Saturday, April 17, 2010
Thursday, May 28, 2009
The Way We Are ?
In understanding the sameness as well as the difference in our clients, I think it is useful to explore our own conditions, for instance, I like many others am guilty of hiding myself from others. What do I mean by this? I am a person who rather than allow people see my sense of true self, my abilities, my history, my frailties, my skills and talents I would rather hide them. I know this is hard to believe, when here I am writing for all to see :-) What I am prone to normally write about is not personal, it is only related to my profession, which I agree is a large part of identity but not all. This way of being open and sharing allows me and others to to only see what I feel safe revealing, I can share something that I believe I am good at, others can use this to define me, but I know that it does not demonstrate who I truly am.
When clients come to see you or me they can tell us what they want us to hear, or they tell us how experiences or others define them, or a version of themselves, they do not tell us who they are. This makes me consider, is it important to know who you are working with? Do you need to know the story or not? Maybe it is useful some of the time and not others, or do we miss something by making assumptions about who people are and therefor how people work? Is it important to know how they see the world, their understanding of it, their deepest darkest fears, frailties and conditions? Or is it more important to focus on what the person wants to achieve? How they see themselves in the future and not the past. The future Person!
If this story about the client that we are told is a half truth, layered in obscurities and illusion, who are we working with and what are we trying to achieve? Is it what the person says or something all together different. Do we need to decode just a little? Just some thoughts to consider in the ethos of working well with those we wish to achieve with, and while I am not sure that there is a answer, I do think it is useful to consider how we can best achieve with those we work with.
Thursday, April 16, 2009
Doing Good Work in the Caring Professions
How do we do good work? I do not think it matters what you do in life but I do think it is important to most of us to know that we are doing a great job. It is no different in the caring professions. For me hearing a clients successes however small or amazingly enormous is rewarding. When I talk to clients and my colleagues about what works, what has been useful? I am exploring my work practices, my successes and my failings. I am continually looking at increasing my tool box by reviewing what is current and taking the opportunity to embrace new learning's.
This type of analytical approach to my work practice is important to me and my belief in doing good work. Now we are getting down to my beliefs, interesting to share beliefs :-). I believe every person accessing my service deserves the best that I can offer. Not only am I worthy of making sure my work is at least good, but I believe my clients are worthy of a professional with great skills. What do you believe? How do you evaluate what you do? How do you plan for your future work? Or as one of my favorite guru's says "how do you role?"
In the past I have found it frustrating working with people in the caring professions, not only as a colleague but as a professional attempting to be in the industry in work places. Some workplaces and workers do not have the opportunity to continually evaluate what they do, these people and work places are so busy, so consumed by workloads, and so unsupported in what they do, that they do not have the time or the desire to do anything other than what they already know. Those who attempt to evaluate, analyse and plan in these environments are so busy that often what they attempt to achieve is tokenistic and of little value. I not only find this frustrating but interesting because I know that I can not work in these environments, in this way. I know that to keep doing what I do with people I need to be assessing the value of my work and looking for improvement in my work practice, skill base, and effectiveness. It is a fact that others can and do, do, the caring profession differently to me.
The way some of us do our work is the way that we have always done our work and quite possibly the way that it will be done in the future, this is more than just no time, no support. The way of doing ...becomes a faith, a belief system in how things work. I find these work practices are inhibiting the current resources of workers, and denying some workers the opportunity to do anything differently. Most people in these industries are good workers, and they have done good work, and will continue to do good work.
So you might ask what is the big deal? They are doing good work. It is difficult for me to put this concern into words I will attempt this by using the example of a kid with a yoyo. Billy has learnt to walk the dog; he is truly amazing at walking the dog. He believes this is the only trick he needs to know to show his capacity as a great yoyo artist. He finds that he impresses people, he has won competitions and everyone knows that Billy is good at walking the dog. Billy is offered the opportunity to learn new tricks, to become a great yoyo artist, and decides it is more important to do what he is doing, he thinks he should focus on his trick and is happy to walk the dog. Billy is offered other learning's but he wants to just walk the dog. Billy grows up and he can walk the dog. He does not impress as many people, but he can walk the dog. Now I am not comparing the caring professionals to a young Billy with a yoyo, but I can see the learning in the comparison. Even with those of us who have learnt many yoyo tricks.
I remember recently reading a passage in a book the Monk who sold his Ferrari, I will attempt to recapture it, it went something like this. The student asks the monk 'teach me everything you know'. The monk replies by starting to pour a cup of tea and says ‘I will show you what I know’, and keeps pouring the cup of tea, the tea is spilling all over the table, all over the floor, all over the rug and the students says 'what on earth are you doing?' the monk says ‘the cup is full’. ‘Yes says the student but you are getting tea everywhere’. ‘Yes says the monk, that is because the cup is full’. The monk says ‘if we already have a full cup there is no room for anything more.’ If we already know all there is to know there is no room for more learning.
The caring industry workers, me included are often guilty of full cups. How is it possible to continue our growth, our worth, our ability if we already know everything there is to learn? Is walking the dog enough? Are we being useful to our client base? So please ask yourself how do you explore, analyse, and progress what you do? How do you do good work? I hope you take the time to reflect on your achievements, discover your strengths, evaluate your good work, and plan for your future work. I hope you found this useful.
Many thanks to the people I learn from, the inspiring good company I keep, and all of the amazingly talented professionals out there doing good work, and those of you who choose to learn more than one trick :-)
Wednesday, March 18, 2009
Acceptance
Milton Erickson talked about the uniqueness of individual.
As therapists we may talk about the skills, resources and the strategies required in addressing issues and concerns that people bring. In the solutions orientated model we talk about what current, future or past strengths and resources are available to the person, what does this person bring or have the potential to bring to this process.
I know this is only one way of working with people but it is the way that I find most useful.
There are times when I recognize the human tendency to believe in the need to conform to others point of view, or way of being.
I do not know if as a teenager you suffered the need to conform or not, or if you just did that. I remember as a teenager that thinking and dressing the same, acting the same and doing the same things as others sucked, except for when it didn’t, as it was nice to feel like you belonged. I found that the shaky group dynamics stuff was a difficult path to walk. For me I remember that finding the balance between knowing what groups I did not want to be a part of and being accepted from the groups that I did want to be apart of was the first stage of getting some balance. Then it was about working out what fits with me and who I am, and allowing the growth of my true self identity to allow me to understand group, friendships and belonging and how I fit in. I feel this was integral to the commencement of my maturity and over all happiness. I don’t not know how many of you remember the teenage years, or if that was an important part of your learning?
Recently I had a client, who wanted to be normal.....They could not see the resources they have in themselves to be who they already are. What do I mean by this? I am constantly surprised that people believe that they have to be a certain way. Imagine if everyone in the world got up at the same time, did the same work, and thought the same thoughts, so much for progress and balance!! Great leaders, great ideas and progress are made from difference not sameness. It is important to me as a human, not just a therapist to believe that we are able to be accepting of ourselves. Accepting who you are, just as you are is important. Bill O'Hanlon in his ebook the science of happiness talks about being grateful. If you are suffering this might feel like a tall ask. I think if you dig and read the article fully that this is talking about being accepting of your circumstance your strengths, your resources. He is not saying be happy with the status quo, just be grateful for what you have in that moment.
Some days I tell people when they ask how I am that I still breathe and I hear that is a good thing!!!! On bad days when I am low, I know that this is all I have in that moment to be grateful for, this is my starting point, as I say this, I find that I uncover all of the other resources available to me in that moment, I move, I speak, I have my faculties, I have people that care enough to ask….. Asking people to accept that they are at this very moment, exactly as they should be and that tomorrow they may be different but it will be exactly what they are meant to be in that moment, may be difficult. As sometimes we are so stuck in what we are not, that we cannot appreciate what we are. Embrace your differences.
Rob McNeilly often closes a teaching seminar with a profound, light but deep statement. One of my favorites is "Do Good Work". It does not matter if you are an artist, a housekeeper, a therapist, a astronaut, a road worker, a banker, unemployed or whatever or whoever you are 'Do Good Work'.
Good Work is Good Work no matter where it is. A good person is a good person no matter what they look like, what they dress like, where they live. A hard working person is a hard working person no matter how much money they earn. Somebody with a sense of humour is still funny even if a different audience hears their humour. Somebody who is poor is just as deserving in life as somebody who is rich. Don’t get me wrong normality is not a bad aim, and for some it is the only aim. However it is the unique differences that inspire and progress us. These are the things we should treasure, accept and celebrate. What makes you uniquely different? What can you accept and be grateful for about you? How can you embrace this moment, this time and all that you have available to you?
Tuesday, March 3, 2009
फ्य्सिचियन हेअल थी सेल्फ एंड थे रिघ्त तो नोट एक्सेप्ट क्लिएंट्स
I remember clearly the day a client walked into my office and told me that I was to be the next in his long line of therapists; He continued to inform me of why he thought accessing therapy with me or any other therapist would not work, including the fact that he had been accessing therapy through different modalities, practitioners and platforms for many years with absolutely no luck, and that he had an unmanageable mental illness.
I listened keenly to his story and after about 25 minutes I asked “what did you find particularly useful in the therapies you have tried”? He looked at me strangely and raised his eyebrows questioningly? I replied to his response that I was curious to find out what he thought was useful about spending so many years in therapy, I followed on with, and I am interested to hear in your experience what was most beneficial in this history of support that you have received”
The gentleman’s response astounded me, he advised me that the last therapist he had was probably the most useless therapist he had ever seen. While muttering that most had been useless she had really topped the cake as she did not bother to iron her clothes, she was constantly late for appointments, she was rude and obnoxious and obviously never heard of being professional in her service delivery. During this conversation the client was animated, energetic and had a smile on his face.
On this particular day, I had what I call a ‘aha moment’, these are moments you often see on a clients face when they work out what they want and how they want to get it. The moment is not reserved just for clients, and I have these moments regularly. Often as therapists we are eager to present a purely professional response to our clients; this includes, our appearance, through to our verbal and non verbal language as we are trained to be professional, we and our clients expect a standard.
My “aha” moment was, this client enjoyed knowing that his former therapist was not what he envisioned a therapist should be. Even more than this the client enjoyed telling the therapist that they were not good enough, that there was no way that they had the skills required and then this client enjoyed sacking them.
My next question was what the client wanted from seeing me? What led him to the idea that seeing me might be useful, he took great pleasure in informing that he did not think he would gain anything from seeing me, that he believed that the only reason he was in my office is because he had run out of options, and he might as well give this a go as he had tried every thing else.
So I rephrased the response into something like so you are only here seeing me because you have run out of options, you do not expect to see any changes at all from accessing my services, you believe this is a hopeless case. I received an affirmative. I then went on to ask. If it was possible to change something, what would it be that you would like to see changed, not saying I can deliver, and I know that you have seen greater therapists than me, but what if you could have it, what ever it is what would you find useful? He said that he liked having a routine, so if we could maintain appointments this would be helpful.
In this moment of clarity, I realised that I had nothing to offer this client other than routine!!! I am sure that this is something he could get else where. In this moment I knew that I did not believe I could be useful for this client. I asked the client if it were ok with him, if we set up a calendar of appointments for the year and he could routinely miss them, he told me to get ###### and left my office.
I am not saying what I did was useful or right for the client, but it definitely was useful for me. This is an uncommon response, I know I could have had this client coming to appointments for years, and he may have enjoyed the routine, but I don’t know that I would have been able to offer anything more than that. I mentioned this to a colleague who informed that I had acted in a unprofessional manner. Interesting that she believed this.
As a professional I have come to the conclusion that I want to do good work and I want to offer myself the opportunity to work with people that want to be worked with. I do not want to play politics, semantics or put myself in a position where good work is not possible. This is just being clear about my role as a therapist.
I often work with people that have not had success elsewhere, so I am not afraid of hard work, I just dislike the thought of not being effective, I don’t even mind if a client wants to take time to get results, in fact I enjoy the process. How ever, if a client asks you to just set up a routine so that they can be displeased with their appointments on a regular basis, how helpful am I being by agreeing to do this? Or are my skills and resources more useful working with someone who wants to do some work? And do we have the right to choose this? A point of discussion.
Saturday, February 7, 2009
हीलिंग Connections
I am sure that these concerns are not just mine; does this mean that therapies are progressing, getting better with time? If so perhaps if you were to look back at past therapies you would find errors, un-useful ways of supporting a client, misconduct by today’s standards etc....I am sure this is possible. Is this important, the history, the proof the standards, the modalities?
If we look at how the world outside of therapies looks after clients we could see that in business we ask our customers what they would like. I am not so sure this is foreign to us. Or in business we convince the client they would like or even need something that we have to sell, good marketing is something that therapies, modalities and the healing professions have really come to grips with, and we sell our services every day. What would happen if as others have before us we just reviewed the most important outcomes from a non biased platform, with out our belief systems of our therapies? If we were to take on an evaluative process that looks at what the customer wants what would we find out??
How do we do this? How do we evaluate what the customer/client wants? In business we ask? So if I were to ask you to explore with your client, what has helped them through a tough time, or assisted them with dealing with mental health issues, emotional health, or some kind of crisis? I know this may seem familiar to some of you but if you could bear with me I think what I am asking is something different, even if you think you have done this before, take time to consider the question from an evaluative framework of what works? I can honestly say if you ask this question it is not often people will tell you it was a modality that worked. In fact I do not remember when asking this question of a client, friend or colleague ever answering in this way.
More often than not and I speak only from my experience in working with people, the answer has been related to something simple, yet powerful that the individual connects with. This can include connecting with the therapist, or more commonly connections may include - a loved one, friends, community, employment, study, a dog or animal, a belief, self, nature, history, a new learning, a spiritual journey, faith, concern, home, family, the future, a cause etc. Is this information important? I believe, scary I know, I believe, based on my own thoughts, my own experiences, and even though I could ask you to look at research that supports this theory, based on different modalities and clinical applications, I have not because I am asking you to explore this, I am asking you to consider this, I am not trying sell or convince you to use a truth based or evidence based concept, I am not writing an academic paper. This is just an idea that I would like you to consider. Ask your client what has worked in the past? What is working now? Or what will work in the future?
I have found it useful, to work with people and connections, and in doing so I form a understanding of what works from the clients experience of what works, this has amazing outcomes. If you think back you may even notice that you will recognise responses from people you know, that directly relate to their connections, such as a person may say I did it for my kids, or I had to because that is what I believe, I was told to by God etc..., getting in touch with nature, just having someone to believe in.. , just believing in....., having faith that things were going to get better. I am sure if you take the time, you can think of many more instances of what people say is useful to them, these will be in my opinion connections people have made in the history of your experiences or connections that you may have heard about.
I wonder what would happen if every modality, every therapist, no matter their background, education, or belief system, started asking the client what connections the clients have found to be useful? In a language that is meaningful to the client e.g. what has worked before? I am sure we all work in unique and different ways with skills that are useful, that every therapy will be at one time or another more popular or evidence based than the other, I would like to think that we all agree that the one common resource in the room no matter the therapist or the therapy is the client, and that to think that we all make use of that resource, with the best interests of the client in mind may be a significant breakthrough in what we all do across our practices and our modalities.
Sunday, January 18, 2009
There is no way of me knowing when in your life you felt the best that you have felt, but you will know when that was. I have no idea when or how often you have felt happiness or even if you can recall it, but I know that you will know if this is so. I am sure, that if you can recall that feeling or even imagine it, as if you are really waking up to one of those mornings, when your eyes open and you stretch and smile. You can feel that it is going to be a good day, the sky is blue, the birds are singing, your body feels alive, you have woken with that smile on your face and you are looking forward to what ever the day is going to bring. If for one moment you can recapture this mood, you can live your life as though it is the best day you have ever had.
I have had the great pleasure of working with many people who are feeling disconnected; some times reconnecting with a mood that is useful is of great assistance. Even creating a mood that is a holiday from the day to day can be of some assistance. Of course this is not the only solution as people are more complex than this. Other times disconnecting from an un-useful mood also helps; again this is not a panacea but may be useful in some cases. No two problems or solutions are the same, even with the similarities that create universal possibilities. In the same way that we explored connecting to something useful, beautiful and inspiring, we can ask an individual how they disconnect from the things that are no longer of any use……I have know way of knowing how in the past you rid yourself or escaped from this feeling, could you explain this to me, what was different when the feeling was gone, what was present instead are some questions that may assist in uncovering internal resources to achieving these results.
It is with some hesitancy that I write any of this down, as my concern is always that the person in front of you carries all of the answers; that we as therapists in the helping professions just need to listen to our clients. When I say listen, I really mean hear, hear their strengths, their possibilities, their resources, because every individual brings these to a session, the problem is normally around your resourceful client not being connected in some way to what is useful for them or you as the therapist not hearing what they are because they do not fit with your theory.
I know this may seem abstract to stop thinking about all that we know, and ask the client what they know! If you would like to try this in a session with a client, I ask that you look for possible resources with the client, not in their presentation which is possibly symptomatic but in areas of their lives where they have been strong, capable, resourceful, coping. These resources may even be in another time? Some may find a future possibility, others will recall this in their past, and you may even find that some clients are resourceful in the present. It is for this reason I have concerns when writing some tools down, as people, us therapists are inclined to pay more attention to the tools, then we do to the individual, which will be of little use to the client. If this were to occur these tools could become part of the therapeutic disease that creates un-wellness with some people, if I in some way lead therapists to focus on diagnosis, theories or anything other than the individual, I to become part of the problem. It is not my intent to debunk any theory, or dismiss any diagnosis, it is however my intent to make sure we in the therapeutic world remember that the person is more important than any one given approach, theory or diagnosis.
