As a part of my presentations for ACA last week, I prepared a couple of short video clips. These clips are part of a much, much longer, three-volume (7.5 hour) video series produced and published by psychotherapy.net. Victor Yalom of psychotherapy.net gave me permission to occasionally share a few short clips like these. If you’re interested in purchasing the whole video series (or having your library do so), you can check out the series here: https://www.psychotherapy.net/videos/expert/john-sommers-flanagan
IMHO, although the whole video series is excellent and obviously I recommend it, these clips can be used all by themselves to stimulate class discussions. Check them out if you’re interested.
Kennedy is a 15-year-old cisgender female referred by her parents for suicidal ideation. Although a case could be made for using a family systems approach, this opening is of me working 1-1 with Kennedy. When I show this video, I like to emphasize that I’m using a “Strengths-based Approach” AND I’m also asking a series of questions that pull for Kennedy to talk about her distress. This is because clients generally need to talk about their distress before they can focus on strengths or solutions. Instead of practicing “toxic positivity” this approach emphasizes the need to come alongside and be empathic with client pain and distress.
Chase is a 35-year-old cisgender Gay male. In this brief excerpt, I try (somewhat poorly) to use a pattern interpretation to facilitate insight into his history of social relationships. Chase’s response is to dismiss my interpretation. Back in my psychoanalytic days, we talked about and used trial interpretations to gauge whether an abstract-oriented psychodynamic approach was a good fit for clients. Chase’s response is so dismissive that I immediately shift to using a very concrete approach to analyzing his social universe. Then, when Chase isn’t able to identify anyone who is validating, I use a strategy I call “Building hope from the bottom up” to help him start the brainstorming process.
A big thanks to psychotherapy.net and Victor Yalom for their support of this work.
As always, if you have thoughts or feedback on these clips or life in general, please feel free to share.
As I type, Steven Hayes, the creator of acceptance and commitment therapy (ACT), is talking in a variety of voices about mindful acceptance. Earlier, he mentioned something about the whole human genome. In case you don’t already know, Steve is an older white guy. His writing about psychotherapy is fantastic. I really like his Ted talk. I’ve found his question, “What shall we do with our difficult thoughts?” an excellent prompt to reflect on.
Steve and I have a history. I’m glad to say that I’ve mindfully accepted that he missed his supervision appointment with me at AABT (now ABCT) back in 1987 in Los Angeles. Really. I’ve let go Steve standing me up, not because I’m all that good at forgiveness, but because him skipping out on our chance to meet makes for a better story. In fact, in this mindful moment, I’ve accepted him missing our meeting so completely that I have no urge to try to meet him today.
This is my first Networker “Symposium.” I hadn’t realized it was quite the distinctive thing. They’ve got numbers you can put on your badges to represent how many times you’ve attended the Symposium. Although it’s just a conference, it does have a particular flair and feel. From the beginning, there was movement, talk about love and sex-tech, dancing, singing, and learning. The breadth of content and diversity of attendees has been marvelous.
I started the first day with a workshop on Love and the Therapeutic relationship with Sabrina N’Diaye. Later, I took in a workshop on Tech-Sex with Tammy Nelson, author of Getting the Sex you Want. Nelson basically blew my mind. Did you know there are “devices” you can use to remotely vibrate your romantic partner’s genitalia? I didn’t . . . and maybe I didn’t want to. Did you know someone commented in the session that “Dominants” use that vibrating device to issue “commands?” I was sitting next to a professional cuddler and sexual surrogate. She was delightful. Steve Hayes (and Ram Dass) would be proud of the fact that I managed my difficult thoughts by staying in the here and now instead of trying to imagine her work or think about what the dominatrix had shared. Just saying. My mind remained as pure as the water of the Stillwater River.
There’s been lots of talk about racism at the Symposium. That’s a good thing. I’m better for it. The more we can all be less racist or anti-racist and aware of our biases, the better. Of course, while I’m typing this, my almost erstwhile buddy Steve continues to talk (and sometimes mumble). I’m aware (somewhat painfully) that I’m more “like” him in age and gender and ethnicity and can’t help but lament that (sorry Steve). Being an old white guy brings privilege (or advantage, as our first keynote speaker preferred). At the same time, looking in the mirror and seeing myself as just another old white guy also brings along gut-level unpleasantness.
Yesterday’s highlights were listening to Ester Perel (very smart, very articulate, very impressive) and learning more about Susan Johnson and her personal history of growing up in a Pub. We also listened to three young women talk about the couple therapy experiences that changed them. Fabulous.
One of my (many) take-aways from the past two days is for me to NOT be THAT old WHITE guy. I want to be a different white guy. How does that work? Among other things, I will try not to think too much of myself . . . or mumble.
Steve is now trying to get us all to love ourselves. That’s a nice idea. Someday, Steve, I hope to get there. But, to channel our Saturday morning Symposium keynote speaker, Emily Nagoski, most of the time, things just don’t fucking work.
Wait. I know that sounds negative. Among many of her excellent points about coping with burnout, Emily played a cool song (of her twin sister’s), a song liberally infused with the F-word. If you’ve ever experienced technology frustration (which I suppose even happens with sex-tech), you should listen. Here’s the link: https://www.youtube.com/watch?v=eottd9Lw8l4 If you listen, don’t think about sex-tech at the same time. There’s no need to thank me for this great advice.
I’ve now abandoned Steve, in favor of one of the darling presenters of the Symposium and PESI. Sorry Steve . . . but I know you’ll mindfully accept your experience of me abandoning you. . . partly because you’ve never acknowledged my existence anyway (see, I’m totally over that 1987 incident).
There’s a woman talking . . . softly . . . without the changing voice routines of Steve Hayes. As she drones on, she mentions that therapy and therapists can be triggering. . . which is interesting given that I can’t find any affect in her voice. I’ve taken a seat on the floor in the back corner of the room and quickly recognized she’s right. She’s right because she instantly triggered me as I walked in the door with her monotone statement that talk therapy doesn’t work for trauma (what about CPT . . . or?). She continued to trigger me with her statement that PTSD was only identified in the 1970s (what about the diagnosis of war neurosis or battle fatigue or the many other earlier versions of PTSD?). And she finished triggering me with her laudatory comments on narrative therapy (does she NOT think of narrative therapy as “talk therapy?”).
I know my job here. Mindful acceptance. Learn what I can. Maybe the learning is about my own triggers or my own internal lament over being an increasingly irrelevant old white guy. Maybe the learning is about how to stay calm and embrace both ends of the constant dialectics and polarities of life.
On the whole, I’m so glad to be here at the Symposium, with Rita, and so grateful to continue learning. The fact that the conference has stimulated some of what Steve would call “difficult thoughts” is a blessing to be mindfully accepted. How else do we learn? How else do we grow? Should we expect to be constantly confronted with easy, comfortable, and affirming thoughts?
I think not. And I accept that . . . in my whole human genome.
Jon Sperry asked if I could write the foreword for a book he and his dad wrote with Oxford University Press.
Because the truth will set me free, I should admit, I’d never written a foreword before. More truth . . . I went ahead and said “Yes” to Jon because (a) I was honored and didn’t want the opportunity to write my first foreword slip away, (b) the book was (is) cool (it’s “The 15-Minute Case Conceptualization”), and (c) Jon Sperry is one of the nicest guys on the planet.
And for even more information about this excellent book, my first-ever foreword is below.
I’ve needed this book for 30 years.
Just last month (before reading this book), I was standing in front of a Zoom camera, trying to teach the basics of case conceptualization to a group of 23 master’s and doctoral students. All of my fine-grained case conceptualization wisdom was being channeled into a single visual and verbal performance.
“My left hand,” I said, “is the client’s problem.” Pausing briefly for dramatic effect, I then continued, “and my right hand is the client’s goal.”
My new-found nonverbal gestures are mostly a function of seeing myself onscreen, and therefore wanting to avoid seeing myself (and being seen by the class) as boring. To add spice to my case conceptualization gesturing. “Case conceptualization is simple,” I said. “All it is, is the path we take to help clients move from their problem state . . . toward their goal state (I finished with a flourish, by wiggling the fingers on my raised right hand).”
But boiled down truths are always partly lies. Despite my fabulous mix of the verbal and nonverbal, I was lying to my students. At the time, I had thought of it as a little white lie, all for the higher purpose of simplification. And although I still like what I said and still believe in the rough truth of my visual case conceptualization description, after reading Len and Jon Sperry’s illuminating work on case conceptualization, I better understand what I should have said.
Case conceptualization is not simple. As the Sperry’s describe in this book, case conceptualization—even when summarized well—includes multiple dimensions of human behavior along with clinician perception, judgment, and decision-making. I needed much more than a few wiggly fingers to communicate the detailed nuances of case conceptualization.
What these authors have done in this book is the gracious service that great writers do so well: They have done our homework for us. They’ve read extensively, taken notes, and gifted us with elegant summaries of dense and complex concepts. They’ve made it easy for us to understand and apply the principles and practices of case conceptualization.
What I might like best is how they transformed a bulky and inconsistent literature into simple, therapist-friendly principles. They emphasize the explanatory, tailoring, and predictive powers of case conceptualization. I’ve never organized case conceptualizations using those “powers” but doing so was like switching on a light-bulb. Of course, case conceptualizations should explain the relationships between client problems and client goals and shine a bright light along the path, but rarely do theorists or writers make this linkage so efficiently. Their second principle, “tailoring” case conceptualizations to individual and diverse clients, is an essential, idiographic, Adlerian idea. The whole idea of tailoring counters the all-too-frequent cook-book approach to case conceptualization. Tailoring breathes life into creating client-specific case conceptualizations. And of course, case conceptualizations need predictive power; Len and Jon equip us with enough foundational predictive language to improve how we evaluate our own work.
Many other examples of how elegantly the authors have done our homework are sprinkled throughout this book. Here’s another of my favorite examples.
In chapter 2, they take us (in a few succinct paragraphs) from what Theodore Millon described as eight evolutionarily-driven personality disorders to eight crisply described behavioral patterns. What I love about this is that Len and Jon’s wisdom transforms what might otherwise be viewed as a pathologizing personality disorder system into language that can be used collaboratively with clients to identify contextually maladaptive interpersonal patterns. This is a beautiful transformation because it spins psychopathology into something clients not only understand but will feel compelled to embrace. The process goes something like this:
Therapist and client engage in an assessment process that touches on the client’s repeating maladaptive behavior patterns. These behavior patterns are palpably troubling and far less than optimal for the client.
As all clinicians inherently know, touching upon clients’ repetitive maladaptive behavior patterns can activate client vulnerability. This is a primary challenge of all counseling and psychotherapy: How can we nudge clients toward awareness without simultaneously activating resistance? For decades, psychoanalysts managed this through cautious trial interpretations. Solution-focused therapists dealt with this by never speaking of problems. Gently coaxing ambivalent clients toward awareness and change is the whole point of motivational interviewing.
When addressed in a sensitive and non-pathologizing way, deep maladaptive behavior patterns can be discussed without activating resistance or excessive emotionality. This is a critical and not often discussed part of case conceptualization. Len and Jon illuminate a path for gentle, sensitive, and collaborative case conceptualization.
When clients can feel, recognize, and embrace their maladaptive behavioral patterns in the context of an accepting therapeutic relationship, insight is possible. In the tradition of Adlerian therapy, when insight happens, client interest is piqued and motivation to change spikes. Good case conceptualizations articulate problem patterns in ways that compel clients to invest in change.
I’m not surprised that Len and Jon Sperry have produced such a magnificently helpful book. If you dig into their backgrounds and conduct a case conceptualization of their personality patterns, you’ll discover they wholeheartedly embrace Alfred Adler’s work and consequently, much of what they do is all about social interest or Gemeinschaftsgefühl. Len and Jon Sperry are in the business of helping others. Reading their book has already helped me become better at teaching case conceptualization. I appreciate their work, and, no doubt, the next time I begin waving my hands in front of my Zoom camera, my students will appreciate their work too.
Last year, for the first time, we offered the Art & Science of Happiness simultaneously as a 3 credit COUN 195 course through the University of Montana and as a non-credit course open to community members through UMOnline. The course was fully online. Many students took the course “live” and synchronously; others enrolled and completed the course at their convenience.
We had 50 students sign up for the course: 30 UM students took the course for credit; 20 were “community” members (hailing from Missoula, Browning, Billings, Pennsylvania, and Canada). Many of the UM students were 19 to 22 years-old. Many of the community members were 60 to 87 years-old. The inter-generational synergy was fabulous.
What You Get in the Art & Science of Happiness
25+ instructional hours with John Sommers-Flanagan, and occasionally Rita Sommers-Flanagan. You can experience these lectures synchronously through Zoom, or asynchronously at times that work into your personal schedule.
10+ hours of small group counseling designed to facilitate reflection, discussion, and experiencing of evidence-based happiness activities (these “lab” groups can be face-to-face or via Zoom)
8 hours of individual supportive wellness counseling with a Master’s student from the Counseling Department at the University of Montana (these services are face-to-face or via Zoom and on a first-come, first served basis, because we have a limited number of available counselors-in-training)
The cost for community UMOnline participants is $250. If that sounds expensive, think of it this way. You get 40+ total hours of a combination of large group instruction, small group counseling, and individual counseling, which translates to $6.25 an hour.
Research from the two previous semesters indicate that some (not all) participants experience:
Reduced depression symptoms (in some cases, depressive symptoms were substantially reduced)
Increased hope and optimism
An increased rate of positive emotions
A reduction in headaches
Greater feelings of social connection
Comments from Previous Community Participants
“Words are inadequate to express my gratitude for the Happiness Class and your amazing expertise. Literally transforming my life after a very difficult and sad nine months; plus, it’s a heckuva lot of fun. Again, thank you.”
“I found the course interesting and rewarding far beyond my expectations.”
“I feel a major shift in my thinking. I am now more focused on gratitude and living in the moment and have developed an unexpected confidence about facing the inevitable challenges that lie ahead, a confidence that even others have noticed.”
[In response to the group counseling component] “I appreciate the interactions that I have with everyone in my group. We are all very different, yet willing to be open and share our thoughts. I wasn’t sure what this would be like and I am already liking it a lot.”
[In response to a homework assignment] “I am applying a very simple formula to myself…When I become aware of how grumpy and scared and negative I feel about an issue in our family, I consciously think of two things for which I feel grateful. It fills the basket of my emotions with more positivity and opens up a new way of approaching my worries.”
The course is offered “live” on Tuesdays/Thursdays from 1pm to 2:20pm, beginning on January 18, 2022, ending the week of May 9, 2022. However, because the course is fully online via Zoom, you can also take the course asynchronously.
I believe this course content is very helpful, and so I’d like to make this course available as widely as possible. Please help me by sharing this information with others. Also, because I’m paid by the University of Montana to teach this course, all proceeds are returned to the University of Montana in general, and the Department of Counseling, in particular.
As W. R. Miller noted in his treatise on motivational interviewing (MI), ambivalence is nearly always the order of the day. Most people, most of the time, would like to be better and healthier versions of themselves. And, most people, most of the time, resist becoming better and healthier versions of themselves. Who knew?
Alfred Adler may have been the first modern psychotherapist to write from a non-psychoanalytic perspective about how to work with individuals not interested in changing. What follows is a complex quote from Adler. He’s writing about how to work with a patient who is depressed, but not motivated or willing to change. You may need to read this excerpt several times to track it and appreciate Adler’s method. You may see all those words below and not want to put in the effort. That’s okay. You can stop reading now if you don’t want to gather in the nuance sprinkled into Adler’s indirect suggestion.
After establishing a sympathetic relation, I give suggestions for a change of conduct in two stages. In the first stage my suggestion is “Only do what is agreeable to you.” The patient usually answers, “Nothing is agreeable.” “Then at least,” I respond, “do not exert yourself to do what is disagreeable.” The patient, who has usually been exhorted to do various uncongenial things to remedy this condition, finds a rather flattering novelty in my advice, and may improve in behavior. Later I insinuate the second rule of conduct, saying that “It is much more difficult and I do not know if you can follow it.” After saying this I am silent, and look doubtfully at the patient. In this way I excite his [her/their] curiosity and ensure his attention, and then proceed, “If you could follow this second rule you would be cured in fourteen days. It is—to consider from time to time how you can give another person pleasure. It would very soon enable you to sleep and would chase away all your sad thoughts. You would feel yourself to be useful and worthwhile.”
I receive various replies to my suggestion, but every patient thinks it is too difficult to act upon. If the answer is, “How can I give pleasure to others when I have none myself?” I relieve the prospect by saying, “Then you will need four weeks.” The more transparent response, “Who gives me pleasure?” I counter with what is probably the strongest move in the game, by saying, “Perhaps you had better train yourself a little thus: do not actually do anything to please anyone else, but just think about how you could do it!” (Adler, 1964a, pp. 25–26)
Similar to Adler, Viktor Frankl also wrote about using “anti-suggestion” or paradox. Frankl was keen on this method as a means for treating anxiety, compulsions, and physical symptoms. An excerpt from our theories textbook describing Frankl’s paradoxical intention follows.
. . . In a case example, Frankl discussed using paradox with a bookkeeper who was suffering from chronic writer’s cramp. The man had seen many physicians without improvement; he was in danger of losing his job. Frankl’s approach was to instruct the man to:
Do just the opposite from what he usually had done; namely, instead of trying to write as neatly and legibly as possible, to write with the worst possible scrawl. He was advised to say to himself, “now I will show people what a good scribbler I am!” And at that moment in which he deliberately tried to scribble, he was unable to do so. “I tried to scrawl but simply could not do it,” he said the next day. Within forty-eight hours the patient was in this way freed from his writer’s cramp, and remained free for the observation period after he had been treated. He is a happy man again and fully able to work. (Frankl, 1967, p. 4)
Frankl attributed the success of paradox, in part, to humor. He claimed that paradox allows individuals to place distance between themselves and their situation. New (humorous) perspectives allow clients to let go of symptoms. Frankl considered paradoxically facilitated attitude changes to represent deep and not superficial change.
Given that Frankl emphasized humor as the therapeutic mechanism underlying paradoxical intention, it fits that he would use a joke to explain how paradoxical intention works,
The basic mechanism underlying the technique…perhaps can best be illustrated by a joke which was told to me some years ago: A boy who came to school late excused himself to the teacher on the grounds that the icy streets were so slippery that whenever he moved one step forward he slipped two steps back again. Thereupon the teacher retorted, “Now I have caught you in a lie—if this were true, how did you ever get to school?” Whereupon the boy calmly replied, “I finally turned around and went home!” (Frankl, 1967, pp. 4–5)
Frankl believed paradoxical intention was especially effective for anxiety, compulsions, and physical symptoms. He reported on numerous cases, similar to the man with writer’s cramp, in which a nearly instantaneous cure resulted from the intervention. In addition to ascribing the cure to humor and distancing from the symptom, Frankl emphasized that paradox teaches clients to intentionally exaggerate, rather than avoid, their existential realities.
I’m writing about paradoxical intention today because of an inspiration from Rita’s blog yesterday. There’s so much ostensible hate, judgment, and certainty in contemporary discourse. That got me thinking about whether a paradoxical approach might be timely and effective. Yesterday, I tried it on myself. Stay tuned, in my next post, I’ll write about how a little paradox worked out for me, and how it might help shift some of the lamentable, polarized arguments happening all around us.
[Note: This is an edited and updated version of a post I did a year or two ago.]
Giving and receiving feedback is a huge topic. In this blog post the focus is on giving and receiving feedback in classroom settings or in counseling/psychotherapy supervision. The following guidelines are far from perfect, but they offer ideas that instructors and students can use to structure the feedback giving and receiving process. Check them out, and feel free to improve on what’s here.
Before you do anything, remember that feedback can feel threatening. Hearing about how we sound and what we look like is pretty much a trigger for self-consciousness and vulnerability. Sometimes, when we look in the mirror, we don’t like what we see, and so obviously, when someone else holds up a mirror, the feedback we experience may be . . . uncomfortable. . . to say the least. To help everyone feel a bit safer, the following can be helpful:
Acknowledge that feedback is scary.
Emphasize that feedback is essential to counseling skill development.
Share the feedback process you’ll be using
Make recommendations and give examples of what kind of feedback is most useful.
Acknowledge that Feedback is Scary: You can talk about mirrors (see above), or about how unpleasant it is for most people to hear their own voices or see their own images, or tell a story of difficult and helpful feedback. I encourage you to find your own way to acknowledge that feedback triggers vulnerability.
Feedback is Essential: Encourage students to lean into their vulnerability and be open to feedback—but don’t pressure them. Explain: “The reason you’re in a counseling class is to improve your skills. Though hard to hear, constructive feedback is useful for skill development. Don’t think of it as criticism, but as an opportunity to learn from mistakes and improve your counseling skills.” What’s important is to norm the value of giving and getting feedback.
Share the Process You’ll be Using: Before starting a role play or in-class practice scenario, describe the guidelines you’ll be using for giving and receiving feedback (and then generate additional rules from students in the class). Here are some guidelines I’ve used:
Everyone who volunteers (or does a demonstration or is being observed) gets appreciation. Saying, “Thanks for volunteering” is essential. I like it when my classes establish a norm where whoever does the role-playing or volunteers gets a round of applause.
After being appreciated, the role-player starts the process with a self-evaluation. You might say something like, “After every role play or presentation, the first thing we’ll do is have the person or people who were role-playing share their own thoughts about what they did well and what they think they didn’t do so well.”
After the volunteer self-evaluates, they’re asked whether they’d like feedback from others. If they say no, then no feedback should be given. Occasionally students will feel so vulnerable about a performance that they don’t want feedback. We need to accept their preference for no feedback and also encourage them to solicit and accept feedback at some later point in time.
Giving Useful Feedback: It’s always good to start with the positive. Try to be very clear and specific about some things you especially liked. I usually take notes to help me with this; I’ll write down exactly what the role player said and put a + sign next to it so I can say something like, “I see in my notes that I put a + sign next to your very first paraphrase. You seemed to be tracking very well and you shared what you heard with your client in a way that felt nice.
Constructive or corrective feedback shouldn’t focus so much on what was done poorly, but emphasize what could be done to perform the skill even better. Constructive or corrective feedback might sound like this: “I noticed you asked several closed questions. Closed questions aren’t bad questions, but sometimes it’s easier to keep clients talking about important content if you replace your closed questions with open questions or with a paraphrase. Let’s try that. How could you change one of your closed questions to an open question or a paraphrase?” BTW: General and positive comments (e.g., “Good job!”) are pleasant and encouraging, but should be used in combination with more specific feedback; it’s important to know what was good about your job.
Constructive feedback should be specific, concrete, and focused on things that can be modified. For example, you can offer a positive or non-facilitative behavioral observation (e.g., “I noticed you leaned back and crossed your arms when the client started talking about sexuality.”). After making an observation, the feedback giver or the group can explore potential hypotheses (e.g., “Your client might interpret you leaning back and crossing your arms as judgmental”). The feedback giver can also offer an alternative (“Instead, you might want to lean forward and focus on some of your excellent nonverbal listening skills.”).
With constructive feedback you can take some of the evaluation out of the comment by just noticing or observing, rather than judging, “I noticed you said the word, ‘Gotcha’ several times.” You can also ask what else they might say instead, “To vary how you’re responding to your client, what might you say instead of ‘Gotcha’?”
General negative comments such as “That was poorly done.” should be avoided. To be constructive, provide feedback that’s specific, concrete, and holds out the potential for positive change. Feedback should never be uniformly negative. Everyone engages in counseling behaviors that are more or less facilitative. If you happen to be the type who easily sees what’s wrong and have trouble offering praise, impose the following rule on yourself: If you can’t offer positive feedback, don’t offer any at all. Another alternative is to consciously focus on using the sandwich feedback technique when appropriate (i.e., say something positive, say something constructive, then say another positive thing).
IMHO, significant constructive feedback is the responsibility of the instructor and should be given during a private, individual supervision session. The general rule: “Give positive feedback in public and constructive feedback in private” can be useful.
Finally, students should be reminded of the disappointing fact that no one performs perfectly, including the teacher or professor. Also, when you do demonstrations, be sure to model the process by doing a self-evaluation (including things you might have done better), and then asking students for observations and feedback.
On September 24, I’m doing a full-day online-only Strengths-Based Suicide Assessment and Treatment Planning workshop. The workshop is on behalf of the Association for Humanistic Counselors . . . a cool professional organization if there ever was one.
Just in case you want two-days of Strengths-Based Suicide Training or you want to come to the U of Montana or you need some college credit, we’ve got a full two-day version of the workshop happening in Missoula on November 19 and 20. In addition, if you’re wanting a continuing education smörgåsbord, this link also includes two day trainings with the fabulous Dr. Kirsten Murray (Strong Couples) and the amazing Dr. Bryan Cochran (LGBTQI+ Clients). Here’s that link: https://www.familiesfirstmt.org/umworkshops.html
There’s more happening too . . . but for now, this is probably enough for one post.
Have a fantastic week, and don’t be afraid to be the early bird.
Fall semester is quickly approaching. For some of you, it may have already arrived.
This post includes my usual free offer of theories resources. Even though Rita and I have our own Theories textbook, and we would love for you use it, the resources below are free and will work for you regardless of whether you use our textbook. My general philosophy on textbooks is that I’d rather be helpful than try to coerce people to buy books.
I’ve got a set of theories lab activities. I tried posting them here, but technology wasn’t helping. If you want them, email me and I’ll send them out as an attachment. firstname.lastname@example.org
You can access several theories-related counseling demonstration videos through my YouTube page. Also, I’ve posted a bunch of links previously, and you can access them with brief descriptions here: https://johnsommersflanagan.com/2020/03/14/free-video-links-for-online-teaching/ If you want access to the complete set of all of our theories videos, you have to use the text, but the preceding link has several potentially useful videos.
Theories is my favorite course to teach. I hope these resources will help you have a fun, engaging, skills-based, and inclusive theories teaching experience.
In our Counseling and Psychotherapy Theories in Context and Practice book, we include short sections on spirituality for each of the major theories. Previously, I’ve posted all the others (just search spirituality on this blog to find them), but discovered this evening that I forgot to post the Gestalt one. Maybe I forgot because it’s especially short and enigmatic . . . meaning, I didn’t find much out there on the crossroads between Gestalt theory and spirituality. If you know of something, please enlighten me!
Here’s the very short excerpt:
Although not always visible or palpable, Gestalt theory and therapy have deep spiritual roots. Laura Perls studied with Martin Buber and had interests in Taoism. Fritz Perls studied Zen Buddhism. Paul Goodman had interests in Taoism, and Gestalt writer, Dave Mann (2010) contended that Goodman’s book, Nature heals, is consistent with his Taoist beliefs about living with nature in accordance with nature. It may be that Gestalt experiments are consistent in style with the Zen Buddhist koan, a puzzle orriddle designed to open Zen novices to deeper levels of consciousness. At the very least, Zen Buddhism and Gestalt therapy share an attitude of acceptance of the now and an exploration of experience.
There are, of course, differences between Gestaltists regarding the role and nature of spirituality in Gestalt theory and practice. For some, the I-Thou connection is where the transcending and spiritual contact happens. Boundaries dissolve and deeper connections and insights blossom. This may have been what led Jesse Thomas (1978) to publish an early Gestalt-spiritual work titled, “The youniverse: Gestalt therapy, non-western religions, and the present age.” Spirituality, from the Gestalt perspective, is both personal and universal (or youniversalJ).
At the other end of the continuum are individuals who don’t see spirituality as warranting a place in Gestalt theory and practice (Mann, 2010). Mann (2010) recommended that Gestalt therapists, like clients, need to decide where they stand on religion and spirituality, recognizing, at the same time, that where they stand may well change. This brings us to perhaps the most famous words Fritz Perls ever wrote, the Gestalt prayer:
I do my thing and you do your thing.
I am not in this world to live up to your expectations,
And you are not in this world to live up to mine.
You are you, and I am I,
and if by chance we find each other, it’s beautiful.
As most of you know, I recently published an article in Psychotherapy Networker on my long-term experience of coping with the death of a client by suicide. In response to the article, I’ve gotten many supportive responses, some of which included additional published resources on coping with client death by suicide.
This blog post has two parts. First, I’m promoting the Networker article again to get it more widely shared as one resource for counselors and psychotherapists who have lost a client. Below, is an excerpt from the article. . . followed by a link. Please share with friends and colleagues as you see fit.
Second, at the end of this post I’m including additional resource articles that several people have shared with me over the past two weeks.
Here’s the excerpt . . .
The Prevention Myth
I’d worked with Ethan for about 20 sessions. Stocky, socially awkward, and intellectually gifted, he often avoided telling me much of anything, but his unhappiness was palpable. He didn’t fit in with classmates or connect with teachers. Ethan felt like a misfit at home and out of place at school. Nearly always, he experienced the grinding pain of being different, regardless of the context.
But aren’t we all different? Don’t we all suffer grinding pain, at least sometimes? What pushed Ethan to suicide when so many others, with equally difficult life situations and psychodynamics, stay alive?
One truth that reassures me now, and I wish I’d grasped back in the 1990s, is that empirical research generally affirms that suicide is unpredictable. This reality runs counter to much of what we hear from well-meaning suicide-prevention professionals. You may have heard the conventional wisdom: “Suicide is 100 percent preventable!” and, “If you educate yourself about risk factors and warning signs, and ask people directly about suicidal thoughts or plans, you can save lives.”
Although there’s some empirical evidence for these statements (i.e., sometimes suicide is preventable, and sometimes you can save lives), the general idea that knowledge of suicide risk, protective factors, and warning signs will equip clinicians to predict individual suicides is an illusion. In a 2017 large-scale meta-analysis covering 50 years of research on risk and protective factors, Joseph Franklin of Vanderbilt University and nine other prominent suicide researchers conducted an exhaustive analysis of 3,428 empirical studies. They found very little support for risk or protective factors as suicide predictors. In one of many of their sobering conclusions, they wrote, “It may be tempting to interpret some of the small differences across outcomes as having meaningful implications, . . . however, we note here that all risk factors were weak in magnitude and that any differences across outcomes . . . are not likely to be meaningful.”
Franklin and his collaborators were articulating the unpleasant conclusion that we have no good science-based tools for accurately predicting suicide. I hope this changes, but at the moment, I find comfort in the scientific validation of my personal experience. For years, I’ve held onto another suicide quotation for solace. In 1995, renowned suicidologist Robert Litman wrote, “When I am asked why one depressed and suicidal patient dies by suicide while nine other equally depressed and equally suicidal patients do not, I answer, ‘I don’t know.’”
Here are the additional resources people have shared with me:
Ellis, T. E., & Patel, A. B. (2012). Client suicide: what now?. Cognitive and Behavioral Practice, 19(2), 277-287.
Jorgensen, M. F., Bender, S., & McCutchen, A. (2021) “I’m haunted by it:” Experiences of licensed counselors who had a client die by suicide. Journal of Counselor Leadership and Advocacy. DOI: 10.1080/2326716X.2021.1916790
Knox, S., Burkard, A. W., Jackson, J. A., Schaack, A. M., & Hess, S. A. (2006). Therapists-in-training who experience a client suicide: Implications for supervision. Professional Psychology: Research and Practice, 37(5), 547-557.
Ting, L., Jacobson, J. M., & Sanders, S. (2008). Available supports and coping behaviors of mental health social workers following fatal and nonfatal client suicidal behavior. Social work, 53(3), 211-221.
As always, thanks for reading, and have a great day!
The place to click if you want to learn about psychotherapy, counseling, or whatever John SF is thinking about.