend to say ‘I hear you’ or ‘I get what you’re saying’ when half the time we are merely trying to rush in with what we have to say next. We angrily shout ‘Listen’ at someone who we feel is not really open to our side of the story. In childhood this is common: children to be seen and not heard. Good parents are genuinely willing and able to listen to their child (at least sometimes!) but sadly many parents cannot or will not hear what their child is really feeling. Some of us know the pain of rarely feeling able to voice our true feelings growing up – it may have been dangerous to do so, perhaps the people in our family were poor at managing real feelings and didn’t model it for us or maybe we had felt mocked, teased or shamed for being too sensitive, too clever, not clever enough, too different, not different enough and so on. There are so many settings in which the voice of the real self learns to hide as we grow: interactions with parents, siblings, friends, school and places of worship. We internalise the social rules around politeness, appropriateness and good manners so that we don’t ‘show ourselves up’ or ‘let anyone else down’. We need to belong and fit in – to feel wanted – so we learn to be good little hypocrites just like the rest of the herd. Some of this is necessary – it is part of emotional self-regulation to know when to express something appropriately, to learn delayed gratification and self-discipline, to consider others’ feelings – so we do not become too selfish or psychopathic, yet too often the shutting down of the real voice goes too far and begins to really hurt us.
Reflection Point
SEEING, LISTENING, FEELING
•Spend five minutes staring closely at something familiar: the back of your hand, a tree, your front door. What do you notice when you pay close attention? How is this different from your normal experience of this everyday object?
•Listen to a song that is not sung in a language you know – if this person had a story what would it be? What are they feeling? Try to hear the voice of the heart.
•Feeling: the next time you feel ‘upset’, ‘out of sorts’ or ‘bored’ – try to tune in to the deeper feelings underlying these ordinary states.
It works the other way too. If we are honest with ourselves much of the time when we claim to be listening to others a good part of us is still caught up with our own needs, sensations and worries. We all do it and pretend we aren’t. Naturally we know when someone’s attention is only partly with us – we can feel it. Usually we take turns and switch the conversation back to them if we fear we are boring them – even whilst we are feeling sulky and resentful at having to do so. In therapy space we must work hard not to play these games too much – the space between us in here must feel different from the space between people out there, if it is to become a place in which psychological healing can occur. Attention to this is vital – which is why Space and Place is one of the streams.
There is a simple and profound power in somebody truly listening to how we feel. Not to the words particularly, the sentence structure, grammar or vocabulary – rather to the emotional content, what we have come to call the music under the words, which is really the voice of the heart. This is what the therapist must try to hear. It may be a tune that the client barely knows themselves, one which even their loved ones struggle to fully know, or may be unable to listen to, but if the client really feels you have heard it (and felt its inbuilt emotion on your pulse as on their own) something transformational may begin. Initially the words used by clients may mask the real song – we all feel pressure to be liked, to seem happier than we really are, perhaps not to impose too much on the good will of others. They may be terrified of the real song, ashamed or angered by it, maybe the music has been in their life for so long they can hardly pick out the melody anymore; yet this secret song of the heart may form the centre of what pains them, keeps them stuck in life or may speak of the real self who is longing for release. Even if nobody else can hear it, as therapists we must try.
Deeply connected to seeing and listening is feeling. Therapists need to have good self-regulation (the ability to manage our cognitive, emotional and behavioural responses to the environment) to stay with appropriate and holding reactions which are empathically attuned to the client and their needs even when we may be feeling lost, preoccupied or overwhelmed ourselves. We also need to be aware of feelings as they are among our best tools for understanding what is going on for the client. When we are experiencing a flood of countertransference response to a grieving client we must tease apart our own memories, past griefs and unconscious reactions from the client’s. This can never be exact science, but openness to our own feeling state and the capacity to evaluate and reflect on it is tied to good practice. In therapy the feelings we have are triggered by what we see and hear: the catch in the voice, the rueful smile, the glistening eye that speaks of unshed tears, the tension in the body when talking about childhood pain. I have often used the question ‘if your tears could speak what would they say?’ to a client consumed with crying and struggling to verbalise their emotions. Silences, tears, resentment, fear – all have their own energy, beyond that which is audible or visible, that we can tune into if we are fully present and engaged.
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The Key to SEEING, LISTENING, FEELING is developing a practised sensitivity to what is outside you and what you experience within you – and letting go of the rush to judgement which the world forces us into. |
There is more wisdom in your body than in your deepest philosophy.
Friedrich Nietzche (1969)
It is through our senses that we receive information from the external world of others and the internal world of ourselves. We may elect to block, defend or absorb that information. Our responses, our learning in and from any situation are a process of perception, attention, concentration and intention. By this means we create patterns of interaction within and without ourselves that configure our experiences of the world. The embodied counsellor consciously works within the interrelationship of the different senses as they are involved in the patterning and weaving of engagement in the living world. Embodiment, in the meaning intended here, is the recognition of the primacy of the counsellor’s body in relationship to others, and to the environment, as the hub of interpersonal experience and individual and collective sense making, and as a primary characteristic of situated practice. Such a position is in contrast to, for example, approaches in which it is the intellectual or theoretical constructs of the counsellor that serve as the foremost source of informing and validating the process of the therapeutic encounter.
The Streams in the Consulting Room
EMBODIMENT
Two of the best sources of information in the therapy room are what the client’s body is doing and how your own body is feeling.
Particularly with the clients who experienced trauma in childhood, or learned to disassociate as a form of protection, helping them to recognise the body memory which arises when they are working through strong emotions can be really beneficial.
Noting my own body’s reactions to material assists me in identifying countertransference, projective identification and deepening my empathic attunement. If I listen well it also assists me in recognising intuitive flashes.
The embodied experience may be developed and explored through a focus on the sensorium of the counsellor which can be best understood as the crucible made up of the sensory, psychological and phenomenal perceptions of the counsellor. Our senses offer five distinct sources of knowledge and experience and in turn structure our relationship with the world. The dominance of any one sense over the others in turn determines and constrains experience and learning. It is argued that in the twenty-first century the world of media technology, written text and externally produced imagery have taken on the role as the dominant source of individual sense making, replacing smell which until relatively recent times played a much more significant role as a source of knowledge. Sight, so closely associated with the brain and mental reasoning, can contribute to a particular isolation from the range of situated knowledge available to the human sensorium. The packaged fruit and meat of the supermarket appeals primarily to the visual sense, to the cognitive, revealing little of the quality or pleasure to the primary senses of taste and smell associated with the consumption of food. This loss of initial direct embodied contact and sense making with our food is now textually, symbolically represented as computer-generated ‘display’ and ‘use by’ dates in much of the developed world’s retail industry.
EMBODIMENT
•How do you typically experience emotional pain in your body? Where does it show up?
•Recall a memory of experiencing emotional comfort from someone else as a child – how is your body involved in this memory?
•Think about how the following emotions impact you physically: shame, loneliness, anger, yearning, guilt.
Sensory knowledge is often ineffable, often outside of verbal reasoning, but is nevertheless experienced, real, impressing, and an inherent part of any life situation. Our senses have an independence from our conscious control and play active independent roles delivering silent knowledge and understanding that often lies hidden from our consciousness of the human condition in our daily engagement with the lived world we inhabit.
Sensory and embodied experience sits at the heart of situated practice and the engagement with the client. The intersubjectivity of the relationship between counsellor and client may blur and soften the boundary between self and the world in the co-transferences of the therapeutic relationship. Embodied situated practice asks that the counsellor focus on their sensory, body awareness at the same time as focusing on, for example, the language of the client, the shared external space and the shared inner mental space. The situated practice of the counsellor supports the creation of the therapeutic potential in the safe, facilitative space of the counselling room. Such a counselling space is potent with embodied experience for the counsellor, evoking in their senses the beingness of a situated counsellor in action. The beingness of the counsellor may be said to be redefined, recontoured within this therapeutic landscape, a felt landscape formed and wounded by the acts of man.
The languaging of the body’s experience is often problematic and challenging to the received ideas about language. Describing the experience of embodied language and into the felt, intuitive uncertain space of the emergent, sometimes conflicting aspects of one’s own feelings and that of our clients.
Reflecting and writing on reflections are important elements of this module. Embodied writing invites you to bring the finely textured weave of human experience into words, to evoke, from within, words and senses from the sensuous living world, to sometimes take creative risks in order to evoke for the reader, and oneself representations in writing that resonate with the visceral counselling encounter of attunement, resonance and sensation. To perhaps explore reflective poetic forms of writing, that seek to bring forth, in a multisensory representation, the embodied encounter of the situated student practitioner.
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The Key to EMBODIMENT is paying attention to what the body is doing and feeling – particularly when the body is expressing something different from the mouth or the face. |
The moment of truth, the sudden emergence of a new insight, is an act of intuition. Such intuitions give the appearance of miraculous flushes; or short-circuits of reasoning. In fact they may be likened to an immersed chain, of which only the beginning and the end are visible above the surface of consciousness. The driver vanishes at one end of the chain and comes up at the other end, guided by invisible links.
Arthur Koestler (1989)
Imagine a young child sitting nervously on the side of a swimming pool. They have been watching other people swim for a while now and have been given some instruction in water safety. Mum and Dad and several friends have tried to explain what it feels like to be in the water. All of this helps to prepare them for the next step. However, these pictures painted by others are inadequate, they can never fully communicate what that first rush of water over the head feels like. We cannot properly explain an experience to someone. It always falls short. In order to have the experience they must jump in the pool, not sit on the edge talking about it.
To really begin to know new terrain we must immerse ourselves in it. We must jump in, get wet, go under the surface, and relinquish control. This stream is deeply connected to Stream 1: The Leap of Faith – in that it takes courage and a willingness to let go. The difference is that the leap is concerned with the run-up to jumping off the cliff – whilst immersion is about what you learn once you hit the water. The metaphor of jumping in to a pool is apt here – your head must go under, you are likely to feel overwhelmed at first. In new territory we must get wet in order to begin to know it well. If you have ever watched somebody swim who is terrified of getting their face or hair wet you will know what I mean – you must relinquish some control and allow yourself to be affected by this new territory. The rigidly models-led mindset tries not to get its hair wet, to stay above and separated from this new world, to not be changed by it. In really tasting the situated world we cannot do this.
Therapist as diving teacher
Part of immersion is feeling comfortable going under the surface: into the unconscious, the half-forgotten, the shadow, the split-off trauma, the denied existential angst, body memory and the hated, fear-inducing parts of the self. If we are to serve as a safe pair of hands for the client to make such treacherous, but necessary, journeys we must be used to these places ourselves – both within the self and within the psyche of others. It needs practice – which is why most of us explore ourselves in therapy during our training and why we get our students to engage in reflective and challenging experiential work right from the start of their degrees. Much of humanity is not at ease under the psychological surface – they will engage in any number of defensive manoeuvres to stay away from such murky depths. The media and the pace of modern living all tend to focus on the surface of things, the cultural spotlight moves and spins rapidly from celebrity to product to movie to YouTube viral video. As Bret Easton Ellis says in his novel Glamorama (1998, p.112), ‘we slide down the surface of things’.
The wise therapist must be different and learn to become skilled at helping others navigate the deeper currents – that is where most human pain is formed and where genuine healing takes place. Living at top-speed superficial level is hurting many people’s psyche in the modern urban world – therapy space must be different, acting as an antidote to the sometimes impersonal, uncaring, crowded, techno-drenched world outside.
IMMERSION
•Recall how you were feeling the first time you ever went for some form of professional help – what feelings, thoughts, fears and fantasies predominated?
•Or when you have had to share a secret with a friend or loved one?
•Immersion is about encountering new territory and allowing ourselves to encounter its depths – is there an area of your life right now where you are clinging to the edge of the pool and finding it hard to let go?
•What will it take for you to go under the surface?
Cognitive immersion helps you to learn
This immersion is one of the major foundations in situatedness.
This has to do with transitions, defences and resistances: the processes involved in letting go of a more models-led mode of learning and function, and embracing a more situated one. Thus: what is this transition, and might it involve a stage of being all at sea, bereft of the old but not yet sure of the new? What are the blocks to even making such a transition? Why might some people make it easier than others? Why might some people resist situatedness en bloc, whilst others resist only pieces of it? Is the challenge to embracing situatedness more of a personal nature, or more to do with ‘getting’ its logic and strategy? Might there be any discernible order to the steps by which a person switches from reliance on models to situatedness?
The learning journey has to do with noteworthy learning events, and the way they weave together to produce alterations in understanding and skill. Thus: what is the discovery process that occurs in the situation? Does it have any discernible structure, or logic? What is it like to undergo its ups and downs, ins and outs, or its refusal to let us know all we might need to know in advance? Why might mistakes and failures be as vital to this learning process as successes? How do key learning events make a coherent whole over time?
The Streams in the Consulting Room
IMMERSION
The more experienced you are as a practitioner the more you should have learned to immerse yourself – but there are always deeper levels to which we can travel. Challenging ourselves to push further down is what separates a good therapist from a truly wise one.
Most of the time, however, immersion shows up in the room when we must work with nervous swimmers, needing to dive deeply into the self – but scared to let go of the side of the pool and go under the water.
We should never forget how it felt for us the first few times we did this and strive to offer strong encouragement and support yet never force people before they are ready.
In the Reflective Practice module and all of the skills training and experiential work on our two degrees (Psychology & Counselling and Therapeutic Psychology) we explicitly give permission and create space for students to struggle with the situated action mode – and it is usually something of a struggle at first due to its clash with the educative/learning context that is more usually academic, and which students have been trained in at primary school, secondary school and college. Struggle is inbuilt to situatedness (it is one of the later streams) and we encourage our students to be more concerned with the Travelling and the Fight along the Way, rather than with any particular outcome. You get to try situatedness out for yourselves, reflect on its operation and potential importance for therapy. The broad aim is to enlarge the sphere of reflection by bringing in new data. The end result is new information, insight and evaluation. The difference is that the data are not theories, experiments, statistical tests, but the outcomes of experience and practice.
When we neglect our experiences we skim over them, stay fairly uninvolved and are only partly present. This can create a bias toward quick responding, which seems more like a sort of bloodless ‘in and out’. This can generate insight, like fire crackers fizzing through the air, but not understanding. Understanding takes much longer to crystallise, and only develops if we are really ‘submerged’ in the situation. It is necessary to get ‘down into it’, ‘get our hands dirty’ rather than remaining ‘high and dry’.
Accepting experience is tantamount to accepting true immersion. This is why presence to, immersion in, and relationship with, the terrain is so important.
The dynamic here is less like riding the wave, and more like being thrown into the water ‘at the deep end’. This is why no amount of teaching how to swim through diagrams on a blackboard, or even mimicking the movements required, will help the non-swimmer. They just have to experience being in water. This applies to everything on the ground. Until we have ‘experienced it’, we just do not know what it is, in the truth it brings to us. That truth is a music that is not simply externally heard, but plays on the drum of the heart, making it beat in a certain way. One reason most adults are tempted to run from such learning is that it has become suffused with fear, expectation and the terror of getting it wrong. Young children do not naturally learn in this way, their curiosity knows no bounds. They do not need to know where the next step in the journey is taking them; instead they delight in the twists and turns and can easily become so absorbed that all sense of time and self – and worry – is gone. For the situated practitioner, recapturing something of that childhood ability is crucial.
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The Key to IMMERSION is courage – being willing to lose your head for a while and go under the waves – it is only then you can begin to develop true confidence in the deep waters of the human psyche. |
Albert Einstein called the intuitive or metaphoric mind a sacred gift. He added that the rational mind was a faithful servant. It is paradoxical that in the context of modern life we have begun to worship the servant and defile the devine.
Matthew Stein (2000, p.26)
The idea behind Einstein’s gift is that intuitive mind is sacred, hard-won and increasingly disrespected in the speed of the modern world. We must practice so it can develop. Practice makes perfect, but the wrong kind of practice gets you into bad habits. This is just as true for the practice of music, sport, dance, DJing, judo, acting as it is for psychotherapy and counselling. In reality we don’t reproduce in any mechanical way or imitative way what we have practised in exercises. Somehow various things are woven together in the here and now of the living situation that cannot be done outside of it. You can think of it as ‘being in the zone’ – not just the mind thinking about it, but the body, the heart and the soul being there too. This is deeply connected to the experiences of trance and flow which we will explore in more depth later. The well is not a machine: it is affected by emotion, situation – some days you cannot draw water, other days the water is polluted and on yet others the bucket gets stuck and just won’t rise to the surface. Yet we know there are some things you can do to help kick start it. For example, it is much easier to get into the well in dialogue, in performance, being witnessed by an audience.
The weaving together cannot be mapped in advance of it actually happening. It therefore always has some spontaneity and improvisation in it, an element of creation in situ. There is an element of inspiration and magic. If you sit in fear not knowing which way to go nothing will come to you, but if you start walking regardless of the fear the universe (or the well) will move towards you and assist.
The truth is that sometimes we are more able to access our intuitive mind than others – usually on days when we are able to get out of our own way. The conscious mind does not drive intuition – it is too slow. If we rely on the conscious mind too much what seems to be intuitive might very well be something else – prejudice, pre-existing beliefs, bits of theory, personal preferences masquerading as intuition. The real thing tends to come up from the unconscious mind, the body, the emotional self, the energetic field between you and your client – from an intangible place that moves faster than the mechanical brain can handle. It frequently shows up as fragments of feeling, imagery, like a door just waiting to be gently pushed open – rather than anything concrete and ready formed.
It feels rather more like the remnants of dreams – sand slipping through fingers, flickering embers, sparks in the sky – than solid blocks of wood. Perhaps this is why we find it harder to trust it when we are sitting in the professional role of therapeutic practitioner. We put pressure on ourselves to know for sure what we are doing and follow the rules, particularly when we are new to the field. Requiring absolute certainty when working with another emotional, complex, messy human being will only disable the intuitive flow and trap us into mistrusting it when it shows up.
Reflection Point
INTUITION
•Think of a time when an intuitive feeling turned out to be correct. Now think of an occasion when an intuitive feeling turned out to be wrong.
•Reflecting on these, can you identify any differences in how these two ‘intuitive moments’ presented themselves to you?
•As a child what messages were you given around being an intuitive person, particularly from members of your own gender?
•As a practitioner what messages does your profession give you about intuition?
Acting on an intuitive flash whilst working must always be tentative – we can never really be quite sure where the intuitive feeling is coming from and whether it will feel right for the client – so it must be offered or shared gently at first to see if it resonates with them. What I have learned over the years is that when these intuitive flashes come they provide fantastic shortcut moments if they are shared in the right way. Often, for me, they come as pictures in my head, or tensions in my body, as metaphors from film, TV or books that when brought into the room turn out to capture excellently something that was ‘floating in the air’ or ‘bubbling just under the surface’ in the room.
As a male practitioner I have worked to build this into my practice. Boys are usually taught that intuition is the province of women – who ever heard of a man’s intuition – and may feel that this is not something they have a natural affinity for. And women may feel that any reliance on intuition may risk stripping away their hard-won sense of professionalism – that they may be mocked or derided for it. Certainly during training both genders are likely to feel cautious about saying that any aspect of the therapy comes from an intuitive place rather than theory or evidence-based research. Supervisors can assist here by owning this element of their own practice and encouraging trainees to explore and reflect upon moments of intuition during therapy.
The Streams in the Consulting Room
INTUITION
With clients who find it hard to feel or describe their emotions you may find much charged emotional energy is left circulating in the room and your intuitive side may pick this up.
Paying close attention to this is a really powerful way of understanding what it feels like being this person and gives you a unique entrance key into the treasure house of their heart and their buried psyche.
Fortunately there is a growing body of work which is fleshing out the idea of intuition having a central place in psychotherapeutic practice based on our understanding of neuroscience. Terry Marks-Tarlow (2012) in her ground-breaking book Clinical Intuition in Psychotherapy acknowledges this longstanding ‘problem’ with intuition: that it can seem like ‘magic’ or ‘mysticism’ to those watching or even to those experiencing it. Psychology has more than a century of history of trying to prove itself a proper science and the hangover of this need has been felt all the way from Freud and his ‘Project for a Scientific Psychology’ (1977 [1895]) in the 1890s through to today’s reification of evidence-based CBT practice. Against such pressure the embracing of intuition as a valid instrument for the professional therapist has faced major obstacles – the therapy tool that dare not speak its name in serious company. Marks-Tarlow’s work argues that ‘clinical intuition fills the gap between theory and practice…accentuates perception of relational patterns in self and others…and is a necessary ingredient for deep change in psychotherapy’ (p.3). Clearly this fits in precisely with what I am putting forward as the situated action position.
Allan Schore (2012) supports this notion and maintains that we can properly understand clinical intuition as the operation, at speed and unconsciously, of non-verbal, right-brain to right-brain communication and empathic attunement occurring within the therapeutic dyad. Whilst its operation may be very rapid, the gradual cultivation of our intuitive self that fills the well requires us to slow down and pay attention, to listen, to feel – which is very closely related to the Seeing, Listening, Feeling stream discussed earlier in this chapter. Intuition comes up from the depths – it doesn’t thrive on the surface and your ability to trust that it has useful information for you will only be consolidated when you have dared to bring it into the interpersonal field.
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The Key to INTUITION is to listen for the flashes of intuition and practise trusting it. |
Could a greater miracle take place than for us to look through each other’s eyes for an instant?
Henry David Thoreau
If each new client in therapy is a fresh piece of terrain we must spend time getting to know the lie of the land, how things look from their vantage point. What does the world look like through their eyes? Our greatest tool for doing this lies in the use of empathy.
Rollo May, in his classic work The Art of Counselling (1965) asks: How does one personality meet and react to another? At some level it is by each making an attempt to understand and feel the emotional and psychological world of the other. Empathy is a translation of a word used by German psychologists ‘einfulung’ – feeling into. It is derived from the Greek ‘pathos’ meaning a deep and strong feeling akin to suffering. May described it as ‘a much deeper state of identification of personalities in which one person so feels in to the other as temporarily to lose his or her identity’ (May 1965, p.61). It is in this space that understanding, compassion, communication and influence can take place.
Empathy is work. It is not surface-level sympathy which is easily given and dipped in sugary condescension. It is easy to empathise with someone whose experiences are judged ‘victimless’ or whose life experience is close to your own. It is much harder to extend your empathic attunement to people whose experiences, motivations and behaviour may be condemned or judged and may be very different to your own beliefs. It takes more discipline and courage to stay connected to the internal world of someone whose wavelength is unfamiliar, which may disturb, challenge or upset you.
This is where morality must be applied in a way different from that commonly understood. As therapists, when we agree to travel with someone into their psychological territory we do not go as a moral judge or jury, rather as a guide, a support, a fellow traveller. To that end we must learn to separate the person from the behaviour, if the behaviour is something with which we personally disagree. Even if our internal terrain is dramatically different from that of the client we can allow ourselves to connect to the underlying feelings of their experience.
We have all felt sadness, loss, love, shame, rage, joy, disappointment, success or loneliness – even though it may have been in very different contexts.
Communicating your empathic attunement to the client may be one of the most therapeutic things you can do. Yet, Kohut (1981) also understood that empathy could only be relevant to human interaction if it results in a response that follows directly from one’s experience-near observations (things we notice either during or very soon after the expereience itself), which Kohut sees as linking empathy and action while emphasising their differences: by this he means that it is only when one is able to step into another’s shoes, to see the world through the other’s eyes that one is able to generate an authentic, accurate, fitting response. The use of empathy in the clinical setting is partly for the purpose of understanding and explaining what one has observed but is primarily for the purpose of communicating our understanding back to the client so that they can internalise this. This is a perfect fit with our philosophy of reflective practice and thinking about action after it takes place.
EMPATHY
•How does it feel when you are in relationship with someone who struggles with being empathically attuned to your internal world?
•What, for you, is the difference between empathy and sympathy?
•What are your personal blocks when you try to ‘feel into’ another person’s emotional inner world?
The Failures of Empathy
We can never get it right every time. Whether as therapists, parents, drivers or cooks we often make mistakes. It is impossible to be perfectly empathically attuned all the time as therapists (it is just the same for parents). In fact we wouldn’t want to be. Heinz Kohut taught us that such failures are of great value to clients: they are what make transmuting internalisations possible, whereby the self-soothing internal structures of the client get a chance to build. From a psychodynamic viewpoint empathy is analogous to the capacity to identify a face in a single act of perception. It is one of the earliest skills we learn as tiny babies: how to read the emotion on mother’s face. This ability comes from the same root as empathy.
According to Kohut, ‘the small child’s perceptual merging with mother’s face constitutes her most important access to mother’s identity and her emotions’ (1981, p.84). Our capacity for empathy originates in our earliest merger with mother whose feelings, actions and behaviours are included in the self. This primary empathy with mother prepares us for the recognition that the basic inner experiences of other people remain similar to our own. With psychopaths and some forms of personality disorder the capacity for empathy barely develops, with frightening results.
The empathic circuits within the brain
The intersubjective nature of the brain is facilitated by a system of neural mirroring in the brain. Mirror neurons discharge both when an action is performed and when a similar action is observed in another person. This seems to match the behaviour of others to our own experience. This enables us to reach some mutual understanding. So think for example of how you feel like yawning when someone near you yawns, or laughs, or feels sick. Have you ever been brought to tears simply by seeing someone else cry? When someone you love is feeling pain have you ever been almost able to feel that pain in your own body? As human beings we are designed to be able to feel our way into someone else’s experiences; this gives us social and evolutionary advantage in that we can tell when someone is with us or against us – whether they are a potential danger or an ally.
The Streams in the Consulting Room
EMPATHY
Those of us who practise therapeutically tend to be well versed in empathising with others.
Pitfalls sometimes arise when the person we are trying to empathise with has behaved badly, what we see as immorally or in a way which damages others.
An old supervisor of mine in a prison setting first introduced me to the notion of separating the person from the behaviour. Even when faced with the worst of human behaviour, reminding ourselves that behind this lies real human suffering, woundedness and pain can help us to remain empathic even when full of revulsion, judgement or dislike.
Psychotherapy becomes a new attachment relationship (in adulthood) which is able to restructure attachment-related implicit memory through affective communication (non-verbal communication, undertones, atmosphere) more than verbal communication; thus the explicit past is not focused on as much but rather the implicit past which unconsciously organises and structures the client’s ‘procedural field’ of relating to others. There is now a good deal of evidence (Badenoch 2008; Cozolino 2010; Gerhardt 2004) which suggests that the brain retains the capacity for re-organisation (or plasticity) well into adulthood and that new emotional experiences will help to restructure neural pathways in the pre-frontal cortex of the brain which controls social and emotional relationships. Significant parts of the emerging field of interpersonal neurobiology (Siegel 2012) consider how the relational world – both developmentally and therapeutically – shapes many of the neural structures that control emotional regulation, management of anxiety, stress and anger and our subjective experience of our psychosocial world.
I would urge you to read Professor Simon Baron-Cohen’s fascinating book Zero Degrees of Empathy (2011) for more on the neuroscientific basis for empathy and what happens to those people who have little or none. He examines how a complete lack of empathy can present – among borderline, psychopathic and narcissistic patients – and how those with limited capacity for cognitive empathy but who are still able to feel affective empathy, such as those diagnosed with Asperger’s Syndrome or those on the Autistic spectrum, are frequently misunderstood.
So empathy is the best tool we have for entering the internal psychological terrain of another person. It is one of the fundamental attributes that defines our humanity and is one of the key ingredients we have in our well. In many ways it is the oil that drives the engines of situatedness.
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The Key to EMPATHY is effort – to take that leap between your subjective experience of the world and imagining your way into theirs. Sometimes this comes naturally but effort is needed for the times it doesn’t. |
We know more than we can tell.
Michael Polanyi (2009, p.4)
Tacit knowledge refers to skills and knowledge which lie deeply within our minds, our hands, our bodies, but of which we often struggle to give a verbal account. Like a painter who ‘knows’ which colours to mix to get the right effect or a mother who ‘knows’ exactly the tone of voice which will comfort her crying child. When we are in the apprentice stage we are constantly tested and interrogated on what we know, in exams, driving tests, the penetrating questions of the more experienced: this tends to make us feel anything coming from tacit knowledge is worthless unless it can be explained, justified or proven.
The more experienced you become, the less you need to make that tacit knowledge explicit, especially in the form of explaining yourself and what you are doing to someone else, who may be evaluating or questioning you. As this living water increases, as tacit knowing expands, this storehouse within us becomes far more than could ever be held at once in the conscious mind.
TACIT KNOWLEDGE
•What does it feel like when you have to teach a complex activity which you ‘know in your bones’ to someone who is brand new to it?
•What happens to your own skill level?
•Think of half a dozen examples in your present life where you use excellent tacit knowledge which would look extraordinary to someone unskilled in the same field.
Smith (2003) references the groundbreaking work of Michael Polanyi on tacit knowledge. Polanyi believed that acts of creativity – especially when they are undertaken in the spirit of discovery – are naturally imbued with powerful personal feelings and lead to a level of commitment on the part of the person involved. His best known text Personal Knowledge (1958) put forward a convincing critique of just how impersonal and (supposedly) value-free the scientific method was becoming (as practised in the West certainly). He sought to restore the value of ‘tacit knowing’ to the heart of the scientific endeavor. Smith highlights Polanyi’s arguments that ‘informed guesses, hunches and imaginings that are part exploratory acts are motivated by what he describes as “passions”’. His most famous quote is ‘we know more than we can tell’. This approach captures beautifully the underlying ethos of situated action and practical wisdom and the real depth and richness it can bring to the practice of psychotherapy – not to replace models-led thinking, rather to humanise, enliven and ground it in the reality of face-to-face meeting which is experienced by us as emotional, physiological, temporal and spacial – as well as the purely cognitive. The scientific method has tended to reify the cognitive and mockingly exclude the other fields as somehow less than itself.
Restricting our view of the territory to a simple cognitive lens is likely to trip us up pretty fast in the lived experience of the human world. Sometimes this produces the phenomenon of stage fright: the actor who tacitly knows all five acts of Hamlet suddenly panics, and tries to remember it all to reassure himself he can do it. But as he fails to bring it all to mind, he freezes or, in similar vein, we leave the terrain and our situated action there for a time, and in that interval it all sinks down deep, we forget it consciously.
So we conclude we cannot do it, we’ve lost it, it has all leaked out of us…but in fact it is still there ‘deep down’. Since it got there through active and conscious relating to the terrain, it is not until we are back in the terrain itself, and start to be alerted to all those sights, tastes, smells, sounds, again, and it is not until we start venturing into the action we once performed there, that the tacit knowing kicks in. Suddenly, ‘it all floods back’, we start to remember ‘what we are doing’, or ‘how to do it’, even though we don’t know how we do it. And it is just as if we have never been away. This is why I have positioned the Leap of Faith as the first stream; until we have taken the leap the whole animal of situated – and tacit – knowing cannot bring itself to life.
Tacit knowledge is notoriously hard to pin down; mostly it cannot be written as sets of rules or procedures to be followed – you either have it or you don’t – aesthetic sense, good taste, emotional intelligence, the ability to speak a language. Precisely because it cannot be made rule bound or abstract, models-led ways of thinking tend to be highly suspicious of it – indeed actively denigrate it in many cases. Despite this ‘drawback’ (from the models-led perspective) tacit knowledge goes on spectacularly doing what it does best: operating superbly in real-world terrain at the speed of light. Before a models-led mind can turn to the index page of the rulebook, tacit knowledge has finished and has its feet up enjoying a cup of tea.
We all experience forms of this tacit knowing daily: walking, brushing your teeth, playing sport, tying your shoelaces, driving, touch typing – through to the most complex forms of human activity: performing open heart surgery, conducting an orchestra, rock climbing, responding to a distressed child. Trying to stop and explain precisely how we were doing it would actively inhibit our ability – and that is why it is notoriously difficult to break down such skill into a set of idiot-proof rules.
The Streams in the Consulting Room
TACIT KNOWLEDGE
Your store of tacit knowledge will build the longer you do work of this nature – it cannot be rushed or faked but must be nurtured, practised and eventually trusted.
Likewise the client knows far more than they can tell – about what has hurt, or what keeps them stuck in old patterns or about how to heal and move forward – our job is to guide and support them in their discovery process and to help build the best space in which they can do this work for themselves.
Incidentally this is not simply true at the individual level. Tacit knowledge operates very strongly within groups and organisations. Hutchins (1996) gives a lovely example of this when he refers to the crew operating a large US aircraft carrier. Of the entire population on the bridge not one of them knows exactly everything that is going on. But as long as each of them performs the role they have been trained for, the ship operates smoothly. And here is the real point, to articulate and make explicit what we are doing at each stage of an operation would, in practice, slow us down and hamper us. The tacit knowledge is lying dormant inside our well, and when in the right domain it flows up out of us like a fountain.
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The Key to TACIT KNOWLEDGE is a decision to be open to your ‘informed guesses, hunches and imaginings’ as a profoundly valuable source of information when practising. Total reliance on trying to cognitively store the theoretical ideas of others will de-skill you in the end – even though it promises the opposite. |
Knowledge knows a tomato is a fruit; wisdom is not putting it in a fruit salad.
Miles Kington
Just like Miles Kingston’s gag above, humour carries with it profound truths, so has a place in the therapeutic world. It must, however, be used with finesse, as humour is a true double-edged sword. It can be one of the sweetest builders of a warm, connected therapeutic relationship, giving a shared language to both people in the dyad, giving moments of playful lightness and relief, taking the sting out of reliving painful memories and enabling both parties to share something creative, energised and real from their internal world.
On the other hand, used injudiciously, or poorly timed, a remark or laugh that feels too ambiguous can flatten the emotional energy of a session and leave it stone dead; it can sow seeds of mistrust and doubt or can reawaken traumatic memories of feeling shamed, humiliated, teased or mocked by others.
The Hungarian novelist Arthur Koestler in his 1964 classic The Act of Creation (Koestler 1989) argues that humour is the third element of creativity alongside discovery and art. The three sections of his book – the Jester, the Sage and the Artist – explore the pivotal role discovery, imagination and humour have played in the great advances within both art and science; indeed he claims humans are at their most creative when rational thought is temporarily suspended, an idea that resonates perfectly with the situated operation of the practice wisdom streams.
Reflection Point
HUMOUR
•How did it feel when you had humour used against you as a weapon?
•Think of a time when something you meant humorously has been misinterpreted. What did the experience leave you with?
•How does the humour you use with your best friend differ from that used with your mother?
•In what sort of client situations would you feel extra cautious about employing humour?
Usually humour comes to us spontaneously as a natural reaction to something showing up in the intersubjective field. Given this, judging the appropriateness of a comment, tone of voice, chuckle or joke, can be tough to handle well as we think on our feet. How often does the true sting of a ‘funny’ comment only become apparent later – when someone is bruised, hurt or feels mocked because of it? Our intent in being humorous is often to bring us closer to others, to show our wit and cleverness, to find release and excitement in the company of others and simply to play. The darker side to humour is one we will rarely admit to: most of us don’t like being caught with blood on our hands. When humour tips over into cruelty, mockery, snideness or sarcasm it can be experienced as wounding, excluding, judging – devastating – by those who feel like the target. If people have a long history of feeling like the butt of others’ jokes they may be hypervigilant towards the underlying stab of humour’s darker side, even perceiving innocent asides as containing hidden messages designed to wound them.
The less well we know people the greater the chance that what we feel is funny might injure them in ways we do not intend. This means that in therapy settings several key streams – slowing down, intuition and empathy – really need to be present when humour enters the therapy space. For me the riskier or edgier sort of laughs can only feel comfortable when we have a good, trusting bond already established. I also need to know the person’s own humour style. If I pay close attention this usually becomes apparent early on, as does their relationship to humour in their childhood. Did they frequently experience humour used as a weapon against them? Do they have a deep history with embedded shame, feeling publicly humiliated, shy or highly anxious? Are there cultural, language or gender considerations which may increase the likelihood of misinterpretation of your intention by the client? Is the line of humour something you enjoy as a form of friendly banter with loved ones – and if so is it leaking into therapy space largely through habit?
The Streams in the Consulting Room
HUMOUR
Humour must be employed cautiously until we know the person fairly well – how sensitive, defensive or paranoid they are; and how robust their self-esteem. We need an idea of their basic moral framework and a sense of how they use language to express themselves.
It cannot be merely imposed by you or used to show off and build a kind of fake chumminess. If it evolves gradually, is shared and keenly alert to the client’s responses it can be a wonderful way of relieving tension, conveying empathy and deepening your relationship.
If misjudged or mistimed, something that can serve as one of the best bonding elements of the relationship can turn into a minefield which can upset the building of trust and safety in both you and the therapy space.
We must also recognise the role that dark humour plays in dealing with life’s tragedies. Years ago in my pre-psychology life I worked for the Crown Prosecution Service at London’s famous Old Bailey court as a law clerk. In my first few days around the office not only was I presented with extremely gruesome photographs of murder victims and post-mortem processes each day on my return from lunch but was horrified to hear my colleagues joking and bantering about rape cases, murder victims and witnesses. At first I thought I might have wandered into an office staffed by callous psychopaths. When I finally reached the courtroom itself I overheard barristers, court officials, police officers and pathologists making the sickest of jokes which, if they had been heard by anyone involved in the case, victims or their relatives, would have been devastating and been rightly condemned as unbelievably insensitive. Gradually I found myself joining in with such dark humour with relish. Being regularly exposed to the utter depravity of which human beings are capable is overwhelming to the psyche and, if we are to continue functioning in such work, we need to find ways to cope and discharge. Later, working in the prison system, at an HIV/AIDS unit and with firefighters dealing with children who set fires, I have seen exactly the same humour emerge. It goes with the territory but is often misunderstood by those from outside. Henman (2008) examines the role humour played in the functioning of American servicemen who had been prisoners of war in Vietnam. She found it helped these men to feel as though they were fighting back and taking control over something unendurable. It helped to build resilience, especially as it served to build strong social support systems within the group, all of whom were encountering the same horrific and overwhelming phenomena.
Various forms of humour are used as defence mechanisms: laughing at myself before others can mock me, trying to show that my flaws and pain don’t affect me too much, to convey strength in the face of adversity. Some clients have responded with self-deprecation, self-mockery or making light of their own pain, for so long that they are able to distance themselves effectively from feeling too much.
So early in therapy humour (used by me) will be warm, gentle and carefully non-controversial. I will watch and listen to see how my patient employs humour, and try to get a feel for the role humour has played in their life to date – and act accordingly, listening to my intuition and extending empathy to feel my way into their inner world as best I can. As the relationship deepens, trust builds and we simply know one another better – humour can morph into something unique and personal to this dyad. In using humour wisely we must take our time, feel our way slowly into its employment and be alert to the client’s reactions and changes in the interpersonal field when either of us has used some ‘funny’. If the client uses humour which seems unfeeling or intensely dark I try to understand its functions in their current psyche, even if I cannot find it funny myself.
So, dear reader, I think we know one another well enough by now – did you hear the one about a man walking in the street one day who was brutally beaten and robbed? As he lay unconscious and bleeding a therapist, who happened to be passing by, rushed up to him and exclaimed, ‘My God! Whoever did this really needs my help!’
Or if that didn’t do it for you: when the new patient was settled comfortably on the couch, the therapist began his therapy session. ‘I’m not aware of your problem,’ the therapist said. ‘So perhaps you should start at the very beginning.’
‘Of course,’ replied the patient. ‘In the beginning, I created the Heavens and the Earth…’
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The Key to HUMOUR is timing (just like comedy really) and to get it right you need to know your audience – so use carefully and sparingly near the start of the contract. |
All the statistics in the world can’t measure the warmth of a smile.
Chris Hart (2009, p.28)
Chris Hart points out a truth that the rigidly models-led crowd really need to hear – maths and science cannot truly address human warmth. When you are feeling sad and in need of human comfort whom do you seek out? The man with a mountain of qualifications? Maybe the woman with the cleverest mind or perhaps those who understand theory with the best base of research evidence or the friend with the largest ego? For most of us what we need when we are feeling sad, alone, lost or disheartened is warm human connection. If we were lucky as babies we will have experienced warm, loving, attentive mothering (and fathering). When we were fed, held, rocked, smiled at and whispered to, our bodies and brains learned the comfort available from another human being, to down regulate, to relax. We learned to scan the face and the eyes for reassurance about how the other was really feeling about us, to tune into the emotional energy contained in their words, what we might call the voice of the heart or the music underneath the words. When that tone conveys judgement, criticism, coldness we feel it deeply – it pushes us away, shuts us down and can make us feel bad about ourselves. Donald Winnicott (1971) called this process mirroring – looking into the face of another in order to really experience the self. He referred to the gleam in the mother’s eye when she sees her child. This cannot be faked – humans are deeply skilled in assessing the truthfulness of the concerned face, the real feelings flowing within the tone of voice, the honesty of a smile. In the raw encounter of therapy, faking it almost guarantees failure.
Reflection Point
WARMTH
•What emotional states do you associate with the word ‘warmth’?
•Think of three memories that make you feel warm. What was so special about them?
•Now contrast with some memories where people left you feeling ‘cold’ – what emotions dominate here?
Some unlucky children grow up with a world full of bad mirroring – a reflection which constantly tells them they are not good enough, problematic, too stupid, too ugly, a nuisance to have around. Even those of us who did not suffer so much were often deprived of enough good mirroring – to toughen us up, to ensure we did not become big-headed or vain, or simply because our parents didn’t know how to do it very well.
The Streams in the Consulting Room
WARMTH
•Do not get too consumed with the myriad intricacies of therapeutic technique or theory.
•Do not hide behind the role of powerful expert in order to handle your own fears and nervousness.
•Do not fall for the lie that cold aloofness equates to true professionalism.
•Much of the residual pain we carry with us from childhood stems from times when the right kind of warmth was not available to us – that will never be truly healed in the absence of genuine warmth from you during therapy.
Many people who come to us as therapists will have been wounded by a lack of human warmth in their lives, or warmth only on offer under certain conditions or that came with a high price attached. They may have struggled to develop the quality of warmth within themselves, showing the world only brittle, chilly armour. The very last thing this person needs when they come to work with me is someone projecting cold, aloof expertise, hiding behind rigid technique or the perfect blank screen. In my opinion much damage was done by orthodox psychoanalytic practitioners in the 1940s and 1950s (immediately after the death of Freud) whose only concern was to encourage the projection of transferential material onto the blank screen. They really believed the screen was a neutral space which was a useful tool in eliciting the central curative factor in analysis – transference.
In order to gradually melt ice there is no point putting the ice cube into the freezer. People have to feel safe in therapeutic space – after all they are likely to be expressing emotions connected to fear, anger, shame or loss – feeling unloved or never good enough. Most of us already have a loud enough critical voice in our heads, we don’t need it reinforced externally.
Being a warm therapist does not mean being overly soppy or sentimental, however; at times our clients will need honesty from us, challenge, containment and boundary. All of these can still be delivered with warmth and concern. Heinz Kohut (1981) called this ‘optimal frustration’ and argued that this represents the ideal conditions for personal growth: enough support to help us not feel alone or invisible, together with a bracing honesty that requires us to take responsibility for doing more of the work of life ourselves as we grow older and more independent.
Most people walking into a first session are not coming because the world feels too warm towards them or because they are able to speak to themselves in a warm, soothing, respectful way. The adult world in which we exist is all too full of coldness, harshness, duplicity, concealment and lack of genuine concern for our well-being. As I frequently say to my students – people don’t come to therapy because they are too happy.
Many childhoods were the same. The therapist – and the potential space she co-creates with the client – must never replicate this. It should feel interested, attentive, holding, human and warm. In this safe space the exploration of the darker parts of self can unfold. In a freezer most of us will close down, protect ourselves and withdraw; in gentle sunshine we tend to relax, soften and open up; in glaring heat we burn, sweat and redden.
Like Goldilocks’ porridge, the therapist cannot be too hot or too cold – we must try to get it just right. Sylvia Plath, in her Unabridged Journals put it beautifully:
How we need that security. How we need another soul to cling to; another body to keep us warm. To rest and trust; to give your soul in confidence: I need this. I need someone to pour myself into. (2002, p.102)
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The Key to WARMTH is meaning it. Human beings are pretty good at detecting fake warmth – so don’t even try. The real thing is the only one that matters. |