Why Therapists Choose to Become Therapists

A Practice-Based Enquiry

Sofie Bager-Charleson

• Publisher: Routledge
• Year: 2018
• eBook ISBN: 9780429924033
• Topic: Psychology
• Subtopic: Mental Health in Psychology
• Index: Psychology

Almost two decades ago, the psychoanalyst Sussman concluded that the therapist's motivation for practicing was a neglected area. Is this maybe a question best left alone?

This book revisits the question. The authors support Sussman's rationale for raising the issue in the first place and wonder if much has changed since he referred to it as a 'neglected' area twenty years ago?

This is an inquiry that moves from personal musing to collaborative and systematic inquiry. At the heart of the book lie six separate accounts as told by counsellors and psychotherapists in a reflective writing- and peer support group. Each therapist represent a different modality and all come with very different backgrounds. These accounts are put into context of ongoing literature and viewed with reference to a survey where 238 other therapists provide their perspective on the question. Like in the case of, for instance, Feltham (1999), Rowan & Jacobs (2003) and Val Wosket (1999) 'the therapist's use of self', is a key theme.

Chapter One
The way we “story” our experiences

Reflective writing is a term used for writing for the purpose of “making sense of ourselves and the world” (Bolton, 2005, p. 4). Rather than storing experiences like computers, we “story” them, asserts Bolton. Bolton, Field, and Thomson (2006, p. 2) contend that, “Writing is different from talking; it has a power all of its own … It can allow an exploration of cognitive, emotional and spiritual areas otherwise not accessible”.

Reflective writing involves “examining our story making processes critically, to create and recreate fresh accounts of our lives from different perspectives, different points of view and to elicit and listen to the responses of peers” (Bolton, 2005, p. 3). To question our “story making” involves “deconstructing” (Pease & Fook, 1999) and examining the narratives that we hold about ourselves and our world, in this case about ourselves as professional helper. In Chapter Two, helping is referred to as being anything from “sparkling” moments to “psychological cannibalism”.

Polkinghorne (1988, p. 14) refers to the significance of narratives on both a personal and a cultural level:

Narratives perform significant functions. At the individual level, people have a narrative of their own lives, which enables them to construe what they are and where they are headed. At the cultural level, narratives serve to give cohesion to shared beliefs and to transmit values.

Reflective writing

Reflective writing should not be confused with “purging”, off-loading, or be seen as an outpouring in its own right. We have assumed that this would be of little interest to the reader.

As Smith (1985) describes, reflective writing usually involves at least three stages; pre-writing, writing, and rewriting. The pre-writing is often a scribbling and unstructured phase, perhaps not too different from “purging”, if that is what is needed by the writer at the time. The actual writing involves organizing the unstructured thoughts into a more reader-friendly format: that is, with a reader in mind. The final stage is, perhaps, what earns this kind of writing its name: “reflective” writing (Bolton, 2005; Carter & Gradin, 2001; Smith, 1985; Winter, Buck, & Sobieschowska, 1999). This is a phase that entails exploring patterns and reoccurring themes in one’s own way of organizing events. We do not, as Smith suggests, gain information about the world through direct contact.

To perceive the world in the way it does, the brain must construct a theory of what the world is like. To do this, the brain must be creative … We work on our theory constantly, adding a touch here, modifying a part there, testing it continually against “experience” … [Smith, 1985, p. 33]

Talking and thinking involves fleeting processes; it is difficult to linger, return, and consider the different stages at which we make sense of our situations. Writing, on the other hand, offers what Smith refers to as “relative permanence”. The words stay, to speak, accessible for us on the paper. The final stage, the rewriting stage, involves rereading your texts with themes and patterns, perhaps with blind spots or biases in mind.

Critical friend

An important part of this exercise is to write with a dialogue with someone else in mind; if you agree to write yourself in connection with this reading, you may write with a peer or with your supervisor either in mind or as an actual companion. During the writing of our respective “stories” for the second section of this book, writing with each other in mind was an important aspect. The term “critical friend” is often used in reflective practice. It has very little, if anything at all, to do with criticism. The point is usually rather to listen and feed back what you hear. Knott and Scragg (2008) refer to it as “mirroring”. We tell each other what we see.

Our writing has involved reading each other’s texts with the view of feeding back what we have “heard”. Our response to each other’s texts has revolved around questions such as; “I get the impression that your theme in this text is ‘this’ and that the essence of your experience is ‘that’; have I got that right? Does that fit in with what you wanted the reader to hear?”

Beverley Taylor defines critical friends in this way,

A critical friend can offer external perspective to extend your reflective capacity. “critical” in this sense does not mean criticizing, but being prepared to ask important questions and make tentative suggestions to unseat previous perception, to find other possibilities and insights. A critical friend is chosen by you as some one you trust and respect. [2006, p. 64, my italics]

We began our writing in a playful, relaxed way. Our first lines were part of a piece of uninterrupted writing; a writing without time to stop and think. We invite you to try for yourself.

The exercise below encourages further thinking about yourself as a “learner”. For us, this was an important theme; all sorts of old prejudices surfaced once we knew we were going to “produce” something rather than holding, containing, and supporting others. We invite you to try this as your first exercise in reflective writing.

Your reflection

Uninterrupted writing

• Write for ten minutes without stopping. As Winter, Buck, and Sobieschowska (1999, p. 11) advise,
  Uninterrupted writing [means] to get down and write. If you can not think of the next word, then repeat the one you are writing until the one you need occurs to you. Don’t spend time wondering what to write next.
• Allow yourself to travel back in time, to your childhood or adolescence. Continue writing without stopping to think from the sentence below;
  “It was a Wednesday morning, I scanned the room for my school shirt and I thought …”
• Stop after ten minutes
• Read your text. How did you find the writing?
• Compare yourself as a “learner” then and now. Is there anything which you bring with your from previous experiences into this context—for instance, with regard to writing?

Confidentiality

With its focus on themes and reoccurring patterns, our own reflective writing does not always follow exact events. In fact, we have encouraged each other to sieve out generic traits rather than listing separate events as they may have occurred in real life. In our case studies here, the clients are usually an amalgam of voices reflecting true events, albeit not in the order and way that they are referred to in our stories. A certain degree of artistic licence has not only been tolerated, but encouraged. We do not, for instance, expect you as a reader to be interested in our exact experiences in a “then he came and I did that and she said” way. We do not think that you would be interested in a long list of precise events. This is not what reflective writing is about.

We assume that what may be of value in the context of reflective writing are generic, abstracted themes sieved out of accumulated experiences. We have focused on experiences which we believe can be of a more general, possibly shared importance in the context of working as a therapist.

As Bolton (2005) points out, “reflective writing is not about confession”. Confession implies that we disown our responsibility, or hand it over to someone else. Reflective writing is quite the opposite, as suggested earlier: a means to an end where we face, challenge, and sometimes reassess our ways of being.

The process is similar to that which we witness our clients do, as they explore their own trains of thought. Underlying values, beliefs, and constructs previously held as “facts” are explored and challenged. Familiar strategies are reassessed in light of an awareness that alternative framings of events are at hand. With this in mind, “narrative truth” proceeds “factual”, or, as Polkinghorne (1988) puts it, “paradigmatic” truth. It is the meaning that the event is given that is being brought to the forefront, rather than the actual event itself.

So, none of us reveals exact client details; all of us have gone to considerable lengths in protecting our clients’ anonymity, and, in doing so, artistic licence has played an important role.

Reflexive awareness

Reflexivity captures a prevalent theme in social and human sciences today, where the enquirer is encouraged to “own” her involvement, no matter what she investigates or engages with professionally. Finlay and Gough (2003, p. 5) write,

Reflexivity in all its guises is now, arguably a defining feature of qualitative research … We realise that meanings are negotiated within particular contexts. [R]esearchers no longer question the need for reflexivity; the question of “how to do it?”

Counsellors and psychotherapists are just as likely as researchers to affect the outcome of the work due to their own personal investment. They are, as Finlay and Gough put it, “actively constructing the collection, selection and interpretation of data”. Rosen and Kuehlwein (1996) conclude that this kind of outlook on practice ultimately rests on “constructivist beliefs” about “reality”. They write, “There are a variety of constructivist models, they all hold in common the epistemological belief that a totally objective reality, one that stands apart from the knowing subject, can never fully be known” (p. 5).

Counsellors and psychotherapist with a constructivist outlook integrate their practice, as Weaver (2008, p. 2) puts it, “from the principle that there is more than one true judgement of the world. There is no absolute authority to whom we can turn to that will provide ‘The Answer’”.

In the second section of this book, we will all approach constructivism from different angles. In Sheila’s story, a development within constructivism called social constructionism is highlighted. Informed by systemic theory, Sheila explores both her own childhood and her practice with reference to “social realities”. Both constructivism and constructionism assume that meanings are created, rather than pre-existing and discovered, as implied earlier with reference to Smith (1985). Social constructionism focuses on relationships. As Gergen (2009, p. 3) puts it, “nothing is real unless people agree that it is … we may say that as we communicate with each other we construct the world in which we live”. Constructivism places a greater importance on the individual than constructionism. Gergen (1996, in Rosen & Kuehlwein, pp. 15, 19) dis-affiliates himself from the “Western individualism of constructivism”. Social constructionism

place[s] no emphasis upon intention, thought, feelings, or wishes of the individual human mind in isolation. It is on the everyday playing field of social exchange and in the relationships between individuals that understanding, knowledge, and meaning are created. [ibid., p. 17]

This critique of “Western individualism” is pursued from different angles by other members of our group. Sherna reconstructs our concept of “self” with reference to intercultural theory on “several selves”, and Susan’s experience of “self” is approached in a transpersonal context, focusing on “the beyond” individuals and their human relationships. For those with a particular interest in social constructionism, Sheila’s chapter will do the theory justice, and further reading is recommended, for instance, Gergen (1999). My own psychoanalytically-inspired thinking and Francesca’s existential emphasis on the individual’s authenticity and dasein bring further angles to our interpretation of reality. In this book, an overriding and shared perspective on our professional “judgements” is that they are personal, individual, subjective, and socio-culturally created interpretations in the sense that reflexivity implies.

Reflexivity embraces both personal and social influences. Counsellors and psychotherapists seem particularly well equipped to consider underlying meanings in the way we construct the world. “Objectivity is pretence”, asserts Parker (1994); “even distance is a stance”. The researcher is no longer regarded as a detached scientist; “the researcher is a central figure who actively constructs the collection, selection and interpretation of data” subjectivity in research is transformed from a problem to an opportunity’, write Finlay and Gough (2003, p. 5). This thinking seeps into all areas of social and human studies, therapeutic practice included.

Construing ourselves as therapists

It will become obvious that some of our own stories relate to the categories referred to by the therapists in the survey. One therapist from the survey replied, for instance, that she embarked on her therapy career regarding herself as someone with an exceptional interest in people, only later recognizing how this extreme intuitive “talent for listening” rested on vigilance and fear. She had to become good at sensing moods and predicting changes in her parents, as she grew up with an alcoholic mother. The reply in the survey about vigilance resonated with me. My story will revolve around the dilemma involved in becoming a therapist on the basis of a set of motives that become reconstrued during training and my own personal therapy.

Inspired by psychoanalytical thinking, I focus on my choice to become a therapist with reference to unconscious motifs, in particular. I refer to a scenario that captures how I needed to re-think my career as a couple counsellor, and to discontinue it for a while. I refer to Andy and Jane, with the aim of illustrating how, as Sedgwick (2005, p. 110) puts it, the client’s projections need a hook in the therapist to catch on to. “The carrier of projections is not just any object”, wrote Jung, “but someone who offer a ‘hook’ to hang on”.

“Unconscious” motivations are approached from different angles in this book. “Not taking things at face value” involves “exploring unconscious motivations”, contends Sussman (1992), when raising questions around the therapists’ motivations for their career. The concept “unconscious” is used in this book in a broad sense, ultimately in the sense that the reflective practice approach implies inviting the practitioner to “explore what is beyond the immediate line of vision” (Taylor, 2006). We do not approach the unconscious as a “thing” within a medical model, or as a great mystery, but more as “a reservoir of latent meaning” as Bateman and Holmes (1999, p. 9) put it. They approach the unconscious as a metaphor for affective meanings that we are unaware of until they emerge in, for instance, the therapeutic dialogue and relationship:

With the shift in contemporary psychoanalysis away from mechanism toward meaning, “the unconscious” becomes a metaphor for the affective meanings of which the [person] is unaware of, and which emerges through the relationship with the analyst. “Unconscious” becomes an adjective rather than a noun: “unconscious processes”, rather than “the unconscious”. This links psychoanalysis with the “post-modern” notion of polysemy or multiple meanings which are to be found in any cultural phenomenon or “text”. [ibid.]

The psychoanalytic perspective addresses transference and countertransference as means for new meanings to emerge. Another angle, which is a different way of framing the process where meanings and realities emerge through interactions, is explored by Sheila Lauchlan in her story about her practice, which is influenced by social constructionism. Sheila quotes Gergen, the father of social constructionism, who writes about “when our eyes are opened to seeing our blindness” through “collaborative discourse”:

[P]sychotherapy may be thought of as a process … the forging of meaning in the con...

Table of contents

• Cover
• Half Title
• Title
• Copyright
• CONTENTS
• ACKNOWLEDGEMENTS
• ABOUT THE AUTHOR AND MEMBERS OF THE REFLECTIVE WRITING GROUP
• INTRODUCTION
• CHAPTER ONE The way we “story” our experiences
• CHAPTER TWO Why do therapists choose to be therapists?
• CHAPTER THREE Reflective practice
• CHAPTER FOUR Sofie’s story: growing up with mental illness in the family
• CHAPTER FIVE Sheila’s story: how meanings emerge between people
• CHAPTER SIX Francesca’s story: working with the givens of life
• CHAPTER SEVEN Sherna’s story: cults, culture, and context
• CHAPTER EIGHT Susan’s story: working with the beyond
• CHAPTER NINE Pam’s story. Design or destiny: what brings us to therapy and the place of the self and possible self-disclosure in the therapeutic alliance
• CHAPTER TEN Concluding reflection
• REFERENCES
• INDEX