Using Systemic social consructionist theory to explore the ethical decision making process in therapy practice.

 

Nigel Glaze 1999

 

Abstract

 

This paper discusses therapists’ attempts to utilise spontaneity as a useful resource, whilst appreciating the ethical dimensions that responding spontaneously pose.

 

I claim that systemic practice emphasises the monitoring of repercussions and effects of spontaneous responses. I believe that reflective practice leads the systemic practitioner to hold a deep commitment to an ethical position. Spontaneous responses may make therapists more liable to make 'mistakes' expressing jarring convictions inappropriately. Privileging many options I explore systemic ideas for therapists to ‘step aside’ from their immediate responses. I then highlight the question “How significant is turning one’s curiosity on oneself?”

 

 

 

 

In this paper I propose that systemic thinking holds a close relationship with social constructionist theory, postmodernism and second order perspectives. These theories highlight an appreciation of the subjectivity of descriptions, and place an emphasis on the recursive influence of therapist and client.

 

Spontaneous responses are a natural aspect of conversational dialogue. I believe therapists monitor their actions (spontaneous responses) because they perceive their actions as potentially having both positive and negative influence.

 

The general assumption that I explore in this paper, is that inappropriate spontaneous responses, ‘mistakes’, can be more easily made when spontaneously responding. In this paper I suggest various systemic ideas for more successfully utilising spontaneity, thus minimizing mistakes. I draw attention towards the self reflective process, which I propose helps to create a context in which therapists develop a relationship with their prejudices and constructed beliefs. Self reflection, turning curiosity toward oneself, may enhance and capitalise upon the creative and beneficial uses of spontaneity.

 

In exploring how to enhance an aspect of therapy practice I am not attempting to capture the ‘correct way’ to do therapy, but attempting to open up new interactional possibilities.Footnote1 I believe systemic practice has highlighted an appreciation toward therapists’ use of power and ethics in the therapeutic relationship.

 

Literature Review

I will offer ideas around how theoretical developments in the field of systemic family therapy have emphasised the importance for therapists to monitor their possible influence on others. Utilising systemic literature, I will offer some ideas that may be useful when attempting to utilise spontaneous responses in the therapeutic relationship. I indicate the significance of personal prejudices in shaping therapists spontaneous responses.

 

Examples from practice

I shall examine an interview with the G. family. I will also comment on the monitoring of spontaneous responses. The first segment (of responding spontaneously) illustrates a response of ‘sarcasm’. This type of response could introduce disrespect and discourtesy leading to serious errors that raise moral and ethical issues, potentially damaging the therapeutic alliance. In the examination of this interview I draw attention toward the significance of monitoring prejudices.

 

The next segment illustrates an example of self reflecting in action (Shon 1986). This example relates some systemic theories useful in assisting the process of ‘stepping aside’ from or maneuvering prejudicial influences.

 

Discussion

A focus group discussion (Training systemic therapists) explores therapist’s views and opinions in relation to spontaneously responding in the therapeutic relationship. Particular questions are offered to structure the discussion (Appendix 1). I will present my proposals for more successfully Utilising spontaneity as a list to provide practical recommendations for therapists who might wish to enhance their self reflecting capacities. I will also use diagrams to aid the illustration of ideas.

 

To my surprise given the significance of spontaneous responses, I note a lack of literature directly related to the subject of Utilising spontaneous responses within the therapeutic relationship.Footnote 2

 

Theoretical developments in the field of systemic family therapy which have highlighted the importance for therapists to monitor their influence on others.

 

 

It is explained in systemic family therapy literature that postmodern developments have led to an increased focus on issues of language, power and ethics in both theory and practice. (McNamee et al., 1992; Inger et al., 1994.) Systemic practice in the late 1990’s highlights the importance for therapists to monitor their influence on others within the therapeutic relationship. I begin this literature review by indicating some of the theoretical developments in the field of systemic family therapy which have led to an appreciation of how the therapist may influences others in the therapeutic relationship.

 

A story of Modernism to Postmodernism

Modernist thinking Brown, (1999) states, has a strong belief that science can come up with the answer to any question as long as observers look hard enough. Gergen, (1994) emphasises the significance of Darwinian theory, linking this theory to the development of modernism “In the Darwinian view, the optimally functioning human being would be one who relies most heavily on powers of observation and reason.”(p64) This perspective assumes that the therapist views himself as an objective observer, who can concentrate on the object (the client) without being affected. From my experience modernism is alive and well, noticing in professional practice that professionals exchange talk more readily as observers, talking knowingly about clients and families. Indeed, from my experience these forms of formal conversation exchange are common in ward rounds, clinical meeting, reviews and the like.

 

Although postmodern ideas have been challenged by writers such as Speed, (1991) who advocates a knowable reality, postmodernism questions the assumptions laid down by modernism. Brown, (1999) indicates that her clinical practice is informed from a postmodernist stance, “I act as an observer being observed, and as a practitioner, I am observing both the client and myself viewing and reacting to the client. So I may no longer presume that I can take an objective view” (p6). Postmodernism appears to consider more, that the way that the therapist observes the ‘world-out-there’, is determined by his position at the time (Goldner, 1991). Hardy et al., (1995) suggests that one’s freedom ‘to see’ is always constrained or supported by the pattern of pre-existing cultural and professional ideas and experiences which have formed a therapists life experiences up to this point. Postmodern assumptions are based on the idea that there are no facts, only ‘interpretations’ (Atwood 1995). For example; I cannot know what a family member is thinking and feeling, I may ask questions and receive responses. My understanding becomes an ‘interpretation’ or story of what their life is like. Postmodernism also proposes the idea that there is no “objective reality being described by clients nor is this information accessible to therapists” (Parry, 1991. p39). Thus each of us is contained within our own picture of reality, and we each are unable to claim that we know what another person is thinking or feeling. Postmodernism infers that our only access to a shared reality is via language (Real 1990). Thus our views of reality are continually evolving as we converse, think and respond.

 

The shifting emphasis in family therapy practice, modernism (holding objective knowledge) to postmodernism (observing oneself as a participant within the meaning making system), is commonly described in systemic practice as a move from first order toward a more second order systems therapy (Hoffman, 1993; Simon, 1992; Maturana, 1991).Footnote 3

Social constructionism extends the postmodernist idea of our realities continually evolving as we converse, and highlights the perspective of evolving through patterns of social interaction. I believe that the theoretical perspective of social constructionism, creates a particular condition for stimulating therapist’s investigations towards a more accountable, more ethical, therapy practice.

 

Social constructionism’s emphasis is on how the construction of meanings in people’s lives is continually emerging in social interaction, and made known through enacted and spoken narratives (Barnett Pearce, 1992). Social constructionism highlights awareness for therapists to look toward observing themselves in action, rather than holding a preoccupation with observing others. Generally the theoretical advancements of social constructionism have elaborated investigations to explore how relationships are distinguished, and how this distinguishing affects the relationship (McNamee et al., 1992; Anderson et al., 1988). In practice when a client tells me that their son, “is angry” I wonder what might be meant by ‘angry’ and ‘is’. Our conversation that follows may create distinctions, which may affect our relationships, and in doing this, evolve new distinctions, which may affect the meanings being made. For example, in asking “how is this?” I create distinctions around the meanings of ‘angry’ and ‘is’ this distinguishing effects how I perceive the relationship and how then the client perceives me as a participant in the relationship.

 

Therapists from a postmodern frame become increasingly aware of the difficulties in changing others, (if there is no objective knowledge how can you know you’ve effected change) (Efran et al.) and focus on their position in the system(Jones 1998). The ethical dimensions of appreciating dilemmas in the use of spontaneity, have become more apparent in the climate where questioning one’s power to influence in a system has been increasingly expanded upon (Anderson et al., 1988; Hoffman 1993; Cecchin et al., 1994; Swan 1994). Second order perspectives in particular highlight the importance for therapists to monitor their influence on others as well as how they are influenced by others. Oliver (1996) describes systemic practice as a moral endeavor through which moment by moment judgments are made with reference to visions of ‘good and bad.’

 

Appreciating and monitoring the possible effects of spontaneous responses

Second order perspectives in particular have encouraged an appreciation for therapists to monitor the effects of their spontaneous responses. Both Held (1995) and Inger et al., (1994) suggest that second order perspectives within the theoretical developments in family therapy, has encouraged a more ethical, less hierarchical and less pejorative form of therapy. Questions about the ethics of therapy are now commonplace in systemic literature (Wittgenstein 1922, Anderson, et al., 1988. Hare-Mustin 1994, Von Foerster 1994.) A questioning ideology may indicate a deepening appreciation of an ethical view which Inger, et al. (1994) defines as a view of appreciating the ‘others otherness’. Systemic therapy has developed from observing others to observing itself in the making of meanings. The preference of meanings within contextual interaction (the how questions) rather than the focusing on the truth of a behaviour (the why questions) can feel less pejorative. For example, from my experience whilst working within an eating disorders center, focusing on a client’s idea that they must control their food consumption in order to be content, is likely to be more helpful, than trying to focus on what they do or do not eat. How therapists orient themselves within a therapeutic alliance becomes related to the therapist’s personal and professional discourses (Hare-Mustin, 1994). Reconsidering one’s spontaneous responses becomes a moral decision making endeavour.

 

Therapists’ spontaneous responses raise important ethical and professional questions. Cecchin (1992) states; “It is important to have clear in your mind some ethical deontological principles”. For me this idea points to the importance of holding a clarity toward the ideas and principles of duties and moral obligations held by the therapist. Professional and ethical codes offer suggestions toward clarity, how therapists ‘ought’/‘should’/’must’ conduct themselves within the therapeutic relationship (Subcommittee of A.F.T. 1999).

 

Cecchin (1992) elaborates the concept of personal and professional beliefs, indicating that it is dangerous to believe too strongly, and perhaps out of that belief respond too extremely. It is stated by Cecchin (1992) that; “the moment when the therapist reflects upon the effect of his interactions that he/she acquires a more ethical and respectful position”(p3). Yet I wonder if there is more to creating a respectful position than reflecting with one’s thoughts. I believe that a more ethical respectful position requires systemic therapists to hold themselves accountable for what they do in the therapeutic relationship. In practice this may take the guise of asking; how do I utilise my prejudices, biases, my spontaneous responses, in a way that is resourceful to all concerned?(the family, society, culture and myself). This thought process is then turned into options for responses (actions) which aid a systemic therapist to become more accountable for his/her participation in the therapeutic relationship.

 

Although spontaneous responses raise ethical questions, they are also essential ingredients in conversational dialogue. Freedman et al., (1997) highlights the quest for playful approaches particularly when working with children. She asks; “How is it possible to play, to maintain a sense of humour, and even have fun, while dealing effectively with distressing, frightening, or perilous situations?”(p6) Freedman et al., (1997) concludes with the thought that; “the resolution (of problems) if approached with a lightness of heart, humour, or playfulness, is dynamic” (p347). From my experience my enthusiasm can aid me to get close to a family, it can assist in developing a more engaged therapeutic alliance. Indeed, I believe one should be careful that when using self reflection, therapy practice does not become a practice of paralysis, self absorption, or oppression. Perhaps, by continually attempting to assess how I involve myself in the therapeutic relationship. I hope that I may keep prejudices, biases and notions “in play”.

 

I believe conversation is a mutual interconnected sharing, in which spontaneity plays its part. From the writings of Anderson et al.,(1990) conversation can be defined as any interaction between people in which there is some ‘shared space’ and there is a mutual interconnection within this space.(Barnett Pearce 1992) refers to two metaphors when he speaks about spontaneous conversation, juggling and weaving. Both processes are interactive and require co-ordination of participants. I believe that as therapists we might consider the question; “how else can I communicate usefully?” rather than become bound and limited by the question; “what is the right way to be responding?”

 

What we bring to the therapy conversation includes all our preconceived ideas, all our prejudices.

Our prejudices are what makes us. Hayward (1996) creates a connection between prejudices and the construction of self identity; “Prejudices may only be our pre-existing thoughts, but our pre-existing thoughts are what constitute our being.”(p227) Therapy involves a constant exchange between therapist and clients and I believe it is our prejudices that become exchanged. Thus it is through this hall of potentially helpful or unhelpful distorting mirrors (Wangberg, 1991) that we attempt to meet each other.

 

One’s strong convictions and prejudices may also generate mistakes, inappropriate jarring spontaneous responses. It appears logical that if therapists have the capacity to influence others for ‘good’ then we also have the capacity to ‘harm’. If power is in all relationships the crucial issue for therapists is how they use or potentially misuse power. “More important than whether a therapist has pre-conceived ideas is what he or she does with those ideas.”(Anderson, 1997). Even though power may be thought of as myth or a social and political construction it is according to Bateson; (1972) “a very powerful myth and probably most people in the world more or less believe in it.”(p486)

 

Self reflection (Shon 1986), turning one’s curiosity toward oneself may be useful in monitoring one’s use of power. I believe of central importance to understanding systemic therapies intentions of providing an arena for change, are the ideas of ‘performing’ and ‘reflecting upon’ the differing stories we live and tell. Self reflection, turning one’s curiosity on oneself, becomes a process of reconsidering, modifying, manoeuvring and potentially creating differences in terms of the effect of influence that our being exerts. If spontaneous responses create a context in which we are more liable to make ‘mistakes’, and speak inappropriately, perhaps unethically, then self reflection in such a context becomes important. Self reflection enables possibilities for the therapist to ask questions and reconsider themselves, their position in the system.

 

Some systemic ideas for Utilising spontaneity

 

Systemic literature offers various ideas for enabling the reconsidering of one’s position in a system. These ideas are most significant in situations when attempting to utilise spontaneity.

 

‘doubt’ and ‘uncertainty’

“Being willing to doubt. To be uncertain requires that we leave our dominant professional discourses-what we know or think we know …that we be continually aware of, reflect on, and be open to examination by ourselves and others.”(Anderson, 1997 p134) To both doubt and question I pose is useful in being able to stimulate a reflecting ability.

 

Asking questions of oneself in conversation may be viewed as employing a position of uncertainty (Mason 1993).Uncertainty is described as part of the therapeutic encounter. Mason (1993) suggests that uncertainty in therapy practice is common, and that a particular type of uncertainty is brought forth when faced with personal responses. For example, when threats are expressed in an interview, an immediate first thought might be to call a halt to the interview. In these situations therapists may ask; ‘how do I create a useful direction forward given this one way of responding?’

 

Mason, (1993) states that safe uncertainty allows; “a context to emerge (in which) new explanations can be placed alongside, rather than instead of, in competition with, the explanations that the clients and therapists bring.”(p194) Using Mason’s ideas a therapist may utilise doubt rather than expertise to ‘open up space’ for new meanings to emerge. He suggests that it may be possible to have strong beliefs (spontaneous responses yearning to come out) and still be consistent with a stance of ‘not knowing’, questioning and doubt. So that if threats are present in an interview a therapist may still hold the strong belief, ‘violence must not be enacted in a therapy interview’ yet respond questioningly; “I would like to ensure this therapy interview provides, a space in which we might converse and respect the conventions of communicating without violence, so how might we proceed with this interview given the strong emotions that are present?”  

 

Multiverse

A single thought, may indicate the lack of a self reflecting process and demonstrate a knowing perspective. Anderson, et al. (1992) suggests that being in a knower position can be a trap for having to defend that position once it is taken. It can also be said that any singular position once taken limits what can be co-constructed in the therapy interaction (Cecchin, 1992). Real (1990) highlights the practical application of moving toward becoming a multiply engaged therapist. He states that; “the multiply-engaged therapist is seen as positioned within rather than acting upon a system.” He indicates that such a therapist facilitates change through participation in, and active engagement with, each systems member’s exceptions and experience. My views continue these ideas suggesting that reflecting on one’s spontaneous responses is a useful guiding stance for a more ecological form of therapy. I claim that generating multiple options for responding assists therapists in manoeuvring from single spontaneous responses.

 

Irreverence

To develop ways for Utilising spontaneous responses, a therapist may consider the strategy of Irreverence (Checcin, et al. 1992) Irreverence is offered as a manoeuvring of the positions a therapist takes in the therapy encounter. Utilising ‘irreverence’ about the position of knower, which Checcin, Lane, and Ray (1992) state allows them to move in and out of different positions at various times and in various contexts. Moving in and out of different positions becomes a very useful idea when considering how systemic therapists may utilise spontaneous responses. In practice I am reminded of situations when I say; “ No, let me put that like this”. Holding an inner dialogue that checks for various ways of asking a question then selects a preferred one. Irreverence shows that; “the revered ‘truths’ we hold are not solidified commandments but flexible benchmarks” (Checcin, et al. 1992 p8). Lax (1992) develops a similar idea indicating that through self reflecting, therapist’s are more and more likely to be able to step aside from their strong stories they initially engage in, and view their stories from other perspectives. Using these ideas in practice my spontaneous responses are a particular type of strong story (prejudice) which may have more potential to jar with the strong stories (prejudices) of others. Irreverence thus becomes an important ability when attempting to utilise spontaneity.

 

Summary

Up to now I have focused on how theoretical developments in the field of systemic family therapy have emphasised the importance for therapists to monitor their possible influence on others. I have shown how self reflecting is particularly important when spontaneously responding and I have offered some systemic ideas that may be useful in the attempt to utilise spontaneity. I will now go on to illustrate how particular systemic ideas may be considered and applied in practice.

 

Examples from practice

 

Brief segments of an interview in which I spontaneously respond.

 

In this section I will use segments from a single therapy session to illustrate how in practice therapists monitor their spontaneous responses (the potential influence/effect spontaneous responses may have). I hope to emphasis the practical application of systemic ideas when attempting to utilize spontaneous responses in the therapeutic relationship. I draw attention toward the significance of therapist’s prejudicial convictions that jar with clients/families beliefs.

 

These segmented examples illustrate an aspect of the work I do in a community mental health team context. The team works in the context of community care and mental health legislation as well as our cultural and societal beliefs about mental health problems. Utilizing a systemic way of thinking about therapy, I note a privileging toward the notions of relationship, emphasizing how the stories and the language with which we tell these stories develops through communication processes. The consideration of my spontaneous responses is seen as a moral decision making process and as an expression of existing in relationships.

 

It could be considered that the aim of therapy is to co-ordinate communication. Coordinating communication in such a way that allows new interpretations of past, present and future action to develop, particularly those stories that are being experienced as problematic. This commitment reflects a systemic prejudice toward creating opportunities for the elaboration and reconstruction of both our own and clients stories lived and told, (Oliver 1992) so that possibilities for choice in action is developed (Lang, Little and Cronen, 1990).

 

Considering the coordinated management of meaning Footnote 4 multiple levels of context (Cronen, et al. 1985). (Diagram I) maybe used to show how extracts of conversation like a spontaneous response can be placed in broader contexts. The highlighting of contexts may demonstrate the common understanding of systemic practice being that symptoms, problems and difficulties arise in the context of relationships, and are understood in terms of interactive and systemic processes. “The main focus of intervention emerges from these patterns of interaction and the meanings given to them.” (A.F.T. Ethics subcommittee, p32)

 

The referral

Both Jane and Andy, went separately to their GP, Both were then referred on to the community mental heath team where they were seen then referred on to me.

 

I initially met with both the parents and the two children. On meeting the family, Jane (34) spoke about how hopeless she felt the situation at home was. She put this down to the relationship difficulties she was having with her husband. Andy (35) however, spoke about Jane having depression saying that this makes her very difficult to cope with, how he would at times react with anger. Jane spoke about her daughter Haley (8) being frightened to go to school, who also had a referral made to a child psychologist. Jane said that her daughter was very anxious and would cry herself to sleep each night. The school had contacted the parents because Haley would become quite distressed if she became criticized in class. Jack (5) had not been referred for therapy but Jane said that Jack was disruptive and that he would have ‘mad’ outbursts. The parents said they were determined to sort things out because of the effects the arguments were having on their children.

(See Diagram II, genogram and referral process).

 

Following are extracts from our second interview.

 

“Shall we leave them to it?”-Alerting myself to sarcasm

 

Jane: You're always pissing about, remember last Saturday                       

- out, drinking not one or two oh no… coming in raising

 your voice and scaring the children…..you’re just like

your father!                                                                      I used body language indicating that  I was wanting the couples attention

Therapist:{how…h..          {how..                                        I was actively trying to interrupt

Andy: Fuck off! who are you! You can fucking talk!…                The transcript becomes difficult to                                                                                               decipher both parents talk over each                                                                                            other.

Therapist:{Can I just…can I just come in here…… …

The argument between Jane and Andy takes a hold the couple talk quickly, the two children in the room move toward one another.

 

Therapist: (Talking calmly to the children)…Shall we

 leave them to it?                                                                The five year old smiles at me, I

Therapist: Hold on!                                                            Spontaneously respond/ alerting myself

to sarcasm.

Therapist: I don’t think this type of conversation is best                 With raised voice and whilst the

said with your children present?                                              argument between the parents continues.

(pause)                                                                          Attempting to regain some sense of order

                                                                                    Acting with the notion of doing more

‘good’ than ‘harm’.

Therapist: Are there things out standing between the                     This question was offered with the

two of you, that you haven’t sorted out, but you would like              attempt to establish a co-ordinated

to, with me?                                                                     context of therapy

Jane: yes,..(pause)..

Andy: yes,…our families, that’s always at the forefront of

our minds…Jane will often say things about my family that

 I can’t stand to hear. 

Therapist: Oh right, only ‘often’ not always, Jane what

sort of things do you say that your husband likes to hear

 about his family?

I invited the family to expand this theme, the strengths each of them has brought to their family from their family of origin. I wondered if  this echoed a family narrative, belief or prejudice; they argue as their parents did, Jane and Andy told me that they felt they were trapped as if they were reliving some script. I asked;

Therapist: “what differences do you now notice in the ways that you relate with one another that none of your parents would have dreamt of doing? Abilities that between you, you have created that they admire?” …”what might these things tell you about yourselves?”  

 

The effect of this question appeared to create a sense of partnership between the parents. A time later……………

 

Therapist: A while ago, I perhaps shouldn’t have said,        I was wondering about the effect of saying         sarcastically shall we leave them to it. I found                                         this a useful slot to bring up reflections toward    the therapeutic context.

you perhaps heard me I mentioned to your children; shall

we leave them to it? I’m mentioning this now because you

seem somewhat different now. Jane & Andy how would

you have wanted me to have responded to your children?

Andy: I understand that you’re thinking that our

arguments aren’t right,                                            I was pleased that Andy had responded  

 I felt that the effect of raising this issue may have

 limited the damaging effects of what I felt to be

 a mistake.

we know that that’s why we are here, but I

think you’re right to point this out to us.   

 

 

Considering therapists spontaneous responses as useful information about the ‘jarring of convictions’ or simply differences in beliefs

 

Speaking to other therapists it seems not uncommon for therapists to be affected by something that they have said. Some therapists feel particularly affected when they think they have made a mistake. In addition to this, others like myself feel that they are drawn to reconsider their responses when a situation has activated their strong views, prejudices and beliefs. For example when I said , “I don’t think this type of conversation is best said with your children present”. When prejudices and biases begin to challenge therapists’ feelings of appropriate responses in the therapeutic relationship they self reflect, reforming their responses and ideas, beliefs and prejudices. In diagram III. I illustrate the looped process of; spontaneously responding > activated strong beliefs in conversation > self reflection > increasing therapeutic coherence > spontaneously responding. This diagram illustrates an oscillating posture between self reflecting and spontaneously responding.

 

I believe that if therapists are to work well in situations where social codes are challenged then therapists’ assumptions and beliefs have to be faced head on. In these situations spontaneous responses may draw attention towards a ‘moralizing’ perspective. In the previous segmented extract, in acting and responding in the way that I did, I felt I was prejudicially attaching particular weight to the rights of the children who I felt had the least power in this situation. There may also be many other prejudices, beliefs and assumptions pervading the situation in the interview. Below are a collection of assumptions following conversations I have had with other therapists around stereotypical beliefs, that may be pervasive in an interview similar to the G. family.

 

Some therapists’ assumptions/beliefs about arguing households

   Parents who fight are overburdened with stresses, wrapped up in their own perspectives they cannot possibly provide the amount of supervision, nurturance, time, and love that their children need.

   Parents who fight fail to teach children role modelling of appropriate behaviour.

   Mothers argue because they become over involved in the pressures of child rearing.

   Fathers are more volatile and are more likely to be physically aggressive.

   Arguments and fighting have long term damaging effects.

   Children growing up with parents who argue will become parents who argue.

   Children are adversely affected having emotional problems due to arguments in the household.

 

Therapists like myself do hold strong views,(convictions) we include all our ideas, opinions and prejudices as resources in the therapy room. However, I am also attracted to the views of a colleague, who suggested that he was generally not himself as a therapist. He told me that he felt he was not spontaneous at all, and that this was because of his therapist's performance. A performance where he monitored and guarded against ‘mistakes’, suggesting that mistakes are jarring convictions, that he might express in the wrong way.

 

I believe we bring all our opinions and prejudices into the therapy room and we guard, monitor and

perform to influence for ‘good’ rather than ‘harm’. The general principals laid down by A.F.T. ethics subcommittee states; “When faced with an ethical dilemma the family therapist should adopt the course of action which ‘maximizes the good’ and does the ‘least harm’.”(p 32) It is I believe a responsibility for a therapist to continuously look at how we have constructed our beliefs of ‘good’ and ‘harm’. Making oneself accountable is highlighted when attempting to use spontaneous responses in the therapeutic relationship.

 

When holding ‘jarring convictions’, what Ideas are there for ‘stepping aside’ from strong prejudicial assumptions?

 

In systemic practice various ideas for ‘stepping aside’, repositioning or manoeuvring might be indicated as useful when a jarring of ideologies between therapist and client has developed. I will indicate how some of these ideas may be used when attempting to understand further and reposition one’s spontaneous responses.

 

Uncertainty (Mason, 1993) and doubt (Anderson, 1997) have both been suggested as particularly useful therapists stances. I propose that these stances are useful when prejudicial extremes play or feature, or where views a therapist holds jar with the convictions held by the family or client. From my experience doubt rather than conviction generates a more tentative tone. I suggest that using doubt, convictions may be questioned with a tentative tone, for example;

 

Spontaneous yet tentative responses

 

 

Therapist:: You must..  no… err…                               With the conviction “what on earth do you like

                                                                           about this man?” I noted various

                                                                           emerging questions.

Therapist:: “I just …., let me ask it like this...which           Reflecting on my thinking whilst speaking

response do you each get from the other that you most like?"                                                           

 

Jane: I want to be able to be understood more. If I felt understood I don’t think we would have these problems.

Therapist:: So did I get you right, you get understanding but you also want more of it?

Jane: Yes.

Therapist: Andy’s understanding at times?

My immediate thoughts were with great surprise ANDY’S UNDERSTANDING! However, I re thought this surprise, thinking that my stories/beliefs had been biased toward seeing this couple as ‘always at each other's throat’, and that humour (I held back a spontaneous response of jocularly shouting Andy’s understanding!) might be undermining in this context. I attempted to employ doubt and offered my response much more tentatively. I believe this had the effect of directing me toward the use of a series of questions. These questions attempted to create a context for Jane and Andy to notice and appreciate what they have and what they don’t have, but would like more of..

 

Mason (1993) elaborates the ideas of uncertainty to develop the application of a respectful, collaborative, evolving narrative. Using Mason’s ideas Andy perhaps saw himself as a strong leader and Jane as a weak mother, and they both may have had great misgivings about their future together. Their relationship may seem tenuous, uncertain, they perhaps don’t know what to do, there is perhaps a great sense of insecurity. This Mason (1993) states is a position of unsafe uncertainty. Understandably Jane and Andy want someone to make things better. The families belief may be that I can change their situation, that I offer a position of safe certainty. I believe Mason (1993) writes from a postmodernist perspective, when he suggests that there are problems if a therapist asserts and acts as if a position of being able to take the burden of responsibility away from the family were possible. In practice, safe uncertainty can help orientate therapists

 

away from a position of knowing how things should be, (Cecchin 1994) and towards positions that entertain different possibilities. In the segment of transcript when I said;

Therapist: I don’t think this type of conversation is best  said with your children present?

I was acting from a position of “Knowing how things should/ought to be”. In most therapy situations using safe uncertainty, manoeuvring the positioning of one’s convictions into a tentative question may also be useful, for example;

Therapist: If you could communicate with each other, the way you hope to be able to, how would you both want to be talking right now?

 

Wangberg (1991) states that she feels quite comfortable with a more humble position. I like this idea very much, however, I believe that there are circumstances, after I have reflected on the options available, that I find it most useful to state clearly my convictions. Reconsidering what was said and done assists therapists continuously in the quest to monitor the effects of employing different perspectives in the therapy context. I suggest that along with the idea that it is useful to be tentative and doubtful, I believe we hold convictions and at times we should face these convictions head on. In doing this we allow ourselves to question more strongly the certainties of both doubt and conviction.

 

Considering relational reflexivity

Relational reflexivity (Burnham 1993) is generally the reflecting together with a family on the process of the session. When I consider my relationship with ‘doubt’ and ‘conviction’, I can visualize both words as constructed concepts. In doing this I am able to position myself in relation to these concepts, i.e. close or distant. Relational reflexivity gives me ideas to consider the effects of my relationship with a constructed concept explicitly with others. Using this information playfully and inviting others to position my responses in accordance with a perceived effect. In this

 

way I might ask; How do you perceive me relating to doubt and certainty? If doubt was over here and certainty over there where would you place an X that may indicate my closeness and distance to doubt and certainty at this time and in this situation? What effects would you note if I changed the position of X in this relationship? In this way I might ask how would you prefer me to position the X?                                   

            Doubt                                                              X                                  Certainty                                                                                      

 

The idea of positioning oneself in relation to certainty and doubt to note the effects of responding in particular ways, perhaps a safer certainty, reminds me of  the idea of using different stances.

 

I like the idea and term used by (Real 1990) when he offers the concept of a ‘multiply engaged use of self’ suggesting that a therapist may use stances as if performing from differing contexts. He suggests various stances; eliciting, probing, contextualizing, matching and amplifying. The overall therapeutic attitude suggested by Real (1990) when attempting to reflect on one’s spontaneous responses is one of placing the person-hood of the therapist in active participation with other system members. In this situation a new system is formed by the introduction of the therapist. In this way a therapist may consider more; ‘what effect is the conversation with this family having on me?’ ‘What way of working or response is beginning to become galvanized?’, ‘What other ways of responding might be available?’ Real, (1990) suggests that guiding the therapist’s use of self is the principal of usefulness. In the earlier example when I re-thought my response of surprise of ANDY’S UNDERSTANDING! this was informed by the idea of usefulness, perceiving it as not useful to respond in a shocked manner. In this situation I chose another option other than being spontaneous, manoeuvring my shock toward a pleasant surprise.

 

In the interview with the G. family I was asking questions in relation to different contexts to stimulate a possible redefinition of an oppressively held belief; such as, ‘parents who argue create children who go on to become parents who argue’. For example, from the context relating this couple’s past, the stories of their family narratives to the present, “what differences do you now notice in the ways that you relate with one another that none of your parents would have dreamt of doing” In doing this I was privileging the taking up of different positions, exceptions to the rule and exploring the links between levels of context (Oliver 1996).

 

It is perhaps most common for systemic therapists to use the C.M.M.(Diagram I) framework in practice as a device to help analyze the levels of influence stories may have (Oliver 1996). It is also a useful therapist’s tool in application to themselves as part of the system of interaction(Oliver 1992) (Diagram IV). C.M.M. starts from the position that living is communicating with focus for analysis being the conversation. In the example illustrated I held a rule for action “Try to do more good than harm” influencing the spontaneous response “Hold on!”. On the other hand Jane and Andy behaved as if constrained by the belief “parents who argue create children who go on to argue” In the parents terms their responses were perceived as if outside their control. They constructed patterns of relating with others which were unwanted. In encouraging a shift from an ‘I’ (I am in control of this session) to an ‘us’(How might we work together) position I attempted to share my perception of an unwanted form of relating. For example when I said; “I mentioned to your children; shall we leave them to it?…Jane & Andy how would you have wanted me to have responded to your children?” The introduction of respect of this couple as parents triggered, I believe, a more mutual and coordinated relationship with myself and the family. In our therapy sessions new definitions of the relationship began to emerge such as; loyalty, loving, supportive, understanding and equality. A new story began to emerge, one of being determined and passionate parents, defiant towards ‘fatalism’.

 

C.M.M. suggests that since we are immersed in the context of our society we act and these actions

 

both provide opportunities and constraints in the forming of our relationships. Jane and Andy held a strong sense of obligation toward their children, but felt constrained by the belief that they will go on to relate to their children as their parents did with them. These sorts of stories construct our moral orders determining whether or not we respond in a particular way. Gergen (1994) spoke about the function of moral languages proposing that; “such languages owe their development to breaches in the acceptable patterns of interchange. Should an individual or group violate common customs, moral language can be employed as a means of correcting or re-channelling the offending action.”(p27) It is useful to encourage the development of a context of respectful consideration, a mutual search for understanding. In this context therapists may be less likely to exploit their social power. The social positioning that a therapist holds may magnify the difficulties with successfully utilizing spontaneity. When a fanatical obligation (spontaneous response) appears to be yearning to be expressed, a therapist may usefully ask; what exceptions are there to this rule? In what context would I hold another view point? Thereby privileging the taking up of different positions and creating a context which has the potential for re-definition.

 

So far in this examples from practice section I have examined my spontaneous responses in a segment from an interview with a family. In doing this I have employed various systemic ideas that may be useful in employing and reconsidering one’s spontaneous responses. I now will go on to discuss more broadly with other therapists the significance of spontaneously responding.

 

In this section I aim to use a focus group discussion, which I intend to open up and invite differing views, ideas and opinions exploring more broadly the significance of spontaneous responses. I will pose particular written questions to a group of training systemic therapists (Appendix I) the themes suggested are used to structure the discussion.Footnote 5

 

Proposals for more successfully Utilising spontaneity will be offered in the form of a list. I will then draw attention more closely to the significance of turning one’s curiosity toward oneself, a concept that has been highlighted as significant when attempting to utilise spontaneity.

 

The group comprised four therapists training in systemic practice, spanning professions of Psychology, Social Work, School Counselling and myself an Art Therapist. Here in a condensed form are some views offered relating to the significance of spontaneous responses.

 

“When are spontaneous responses apparent to you?”

Therapist 1. said she thought that although situations of responding spontaneously regularly happen, it was very hard to keep these circumstances in mind afterwards. But some circumstances stand out, boldly. This she said: “is more often because these circumstances are significant perhaps in terms of being funny or dramatic in some way.” For therapist 1. thinking about her spontaneous responses happened at times when she wanted but chose not to laugh. These ideas perhaps connect with the notion that spontaneous responses are noted when jarring convictions are activated.

 

“What examples of this do you have?”

Therapist 1 gave her account of her different convictions. A client had told therapist 1 that he had been seeing a prostitute. He said how he sincerely thought the prostitute was in love with him because she had asked if she could give him a love bite. Therapist 1. said that the way the client had said this, made her want to laugh, but she chose not to, because by doing so would have hurt his feelings. For the therapist this request on behalf of the prostitute did not show that the prostitute loved the client. The therapist said that the client was very sincere in his account. The therapist felt that laughing would not have been a good therapeutic response. Reconsidering this situation gave useful information about the differing beliefs and jarring convictions held by therapist and client.

 

Therapist 1 gave another example of wanting to laugh but not doing so. In this story a client said that he lived in ‘a dead end place’, a place that the therapist had lived in for years. The therapist said that her reason for censoring her laugh was because she thought that therapists do not give information about themselves. These notions remind me of obligatory ideas around the professional role. These obligatory ideas might be noticed when a therapist says to themselves; “to be a ‘good’ therapist I should not give personal information away”. Writers in the systemic field have challenged the rigidity and power differentiation of this idea (White & Epston, 1990, Roberts, 1994). Therapist 1. then went on to say that she would probably have laughed and said something now. This therapist said that more and more she was developing her abilities to question; ‘should I respond like this or in another way?

 

 

“How do you understand this reflection and spontaneity process?”

Therapist 2. said that being spontaneous and reflecting did not fit well together for her. She went on to say; “Reflection seems to be a slowing down process, a being able to consider the conversation in your own mind. This is quite different from a spontaneous response which seems more activated and energised.”

 

Ideas were expressed in the group of therapists that being spontaneous can aid with creating more warmth, affinity and feelings of being more genuine. Although therapist 2. gave another idea that; “for some families they might be too spontaneous and that coming to therapy is a slowing down of things. In slowing things down they might reconsider more what they are involved in. Families like therapists in training are learning to be clear about how it is that we do what we do. Thereby it may be more difficult to be spontaneous and be aware of your thoughts whilst using them. Quickly using considered thoughts seems different from being spontaneous. Therapist 2. said that as a training therapist it is necessary to slow things down in order to make changes and their actions more conscious. “If they just act spontaneously they don’t learn.” 

 

“Is spontaneity worth Utilising?”

Therapist 3 said that being spontaneous was quite difficult for him, but he admired greatly the ability in others. In clinical situations he said; “spontaneity appears to connect with how much I am engaged in the therapeutic relationship.” He said that he became less spontaneous the more mindful he became of offending clients. Therapist 3 pointed out that with some families he felt on his guard. In these families he said he was very conscious of trying to do the right thing or act in a certain manner. With others families he said; “you can be much more relaxed and ‘laid back’. You feel that engagement has occurred and you can be both jocular and thoughtful. (He said,) You can be more spontaneous because you feel it doesn’t matter so much, you're less likely to make mistakes”.

 

I have attempted to illustrate an idea that evolved from the group (diagram III). In this diagram I indicate an oscillating response of spontaneously responding and self reflecting.

 

In the discussion I stated that I noticed times when I spontaneously respond with comments of sarcasm, jocularity and the like. These comments may connect with, or become started by, a strong belief. Noticing this then can be useful in providing information about the prejudices I hold. Agreeing with the idea that one’s reflecting on spontaneous responses happens more when information from a personal domain enters into a therapy domain. I believe that noticing these situations more and questioning one’s beliefs/prejudices that have the potential to create a jarring, is useful in the endeavour of maintaining the therapeutic alliance.

 

Therapists monitoring themselves may encourage an avoidance of strong views, because these views may impinge on the therapeutic relationship in some way. Indeed, there may be a tendency for therapists to ‘water down’ or avoid holding a passionate view. Various writers in the field of systemic family therapy have written about stepping aside or manoeuvring, or safe uncertainty or multiple uses of self (Diagram V). All these approaches appear to assist therapists with the ethical issues of positioning one’s ideas to respond usefully or appropriately.

 

In principle I believe that therapists should be aware of their spontaneous thoughts that come to mind and that therapists have to judge how or whether to respond. Spontaneous responses are telling you something whether that is about a bias, the situation or the relationship. Spontaneous thoughts need to be listened to so that these thoughts can be presented and verbalised. One particular therapist said that he aspires to be able to be spontaneous, but that he is continually on his guard for inappropriate responses, I think this is useful therapeutic positioning. 

 

Proposals for more successfully Utilising spontaneity

 

Systemic thinking has intensified understanding of how to utilise spontaneous responses in numerous ways. Some suggestions that I note are.

 

   Doubt rather than certainty is a more useful stance in attempting to generate curiosity toward one’s convictions. Asking questions such as; how else might I respond given this immediate way of responding?

 

   Considering many positions (responses) may be more useful than singular ways forward.

 

   When responding spontaneously, turning one’s curiosity toward oneself may highlight prejudicial biases. Being willing and open to self examination deepens a sense of prejudicial biases and enables more accountability towards one’s spontaneous responses.

 

   Holding oneself to account may be useful when attempting to guard against inappropriate responses.

 

   Considering one’s convictions as constructed beliefs may be useful when attempting to manoeuvre from them. I am reminded of their similarities when applying them in practice using a social constructionist ideology, suggesting to me that absolute claims are replaced with a collaborative search for meanings (Gergen 1994). 

 

   Sharing with others when one is curious toward oneself may aid understanding and the relational dialogue.

 

The self reflecting process: when curiosity is turned toward oneself?

So far I have explored the systemic/family therapy context in which the importance for monitoring one’s spontaneous responses may have developed. I have also illustrated how various systemic ideas may be usefully applied when attempting to utilise spontaneity. I would now like to ask; How significant is turning one’s curiosity toward oneself?

 

I propose that turning one’s curiosity toward oneself is useful, particularly when monitoring spontaneous responses. Jones (1998) reflects on her self reflecting practice; “Asking questions of myself is, in my experience, most useful when the system becomes stuck”(p6). I believe that turning one’s curiosity toward oneself is particularly useful when therapists are spontaneously disposed, and their self reflecting capacities reduced. An extreme example of this reduction in self reflecting capacities is when a therapist is passionately asserting their views, preoccupied in this state greatly impedes one’s ability to turn curiosity toward oneself. In such situations, when therapists passionately assert their views, they are in more danger of expressing ‘jarring convictions’.

 

From my experience therapists like myself turn their curiosity toward themselves when they become alerted to their jarring convictions. These convictions may be personal matters, discourses or prejudices from other domains entering the therapy domain, for example;

   Responses of boredom; ”I’m tired of listening to this waffle”,

   Disgust; “I don’t believe it”,

   Erotically aroused; “nice legs”,

   Appreciation; “wonderful”,

   Anger; “shut up!”,

If a therapist brings all his prejudices to the therapy room, and a client brings all their prejudices to the therapy room then jarring convictions may be tensions between people’s differences being expressed. It is in these situations when tensions become noted that I believe it is most useful to turn one’s curiosity toward oneself.

 

In wondering about the significance of turning one’s curiosity toward oneself, I am drawn to the idea that this reconsidering process, may indicate change in the whole family/therapy system. When a therapist becomes a participant, and responses become recursively connected, whilst involved and joined with a family system, the tensions between jarring convictions may indicate how the whole system might be struggling toward change. Alternatively, I might simply wonder, how my self reflective processes might resonate with changes for the family/therapy system.

 

I am reminded of the tendency to turn curiosity toward myself in situations where I was going to say something but did not. When reflecting on these situations, new information became available for reconsidering the views I was holding and reconsidering the possible influences my involvement was having. So when noticing my yearning spontaneous responses I might self reflect asking; why am I thinking these thoughts, holding these views, having these feelings at this point in therapy? How might this resonate with the issues that the clients bring to the interview? Would it be useful or not for me to persist with these notions?

 

Being curious toward oneself is I believe a very useful stance for therapists attempting to utilise spontaneity in the therapeutic relationship. In addition to professional codes of ethics turning curiosity toward oneself may go some way in enabling therapists to practice more accountably and responsibly.

 

 

I believe that the developments in systemic therapy have facilitated an emphasis for therapists to monitor the effects of their responses in the therapeutic relationship. This paper has focused on the monitoring of spontaneous responses while reflexively relating systemic theory to practice. Self reflecting processes turning one’s curiosity toward oneself helps to create a context in which therapists develop a relationship with their prejudices and constructed beliefs. In doing, this I believe, therapists develop a more ecological, ethical and respectful form of therapy practice.

Notes on diagrams

 

 

 

 

I.     In diagram I. I have used concepts of multiple levels of meaning. Burnham, J. and Harris, Q. (1996) p165 have usefully elaborated this concept of working with multiple levels of meaning. Related to ideas from Bateson (1973) and clarified by Pearce and Cronen (1980), and Cronen, Johnson and Lannaman (1982) in their coordinated management of meaning C.M.M. Pearce and Cronen propose a hierarchy of levels of context in which the meanings of any level can be understood as by reference to a higher level i.e., in ascending order; Content (of a statement); The speech act (the utterance as a whole);Episode; (the definition of the relationship between the people creating the episode): Life story (stories people have about themselves); Family narratives (family mottos and ways of behaving in the world); Social mores (laws, regulations and social prescription for the citizens of a particular society); and Cultural patterns (the beliefs, values and practices that distinguish a culture as unique, different from other cultures). Although the higher levels exert a stronger (Contextual) force downwards, the lower levels also exert a weaker  (Implicative) force upwards.

 

II.   In diagram II. I have illustrated the family/ professional system and included a mapping of the referral process.

 

III.In diagram III. I have attempted to map out the thought/action process. This mapping relates to ideas presented by Oliver (1992, 1996) around strange loops. Although this diagram is not a strange loop as such it illustrates an idea of oscillation between spontaneously responding and self reflecting in action. Similarities may be drawn in Held (1995) ‘Ethical and other practical implications of Postmodern anti-realism.’ when she speaks about an oscillating component toward realism in systemic practice. (Strange loops are a C.M.M. device for describing how two levels of context are understood and exist within the context of the other. At each level of the loop, two conflicting stories co-exist; i.e. spontaneity >self reflection; a mistake >increased coherence and therapeutic fit. Oliver (1992) states that the loop is held in place by a meaning at a higher level of context. If that meaning were to change, the loop would unravel and no longer be maintained.)

 

IV.In diagram IV. I have again used C.M.M. and illustrated the interaction of speech (or prejudices) between family and therapist. How the speech from a family or therapist maybe influenced an understanding within a particular level of context.

 

V.  In diagram V. I have illustrated a range of systemic ideas that may be useful when attempting to utilise spontaneity. These ideas have been elaborated upon within the main body of text.

 

 

 

 

 

 

 

 

 

 

force                                                                                                                force

 

 

e.g. Social & cultural beliefs,

including myths & legends & traditions

“Deprivation breeds hardships”

“Laws against domestic violence”

e.g. Family mottoes and ways of behaving in the world

 families beliefs & professionals beliefs, prejudices and biases

“You will always be just like your mother/father”

e.g. stories people have about themselves

“I’ve always been an angry person”

 

e.g. the definition of the relationship; 

“I’m the dominant father she’s the week mother”/

”He’s the violent father I’m the sensitive mother”

 

e.g. the conversation patterns/reciprocated acts

“Our usual fights at the weekends”

 

e.g. segment of speech the utterance as a whole/messages of meanings

“Threats to my worth”

 

e.g. spontaneous response

“Piss off”

 

 

 

 

 

(1-12-98)

                                                                       

Community

                                                                        Mental Health           Community  

                                                                        Team                          Psychiatric Nurse

                        GP                                                      

                                                                                                           

                                                                                                            Art therapy services

                                                                                                            (Systemic practice)

                                                                                                                       

          J                A                                                                                                                                                                                                                                                     

Family                       

 Child                                                            Household                            

 Psychologist                                                                                                                                                               H              J                                                                                                                                                                                                                                                                          

            Child and family

            services                                             

 

 

Spontaneously responding                                                Self reflecting in action

 

 

More coherence/warmth                                        Appreciating the effects

in the therapeutic relationship                                          of one’s responses (Appreciating                                                                                      the others otherness)

 

 

More therapist uses their strong                                       Therapist increases self scrutiny,

opinions, beliefs personal stories                                     curiosity, respectful awareness

                                                                                    and sensitivity.

 

                                    Viewing oneself as a participant

                                    “Catching oneself”                                                     

                                    about to respond. Noting one’s jarring convictions

Viewing oneself as observer

Possible inappropriate                                                      

response expressing jarring                                               Therapist works harder to increase convictions a “mistake”.                                                     coherence and fit in the therapeutic                                                                                  alliance.

                       

Response by client                                                  

Possible deterioration of

therapeutic alliance

 

 

 

 

 

 

 

 

Therapists system                                                                Families system

 

 

 

 

 

Cultural patterns                                                                 Cultural patterns

 

 

 

 

Social mores                                                                         Social mores

 

“Try to do more good than harm”

 

 

 

Family narratives                                                                 Family narratives

“Parents who argue create children who argue”

 

 

 

Life story                                                                               Life story

 

 

 

 

Interpersonal relationship                                                 Interpersonal relationship

 

 

 

 

Episode                                                                                 Episode

 

 

 

 

Speech act                                                                             Speech act

 

“Hold on”                                                                               J:“You’re just like your father”

                                                                                                A:“Fuck off who are you!”

 

Appendix 1.

Developing discussion around spontaneously responding and self reflecting processes in the therapeutic relationship.

 

This focus group discussion is intended to be used as part of my dissertation “Self reflection in action: A discussion around spontaneously responding in the therapeutic relationship”. I hope to open up discussion around the difficulties and beneficial uses of self reflecting in action whilst spontaneously responding in the therapeutic relationship.

 

The dissertation topic I have chosen is connected with a personal quest, an intention to increase and explore my abilities toward self reflecting in action . I see this exploration as useful in being able to successfully utilise creative conversational spontaneity.

 

Below are a set of questions aimed at providing a structure for the discussion. These are divided into three themes.

 

            Firstly; how therapists appreciate the ethical dimensions to their spontaneous responses. From my experience therapists pursue an awareness of  the effect they have in the therapeutic relationship. Greater emphasis of  the ethical dimensions seems to be required when attempting to utilise spontaneous responses

 

            Secondly; Therapists prejudices ‘Fanaticism and extremes; the strong stories that impinge on the therapeutic relationship’. Authors such as Lax (1992) have indicated that therapists might through self reflecting be able to step aside from the strong stories they initially engage in, and view these stories from other perspectives.

 

            And last; Reflecting on reflecting in action: what significance might noticing when self reflecting in action takes place, have on the therapeutic relationship? I have ideas that when therapists jump out of being spontaneously disposed, and turn their curiosity on themselves, that this may be indicative of a difference or turning point in the therapeutic relationship.

Questions

 

How therapists appreciate ethical dimensions to their spontaneous responses.

 

1.    As therapists you may from time to time find yourself submerged in conversation with clients, spontaneously responding. Is this situation more difficult to reflect on your actions? How do you account for this?

 

2.    How can self reflection in action become amplified and expanded in situations of spontaneously responding?

 

3.    How can systemic therapists develop ways for successfully Utilising frank, unrestricted thoughts and respond spontaneously yet become mindful of inappropriate responses?

 

Therapist’s prejudices ‘Fanaticism and extremes; the strong stories that impinge on the therapeutic relationship’

 

4.    In what ways are inappropriate spontaneous responses more likely if a therapist believes too strongly perhaps fanatically?

 

5.    Generally, self reflecting in action appears to be the ability to consider one’s thinking whilst involved in doing. It is suggested that self reflection in action is more likely when a therapist retains a curiosity toward their own prejudices and participation in the problem determined system. If this ability is impeded by single-mindedness, fanaticism, one’s strong stories, how might these impeding positions be overcome? Is it possible to believe in something very strongly yet be able to manoeuvre (step aside) from one’s passionate perspective? How? Do you have examples of this?

 

Reflecting on reflecting in action: what significance might noticing when self reflecting in action takes place, have on the therapeutic relationship?

 

6.    What ideas do you have as to when self reflecting in action comes to the fore. Reflecting on when your self reflecting abilities have been employed; Elsa Jones (1998) believes that asking questions of herself is most useful when the therapeutic relationship becomes stuck. So when do you notice yourself asking self reflecting questions: such as, why am I thinking these thoughts, holding these views, having these feelings at this point in therapy? And how might these responses resonate with the issues that the clients bring to the interview? Would it be useful or not useful for me to persist with these notions? What effect does turning your curiosity upon yourself in this sort of way have in terms of change and differences for the whole therapeutic relationship?

 

7.    How might self reflection in action become indicative of a turning point for the therapeutic relationship?

 

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