Category Archives: Counselling/Therapy

Narratives of self-knowledge (public talk)

I was delighted to co-present a talk on therapy, bio-ethics and philosophy alongside my longtime pal Emily Postan at Blackwell’s Bookshop in Edinburgh on Monday 18th March 2019. There was a mixed audience including the general public, therapists, and academics from a range of different disciplines.

The idea for the talk emerged after I attended an earlier Cafés Philosophiques session, one which explored ideas of self-knowledge through an examination of Beckett’s Krapp’s Last Tape.

My thought was that narrative therapy presents interesting challenges to at least some traditional ideas of self-knowledge. Not least, when I am working with people I sometimes find myself asking “What story do you prefer?” This seems to call into question the idea that there is a single “right” story that I, as some sort of mind expert, might be able to investigate and discern. I like this result. But it can also be puzzling. Can we just make up who we are? My answer might be “sort of, but not anything goes…”

Getting this answer into some sort of coherent shape was the aim of doing the talk. And, if I got there at all, it was with great help from Emily who is interested in themes of narrative and personality identity because of the crucial role they play in our thinking about bio-ethics. Along the way we touched on a range of themes, including how diagnoses can be both tools and weapons and how to think about the body (as opposed to just the mind) in relation to our identity.

Emily and I haven’t written up the talk and I suspect we won’t. It was very much a live event and being in the moment. But the abstract is below.

Narratives of self-knowledge – locating ourselves between decision and discovery

Matthew Elton and Emily Postan

Psychotherapy may be seen as an investigation into a (broken) self followed by an attempt to make internal changes leading to a new (and fixed) version of that self. But one particular approach, narrative therapy, resists the idea that what’s most needed is some internal re-jigging of the innards of the mind and favours something more like a re-positioning in relation to the range of stories that can be made to fit the many episodes that make up our lives. In doing so, it often challenges dominant and socially privileged narratives – for example ones featuring categories such as depression, anxiety, and many more – that may be what has brought a person into the therapy room in the first place.

Similar challenges arise way beyond the therapy room, not least in bioethics. The radical prospect of being willing to set aside any pre-existing narrative can be dizzying for the individual and troubling for the theorist. The idea that every one of us creates who we are through the stories we tell about ourselves poses a beguiling yet unsettling prospect. If such freedom is permissible, does anything constrain our investigation of who we are and who we can be? And if something does constrain it, in what ways does this differ from the imposition of others’ ideas of who we are allowed to be? Drawing on examples from psychotherapy, philosophy, and bioethics our speakers explore what self-knowledge might mean for those who are strongly motivated to embrace a narrative conception of identity.

Speakers: Matthew Elton is a psychotherapist in private practice in Edinburgh and a former lecturer in philosophy at the University of Stirling. Emily Postan is Early Career Fellow in Bioethics in the School of Law, University of Edinburgh.

The Responsiveness Ladder (workshop for therapists)

I had a great response to my workshop on what I call the responsiveness ladder at the Scottish Transactional Analysis Association conference on Saturday 18th November 2017.

The idea of the ladder came from thinking about exchanges between people that ought in theory to go well but which actually end up making things worse. Think about a person who is getting anxious because they are running late. Let’s call this person the struggler. And, lucky them, they have a supporter. The supporter says, in a calm and warm voice: “No need to worry about it. Just call them and let them know you’re a few minutes behind.” At this point the struggler has some sort of meltdown, perhaps resulting in exclaiming “you just don’t understand” (or worse) or, on another occasion, turning into a sulk. In the workshop we looked a lots of other cases of exchanges like this, and also at some therapy tools that can be used to understand them, such as the Drama Triangle from Transactional Analysis.

The responsiveness ladder takes a slightly different approach to the Drama Triangle. It suggests that at different times and in different contexts we can managed different levels of sophisticated in our responses. When things are going well – we are well-fed, well-rested and so on – then we can respond with our best rational self. We are, in this case, on the top-rung of our responsiveness ladder. But when things are going badly – we are stressed, we are hungry, we are tired etc. – then we are on a much lower rung. At the lower rungs we are – like much younger versions of ourselves – not equipped to respond in such sophisticated ways.

This is something that we all – many of us anyway – might know intuitively. The ladder is a way of making it explicit. And of emphasising, as I said in the workshop:

never mind what rung you think that person ought to be on, pitch yourself at the rung they actually are on.

If we pitch our support at a rung that is higher than where the struggler currently is, our support will land badly. To be effective, we need to tune into the rung they are at. Does this mean we have to “baby” people? Or that we have to as, as Transactional Analysis might say, “Rescue” people, i.e. offer un-requested help while discounting the struggler’s ability to think and problem-solve for themselves? After all, we know that the struggler is capable of behaving in grown-up ways, so why can’t they just do that? In the workshop I argued that often pitching to the rung they are at is the fastest and most efficient way to respond. And that when you do this, it helps the person quickly climb back up their responsiveness ladder.

Basically, if someone is upset, it’s often best to save all the rational talk until they are feeling a bit calmer or more connected. And it makes sense for a supporter to focus on helping the struggler get calmer and connected before anything else because, well, not only is it kinder, it’s also more efficient and more practical.

Of course, if you are often the supporter of someone who is often on their bottom rung, you might want to do something about that whole setup. And the workshop didn’t contest that. But it did look at how we can be surprised over and over again by something that, once we describe it in terms of the responsiveness ladder is perfectly predictable. Knowing more about what’s going on – or having better ways to describe it – gives us more options for how to move ahead.

From the workshop abstract:

The responsiveness ladder is a tool for clients and therapists seeking to understand why well-intended offers of support, comfort and practical advice can repeatedly go very wrong. When under stress, we drop down the rungs of the responsiveness ladder. Transactions that are pitched at too high a rung are experienced as unhelpful, discounting, and even antagonistic. The image of the ladder and its rungs can help us understand why things go wrong, help us adjust how we pitch our transactions, and help us focus on what a person can manage in the given moment instead of focusing on what they “should” to be able to manage.

I do have slides for the workshop, although they might not make too much sense outwith the presentation. But do get in touch if you’d like to see the slides or ask more about the model. I would like to write up the workshop at some stage, not least to incorporate some of the great ideas participants came up with during the session.. And if I do, I’ll update this page.

Practice & performance – learning new life grooves

I’m facilitating a one day event for the Scottish Association of Transactional Analysis on August 20th 2016. The day will be exploring some ideas that I’ve been thinking about a lot over the last year to with some of the parallels between achieving (or struggling to achieve) therapeutic change and the challenge of learning complex practical skills, such as mastery of a musical instrument, a sport, or a second language.

My goal for the event is to explore the lessons therapists and their clients can borrow from the learning of complex practical skills, such as performing music, playing sport, or gaining a second language.

In music, sport, and second language learning, we know that acquiring skills takes deliberative practice. In order to establish new grooves, ones that we can rely on even when under pressure, we have to repeat them many times, often slowly, and we have to repeat them right.

Teachers and coaches have much experience of how unhelpful habits can impede a student’s learning and growth. And they know a lot about what it takes to unlearn bad habits and replace them with new and more productive ones. They also have a good understanding of how new learning that feels secure in rehearsal or practice, can collapse in the face of performance pressure.

If these ideas are of interest and you can’t make the event, then I very much hope to be writing some of them up here or elsewhere.

Update (Mon 22nd August 2016)

Slides from the day. Some of these won’t make much sense out of context! I’ve also put up the handout from the “plinth” activity.

Learning New Life Grooves (slides)

Activity #3 – Standing on a Box (handout for “plinth” activity)

 

Coaching vs Counselling

What is the difference between coaching and counselling? You’ll probably get as many answers to this as coaches and counsellors you ask. Both kinds of support are aimed at helping you achieve more of your potential and at removing obstacles in your way.

I think that good coaching does overlap in some ways with good counselling. Both approaches will explore some of the self-imposed limits that are holding you back and preventing you getting more of what you want out of life. And both approaches are prepared to ask important questions about emotions and values, supporting you if the asking of these is, for a while, uncomfortable.

If you are finding yourself constantly tearful, then counselling is more likely the help you need. On the other hand, if you have plans that you often think about but just, somehow, can’t realise, then coaching might be a better fit. Maybe your challenge is somewhere in between. In that case, you could do worse than give a counsellor or a coach a quick call and just ask.

A few minutes on the phone with a counsellor or a coach is going to be far more useful than any amount of online reading about the difference between the two approaches. If you contact me and I think coaching is more what you need, I’ll refer you on. And any good coach, if they feel it’s counselling you need, will do the same.

Here’s my Edinburgh colleague Mandy Day-Calder, with her own take on the difference between coaching and counselling:

Coaching differs from counselling in that we would concentrate on what is happening for you just now. Our sessions would involve an exploration of your whole life – I will ask you questions and then let you do most of the talking! Using some creative visual exercises we would define a sense of how you would like things to be, where you want to make changes and then we would focus our sessions on working towards your goals by creating mini-steps or ‘actions’. In doing so we would hope to uncover what’s important to you and how you want to live your life. All sounds very ‘big’ but we would take it step by step. Though we will be working together, I will never take over or tell you what to do – you know yourself better so you are the expert… in fact you are in charge!

Coaching isn’t always easy – what learning or process of change is? It is likely that you may feel resistance along the way as familiar patterns of thinking / behaviour arise. However, I will be there to guide and encourage you – challenge and keep you on track you if need be (not ‘nag’ – I save that for my partner!) My style is to make coaching fun as well as hard work!

If you came to this site thinking about counselling, but wonder whether coaching is what you need, you can contact Mandy via mandy@achievingbybelieving.com or give her a call on 07493 068 938.