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Existential couples work


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Key note lecture by Emmy van Deurzen to a conference of family counsellors working in the
public sector, Vasteras, Sweden, 7 May 2010

Published in: Health & Medicine

Existential couples work

  1. 1. Existential Work with CouplesVästerås- National Association of Family and Couple Therapy Conference May 2010 <br />Emmy van Deurzen<br />
  2. 2. Emmy van Deurzen<br /><ul><li>Honorary Professor University of Sheffield
  3. 3. Visiting Professor Middlesex University
  4. 4. Professor Schiller International University
  5. 5. Director Dilemma Consultancy Ltd.
  6. 6. Director Existential Academy Ltd.
  7. 7. Director New School of Psychotherapy</li></ul> and Counselling-London<br />
  8. 8. Author of Books on Existential Psychotherapy and Counselling<br />
  9. 9. Existential and Human Issues<br />
  10. 10. Existential Supervision<br />Edited by Emmy van Deurzen and Sarah Young<br />
  11. 11. Dictionary: Emmy van Deurzen& Raymond Kenward.<br />
  12. 12. RECENT BOOK: 2009<br />
  13. 13. 2010: Second Edition Everyday MysteriesSkills in Existential Counselling and Psychotherapy with Martin Adams<br />
  14. 14. Forthcoming<br />Emotional Well Being and Health, with Digby Tantam, London: Sage, 2010<br />
  15. 15. Existential Perspectives on Relationship Therapy<br />2011, with Susan Iacovou, Palgrave, Macmillan<br />How to apply existential theory to couple work<br />Couple of chapters previously<br />
  16. 16. Dark ages of therapy:blind leading the blind.<br />
  17. 17. Existential Approach<br />The existential approach to counselling and psychotherapy is a philosophical method for understanding human difficulties. <br />
  18. 18. HUMAN CONDITION<br />It focuses on the way in which the individual struggles with the human condition and in particular with our inevitable limitations: only if we deal with the negatives are the positives an option: paradox and conflictare central to the approach. <br />
  19. 19. Aim of existential therapy.<br /><ul><li>Enable people to tell the truth about their lives and themselves.
  20. 20. Help them live passionately and to the full.
  21. 21. Facilitate their greater understanding of the human condition.
  22. 22. Recognize strengths and weaknesses and make the most of both. </li></li></ul><li>Existential approach not a technique<br />It is a worldview which allows to integrate a variety of methods<br />Addresses universal problems <br />Provides philosophical questioning and logic tools <br />Non prescriptive<br />
  23. 23. Different aspects of therapeutic relationship<br />Being<br />therapist<br />client<br />Client’s life<br />
  24. 24. Role of Existential Couple Therapist: work in synergy<br />
  25. 25. Balancing pros and cons after structural analysis<br />
  26. 26. Life as the guide and the goal. <br />What are the life issues this couple is preoccupied with?<br />What understanding of these does the therapist have?<br />What are the couple’s values and projects?<br />How can <br /> I enhance<br /> my own<br /> engagement <br /> with these<br /> issues, values and projects?<br />
  27. 27. Existential therapy with each partner, while other listens:Teaching reflecting on living and listening<br />What is the person’s worldview?<br />What is their situation?<br />What are their values?<br />What is their purpose in life?<br />What has been their fate?<br />What is their destiny?<br />What are their struggles?<br />What are their talents?<br />What are their yearnings?<br />What are their connections to the world and others?<br />What is their attitude?<br />What are their actions?<br />
  28. 28. Existential Couple Work: aims<br />Focus on shared meaning and human and life issues<br />Values of couple and how they provoke tension and conflict<br />See conflict and daily conflict resolution as a basis of relationship<br />Relationships as a challenge and skill to acquire: learning about life together<br />Dialogue, understanding and respect as the objective: creating a good space <br />Mutuality and reciprocity as a way of overcoming isolation<br />
  29. 29. Useful contributions from Family Therapy : working with the system<br />Family therapy overpowers couple therapy, even though a number of big names mostly saw couples but same idea: systemic function<br />JacksonCoined concepts like quid pro quo, homeostasis, and double bind for conjoint therapy <br />SatirCoined naming roles members played, fostered self-esteem and actualization, and saw the therapist as a nurturing teacher <br />BowenMultigenerational theory approach, with differentiation, triangulation, and projection processes, with the therapist as an anxiety-lowering coach - societal projection process was the forerunner of our modern awareness of cultural differences <br />HaleyPower and control (or love and connection) were key. Avoided insight, emotional catharsis, conscious power plays. Saw system as more, and more important, than the sum of the parts <br />
  30. 30. Existential focus on landscapes of our life<br /><ul><li>Understand the Lebenswelt:</li></ul> the world in which we live.<br />1.How do we co-constitute the world?<br />2.What does our life landscape look like?<br />3.Where are we going?<br />
  31. 31. Dealing with Crisis<br />Sooner or later comes a crisis in our affairs, and how we meet it determines our future happiness and success. Since the beginning of time, every form of life has been called upon to meet such crisis. <br />Robert Collier.<br />Couples are only as strong as their ability to meet crisis together. <br />
  32. 32. When crisis strikes our lives are revolutionized<br />In the whirlwind of change we need to find steadiness, persistence and resilience<br />
  33. 33. Conflict is essential<br />Conflicts are the core of existence: we are deepened by adversity and suffering<br />You can let it destroy you or let it teach you<br />In relationship we can stand stronger both through support and through constant challenge <br />Relationships are about tension: fission or fusion. <br />Most conflicts are not just with others but with ourselves.<br />Conflict does not have to lead to combat.<br />
  34. 34. Breakthrough in stead of breakdown. <br />Loss and transition are about breakdown of the old.<br />Instead of breaking down and becoming depressed it can mean we break through some block and move on to a next level. <br />In the process we become stronger.<br />Relationships are tested and tried in times of crisis<br />This makes them more solid or ruptures them<br />
  35. 35. What is relationship?<br />
  36. 36. Caricature <br />
  37. 37. Trying to change<br />Secretly wish for change<br />Get angry and protest<br />Get upset, even suicidal<br />Demand change<br />Set ultimatum<br />Reason and try to persuade<br />Argue your case<br />Withdraw and endure<br />Get support from others<br /> Give up<br />
  38. 38. The cycle of change<br />Change happens automatically in nature<br />It is unstoppable and often unpredictable<br />Renewal is the rule, not the exception<br />We do not have to do anything for it<br />Mostly we try to prevent it to create stability and certainty<br />This goes against nature: dams up the flow of life<br />It leads to sedimentation and festering of problems<br />Rediscover change as a natural cycle that carries renewal<br />
  39. 39. Process of change<br />Everything (every object and every process) is made of opposing forces/opposing sides.<br />Gradual changes lead to turning points, where one opposite overcomes the other.<br />Change moves in spirals, <br /> not circles.<br />
  40. 40. Dialectics<br />Thesis, antithesis, synthesis.<br />Human evolution proceeds with constant conflict and forward movement in overcoming a previous state. <br />Paradoxes and dilemmas can be integrated and gone beyond.<br />True human evolution happens through reflection, learning and understanding<br />
  41. 41. future<br />Antithesis: your view<br />(present)<br />Thesis: my view<br />(past )<br />Dialectics: transcendence in space<br />Synthesis:<br />a wider view<br />
  42. 42. Dialectics of relationship<br />Thesis<br />Antithesis<br />Synthesis<br />Relational dialectics, Baxter and Montgomery (Griffin, A first look at communication theory, N.Y.:Mc Graw Hill 1999.)<br />
  43. 43. Kierkegaard’s theory of development<br />To become oneself is to become concrete. But to become concrete is neither to become finite nor to become infinite, for that which is to become concrete is indeed a synthesis. Consequently the progress of becoming must be an infinite coming back to itself in the finitising process. (1855: 29-30)<br />
  44. 44. Kierkegaard’s stages.<br />Vegetative<br />Animal<br />Aesthetic<br />Ethical<br />Thinking<br />Doubt<br />Leap of Faith<br />Spiritual<br />
  45. 45. Natural transitions<br />Human development: child and adult: Erikson close to existential model because of paradoxical nature of overcoming conflicts<br />Human evolution: constant transformation necessary<br />Stages of life: predictable evolution<br />
  46. 46. Erikson’s 8 stages of life<br />basic trust vs. mistrust; <br />autonomy vs. shame and doubt; <br />initiative vs. guilt; <br />industry vs. inferiority; <br />identity vs. identity diffusion; <br />intimacy vs. isolation; <br />generativity vs. stagnation <br />ego integrity vs. despair.<br />
  47. 47. Like Sisyphus<br />Always onwards<br />And upwards<br />Enough<br />To fill <br />A <br />Human <br />Heart. <br />
  48. 48. Common Conflicts<br />Closeness/intimacy vs freedom/expansion<br />Economy vs spending <br />Control/attention vs laissez faire/ neglect<br />Openness with rest of world vs secrets<br />Cleanliness vs. letting be <br />Success vs enjoyment <br />Pro creation vs self creation or recreation<br />Loyalty vs oppression <br />Exclusivity vs inclusivity<br />
  49. 49. Friedrich Glasl’s model of conflict<br /> Stage 1: Hardening (self help)Stage 2: Debates And Polemics (moderation)Stage 3: Actions, Not Words (fac. mediation)Stage 4: Images And Coalitions (mediation)Stage 5: Loss Of Face (therapy)<br /> Stage 6: Strategies Of Threats (arbitration)Stage 7: Limited Destructive Blows (legal)Stage 8: Fragmentation Of The Enemy (police)Stage 9: Together Into The Abyss (no repair)<br />
  50. 50. Bridging the divide<br />
  51. 51. Growing interest:Excitement<br />Finding excuses to be together:Experimentation<br />Acknowledgement:Explanation<br />Having something new and secret: Exhilaration <br />Public declaration (Discovery):Exposure<br />Crisis:Ecstasy-Ecdysis<br />Chaos: living several lives: Exhaustion<br />Giving up past: property, ties, animals, home, car, beliefs, career aspirations: Extraction <br />Letting go (de-cathecting):Extinction<br />Creating new opportunities together:Exploration<br />Making a new commitment:Extension<br />Living life anew:Expansion<br />Crisis: making new relationship in midlife.<br />
  52. 52. Jean Paul Sartre and Simone de Beauvoir: a different view of relationship <br />
  53. 53. Sartre’s lack. <br />The existence of desire as a human fact is sufficient to prove that human reality is a lack. (Sartre, Being and Nothingness:87)<br />We are nothing trying to be something. <br /> <br />
  54. 54. The Look: Sartre’s Other<br />The Other looks at me and as such he holds the secret of my being, he knows what I am. Thus the profound meaning of my being is outside of me, imprisoned in an absence. The Other has the advantage over me. (Sartre, Being and Nothingness:363) <br />
  55. 55. Sartre’s development<br />Hazel Barnes (Barnes, 1990) <br />Pre-reflective cogito of pure intentionality: act in the world without any reflection upon what we are or even that we are. <br />Self as ego, which develops out of the feedback others give us about our actions in the world. <br />Self as value, when we begin to shape our selfhood in the way that we choose and want to be. <br />Embodied consciousness of the person who lives wholeheartedly, fully bodily immersed in the world and yet wholly aware of his or her own existence and actions.<br />
  56. 56. Sartre’s possession<br />Thus the lover does not desire to possess the beloved as one possesses a thing; he demands a special type of appropriation. He wants to possess a freedom as a freedom. (Sartre B&N:367)<br />
  57. 57. Competitive relationships<br />Domination: sadism.<br />Submission: masochism.<br />Withdrawal: indifference.<br />
  58. 58. Competition<br />
  59. 59. Cooperative relationships<br />Mutuality: reciprocity-equality.<br />Generosity: giving of oneself.<br />Collaboration: working together.<br />
  60. 60. Co-operation<br />
  61. 61. Sartre’s later theory of human relations.<br />We move from seriality to reciprocity. <br />From being like the practico-inert to being a project. <br />From competitive relationships of sadism, masochism and indifference, to cooperative relationships of reciprocity, generosity and engagement. (Critique for a Dialectical Reason.)<br />
  62. 62. Simone de Beauvoir (08-86): an ethics of ambiguity. <br />Life is preoccupied in both perpetuating itself and in transcending itself. If all it does is to maintain itself than life is only not dying. <br />I wish that every human life might be pure transparent freedom. <br />It is not in giving life but in risking life that man is raised above the animal; that is why superiority has been accorded in humanity not to the sex that brings forth but to that which kills. <br />(Le deuxiemesexe)<br />
  63. 63. Relationship is essential to freedom<br />“A man alone in the world would be paralyzed by...the vanity of all of his goals. But man is not alone in the world” (Pyrrhus and Cinéas, 42), <br />The other, as free, is immune to my power.<br />Common commitment to a shared goal is essential for relationship to work for both <br />I can only be truly free to pursue my cause if I can persuade others to join it. When this stops being true the relationship falters. <br />
  64. 64. Finding a way forward<br />
  65. 65. Buber’s encounter<br />The interhuman: das Zwischenmenschlichen; the in-between is where real communication takes place (Buber, Between Man and Man, 1929).<br />All actual life is encounter (ibid: 62)<br />This is where truth is found.<br />In inter-subjectivity we create the world in which we live together: I-It or I-Thou. <br />
  66. 66. Human evolution. <br />Working together towards a common purpose. <br />To understand the difficulties we encounter, in life, in the world, with each other and in ourselves is to live with consciousness. <br />
  67. 67. Different dimensions of the four spheres of existence<br />
  68. 68. Kierkegaard’s paradox<br />Personhood is a synthesis of possibility and necessity. <br />Its continued existence is like breathing (respiration), <br />which is an inhaling and exhaling.<br />(Kierkegaard, Sickness unto Death: 40)<br />
  69. 69. Inspiration and expiration: finding a rhythm together<br />
  70. 70. Space in the relationship<br />
  71. 71. Relative importance<br />
  72. 72. What does it mean to live as a couple?<br />
  73. 73. Are you doomed to remain true till death do you part?<br />
  74. 74. Who are we as we live alone or together through the four seasons of life?<br />
  75. 75. Your own little sphere of existence matters<br />
  76. 76. Different perspectives<br />Depending on where we stand light refracts differently through the prism of life.<br />
  77. 77. That person is located in a universe with other planets, stars, suns, moons and spheres<br />
  78. 78. Sphere as a planet or a cell: micro or macro level. <br />
  79. 79. If a cell: connection with other cells, function and internal constitution are paramount<br />
  80. 80. If planet: orbit and position matter<br />
  81. 81. Merleau Pont: Visible and Invisible<br />Things are structures – frameworks – the stars of our life: they gravitate around us. Yet there is a secret bond between us and them – <br /> through perception <br /> we enter into the <br /> essence of the flesh<br />(Visible and Invisible: 220)<br />
  82. 82. You experience yourself as having a nucleus: a core, a heart or a soul<br />
  83. 83. Perhaps we are more like suns, generating heat and light<br />
  84. 84. Solar anatomy <br />
  85. 85. Layers of the sun<br />Corona, chromosphere, photosphere, convection zone, and core. <br />
  86. 86. Four dimensions of life.<br />
  87. 87. Merleau Ponty: soul<br />The soul is the hollow of the body, the body is the distension of the soul. The soul adheres to the body as their signification adheres to the cultural things, whose reverse or other side it is. (233)<br />
  88. 88. Four dimensions of life.<br />
  89. 89. Dimensions of Existence<br />
  90. 90. Four dimensions and couples<br />Physical: how do we divide physical space?<br />Social: how do we relate to other people together?<br />Personal: how do we define ourselves in relation to each other?<br />Spiritual: what are the values we adhere to as a couple?<br />
  91. 91. Rules for good relationships<br />Respect each other’s authority.<br />Make as many demands as contributions.<br />Give as much appreciation as criticism. <br />Agree on how time and money are spent: be fair to each other. <br />Agree on values and objectives for future: let conflict and controversy be your guide.<br />Teach and learn from each other. <br />Be loyal and make relating a priority.<br />Have good physical connection, communicate regularly, be yourself as well as together, have a joint narrative and ideal. <br />
  92. 92. Existential Couple Praxis<br />See each partner alone for a session after initial meeting. <br />Get personal background, resentments, conflicts, values, objectives.<br />Together: work with each separately while other learns to listen and hear.<br />Teach mutual respect, understanding, appreciation, open communication.<br />Discuss principles of good relating.<br />Teach finding creative solutions that are fair and take each into account. <br />
  93. 93. Work with a couple with ASD<br /><ul><li>Cathy and Cliff married for thirty plus years
  94. 94. Split up for a year because Cathy had become suicidal
  95. 95. Could not stand living with Cliff any longer
  96. 96. He had been diagnosed with AS and was content to live an isolated routine life
  97. 97. They came to see me to try and mend the relationship, both unhappy to be so non communicative
  98. 98. His world was physically well regulated, socially contained by isolation and cynical distance when with others, personally content, spiritually aspiring to a quiet life with clear routines
  99. 99. Her world was physically marred by high sensitivity, social isolation, lack of confidence</li></li></ul><li>Cathy and Cliff’s worlds<br /><ul><li>His world was physically well regulated, socially contained by isolation and cynical distance when with others, personally content, spiritually aspiring to a quiet life with clear routines.
  100. 100. Her world was physically marred by high sensitivity, social anxiety, a personal world full of dread and doubt about the effect of the relationship on her as a person and a spiritual world full of guilt over having failed both with her husband and children, who she perceived as against her.
  101. 101. First five sessions (hour and half each) spent in collecting information about their experiences, their fears, their hopes, their aspirations, their love for each other, their worries and despair.
  102. 102. Listening to each for twenty minutes to half an hour, then translating what I heard to the other, helping them understand each other’s experience. </li></li></ul><li>Cathy and Cliff: renewal <br /><ul><li> Cliff needed to understand that Cathy was sensitive and fretted greatly over his non verbal communication, glaring at her: making ‘that face’. He meant nothing by it, but was unaware that he came across as sarcastically putting her down and condemning her.
  103. 103. He accepted very easily that Cathy needed support from him and that his love was crucial to her.
  104. 104. He understood that he needed to make her physical and social world safe and in some way protect her. He rose to this challenge very rapidly. </li></li></ul><li>Cathy’s learning<br /><ul><li>Cathy needed to believe that Cliff really did not know what his impact was and once she began to do so became able to see that her disapproval of him was devastating to him. She was in the habit of making strongly critical remarks about his behavior and was unaware that this had made him ever more defensive and private.
  105. 105. She had long known Cliff had AS, but realized that she herself had a female version of this which made her particularly vulnerable to misinterpreting his non verbal communication
  106. 106. She accepted very easily that she was entitled to being understood and supported and quickly learnt to ask for what she needed from him, in the sessions. </li></li></ul><li>Outcome<br /><ul><li>Once they had agreed to make it work together they were keen to use the sessions to explain their experience to the other, with the help of the ‘interpreter’ or ‘referee’, who could remind them of what the other had intended.
  107. 107. They became good at finding words to overcome the negative body language and non verbal communication that had trapped them in a negative spiral for so long
  108. 108. They began to work as a team and to take on dealing with communication with the children and third parties, together, as a couple, learning to stand together and support each other. </li></li></ul><li>Dimensions and Tensions of Human Existence<br />
  109. 109. The bubble of our worldview<br />Our world always seems personal and yet is universal for the way we see the world determines our view on how things are. <br />
  110. 110. Emotions are our orientation.<br />Emotions are like the weather: never none.<br />They are the way we relate to the world. <br />They define the mood of the moment.<br />They are our atmosphere and modality.<br />They tell us where we are. <br />Learn to tune in rather than tune out. <br />Use the emotional compass.<br />
  111. 111. Formulate the questions by finding the atmosphere and the mood.<br />When we master a mood, we do so by way of a counter-mood; we are never free of moods. (Heidegger 1927:136)<br />
  112. 112. Happiness<br />High<br />pride<br />joy<br />jealousy<br />love<br />anger-<br />despair<br />hope-<br />desire<br />Depression<br />Disappointment<br />Disengagement<br />Anxiety<br />Excitement<br />Engagement<br />fear<br />envy<br />sorrow<br />shame<br />Sadness<br />Low<br />
  113. 113. Exhilaration<br />Happiness 12:High<br />1:Pride-confidence-arrogance<br /> Joy-thrill-excitement:11<br /> 2:Jealousy-worry-vigilance<br />Love-courage-commitment:10<br />Up<br />gain<br />Down<br />loss<br />3:Anger-hate-despair<br />Hope-desire-resolve:9<br />4:Fear-confusion-cowardice<br />Envy-curiosity-aspiration:8<br />5:Sorrow-misery-resignation<br />Shame-emptiness-guilt:7<br />6. Low <br />Despondency<br />Depression<br />
  114. 114. The colour of emotion<br />
  115. 115.
  116. 116. Our emotions colour our worldview<br />They create different atmospheres at different times.<br />
  117. 117. Depressed worldview<br />
  118. 118. We affect others and are affected by each other<br />The Interbrain: the connections of the chain gang:<br />Tantam 2009<br /> Butterfly effect: each action causes re-action, each emotion has an impact on the other<br />
  119. 119. Understanding our own and each other’s emotions<br />
  120. 120. Compass of Physical Sensation<br />Satisfaction<br />Fullness<br />Greed<br />Pleasure<br />Stinginess<br />Lust<br />Frustration<br />Excitement<br />Loss<br />Threat<br />Gain<br />Survival<br />Disgust<br />Craving<br />Pain<br />Need<br />Deprivation<br />Emptiness<br />
  121. 121. Compass of Social Feeling<br />Belonging<br />Oneness<br />Care<br />Acceptance<br />Jealousy<br />Love<br />Approval<br />Anger<br />Disengagement<br />Engagement<br />Fear<br />Envy<br />Rejection<br />Shame<br />Isolation<br />Separateness<br />
  122. 122. Compass of Personal Thinking<br />Perfection<br />Strength<br />Superiority<br />Confidence<br />Stubbornness<br />Commitment<br />Defiance<br />Courage<br />Failure<br />Success<br />Deflation<br />Anxiety<br />Humiliation<br />Inferiority<br />Imperfection<br />Weakness<br />
  123. 123. Compass of Spiritual Intuition<br />Meaning <br />Purpose<br />Pride<br />Bliss<br />Prudence<br />Resoluteness<br />Wrath<br />Hope<br />Evil<br />Good<br />Resignation<br />Aspiration<br />Disillusionment<br />Guilt<br />Futility<br />Absurdity<br />
  124. 124. Learning to be acouple:<br />Is learning about life, each other and ourselves; we learn to be, by living and overcoming our mistakes and pay attention to each other and ourselves. <br />
  125. 125. Relating in peace Rely on your capacity to face whatever may come.<br />
  126. 126.  <br />DESIRES<br />FEARS<br />VALUES<br />PHYSICAL<br />life<br />death<br />vitality<br />SOCIAL<br />love<br />hate<br />reciprocity<br />PERSONAL<br />identity<br />freedom<br />integrity<br />SPIRITUAL<br />good<br />evil<br />transparency<br />Human values rediscovered.<br />
  127. 127. Magritte:Empire of Lights.<br />Learning to live with paradox and the tensions of life<br />
  128. 128.<br /><br /><br /><br />
  129. 129. Baumeister (1991) Meanings of Life<br />Baumeister concluded that there are four basic needs for meaning: <br />Need for purpose (spiritual)<br />Need for value (social)<br />Need for efficacy (physical)<br />Need for self-worth (personal)<br />It is the process of going in the general direction of these four objectives that makes for a good life.<br />
  130. 130. Baumeister (1991:214)<br />Happiness is when ‘reality lives up to your desires’. <br />Long-term goals offer a sense of direction, but it is necessary to have short-term goals in order to derive daily meaning. <br />In fact it is having short term achievable goals that allow us to feel efficient and purposeful that gives us most of a sense of self worth and value of life. <br />
  131. 131. The right level of challenge<br />To live a meaningful life and have goals and values is not enough: you must also feel you are capable of achieving these things. <br /> ‘It is necessary to find moderately difficult tasks to maintain that middle ground between boredom (too easy) and anxiety (too hard).’ (41)<br />
  132. 132. Satir’s model of change<br />1Old Status Quo: Encourage people to seek improvement information and concepts from outside the group.<br />2Resistance:Help people to open up, become aware, and overcome the reaction to deny, avoid or blame.<br />3Chaos:Help build a safe environment that enables people to focus on their feelings, acknowledge their fear, and use their support systems. Help management avoid any attempt to short circuit this stage with magical solutions.<br />4Integration:Offer reassurance and help finding new methods for coping with difficulties.<br />5New Status Quo:Help people feel safe so they can practice.<br />Satir Model: Family Therapy and Beyond, ISBN 0831400781,<br /> Science and Behavior Books, 1991.<br />
  133. 133. Satir's Self Esteem<br />"I am Me. I own my fantasies, my dreams, my hopes, my fears. I own my triumphs and successes, all my failures and mistake...I have the tools to survive, to be close to others, to be productive...I am me, and I am okay" (p.28).<br />
  134. 134. Behavioural change processes<br />1. Stimulus control – avoiding or resisting stimuli that<br /> promote problem behaviours.<br />2. Counter conditioning – introducing alternatives to<br /> the problem behaviours.<br />3. Reinforcement management – rewarding oneself or<br /> being rewarded by others for making change.<br />4. Self-liberation – belief in ability to effect change<br /> and acting upon this with a commitment to alter<br /> behaviour.<br />5. Helping relationships – being open and trusting<br /> about problems with those who care, accept and<br /> support.<br />
  135. 135. Levels of Change<br />1. Symptoms/situational – presenting difficulties.<br />2. Maladaptive cognitions – unhelpful thought patterns<br /> and beliefs.<br />3. Current interpersonal conflicts – difficulties within<br /> relationships.<br />4. Family/systemic conflicts – specific conflicts within<br /> the immediate system.<br />5. Intrapersonal conflicts – difficulties within the self.<br />
  136. 136. Experiential change processes<br />1. Consciousness raising – increasing information about<br /> oneself in relation to the problem.<br />2. Dramatic relief – experiencing and expressing feelings surrounding the problem.<br />3. Self re-evaluation – reviewing thoughts and feelings<br /> about oneself in relation to the problem.<br />4. Environmental re-evaluation – considering if and<br /> how one’s problems and subsequent behaviour<br /> affect others and the immediate environment.<br />5. Social liberation – recognition and creation of alternative possibilities in the social environment that may encourage behaviour change.<br />
  137. 137. The Trans-theoretical ModelProchaska and DiClemente<br />Emphasis is not on why and how a problem has developed but, rather, how best change can be understood and facilitated.<br />Change<br />A process of change represents a form of overt or covert intervention that is either experienced or initiated by a person in addressing their thinking, feeling or behaviour in relation to their presenting problems. <br />A common set of ten change processes are identified that span the diversity of problems experienced. Studies suggest that self-changers tend to use the full range of these change processes.<br />Prochaska, J.O., Norcross, J.C. and DiClemente, C.C.(1994) Changing for Good. New York: Avon Books<br />
  138. 138. Context and connections<br />Umwelt: understand physical context and embodiment: person’s relation to the world around them. <br />Mitwelt: describe and take into account the social, cultural and political dimension of the client’s life. <br />Eigenwelt: read and understand the text of the client’s life, find the narrative point of gravity. Who do they think they are?<br />Uberwelt: recognize worldview and values: what is the purpose of the person’s life?<br />
  139. 139. Making new connections<br />Umwelt: understand physical context and embodiment: person’s relation to the world around them. Behavioural/Bioenergy/Biodynamic/Classic Psychoanalysis.<br />Mitwelt: describe and take into account the social, cultural and political dimension of the client’s life. Object relations/Systemic/TA/Group/CBT.<br />Eigenwelt: read and understand the text of the client’s life, find the narrative point of gravity. Who do they think they are? Gestalt/Self Psychology/Ego-Psychology<br />Uberwelt: recognize worldview and values: what is the purpose of the person’s life? Jungian/Psychosynthesis/Core process/Transpersonal<br />