THE NEW PSYCHIATRY BY MY GUEST BLOGGER

Negotiation and the Power of Finding Alternative Options
Total freedom for everyone is a dangerous myth. In pursuit of absolute freedom, we will all end up feeling like “slaves” of one kind or another. The answer to feelings of “oppression” is for everyone to always have plenty of options.
So, when negotiating with anyone, including psycho-social service professionals and including clients, one should always solicit at least 2 alternative options from the other person, and always suggest as least 2 options of your own, and always negotiate at least 2 compromise options in any difficult negotiation situation.
Person-to-Person Therapy
Acceptance and Commitment Therapy (ACT) is a modern therapy that has the objective of achieving as much “psychological flexibility” as possible. It basically aims to undo the obsessive, compulsive and addictive patterns that result from past trauma and too much worrying about further future traumas. So, modelling “psychological flexibility” in one’s own behaviour, and actively contradicting one’s own obsessions, compulsions and addictions makes complete sense.
Peter K. Gerlach, author of the “Break the Cycle” programme, gives a good explanation as to how “addictive personalities” gets passed down from one generation to the next, so I recommend studying his work and working through his programme.
John Bradshaw, author of “Healing the Shame That Binds You”, also has much to say on the subject of “addictive personalities”, their roots in “being excessively shamed”, and how to recover.
Another therapy that is calling out for more attention is Schema Therapy which explains that we see the world through “filters” (called “Schemas”) that have arisen as a result of past traumatic experiences, and the way that one sees the world has to be adjusted if one is ever to recover.
Then there’s my invention which I call “Modality Therapy”. In this therapy I have found it extremely simple and helpful to label, as well as possible, everyone’s “operational mode” (though perfection in such labelling is not required). See Appendix 3 for full details.
Then there’s my variation of the “Open Dialogue” group therapy process which is a facilitated group healing process. See Appendix 4 for my “Open Dialogue Group Guidelines”.
Meditation
If you have stumbled across a kind of meditation that produces positive results for you, then that’s all very well and good. But, I personally dislike most off-the-shelf versions of meditation as they all seem very unnatural to me.
My own version of “meditation” involves “tuning in” to one’s own inner “tinnitus”, as and when, in any idle moment.
“Tinnitus” is the whistling sound that can sometimes, if not often, be noticed in one or both ears behind the sounds of the everyday world. I find that when I “tune in” to my inner “tinnitus”, I get to notice it more clearly and more loudly. And, this technique requires no special position, and it doesn’t matter at all whether one shuts one’s eyes or keeps them open.
“Tune in” whenever you think to do so, whenever you can do so, whilst you get on with your life, whatever you happen to be doing at the time. It can do no harm, and is likely to do much good.
The Healing Power of “Being There for Another Person”
“Being there for another person” can be done in many ways. I will list some of the most beneficial ways here:
1. Providing low-key company (relaxing together, parallel activity, occasional inconsequential conversation).
2. Witnessing (being with and just paying attention to what is going on for the other person, noticing the client’s existence for more than a few minutes at a time).
3. Listening (being with and gently encouraging the other person to do as much or as little talking as they need to, as and when it suits them).
4. Hearing/Understanding (trying to make some sense of some of what is being said and showing some understanding, support and encouragement only when we sense that that understanding, support and encouragement is likely to be welcomed).
5. Making it as easy as possible for a client to process what needs to be processed in the service of “going through” with as little “interference” as possible, where “interference” is any communication or intervention generated by any agendas other than the client’s agenda.
6. Making it easy for client to “get things off their chests” with as little “interference” (see above) as possible.
7. Talking to the client with thoughtfulness, consideration, kindness, care and helpfulness, even when that client is so preoccupied with his or her inner life that he or she is verbally silent, only uttering the occasional word or phrase, or communicating in any way that makes him or her hard or even impossible to understand with any clarity.
[Such thoughtfulness, consideration, kindness, care and helpfulness is always noticed by the client, even when it looks like it has not been noticed, and it provides the client with a incentive to express himself or herself better which is an essential part of his or her journey towards some kind of recovery].

The healing process of “going through” proceeds at a pace that is inversely proportional to the amount of “interference” given, and so one should always be mindful of putting downward pressure on “interference”, so as to facilitate as much “going through” as possible.
However, perfection in this area is not required because a client that has a great deal of support in “going though” what he needs to “go through” will quickly become more tolerant of a modest degree of “interference”, especially when that “interference” is perceived as occurring for good reason and/or as a result of necessity.
It should be noted, however, that in the early stages of “going through” some clients will become more “difficult to manage” and not less, but patience and professionalism are recommended because the dividends associated with “being there” for clients in the “bad times” as well as the “good” are always great.
Also, on the subject of “interference”, when aiming to provide “therapeutic engagement” with anyone, one should be cautious about interrupting any silence. Silence can be therapeutic because it gives the client a space in which to work things out for himself or herself in the absence of “interference”. Too much silence can also be anti-therapeutic when the client is prone to feeling, unsupported, misunderstood and/or abandoned (left to do everything on his or her own). So, a balance needs to be struck, knowing that too much silence is always better than too little. Therefore the rule of thumb should be: If in doubt about whether to interrupt a silence, then don’t interrupt it.
More about the Value of Understanding, Support and Encouragement
What is written here applies to clients regardless of their degree of “emotional disturbance”, but the effects of good practice with more disturbed clients will be noticed more clearly, although good effects will show up more quickly with some clients as opposed to others.
Many clients talk unintelligibly for some of the time, if not much of the time. Some clients hardly talk or communicate at all. The problem here is that as a result of this “acquired behaviour” they rarely or almost never get any feedback from others showing that even parts of “their story” have been well understood by another human being. This is unfortunate because the resultant “isolation” forces them deeper into a chaotic inner world that is disconnected from present time reality to some degree, maybe to a severe degree. The chaotic inner world of such people is held in place by a network of past traumas and future fears which may be beyond “unpicking” even with the help of the most experienced of therapists.
The answer is to spend a lot of time with such clients providing them with company, waiting patiently to pick up as many verbal clues as possible, observing patiently to pick up as many non-verbal clues as possible, and deducing what patterns of thoughts and feelings might be turning up for the client, repeating themselves in the client’s inner life, and doing battle in the client’s present time reality.
And, as part of this process, as much feedback as possible should be given to the client to show some understanding, support and encouragement of a kind that the client welcomes, whilst being very mindful of the problem of too much “interference” (see above).
And, one should typically communicate with “emotionally disturbed” clients as if there’s nothing concerning about their presentation (this is the opposite of “pathologisation” — see below). Some nurses do this instinctively. Others do this to a lesser degree. But, sadly, psychiatrists see no point in hiding their absurd prejudices, and they see every point in treating their prejudices as incontrovertible facts that, when “challenged” by others (they say “denied” by others) are taken to be clear evidence of those others’ insanity.

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