Tag: organismic self-regulation

Recursive spiral clocks.

Timing is everything. I repeat, timing is everything!

the bristol therapist facebook page digest – january 2018

Quite a while back, I got excited and over-committed myself to an in-depth process of chewing over everything I read online that would culminate in a weekly digest. The two main outcomes of that experiment were an inability to get beyond week two, and a consequent reduction in how much online content I read.

The original point was to reduce the risk of introjecting ideas and values by ensuring that what I was reading was subjected to at least some degree of critical thought. As I couldn’t keep up with what I was reading, I was forced to question the behaviour as it started to seem compulsive. The end result was of becoming more discerning about what and how much online content I read; the unforeseen and welcome side effect of a gestalt experiment.

I still like the core idea though, so am resurrecting it in amended form for this therapy blog. I’ll aim to make it monthly rather than weekly, and focus on the articles I share through my facebook page. This also opens more possibility for dialogue, as I’m open to being sent links to interesting articles in a broadly therapy/psychology/being-human kind of vibe.

January was a quiet month for me on the facebook page, so I can overview everything here instead of choosing a top few articles. I imagine that in months where I post more, I’ll likely stick to a top five to stop this spiralling out of control.

I’m also going to err on the side of sloppy as this is meant to be about initial responses and chewing things over, so feel free to have at me in the comments.

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If It’s Important, Learn It Repeatedly.

This blog post is a reflection on Cal Newport’s book Deep Work, which seems to be all about practices for focusing on in-depth pieces of work and not getting distracted. (I’ll let you know if I ever manage to read it!)

Reflecting on the inspiration he felt whilst reading the book, and how even by the end of the book that feeling was disippating, Ben says:

“The window to act on a timely idea is very small. The heat of inspiration only lasts a few days, or even hours, and if it runs out before you’ve formed and implemented a plan, you’re essentially back at the status quo.”

This resonates greatly for me in my work as a therapist (and reflecting on my own time in therapy as a client). The problem with breakthrough moments in therapy, the insights and the ah-ha of realisation, is that these moments by themselves aren’t usually enough to shift actual behaviour.

As therapists, we kind of rely on a naive assumption that, following such a breakthrough experience in the therapy session, the client will then automatically go out and change things in their everyday lives. But even a brief reflection on my own process reveals that I’m more likely to lose the “heat of inspiration” than turn it into tangible action.

This is in part why gestalt therapists assimilated the behavioural therapy practice of setting homework tasks to be carried out between sessions. This practice also lives on in modern day Cognitive Behavioural Therapy.

Then again, what we alos find in therapy is that the insights that are most important and driven by organismic need tend to recur. So at least part of the point of being in therapy long-term is to allow the repetition of gaining the same insight several times to take place in order to reinforce the necessary changes.

So when Ben talks about re-reading books:

“If you’ve ever read a book a second time, you may have noticed that it’s an entirely different experience from the first time. It doesn’t feel redundant or repetitive. Instead, it feels like gaps are being filled in. Different details strike you as important. The points you do remember now have the benefit of context, and much of it seems entirely new.”

He’s also summarising why the same insights need to be discovered and talked over in therapy. The analagy is with chewing food. Most mouthfuls of food need to be chewed several times before they are ready for swallowing. The same is true of insights in therapy; talking them over, then rediscovering them later and talking them over again allows us to assimilate the lessons and the changes more effectively.

TL;DR: “If it’s worth learning, it’s worth learning repeatedly.”

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Antidepressants: Please, PLEASE, do not just abandon your meds!

This article is part of a continuing backlash against erstwhile journalist Johann Hari’s new book, Lost Connections: Uncovering the real causes of depression – and the unexpected solutions.

In short, Johann’s book seems to rely heavily on a simplistic medication = bad formulation that gives the impression people should abandon anti-depressants in pursuit of real “cures” for depression. This particularly article is a simple plea that people wanting to come off any kind of medication for depression, anxiety etc don’t just stop their meds, and at least go talk to their GP about it.

As for the wider issues with Johann’s book, well I’ve not read it so can’t comment directly on the text. However, one of the reasons I haven’t read it, and am wary of reading it, is that the very title contains two huge red flags. One is “real causes of depression”, and the other is “solutions”. The very idea that depression can be reduced to something that has identifiable causes and solutions is facile, and flies in the face of what most people discover about depression for themselves, both in and out of therapy.

I don’t mean that reasons for being depressed can’t be found, or that ways out of being depressed can’t be found. Just that, for the most part, you can’t say to someone, “your depression is caused by x, and if you do y, you will be cured”. Depression isn’t a disease to be cured.

Johann also doesn’t seem to be aware that there is a decades long tradition in psychotherapy of challenging the reductive idea of depression as a problem of brain chemistry. And performs a classic throwing out of the baby with the bathwater by seeming to conclude that medication can simply be jettisoned. Many people need to work on their depression through both medication and therapy.

So in part I shared this article to siugnal that I’m not in the “medication is inherently bad” camp. I’m still skeptical about the extent to which medication like antidepressants are prescribed, and think that a society that took depression seriously would be able to support most cases of depression without medication. But then, almost by definition, such a society would most likely experience very low levels of depression in the first place, such is the problem with any “in an ideal world” formulation!

In our current society, very little room is made for people to work through depression in the ways they need and in their own time. I get the sense that Johann Hari is arguing more or less the same thing, but presents it as a unique idea that has only just been stumbled on, and gives the impression that it’s possible to simply throw away the meds and kickstart that world right now.

TL;DR: It’s ok if you need meds. If you want to stop your meds, always work out a plan with your prescriber first.

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This Is The Best Time To Do Anything: 4 Powerful Secrets From Research.

I’m a sucker for “secrets from research” type posts, even though the secrets have clearly been published in books and journals, so aren’t that much of a secret.

In the context of gestalt therapy, stuff like this plays to the idea that you’re better off tuning in to your own experience and working out what you need (organismic self-regulation) than adapting yourself to externally imposed ideas about what you should need (introjective or shouldistic self-regulation).

Which of course immediately throws up the objection that following our own needs is largely impossible given the consistent demands of school timetables and the workplace. But therapy doesn’t end at individual behavioural changes. To me, one of the signs of effective therapy, is getting people to the point at which they are able to challenge their own society and take political action.

Yes, school timetables are often rigid and tend to prioritise the needs of the school over the needs of the children and parents. So find parents who agree and channel that frustration into political pressure. Yes, the workplace grinds people into dust. So join a union, organise politically, negotiate explicit demands with other workers, and be prepared to engage in long-term political action.

Practically every course of therapy hits the boundary between individual need and social demands. These conflicts can’t be solved in one to one therapy. But they can be brought into awareness, explored, and a subsequent movement into political action can be supported.

TL;DR: Highlights from Dan Pink’s book When: the scientific secrets of perfect timing, especially for larks, night owls, and third birds.

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Here’s what the evidence shows about the links between creativity and depression.

I really enjoy the British Psychological Society’s research digest. It’s a really good example of using blogging to make academic research accessible to a wider audience.

This post is based on a meta-analysis looking at the link between creativity and mental illness, prinipally mood disorders as this seems to be where the most research focuses. It suggests that a fruitful focus for further research would be into how creativity links to mood disorder.

Interestingly, in considering possible explanatons, Alex suggests creative lifestyle and the possibility that creativity simply expresses in a way that is more likely to match the symptomology of mood disorders eg:

“many aspects of the “flow state” – extended bursts of activity, disregarding the need for sleep or food, absorption or attentional wandering, rapidly flowing thoughts – are also treated as markers of bipolar disorder”

Working regularly with creative people in therapy, I’d suggest that highly creative people tend to also be more sensitive and emotionally oriented, and this opens them up to being more easily hurt by a society that tends not to value creatvity. The arts tend to be undervalued in education for example, and many of the creative clients I’ve worked with have reported feeling like they were a square peg being hammered into a round hole.

So yes, the lifestyles of creative industries likely contribute to the development of mood disorders, but the way creative people experience their world might be more casutive. Especially if you’re going to reference “the profligate substance misuse” as a given aspect of the creative lifestyle without asking from where the need for substance misuse arises.

TL;DR: Creative people are more likely than average to have a mood disorder, but people with mood disorders are not more likely than average to be creative.

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Want to take your psychotherapy to the next level? Ask for what you want.

As will become clear as I unfold The Golden Arrow, wanting offers a major in-road into understanding what we need. What I like about this post is that it encourages clients to ask for what they want from their therapist.

I’d extend that to most relationships. It’s useful to ask yourself every now and then, “what do I want from this relationship?”. This is often hard for people because it feels like a very selfish or transactional thing to ask of a relationship. But ultimately, healthy relationships develop out of some kind of mutual need, and it’s ok to ask if the relationship is still mutually needful.

Asking for what you want is a way into that, not necessarily an end in itself. And in therapy at least, it can make for really interesting sessions that can redefine where the therapy is going.

TL;DR: It’s ok, and actively good, to tell your therapist what you want.

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Photo credit: “…Time…” by Darren Tunnicliff, shared under Creative Commons.

england at euro 2016

Therapy pro-tips: 6 emotional survival tips for England fans this Euro 2016

Bristol 24/7 asked me if I could provide some professional advice for England fans facing the emotional roller coaster of Euro 2016, and I duly obliged. See: 6 emotional survival tips for England fans.

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Photo credit: The Telegraph.

Simple questions, complex therapy

The most elaborate of complexities can arise from the most elegant of simplicities. In gestalt, simplicity is achieved and maintained through a rigorous attention to the present moment, the legendary here and now.

Simple questions, complex therapy

Gestalt therapy can be stripped back to three basic questions:

1. What are you aware of now?
2. What do you need now?
3. What does this mean to you now?

Really, if you wanted to strip right back to bare bones, you could stick to question one. The entire body of gestalt therapy literature is essentially an elaboration on the question, “what are you aware of now?”. And arguably so is human experience, which is why the question works.

There is a cyclical flow to human experience, driven by awareness and organised by need. The function of these three questions is to explore this cyclical flow in the context of this person who is in therapy with me in this place at this time. It isn’t about diagnosing what is wrong with the person I am asking these questions. It’s about using these questions to explore the contact possibilities that exist between us.

The common by-products of this exploration are insight, realisation, and healing.

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Photo credit: Simplicity (1/52) by Rodger Evans, licenced under Creative Commons

introjection visualised by jennydrewsomething

Shoulds: the internalised wants of other people

One of the arch-villains of gestalt therapy is the word “should”.

If you’re in therapy with a gestalt therapist, and you start talking about things you should be doing, chances are your therapist’s self-talk has started going, “holy shit! Introjection at twelve o’clock! Kill it! KILL IT WITH FIRE!”. This is because “should” is treated as a dog-whistle term for introjection, and if gestalt had a Wanted: Dead or Very Dead list, introjects would be towards the top.

Introjection is a hang-over from gestalt’s psychoanalytic heritage that hasn’t quite been deconstructed satisfactorily. Which is ironic, really, considering that that’s what introjection is all about. Essentially, introjection is the uncritical internalisation (metaphorically, swallowing whole) of the thoughts, opinions, rules etc of other people. Two main types of introjection can be identified: force-feeding (ie, I introject your rules because you force them down my throat), and inferences (ie, no one says anything directly, but I develop the impression that such and such is the case). The key factor is that I do not apply critical thought to (metaphorically, I don’t chew) what I take in.introjection visualised by jennydrewsomething

A key force in gestalt therapy is semantics. The words you and I use to communicate don’t just contain valuable information about the kind of people we are, they also shape the very experiences we are attempting to communicate. In day to day therapy, this translates into drawing someone’s attention to the words they are speaking. This then raises that person’s awareness of how they are creating their experience in the moment.

I find it instructive to replace “I should” with “x wants me to”. The word should is most usually used to invoke an external authority. What Gary Yontef calls shouldistic-regulation (ie, regulating oneself according to external authority) stands in direct opposition to organismic self-regulation (ie, regulating oneself according to organismic need). When someone says, “I should do better”, they nearly always mean, “x wants me to do better”, where x is a significant internalised other. Shouldistic-regulation is striving to do better because I should. Organismic self-regulation is striving to do better because that’s what I need to do at this time.

The same applies to societal norms and moral codes. “I should not steal”, is really, “x wants me to not steal”. This is obviously the case with regards to force-fed introjects; someone has to do the force-feeding. This is less obviously the case with inferences because, at first glance, no one is doing any force-feeding. The modification I would make in this case is, “I imagine x wants me to”. That is, the inference I am making derives from either the kind of social atmosphere I am experiencing, or the extension of pre-existing rules.

Social atmospheres “give me the impression” that such and such is and isn’t acceptable. But social atmospheres emerge out of the interactions of actual people, allowing me to identify who it is that I am imagining wants me to x. Pre-existing rules give me a way of anticipating what possible rules might apply to a new area of activity. As pre-existing rules are put in place by actual people, I am again able to identify who it is I am imagining wants me to x.

The therapeutic objective in this odd little game is grounding social constructs in actual people. Moral codes do not spontaneously come into being of their own accord; they are created and maintained by people. The kinds of introjects that become the focus of significant therapeutic effort generally need to be traced back to their origin. And that origin is frequently “my dad”, or “my mum”, or “God”.

A hugely important part of therapy is deconstructing the introjected rules by which a person is constrained. That process will invoke resistance from the internalised originator of those rules. And frankly, if I’m going to be up against someone’s internalisation of God, I’d rather know about it!

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Image credit: jennydrewsomething.

Statue of Arjuna

The Golden Arrow: how to live a more or less fulfilling life

The Golden Arrow is a heuristic tool I’ve been thinking about for a while now to help frame my understanding of what …

the gestalt cycle of figure formation and destruction

Rising and falling: the cycle of gestalt formation and destruction

My first encounter with what pre-gestalt Fritz Perls would have recognised as concentration therapy, came in the form of …

Recursive spiral clocks.

Timing is everything. I repeat, timing is everything!

the bristol therapist facebook page digest – january 2018 Quite a while back, I got excited and over-committed myself …