This PowerPoint Presentation by Dr Werner Sattmann-Frese outlines key aspects of a complexity oriented and ecologically and somatically (body-centred) aware approach to counselling and psychotherapy. Werner is a senior lecturer and program manager at the Jansen Newman Institute in Sydney.
Why invest into infodemic management in health emergencies
Ecopsychotherapy - ASPA Conference 2013
1. Complexity Informed and
Ecologically and Somatically
Aware Psychotherapy
ASPA Conference 2013
Dr Werner Sattmann-Frese
Jansen Newman Institute - Sydney
2. Questions
• Is the world still getting worse in spite of a
hundred years of psychotherapy (Hillman &
Ventura)?
• How helpful are the new developments in
neuroscience for a deeper understanding of the
human condition?
• What are the elements of a complexity informed
and somatically and ecologically aware approach
to counselling and psychotherapy?
3. Questions
• What are the current epistemologies
informing psychotherapy and counselling”
• What are the factors contributing to
adverse childhood experiences and
attachment problems including abuse and
neglect?
4. Psychologies
• One-person psychology
• Thoughts, feelings, and behaviours are generated
from within
• Relational psychology
• Emotions and feelings are socially constructed
rather than natural, spontaneous, and private
• Ecological psychology
• Feelings, thoughts, and behaviours are the results
of complex interactions of natural, relational, and
environmental factors (as well as rather than
either - or)
6. Selves
• The notion of the self is currently under
siege:
• True selves
• Relational selves
• Socially constructed selves
• Ecological selves
7. Causes of feelings and
emotions
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Internal physiological needs and necessities
Past relational experiences
Past environmental influences
Present relational experiences
Present environmental influences
All experiences and impressions are the result of a
multitude of economic and psychosocial influences
that impact children, their caregivers, other
important people, and the rest of society.
8. Conventional views on developmental
traumas
• Mothers fail to provide the tangible love
required for successful attachment
(Bowlby)
• Mothers lack attunement with their
babies as result of their own trauma
history
9. Social ecology informed views
• Social and emotional exploitation of parents and
people in general
• Manipulation of parents by using their own selfesteem problems
• Inclusion of addiction producing substances in
conventional foods and drinks
• Lifestyle choices
• Stress from unemployment and underemployment
• All of these problems may interact to form signs
and symptoms of emotional distress (see
ADD/ADHD)
10. Factors contributing directly to a child’s
emotional and physical wellbeing
• Parents’ ability to function as good-enough self
objects in a child’s life
• Available and affordable lifestyle choices including
built environments
• Access to nature and natural ambient sounds
• Opportunities to play with companion animals
• Access to members of the extended family and
friends of the family
• Sustainable financial resources
• Wholesome diets
• Education and child minding facilities
11. How are these factors
represented in neuroscience?
• Let us explore the various approaches to
neuroscience to find answers to this question.
• Neuroscience is not a unified approach to
generating understandings on mental and
physical health and wellbeing. It differs both in
terms of perspectives and worldviews.
• The next slide briefly outlines the wide range of
perspectives.
12. Neuroscience areas
• Molecular and cellular neuroscience
• Affective neuroscience
• Cognitive and behavioural
neuroscience
• Neuropsychiatry
• Developmental neuroscience
• Social neuroscience
• Cultural neuroscience
• Critical neuroscience
13. Neuroscience
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•
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The decade of the brain
Neuro-disciplines
Neuro-cultures (Ortega and Vidal)
Neuroscience as cultural activity
embedded in the modern medical
model
• Neuro-ethics (Fukuyama, Illes)
14. Emotional learning
• Some of the most impressive evidence for
brain plasticity is emotional learning (LeDoux,
1996). Plasticity in the neural circuitry
underlying emotion is also likely to play an
important role in understanding the impact of
early environmental factors in influencing later
individual differences and risk for
psychopathology (Meaney et al. 1996). http://psyphz.psych.wisc.edu/web/pubs/2000/Emotion
15. Points of criticism
• Brain centrism
• Focus on ‘insight’ rather than ‘outsight’ (Black
box)
• Focus on individuality and interiority
• Focus on excluding rather than including the
wider world
• Promotion of individual choice and autonomy
• Explaining the complexity of life in terms of
‘scanable’ brain functions
• Slaby (2010)
16. A narrow focus
• Secure attachment depends not on the
mother’s psychobiological attunement with the
infant’s cognition or behaviour but rather on her
regulation of the infant’s internal states of
arousal, the energetic dimension of the child’s
affective state.
• Schore, A. (2209). Relational trauma and the developing
right brain, p. 20.
(www.allanschore.com/pdf/SchoreIMHJTrauma01.pdf).
17. Jan Slaby:
• The neurosciences are bringing upon the horizon
new technologies that are mobilized in the name
of educational improvement, treatment, illness
prevention, and security: new pharmaceutical
drugs, brain-based methods to boost intelligence,
attention and happiness as well as screening
devices with potentially wide-ranging medical,
civil, and military uses.
• Slaby (2010, p. 398)
18. Departures from neuroscience
informed mental health
• Health and complexity science (Sturmberg and
collaborators)
• Ecotherapy (Clinebell and others)
• Ecopsychology (Conn, Kanner, Roszak, Winter,
and others)
• Ecologically aware counselling and psychotherapy
(JNI - Sattmann-Frese)
• Perspectivism (Nietzsche)
• PREMIUM, PRIME, SHARE (Patel)
19. Handbook of Systems and
Complexity in Health
Editors: Joachim P. Sturmberg,
Carmel M. Martin
ISBN: 978-1-4614-4997-3
(Print) 978-1-4614-4998-0
(Online)
20. Mary-Jane Rust & Nick Totton
Ecopsychology Anthology
out now:
Vital Signs: Psychological
Responses to
Ecological Crisis
Editors: Mary-Jayne Rust
& Nick Totton.
Karnac Dec 2011.
23. The Psychology of
Environmental Problems:
Psychology for Sustainability
Paperback: 504 pages
Publisher: Psychology Press; 3
edition (March 18, 2010)
Language: English
ISBN-10: 1848728093
ISBN-13: 978-1848728097
24. Learning for Sustainable
Living by Werner J. SattmanFrese and Stuart B. Hill
Paperback: 348 pages
Publisher: Lulu.com (March
19, 2009)
Language: English
ISBN-10: 1409251020
ISBN-13: 978-1409251026
25. Cynefin model of knowledge
• “It is more properly understood as the place of our multiple
affiliations, the sense that we all, individually and collectively,
have many roots, cultural, religious, geographic, tribal, and
so forth. We can never be fully aware of the nature of those
affiliations, but they profoundly influence what we are. The
name seeks to remind us that all human interactions are
strongly in fluenced and frequently determined by the
patterns of our multiple experiences, both through the direct
influence of personal experience and through collective
experience expressed as stories”.
• Kurtz & Snowdon (2002, cited in Sturmberg, 2013, p.41)
26. Perspectivism
• Perspectivism is the philosophical view developed
by Friedrich Nietzsche that all ideations take place
from particular perspectives. This means that there
are many possible conceptual schemes, or
perspectives in which judgment of truth or value
can be made. This is often taken to imply that no
way of seeing the world can be taken as definitively
"true", but does not necessarily entail that all
perspectives are equally valid.
• http://en.wikipedia.org/wiki/Perspectivism
27. Complexity informed therapy
• Complexity informed therapy is
atheoretical since the imperative is not
to look for causes in a particular
theoretical framework, but to question,
explore and remain curious and open to
all possibilities.
• Evans, (2003, p.1)
28. Complexity science in psychotherapy
• Individual lives and patterns of human
relationships are always unique. No one
individual is the same as another in this world
(Raelian cloning claims notwithstanding!) and
even if that were the case, there is no pattern
of human relationships which is exactly the
same as another pattern.
• Evans, (2003, p. 1)
29. Complexity informed therapy
• If a therapist has only one lens, as provided, say
by strict adherence to a particular theory of
change, then it is likely that complex problems
will be reduced to a simple problems. This may
be good only in that it simplifies the therapist’s
life but it probably does not help appreciate the
complexity of the patient’s life.
• Evans (2003, p. 1)
30. Complexity informed therapy
• One of the important ramifications of adopting this
meta lens is that the same principles of change
which apply to the “patient” must also apply to the
therapist himself/herself. This is captured in the
concept of “fractal” wherein there is self-similarity at
different levels of scale. It must therefore be
acknowledged that the therapist changes by the
action of participating in therapy process.
• Evans, (2003, p. 11)
31. Key Features of Ecologically Aware
Counselling and Psychotherapy
(EACP)
32. Summary of Features
Somatic awareness
Cultural awareness
Awareness of power relations
Awareness of clients’ ecological footprints
Awareness of past and present
environmental influences
Awareness of the effects of lifestyle choices
Spiritual awareness
Understanding, reflection, and action
33. Somatic Awareness
EACP conceptualises and utilises an
awareness of clients’ embodied
(somatic) reality, of the somatic
expression of trauma, but also of body
sensations and symptoms sensations
associated with healing and change.
34. Somatic Awareness Practice
Work with body awareness
Mirror the client’s physical emotional
expression
Encourage and work with the effects of deep
breathing
Use exercises to facilitate the experience of
body-mind and person-planet unity
35. Cultural Awareness
EACP promotes the awareness of
cultural differences, their potential for
conflict, but also for learning and
change
36. Cultural Awareness Practice
Facilitate the awareness of ‘cultural empathy’,
the awareness that we cannot impose our
values on people form other cultural
backgrounds
Seek to learn from other people about what is
important to them
Do not idealise the features of other cultures they all have their light and dark sides
37. Awareness of Power Relations
EACP promotes and utilises the awareness
of power relations in counselling and
psychotherapy.
38. Power Relations Practice
Be aware that your client needs you over time to
embody many different roles. These include
being:
a role model to look up to
a container to hold his or her difficult feelings
a mirror
a person to cope with his or her anger and rage
a wise mentor and educator
a generous ‘friend’ ready to share power.
39. Environmental Awareness
EACP aims to facilitate healing and change
with an awareness of the client’s ecological
footprint. It asks deep questions when most
other therapeutic approaches do not question
the ecological consequences of therapy
outcomes.
It may also encourage people living in a state
of guilt to ‘take more from life and the world’.
40. Environmental Awareness Practice
Work from the assumption that what is good for the
environment is also good for the client.
Assist the client to feel and understand the deep
needs behind his or her unsustainable wants.
Assist the client in learning to satisfy these deep
needs thereby making the wants redundant.
Keep asking deep questions to achieve all this.
Do not hijack the client’s process for the ‘greater
good’ of the planet.
Remember that some clients may need to ‘take more
from life’.
41. Awareness of Past
Environmental Influences
EACP places value in inquiring about
the clients’ early traumatising or selfsupporting environmental living
conditions.
42. Past Environmental Influences Practice
Inquire about environmental factors that
influenced your family of origin including the
effects of wars and ecological catastrophes.
Inquire about environmental features that
may have compensated for empathic failures
and attachment difficulties of primary
caregivers such as access to nature and
companion animals.
43. Awareness of present
environmental influences
EACP places value in inquiring about
the influences of present urban,
suburban, or rural environments on
clients’ mental and physical health and
wellbeing.
45. Present environmental influences practice
Inquire about environmental health hazards
the client may be subjected to.
Inquire about his or her lifestyle choices and
diet.
Use the questionnaire as a guide.
Explore what may have influenced the client’s
well-being on the way to your office such as
heavy traffic, smog, and road rage).
46. Awareness of the effects of
lifestyle choices
EACP facilitates the understanding of
the effects of lifestyle choices, including
diets and exercising, on clients’ (mental
and physical) health and wellbeing.
47. Lifestyle choices - practice
Inquire about the client’s lifestyle choices
such as exercising and diet.
Explore the effects of possible addictions to
drugs, nicotine, coffee, and prescription
drugs.
Use the questionnaire that will be supplied as
a guide.
49. Spiritual awareness - practice
Explore with the client his or her
spiritual needs within the framework of
his or her spiritual or religious
orientation
Facilitate through mindfulness
exercises the developing of a felt sense
of person-planet unity
50. Understanding, reflection, and action
EACP places value in deepening the
understanding of the effects of political
decisions and cultural practices on a client’s
life.
EACP promotes political and social action
designed to address the causes of
unsustainable perceptions, behaviours, and
practices.
51. Understanding, reflection, and action practice
Assist the client in deepening his or her
understanding of the effects of political decisions and
cultural practices on his or her daily life.
Promote and encourage political and social action
designed to address the causes of unsustainable
perceptions, behaviours, and practices.
Promote collaboration and assist the client in
identifying people and organisations to join.
Be proactive yourself to be able to function as a role
model.
52. Responses to changing environments
• With global warning and other factors having an
increasing financial impact even on developed
societies collaborative learning and healing may
become the practices of the future.
• Responding to treatment gaps in mental health:
• PREMIUM
• PRIME
• SHARE
53. PREMIUM
• PREMIUM aims to develop culturally appropriate
psychological treatments for Depression and Harmful
Drinking that can be delivered by non-specialist health
workers in low resource settings.
• PREMIUM will be implemented through a partnership
between Sangath, a mental health NGO in Goa, India and
the Centre for Global Mental Health, London School of
Hygiene & Tropical Medicine. Other partners are: the
Directorate of Health Services, Government of Goa; the
South Asia Network for Chronic Diseases of the Public
Health Foundation of India; and Oxford University.
PREMIUM is fully funded by the Wellcome Trust.
• Vikram Patel, (email: vikram.patel@lshtm.ac.uk)
54. PRIME
• The majority of people living with mental disorders in
low- and middle-income countries do not receive the
treatment that they need.
• PRIME includes a strong emphasis on capacity building
and the translation of research findings into policy and
practice, with a view to reducing inequities and meeting
the needs of vulnerable populations, particularly women
and people living in poverty.
55. References
•
Clinebell, H., (1996). Ecotherapy, Minneapolis, IL: Fortress
Press.
• Evans, B. (2003). The fifth wave: Psychotherapy and
complexity science. www.plexusinstitute.org.
• Kurtz, C.F. & Snowdon, D.J. (2003). The new dynamics of
strategy: Sense making in a complex and complicated
world. IBM Syst. J. 42(3), 462-483.
• Slaby, J. (2010) Steps towards a critical neuroscience.
Phenom Cogn Sci 9:397–416
• Sturmberg, J.P. & Martin, C.M. (eds.) (2013). Handbook of
systems and complexity in health. New York: Springer
57. Acknowledgment
• Some of the views presented here were
developed as part of my work for the
Jansen Newman Institute, Sydney.
• I would like to thank JNI and students in
the PSY609 Master of Counselling and
Applied Psychotherapy program for
their generous contributions.