Taking a Systemic Approach (to yourself)

There’s a phrase that gets used a lot in physical therapy:

“the symptom is the victim, not the criminal.”

This has incredible implications (truth) in our psychological functioning as well.  This post emphasizes and encourages a certain attitude you can take in order to boost your growth and create widespread change.  At the end of this post, I’m going to contrast a “systemic approach to yourself” versus “systemic therapy,” even though they’re definitely made of the same stuff.

So let’s examine “taking a systemic approach to yourself.”

It’s the idea there isn’t a singular thing going wrong.  The more you hunt for a singular thing –  the one root cause to your unhappiness – the one thing that needs to be found and fixed – the more time you’ll spend spinning your wheels and the less time you’ll spend enjoying living and reaping the benefits of your efforts. If you want to create change, the best approach is to try to turn over every rock. It will be rare to find a golden ticket under one of the rocks, but the landscape will look entirely different once you turn over enough of them.

This post is the encouragement to examine more aspects of your life… to get wider in your efforts.

How many minutes of your day are spent going through the motions? How much doesn’t get a second glance?  How many of your settings are set to default?

Here’s a range of examples:

How many steps a day do you take without feeling your feet on the ground? How many interpersonal interactions are completely routine (and lacking in satisfaction)? How many shallow breaths do you take a day?* More importantly, how many huge ones do you take on purpose? How much of your diet is habitual and hasn’t been adjusted in a while?  How many calories are in liquid form? When was the last time you changed your exercise routine? How long have you used the same mouthwash?   If you wear heels, do different pairs have different lengths?  When was the last time you made a really weird face? How do you normally sit? Which leg is the crossed-over one? When was the last time you crossed over your other leg? How much hazelnut creamer do you put in your coffee? How long have you done that? When was the last time you tried out some different pillows?  When was the last time you imitated your mom?  How different is your Monday morning from your Friday night?  Are you getting something auto-debited that you really don’t need / use?  Do you really like the tv shows you watch? What do you do during commercials?

Sure, your mouthwash isn’t causing your knee pain and your heels aren’t causing your depression, but how fast do you want change to happen?

Sometimes things stick around in our lives for far too long. The only thing that keeps them there is we’re not consciously choosing them anymore. They’ve become default. “Taking a systemic approach” to your self-improvement is taking the extra time to see what default motions could be adjusted. I deliberately put really big things and really small things on that list of questions. Your pillows probably aren’t killing you. But if you want to make some really significant change, the idea is to shake things up and get wider as opposed to having a magnifying glass on a ‘symptom’ and hoping a singular root cause will present itself. There are infinite causes. Things have been in motion for a very long time.  But we can only fully do one thing at a time. Taking a systemic approach to yourself takes thing-by-thing and examines it. It stops looking for the magical thing. It starts looking at moment-by-moment movements to see what can be examined – conscious choice by conscious choice.   This is hard.  It’s easier to wish for a magical thing.

The up-side:  this hard work is a safeguard against helplessness.  When we go directly at a symptom, we are agreeing to a losing battle. Everything else in the overall configuration supports that symptom and there’s truly no way to move it without reconfiguring the connections. We are webs. We are a “system of contacts” (PHG). If we go at a symptom and try to simply remove it from the field, we will eventually feel helpless – because we will lose.

In sum, taking a systemic approach to your development is the effort to get wider. It’s the understanding that everything is interconnected. It’s a commitment to the details, to the smaller things, to the whole of your growth.  We really can’t make this wide commitment to rethink our defaults unless we have the belief (hope) that it will pay off – that it will only be short term suffering and hard work – that we will yield fruit after the labor. That’s the purpose of this post: the encouragement towards that belief – the hope – that hard work pays off.  We pay for it now or we pay for it later.

* There’s a pointed phrase in yoga: “most people breathe just enough to stay alive.”

As promised, some contrast.  More often than not in this blog, I’ll be referencing a “systemic approach to therapy” rather than a “systemic approach to yourself.”  They’re made of the same stuff but there is a contrast that’s warranted.  This post emphasizes an attitude you can take on a moment by moment basis in order to boost your own growth.  I am encouraging you to shake up and second-guess as much as you can handle, even if it doesn’t seem immediately connected to a symptom or a goal.  If a therapist took this hyper-diligent approach with clients, it would be exhausting for everyone.  I literally just laughed out loud.  “Hey, did you notice how we just shook hands?  Maybe we could do that better.  How did I just shut that door?  Was that the best way? How did you engage your hamstrings when you sat down on the couch?  Want to try that again?  How’s your water?  Do you think we should try turning the fridge temperature up or down a few degrees?” Lol.  So when I speak of ‘systemic therapy,’ I’m really talking about the beliefs about symptoms.  It’s the interconnectedness and the embedded-ness of supports/symptoms.  It’s the understanding that a direct attempt at removing a symptom is playing whack-a-mole.  Another mole pops up.

Despite the contrast, the common ground is this:  it’s best when clients take a systemic approach to their own self-improvement (with this wide hyper-diligence) in between meetings and then use their therapists to co-create some different frequencies and find where even newer rocks can be turned over, rocks that wouldn’t have shown up on the radar if someone else didn’t call attention to them.

 

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LPC Supervision

As a part of a standard audit by the licensing board, I had to provide a synopsis of the style of supervision I provide to clinicians who are seeking their license. I might as well post it here as well:

My primary identification regarding a treatment modality is gestalt. Gestalt can be viewed as a synergistic interplay between existential phenomenology, systemic, cognitive behavioral, and humanistic modes of psychotherapy.

Respectively, I help the supervisee gain greater sensitivity to the clients’ response to the human condition and fears of death and loss, patterns and forces inherent in context and family of origin, the way thoughts/beliefs affect mood/behavior, and the natural aspirations towards an actualized self and self-preservation.

There is a strong emphasis on *self-of-therapist*. This is due to the belief that the self is the most effective instrument of therapy. I value authenticity and transparency and, even if the supervisee does not wish to prioritize these aspects in their work, I help them see how their “self” will come out in their “work” whether they’d like it to or not. Therefore I discourage compartmentalization of self-as-therapist against the rest of one’s life. I encourage an integration *self* and *therapist* so their work is a graceful extension of a clear world-view and a true desire to be of service (as opposed to a harmful counter-transference and/or a stagnating hypocrisy).

I do not encourage supervisees to identify with gestalt. Rather, I encourage supervisees to identify with (and intensely study) the theories that make the most sense to them and what will bring out the gifts, talents, and strengths of their personality. I do not discuss techniques. I encourage the deeper striving towards mastery of theory. Throughout the course of supervision, I employ the concepts (per Carl Whitaker) of the Battle for Structure and the Battle for Initiative. These concepts are applicable to any school of thought – any style of therapy – any interpersonal relation.

Battle for Structure: we look at how every behavior of the therapist is a creative act that builds the structure of the therapy relationship. I want therapists to build the structure deliberately. This, again, is universal across the different styles of therapy. Therapists choose the structure they’d like to create based on the theory from which they’re operating.

Battle for Initiative: we look at how the goal of the therapy is for the client to be successfully discharged and have no further need for the therapist. I want therapists to be deliberate about how they help the client tap into their own creativity. We want to leave clients excited about and invested in the creation of the remainder of their lives. We are careful not to create a dependence on the therapist. This, again, is universal across the different styles of therapy. Therapists will choose how they go about this depending on their school of thought.

 

In sum, I help therapists develop their ability to:

(1) Theory: Understand why things are happening the way they are.

(2) Battle For Structure: Be aware of and deliberate about the structure of the relationship they’re creating.

(3) Battle For Initiative: Be aware of and deliberate about bringing forth the client’s creativity.

The Other Side of Power – The Larger System at Play

My last post emphasized “the existential responsibility” side of the coin. I’d like to spend a little time on the other side of the coin in the service of the whole.

This also provides a nice segue to talk about psychological health in general. As I’ve said prior, the goal is response-ability. The growth of a human depends on its ability to respond effectively in its environment.  Abilities can fit nicely into sets of polarities or opposites, with a continuum running between.  Seeing abilities in sets of opposites is very useful in order to ascertain where one is stuck, off-balance, or has an INability.

Health (or even happiness?) can be summed up succinctly as the ability to perform both extremes of an ability-continuum coupled with the ability to recognize the situation and what it calls for.

1) Ability to reach the extreme ends of an ability-continuum
2) Ability to recognize what the situation calls for

Response-ability.

We become the most unhappy when we’re in situations where one of those two things is off.  We either (1) lack an ability that’s being called for or (2) we misinterpret the situation and respond “out of touch.”

At root, this is psychological digestion at the boundary of organism and environment.  Food and senses touch (see the mold, smell the milk gone bad, taste a chemical out-of-place taste).  Senses help to determine whether it’s worth putting it inside us. Teeth do the work at the entry.  In the end, it boils down (ha) to whether we have the full ability to take in and whether we have the full ability to keep outspit out.

If we’re not fully able in those polar skills, we’re in danger of swallowing something bad for us or rejecting something good for us.  Even if we have full abilities but then we misinterpret the situation, it’s the exact same danger.

I hope that makes sense.  It can be hard to see abilities as sets of opposites until you get used to it.

So back to the coin.

Existential responsibility:  “Yes, this is my situation.  Yes, I have created it.  Yes, I am responsible for what happens next.” Basically a God-like attitude, yes?  Is this good?

It’s an ability.

Polarity? Continuum?

“I am powerless against the forces much, much bigger than myself.  Forces other than myself will determine how things unfold from here on out.”

Is that good?

It’s an ability.

Rather than look at this particular polarity as beliefs (nouns), please try to look at them as verbs or abilities (in the sense of taking the stance or, more abstractly, being with the belief).  One could move to the far side of the continuum to touch the extreme pole and then one could move all the way to the other side to touch the opposite pole.  They’re polar abilities and they both have a perfect function…  depending on what the situation calls for.

I will often say to parents, “we want to teach your kids there are powers much bigger than themselves.”  I usually feel the need to clarify with, “I’m not talking about God or the police.”  This isn’t about following societal laws or being religious.  It’s about the realization there are powerful laws (natural laws) and how, if we don’t follow them, things don’t go well.

This belief (or the lack thereof) seems to be buried so deep down there sometimes.

It has a couple of fuzzy twins like “being an exception” or “I shouldn’t have to.” Those are very, very close to what I’m talking about in this post but they’re not exactly what I’m talking about.

I’m talking very simply about the realization that we’re not God.  We didn’t create these rules.  And when we don’t play by the rules, things don’t go well.  We can’t deprive ourselves of sleep for a period of time and then expect things to go well.  We can’t put junk in our bodies and then expect to feel good.  We can’t sit in a chair 99% of the time and then expect not to get a nasty case of Chair Pain Syndrome.  We can’t be selfish in our relationships and then expect to have warm, deeply satisfying relationships.

I’m talking about the genuine surprise within a person after they go on a 30 year drug binge and then can’t understand why their system is misfiring.  I’m using an extreme example (albeit a true one I’ve seen time and time again) to illustrate a concept that can be very subtle and buried but can still be very destructive.  My hope in writing this piece is it emphasizes this belief (the “I am not God and I didn’t create these rules so I really can’t bend them” belief) and it supports people to refrain from doing destructive things.

I love the word-play with being “care-full” – not “careful” in the sense of hyper-cautious, scared, mistrusting, but care-full in the sense of trying to be fully in touch with these powers that are much greater than ourselves and then taking-full-care to move with them, not against them, because we will lose every time.

So back to the coin.

The polar abilities.  The whole coin.

The ability to be open to the possibility I have created my situations and I am fully responsible for what happens next and the ability to acknowledge, respect, and move in harmony with powers much, much greater than myself…  followed by the ability to recognize what the situation calls for.

We’re back to the serenity prayer.  The courage to change the things you can.  The serenity to accept the things you can’t change.  And the wisdom to know the difference.

Please be care-full and play by the rules.

Power, the Structure of Therapy, and Existential Responsibility

These thoughts and connections were fueled from something I came across in which a therapist was advocating for the use of workbooks and activities in order to, “make sure we get somewhere.”

I love both gestalt philosophy and gestalt therapy so I am going to take that phrase and hold it under some gestalt lenses.

The “somewhere” gestalt wants “to get” is: Here. Now.

Why?

*The power is in the present.*

Gestalt unapologetically wants to make its clients more powerful. In the past, I imagined one day opening a practice called “Power and Peace.” I appreciate how those words complement each other and seem to express the polarity of the *centrality* of peacefulness and a *reach* of power.  (Saying the “power” alone makes it sound like we want a bunch of narcissists or Napoleons running around?)  Psychological growth really seems like it’s made up of centralizing and expanding.

The reason the power is in the present is because it’s the only time we can DO anything. The past and future are extremely important too, but with a key difference. We can’t DO anything in the past. We can’t DO anything in the future.  Our power is within what we can do – what we can create.  The only time we can do anything is now. Here. Where you are. You can imagine doing something 5 minutes from now, but that’s you, now, imagining. If you’re under water, you can imagine breathing all you want but it won’t do you any good.   You need actual movements towards actual air.  I was really struck the first time I read PHG say, “the wholly inadequate motions of thinking.”  I was probably offended.  I treasure(d) my thinking.

Therefore, one of the results of gestalt therapy is the consistent movement closer and closer to the now. Closer and closer to one’s power. And also closer and closer to one’s peace. It reminds me of the phrase, “the only zen you find at the top of a mountain is the zen you bring.” The task is to learn how to appreciate the now. The better we do at that task, the less it matters what’s actually happening in the now.  This touches some ontological stuff – the appreciation or even amazement that this (life) is even happening.  This is a child-like quality that unfortunately a lot of us lose.  Viktor Frankl’s Man’s Search For Meaning is a great place to jump-start this concept.

So you see how the words look through that lens? Using a workbook “to make sure we get somewhere”… do we want to get better at living in workbooks? Not from a gestalt perspective. We want to get better at living in the now.  The now is where you can do things.  The now is where you can have fun.  The now is where you can find meaning.  The now is where you actually are.

The other key piece that ties in is the structure of therapy. From an existential perspective, the therapeutic growth is the increase of “responsibility” of authorship of one’s life: Yes, this is my situation. Yes, I have created it. Yes, I am responsible for what happens next.  Carl Whitaker said, “you’re responsible for what happens, not for what you say you wanted to happen.”

The benefit of leaving the canvas of the therapeutic structure blank for a client to use (as opposed to a workbook) is it’s the microcosm and bridge for the same concept in the general, larger (scarier, harsher) sense. By having a client *feel* the structure-less-ness, it provides a *safe* opportunity to examine the relation between creative-self and empty-canvas. It’s such a heavy relation. It’s such a scary idea that we’re creating our one chance at existence. A “structureless” therapy (a blank canvas) lets the client get the feel of the paintbrush, to splash around with paints, to begin to get mastery over certain types of strokes and previously unknown colors, to examine the painting and make critical decisions about its aesthetic satisfaction – to look at how and when the client turns away from the canvas or drops the paintbrush – and then supports the client in the often painful task (there’s always a good reason we drop the paintbrush) of picking it back up. The existential responsibility is the sense of holding the paintbrush and being open to the possibility you created the painting.

On the flip side, let’s go a layer deeper into this and weave.  It’s a paradox – or at least a misnomer – to say the therapy is structureless.  The interplay of canvas and paintbrush is the structure.  It’s a very specific structure.  And the therapist is very deliberate and heavy-handed in providing the canvas and examining the relation of creative-self and empty-canvas.  That’s the therapist’s one and only agenda.  Interestingly, what ends up on the canvas is the agenda of the client.   So, said in a different way, the therapist’s agenda is in support of (or at least in relation to) the client’s agenda.  It’s this interweaving of agendas Whitaker refers to when he talks about purposely “winning” the Battle for Structure and purposely “losing” the Battle for Initiative.  To put the therapist’s energies into words, it’s something like: “hey, we’re going to be examining your creative power and we’re not going to be doing anything other than that” (winning the Battle for Structure) while also: “in the end, I deeply believe you know what’s best for you.  I’d like you to be consistently fine-tuning your ability to check inwards to find your truths, so I’m not going to tell you what to do with your paintbrush.  Your paintbrush is yours and yours only.  And I’m really happy to support you while we play around with the difficult brushstrokes you’ve been hoping to improve” (losing the Battle for Initiative).

Here are two separate PHG quotes which will take us full circle back to power.  The first one contrasts on the continuum of “existential responsibility” and the second one is very clear about how we want our clients to be powerful.  (“Weapons” is a pretty powerful word, yes?)

“An unknown number, perhaps a majority, believe they would have no troubles if the world would just treat them right. A smaller contingent does have, at least at times, a vague recognition that they themselves are responsible for the ills that beset them, at any rate in part, but they lack techniques for coping with them.” Techniques for coping?  How about psychological weapons:  “We wish to strengthen and supply [the client] with more effective weapons.”

How strong do you feel?  Do you feel like you have the weapons necessary to handle your current obstacles?  What brushstrokes are you being challenged to make?  What parts of your situations are you deeming outside of your control?

Not of Correction, but of Growth

In a recent Structured Group, we studied a section with two beautiful parts that fuel my fire. That was weeks ago but they’re still on my mind and I’d like to share them with the blog-universe.

In my first post I mentioned how I’m not sure what shape this blog will take. Not surprisingly, there’s a vein of comparing / contrasting gestalt with other methodologies. I’m passionate about theory and that’s why I like teaching and supervising in addition to doing gestalt therapy. Making sense of the world (psychological / philosophical theory) is one of the relationships that hold me up.

(I also mentioned in my first post I’d be adding a disclaimer to every post and saying what music I’m listening to. False. Writing on the fly. No music. And I got over my initial blogging resistance / fear of being sued. Ha.)

So here are the two quotes and then I’ll explain why I love them.

“This is to psychologize without pre-judgment of normal or abnormal, and from this point of view psychotherapy is a method not of correction but of growth.”

Mmm.

“The psychotherapy proposed in the previous chapters emphasizes: concentrating on the structure of the actual situation; preserving the integrity of the actuality by finding the intrinsic relation of socio-cultural, animal, and physical factors; experimenting; promoting the creative power of the patient… ”

Double mmm.

Sometimes people start counseling with the assumption they will be judged. Sometimes this has fear with it (“please don’t judge me”) and sometimes this is welcomed (“please tell me what I’m doing wrong”).

Judgment and correction go hand in hand. Gestalt therapy is not of correction, but of growth. There’s absolutely nothing *wrong* with the way a person is living. There is, however, a chance to optimize and to grow into new areas which will certainly *improve* the way a person is living… literally opening up new options… new skills… more payoffs… less costs.

There’s an Alice in Wonderland quote I keep in my office.  Alice comes to a crossroad and asks the cat, “which way should I go?” The cat says, “where are you trying to get to?” Alice says, “I don’t really know.” The cat says, “then it doesn’t matter which road you take.”

Gestalt therapy, similar to the cat, is interested in *your* desires/goals. If you’re not sure what your desires are, do you desire to know what your desires are?

Then by “preserving the integrity of the actuality by finding the intrinsic relation[s]…” we can land on a clearer image of what path may be the most valuable to you. It’s not correction. It’s examination. From examining, your perceptions become clearer / brighter / truer and then your “creative power” is “promoted.” Alice gets a better sense of where she’d like to get to and which path would give her the best odds. AND there’s additional self-support to be able to take the risk of choosing the path, even if she’s not certain it will pan out.

Gestalt develops your ability to self-support. Lara Perls said, “we support the client as much as necessary and as little as possible.”  The second part, “as little as possible,” is because we want to increase your ability to self-support.  We don’t support too much because then it would get in the way of developing your own abilities.  We’re looking for your growing edge (within the “intrinsic relations”) so that you can be with it and relate to it – thereby moving it and increasing/expanding your comfortable area of self-support.  The scary part about therapy is the ‘growing edge’ is where your anxiety lies.   But we also support you as much as much as necessary… while at the same time we’re trying to work ourselves out of a job. We’re very interested in your ability to feel grounded and supported within yourself. This often means reconfiguring your relationships. What is supporting you? Your relationship with your breathing? With posture? With the ground? With your ears? With Sam Adams? With a good book? With your spouse? With an imagined future? Are you aware of the relationship that’s holding you up? What’s the cost of that relationship?

It’s not correction. It’s growth. It’s examining the relationships, lighting things up. We want you to know what movements you’re making, what the costs are, and what the payoffs are.   In the words of Perls, Hefferline and Goodman, “At this point, the patient can take over on his own.”