Peggy-Sax 2Peggy Sax: February 9, 2012

Since our conversation on “Just being ways of being,”(Part One and Part Two) I have been thinking a lot  about reflection-on-action in everyday practice as a practitioner. When narrative practitioners introduce practices that link lives and provide witnessing opportunities, we don’t go “by the book” but rather lean into ethical considerations from a “decentered- influential” posture. We are guided by certain practices/maps of narrative practice to go with what can emerge in the moment.  We do a lot of what Donald Schon called “Thinking on one’s feet” and then do our best to pause to reflect – on our own and with the persons consulting with us – about what worked and what didn’t work. To borrow a phrase from my GPS, we aspire to are continually “recalculating” to incorporate changes in direction when we go off the original map into new unexplored territory.

I’d like to offer a few illustrations from the past week in my therapy practice to invite conversation about this process of “thinking on one’s feet” and  “re-calculating.” I believe there are some differences from a position of eclecticism since there is a sense of accountability to a particular overarching set of ideas and practices. For example, when I say I don’t always go ‘by the book’ I also mean the narrative book. I don’t police – or feel policed- in these deviations but I do experience myself as in conversation with Michael White, David Epston and others. I might ask, “What would Michael say?” For example,  I don’t always separate the speaking and listening positions (as Michael suggests for outsider witness practices). Nor do I always act as a conduit between two people’s whose lives I am linking (as David Epston would suggest). I “talk” with Michael or David about why I made the choice I did….and what I am discovering.

Looking over these three examples, there is a lot of “thinking on one’s feet” as Donald Schon would suggest – as well as intentional choices. And of course there are always surprises. The trial and error is hopefully adjusted as we move forward, as long as I remember to pause to continually consult with the persons whose lives are at the center of these practices, and to readjust my practices accordingly.

Here are 3 illustrations. I’ve done what I can to disguise the identities. Please join me in finding ways to protect confidentiality.

1- Last week, I began working with a woman whose young adult daughter recently died tragically in an accident.  We have now met twice. During our first session, Sharon poignantly asked “How do I  learn to grieve? What do I do with all of this overwhelming emotion?” She also asked,  “How can I function? I sometimes feel relief while distracted at my job… Is it okay to function?” (I was reminded to open space to hold the complexity of her experience, and to ask questions to acknowledge the potency of these complexities in our work together). In approaching grief, Sharon  started reading a couple of books that those close to her gave to her, but now can’t find them. Her friends and family also give advice, some of which is helpful. I asked, “Would you like for me to share with you some of what I’ve learned from other moms who have lost their children?” She said, “Yes.” I added, “ I know you know this, but I want to begin by acknowledging that everyone grieves differently.  Can you pay attention to whatever does or does not make sense to you, and then perhaps we can begin to adapt these grieving practices to your own preferences?” “Yes, I understand. That makes sense.”

I started to tell Sharon how much I have learned from a woman whose son died 4 years ago, and who now wishes to make herself available to other bereaved parents. Sharon asked, “You mean Suzanne and Jamie?” “Yes!” I said. “Suzanne has not only given me permission to share her story, but I’m sure she would like to meet you. Since Jamie’s death, Suzanne has transformed her life in these ways that put her – and Jamie – at service to others (I also made a link between Suzanne’s expression of meaningfulness and a story Sharon told me about her caring for a person in her work in a way that might not have happened before her daughter’s death).. “Just let me know when, and I would be happy to arrange for Suzanne to come to one of our sessions.”  Sharon responded, “Suzanne’s sister already called me to encourage me to call Suzanne. And do you want to know another coincidence? Many years ago, I used to work at an after school program, Jamie was one of my students. When I left that job, the parents gave me a patchwork quilt that includes a square made by Jamie! …..You know, I think I would prefer to call Suzanne myself and reserve our sessions for ourselves.” I told Sharon I believed Suzanne would be happy to hear from her, and very moved to know that she knew Jamie, and to hear this quilt story.

During our second session Sharon guided me to a listener position wherein Sharon spoke – and cried – while I listened intently. Occasionally I asked a question or added a reflection but through her body language and responses, she let me know how important it is to her to be able to speak freely without interruption. We only mentioned Suzanne and Jamie once. We are co-creating a space where Sharon can be with the overwhelming grief.  I believe she steered the conversation where she wanted it to go. She told me about the (approx) 15 people in her circle of support now all linked through email – friends and family she has known for many years. One person shared that Sharon’s daughter came to her in a dream, and how comforting this was to her. Nearing the end of the session, I mentioned that I look forward to getting to know Sharon’s daughter through her – that I welcome hearing stories, seeing photos, and anything that brings her into the room with us. At first couldn’t quite grasp what I meant or why…but when she did, she smiled, and said this idea moved and comforted her.

I purposely schedule Sharon at the end of the day. We go until she is ready to leave.  I asked, “Is there something else you would like to say before we end this session?” The first session lasted 1 ½ hrs. This time we met for 65 minutes. Both times Sharon has extended family back home making supper. We spoke about how comforting it is to go home to the cooked meal with extended family. We discovered that we were both looking forward to Fahitas for dinner.

2. I am working with a university professor who is very unhappy in her job. Jill has a history of depression and recognizes some Old Foes revisiting such as panic attacks, uncontrollable crying jags, despondency, loss of sleep. Through our work together, she is listening to her own voice, and feels relief having come to the decision to leave her current position. However, she is overwhelmed by the actual process of leaving her job without burning bridges along the way. She doesn’t know whom she can trust. In our session last week, I called the Human Resources Department to inquire for an anonymous client about the protocol for requesting leave. I also offered to invite someone I know to meet with us – Chava, a tenured university professor with whom I worked through “Hell and back” a few years ago when she took a leave of absence for he job. Jill jumped at this prospect.

When I asked Chava about joining us, she said “I would be happy to do a mitzvah” (a good deed). Thanking her, she looked me right in the eyes and said, “You are profoundly welcome.” We found a time early the following week (tomorrow), knowing that 5 days might feel like an eternity to Jill.  Chava said, “Please feel free to give her my name ahead of time. She can then look me up, and even call or email.” I thought about it, and while knowing this might be a bit risky if Jill was to lean too heavily on Chava, I did just that (and had a private little “conversation” with David Epston about why I made this choice). Over the weekend, Jill has sent several emails to both me and Chava. Chava and I scheduled a brief phone call to  prepare, and during that call, I asked her how it was for her to receive the email, and my concern that I do not want to put her in an awkward position demanding more than she wishes to give. Again she asserted, “This is a gift for me too, Peggy – to pay it forward like this, knowing that what I went through can be somehow useful to someone else.”

On her own, Chava had contacted a senior faculty member with administrative knowledge to ask questions on behalf of  this anonymous person. She titled her email, “Sensitive question re: the circle of compassion.” The senior faculty member sent answers to specific questions as well as this line: “Let the colleague know, too, that these situations (whether depression or other medical issues) involve far more faculty members than one might expect.  It may be the case that someone NOT experiencing something like this during their career at this college is more the exception than vice-versa!” Chava sent this to me so I can share it with Jill in a future session.  I don’t know how Jill might have received this comforting thought otherwise…Slowly we are creating a “circle of compassion” in a situation where a community member has had great difficulty finding allies.

3. I am working with someone through her finding dignity amidst a public scandal. Cathy is finding it difficult to go out into the public in community life. I told her about the lunchtime yoga class that I now attend (thanks to Mary Brevda) – how there is no rank there, with everyone the same on the mat. She told me she would try to come on Tuesday. She said “You can be my body guard.” I said, “I’ll be there.” Someone else might think that is intruding on my private time, but so far, my enjoyment of this class is enhanced by sharing it with others I know from all sorts of different part of the community. Yesterday, Cathy left me a voice message to say, “Turns out I have a dentist appointment today so I can’t come to yoga…but I will get there!”

All of these conversations are “grist for the mill” in therapy sessions. I never know what will emerge. How similar is this to your experiences? What do you notice and want to ask? Do you have some stories of your own you would like to share? What kind of “thinking on one’s feet” and  “re-calculating” do you do?

Thanks for listening and joining me here.

sarahhughes2_profile 2Sarah Hughes: February 9, 2012

Thanks, Peggy, for these wonderful stories that made me smile with pure joy.  I love hearing of your connections and how genuine and loving they feel.
This fits right in with a story I was wanting to tell.   I like your examples as not only are they recalculating and thinking on your feet but they are also decentering of the model of therapy as a one hour session of talking.  They seem to creatively break through the limits of what can happen in therapy.  I find it exciting and liberating.

My story is that in my job as a mental health worker, I have many clients. Too many for the hours I have in that job.  Our team meets once a month for a consultation day and I brought forward my list and my sense of overwhelm.  The team responded by suggesting that I learn to say no. That I have a longer waiting list.  That I look at myself and what this says about me. Hmmmm… I felt heavier and heavier.  I guess I am not strong enought to have good boundaries.  I knew I did not want to buy into this story of me but it was the end of e day, I was tired and I just let it go and dragged myself home.

Luckily a few days later I had a Skype meeting with my supervisor jean.  I told her this story and she asked me about some of the ways I was managing with all these people.  I told her a few stories of systems I had set up of letter writing between session, people leaving me messages on Facebook, a couple of people living in the same very remote area that I connected together to have coffee and make art together and now they are meditating too. Jean had some ideas for me of other ways to connect outside of a traditional one hour session every two weeks.  She liked my ideas and I liked here.  I was no longer heavy. I was light and bright and creative and excited. Full of new ideas -thinking on my feet!

Jean used the words ACTIONS.  How could I acknowledge these acts?  Use them more deliberatlyj in ways to “manage my caseload”. This is where we had the discussion of decentered and influential that really reminded me oh yes that is how I want to work!

I love hearing your stories Peggy as they really resonate and get me thinking of other ways of working with people here in ways that fit with my ethics and my positioning in this work!
Sarah

Bonnie-Miller 2Bonnie Miller: February 9, 2012

I agree with you Sarah- it’s wonderful to read Peggy’s stories and think of our own.

I have one that is second-hand, but Sarah, your story made me think of it.

one of the therapists in our narrative supervision group got us talking about the discourse around ‘personal sharing’- the word ‘boundaries’ was brought up. In our conversation she illuminated for us how intentional she is in her sharing, and also how this practice brings something to her own understanding- a beautiful example of the bi-directional nature of therapy in a narrative way of working.

There is something important, I think, in being able to think on one’s feet AND have the ability to stand on solid ground with our intentions. We do things for a reason, and we can articulate these reasons.

I think this is very important, when we can be seen as playing outside the regular ‘rules’ of therapy.

Bonnie

Peggy-Sax 2Peggy: February 10, 2012

Hi Sarah and Bonnie,

This conversation is like tonic to my soul. Thank you for joining me here. Sarah, I am so glad you can stay in touch with Jean via Skype to keep you thinking about the actions, and supporting you in your challenging job as a mental health worker. What you mention about heavier vs lighter ways of being in our work really strikes a cord with me. Why do you think this is? In one situation you are prescribed how to respond (“learn to say no,” “work on your boundaries” etc) and in the other instance, you enlist your own solutions – letter-writing between sessions, Facebook messages,connecting others living nearby, etc. This reminds me of what we continually learn about centrality of “personal agency” in the lives of our clients. Why should we – in the designated role of service providers-  be any different?

Recently, someone (a Harvard trained professor) shared this favorite quote with me, “”Of all of the options open to you right now, which one will bring the most love into the world?”   How can we get the word out that there are ethical and “professional” ways to bring more love into the world?” We have work to do in the world to demonstrate that these specifically developed “loving” ways of being in our work are highly ethical, guided by clearly articulated intentions, and manifested in specific actions. We cannot speak of “love” because that is too loaded especially because of the history of violations (sexual and other exploitation) in helping professions. We even have to be careful here in the USA using the term “solidarity” because of the political connotations that might turn some people on, and others off. I often hear people say to me,”That would never work in my community because people’s privacy is too important to them” or  “I could never work that way – my personal life is too important to me.” Yet these linking lives practices rest on choice – for both the client and the therapist. We only proceed with permission, and a sense of co-creating options. We stand on solid ground with our intentions, and my hope is that we can get better and better at articulating the reasons why we work it these ways. Bonnie, thanks for the clear reminder (it can never be said too much) that this is not just random “thinking on one’s feet” or “spreading love.” It it is ethical practice – we work in these ways not because we have poor boundaries or lack personal lives…not even because it energizes us….but for clearly articulated reasons …and…best of all…..it works!

Peggy

sarahhughes2_profile 2Sarah Hughes: February 10, 2012

Lovely tonic for me to savor too.
Thanks Bonnie for your words as I was thinking as I was logging in that I needed to make that piece around intentions and ethics and thinking things through.  I know that just good intentions are not enough -there are many things we must think through including our intentions.
Cheers
Sarah

Cate-Ryan 2Cate: February 10, 2012

Hi Peggy, Amy and Bonnie,

Thank you for brewing this tonic, it is lovely to enjoy at the end of my 1st week back at work from holidays, especially after the ending I had to my friday afternoon where there was SO much ‘thinking on my feet’ and ‘re-calculating’ – such perfect description of the work I do!

In my role as a Youth and Family Worker, I work in the community setting, supporting young people and the significant others in their life to stabilise housing & relationships, which in turn involves anything from relationship counselling, mediation, referral and collaboration with mental health, housing and income systems, supporting engagement in education, training and employment, building community and webs of support, exploring cultural connections and of course having fun (a very essential element to the relationships we build and model with people!). We achieve this through ‘active outreach’ which looks like proactive phone calls, visiting people’s homes (sometimes multiple times in a week), wake up calls, assisting with transport, and weaved into this is discussions about safety, hopes, goals, grief, injustices and ways to continue creating the ground to stand on how they want things to be in their life.

I can often be making a call or heading out to a visit and really not know what to expect in relation to what might come across our path today, though there is always hope that it might entail what we planned to work on from the last session. In this space of not knowing exactly what to expect (this is sometimes even where we might find the young person), ‘thinking on my feet’ and ‘recalculating’, I feel like the only solid thing in my work is the intentions defined and re-defined in collaboration with the young person through a process of  refection about what it is we are coming together to work on. it just might be that at different time some things get put on the back burner just for the while, but not out of sight.

As I’ve been reading your stories and writing this reflection I’ve been thinking about a 16 young woman I’ve been working with for almost a year. She’s been negotiating various accommodation options since she was around 13 and even as i type this, a place where she can safely call home is still something that is under threat from grips of exploitation and the fluidness of a share house that takes communal boundaries as a way of surviving because you never know when you’ll be the person who doesn’t have your own resources to get by. There is a saying here in Australia which is ‘like crabs in a bucket. when 1 crab is striving and trying to escape from the bottom of the bucket, others grab onto the crab and pull it back down’. As we’ve worked together, it’s never ceased to amaze me how this young woman gets back up and continues to look at the sky above the bucket and find ways to reach out again and again. One thing she shared with me last year was that she never felt she had a parent to teach her boundaries or how to continue things and keep ‘on track’. This is something we’ve held onto in our work because learning boundaries was something she wanted. It gave us some intentional foundations to base our work and bring things back into the boundaries of her hopes and goals, which include containing and slowing working through some of the dark from her past. Anyway, yesterday afternoon when we met and caught up on the last 3 weeks I thought the meeting was over as I dropped her home, however due to mental health concerns for one of her housemates whom she identifies as being the primary carer, she asked me to come inside to the house and check on him. this ‘recalculation’ involved mediating between household tension because the rent was due that afternoon, discussing a safety plan with the unwell housemate, the young woman and the housemates brother and then unpacking with the young woman the pressure she was feeling about her caring responsibilities and what it would take to get to school on monday morning. In the middle of this too, I introduced myself incredibly intentionally as “Cate, a youth worker” to a ‘friend’ that dropped in because he’d popped around to have a cone (does that translate across cultures?) and I certainly wasn’t okay with someone smoking marijuana when I was at a house visit! He got the point and actually said…sooo, better not light up then!

In all of this I’m simply grateful to share in this context that there is intentionality in everything that I do out there is the murkiness of community support work. Too often our roles get watered done by the government ‘professionals’ as ‘the transport to appointments’ or ‘people to fill out forms’. In this young woman’s case, her Mental Health worker actually said to me at her first appointment that if I was to transport this young woman to her counselling appointments I am creating over dependence and am over invested. This was a real blow at the end of last year to my sense of ‘professionalism’ and to the trust the young woman and I had built to take the conversation of her past hurts into the realm of mental health support.
From this conversation, this tonic, I will hold on to your words Peggy,

It it is ethical practice – we work in these ways not because we have poor boundaries or lack personal lives…not even because it energizes us….but for clearly articulated reasons …and…best of all…..it works

and

I believe there are some differences from a position of eclecticism since there is a sense of accountability to a particular overarching set of ideas and practices. For example, when I say I don’t always go ‘by the book’ I also mean the narrative book.

I don’t police – or feel policed- in these deviation…
though i would probably say in my head I think more of shona, maggie, rob and this wonderful community.

Sarah, I also look for the way you describe your work in all of the mental health professionals I meet and work really hard at my relationship with them so we can learn from each other’s positions, the value of the roles we have in people’s live even if we come from very different systems.

and Bonnie, I’ll look out for my solid ground amidst the moments I’m “thinking on my feet”.

Cate
ps sorry this is so long!

MohammadMohammad: February 12, 2012

Hi Cate,
Hi Sarah,
Hi Peggy,
Hi Bonnie,
And Hi All,

This tonic is enlightening! I wish I could openly have some every now and again in my day to day practice too.
The structure of the agency I work within would most likely consider it “boundary violations”.
I already push the boundaries by writing my notes in narrative terms and stray from the book by writing conservatively things like: “Therapist helped Pt. richly describe an occasion when she had managed to loosen the hold of the depression on her life and reinforced Pt.’s ability to take a stance against the depression.”
Though in my conversations with those who come for my consult, in the privacy of my office, I openly speak the language of the heart, the language I am most fluent in.
I got a long way to go!
Mohammad

sarahhughes2_profile 2Sarah: February 12, 2012

Mohammad,
I love your notes!  I am going to write mine more like that.  I am a little bit removed from the medical mental Heath structures as I am in a small rural town .  I have a community service agency that trusts me and my thinking in my feet but I report to a larger health authority in my computer notes that reflect nothing of what really happens or my heart work. These would also be considered violations.
It feels to me you are doing great work – it requires a whole different way of thinking on your feet and covering your tracks.  You have just added another dimension to my sweet tonic.
Thank you,
Sarah