December 2018
A Therapeutic Conversation by Dr Elizabeth McCardell, M. Couns., PhD
In September this year I travelled to
Germany and then to Scotland, particularly around the Isle of Mull. In Germany
I met with a couple of Facebook friends for the first time, one of whom is a
psychotherapist like myself, the other an artist, like my otherwise self. We
talked for hours in a little café called La
Boheme in the old town of Heidelberg. This was, for me, a turning point in
life and work. I remain in conversational contact with my colleague and he encourages
me to new understandings and new readings and has enlivened how I work. I’m
delighted by all this, and have been mulling on things ever since.
In a non-direct way, through talking about
Psychodynamic-interpersonal Psychotherapy, which both of us practice, I’ve been
introduced to Conversational Psychotherapy, or simply the Conversation Model.
It’s filling in my intuitive sense about how I work and how I’ve come to
understand the self, and myself. This concept of self, which is a kind of
consciousness, has been there all along, largely unarticulated, prompted by my
early readings (in the 1970s) of William James and other relational-humanistic
psychologists, but the clear statements of the Australian psychiatrist Russell
Meares, b. 1936 (son of Ainslie Meares, psychiatrist, hypnotherapist and writer
on meditation) has brought it into the clear light for me.
The self, seen as a dynamical
interrelational process, is not an abstract entity somehow separated from
environmental encounter, nor known through the immersion of arcane texts; it is
a dual process of felt bodily reaction and a dynamic play with inner events
that bring about reflective awareness.
The self is ecological and relational and involves a sense of aliveness,
of vitality, of well-being, positive feeling (warmth and intimacy),
non-linearity, coherence, continuity, temporarily, spatiality, content beyond
the immediate present (that is of the possible, the imagined, the remembered),
with a sense of ownership, boundedness, agency and a that duality.
The self, according to William James (1842-1910)
is a duplex of one pole of awareness and another pole of inner events in a
dance of self-reflectivity. Consciousness doesn’t always take this form. When
we are alarmed or annoyed, reflective awareness is lost. Meares identifies the
characteristic consciousness of those damaged by the impacts of the social
environment as adualistic. It is reactive and responsive to the brain’s
interplay with the environment, without self-reflectiveness. The aim of therapy
is to restore, generate, and potentiate that dualistic kind of consciousness
that is the self. But this pole of awareness plus a reflective pole of inner
events cannot happen by itself. It has to be met, connected with, related to,
for the self is part of an ecology. As a part of an ecology, any change in one
part affects everything.
Trauma plays a big part in this disturbance
and interruption of the dual process, for it locks the
person into reactivity, dullness, and a sense of stuckness. Psychotherapy then
becomes very useful in creating a close, safe and supportive environment of
reciprocity and engagement as it reconnects a person to themselves and the
social environment.
Conversation, as defined in the Oxford
English Dictionary, is “the action of living, or having one’s being in a place
or among persons”. It isn’t just about talk; it’s engagement and focus upon the
shifts, the movements, the waxings, and wanings of this experience, and it is
this that lies at the core of the interpersonal therapeutic approach. It is in
conversation (in its style, content, context) that we come not only to express
what we know but come to know what we don’t yet know.
Conversational Psychotherapy is directed
towards the restoration of a disrupted sense of personal being, or self. It’s
interested in the inner life as well as emotions of reaction and building a
capacity for self-awareness. An old mentor of mine used to ask me, “And how is the
inner life” and such is a very good question for therapists to ask. We should
not ignore a person’s perception of their inner life for herein lies tools for
healing and strengthening their capacity
for self-reflection and not getting caught up in reactions and adualistic looping,
that won’t go away in isolation from conversation.
So, talking with my friends in the little café near
the old bridge of the city of thinkers was not only great fun, but is bringing
a greater awareness to my psychotherapeutic practice. Thank you, Jürgen and
Aksel.
