Thursday, September 2, 2010

Finding

终日寻春不见春,
芒鞋踏破岭头云;
归来偶把梅花嗅,
春在枝头已十分。
--唐·无尽藏


Is it better to be constantly searching or to have found? In my search for more meaningful connection with people I will be changing my work place. Each change is an opportunity for growth rather than a destination to be desired.

A friend congratulated me and asked if I will be happier at the new place. I said I'm rather happy at the old place, and the new place may in fact give me more stress.

Perhaps my search for ___ (fill in the blanks) has no ultimate end. Just participate fully and savour each moment of the here and now.

Sunday, August 8, 2010

Thinking behind practice – post-structuralism, culture, and individualism


I am doing a series of reflections as part of a post graduate course on Narrative Therapy. Overall there will be about ten reflection papers on various concepts and practices that currently form and shape Narrative Therapy.

I chose this set of readings for reflection because post-structuralism has been a significant influence towards my approach to counselling and other aspects of life.  In the counselling arena it has been liberating for me and my clients.  I have a client, X, who was referred to me by school personnel for anger and defiance issues.  Problems happened over the past year and the school counsellor described him as being “resistant” and unwilling to speak.
In my first meeting with the 15 year old boy at his home, he stood by the door and softly apologised for getting home late before going to his room to change out of his school uniform.  I imagined if I had taken up the image of a “resistant” angry boy as a fixed identity then I might not have noticed such subtle expressions of an alternative identity (Thomas, 2002).
Post-structuralism for me invites a sense of inquisitiveness that leaves no stone unturned, where I become an investigative journalist writing an expose (this was how Michael White described a therapist’s role during a 2007 workshop). The brief referral report on X seemed totalizing of his identity and I chose to open an inquiry into the report, allowing X to read the report and respond to all the statements.  There have been other occasions where I invited clients to expose the labels that structuralist ideas may impose on them and this endeavour has often proven fruitful in uncovering their skills, knowledge, and values in response to problems faced.
In later dialogues with X, many other stories unfolded around his school life that contradicted the problem saturated story.  This included his experience of the injustice inflicted on him by certain teachers who did not listen to his explanations, the experience of humiliation when unusual punishments were enforced on him, and the skill of walking away as a means to prevent anger from blowing up.
In his telling over two sessions, the label of an angry defiant youth was not a problem isolated to his “self” or an identity that pervaded in all contexts. I was delighted when X told me he felt more relaxed after the second session.
In working with youths, I have become more aware of their culture and how the culture encompasses their preferred response to life’s problems.  In reading about psychological colonisation (Arulampalam, Perera, Mel, White, & Denborough, 2006)  it reminds me that as adults we often impose our adult ways of problem solving as the sole acceptable or “normal” way.  I have learned to be sensitive to and to be appreciative of youth culture because privileging their ways invites personal agency and relieves the effort of introducing an alien culture to them.  For each client that I meet, I envision a meeting of cultures and therefore an exciting opportunity to learn more about my client’s life.
References
Arulampalam, S., Perera, L., Mel, S. d., White, C., & Denborough, D. (2006). Chap 3: Avoiding psychological colonisation: Stories from Sri Lanka. In Trauma: Narrative responses to traumatic experience. Adelaide: Dulwich Centre Publications.
Thomas, L. (2002). Poststructuralism and therapy - what's it all about. The International Journal of Narrative Therapy and Community Work(2), pp 91-99.

Working with children

I am doing a series of reflections as part of a post graduate course on Narrative Therapy. Overall there will be about ten reflection papers on various concepts and practices that currently form and shape Narrative Therapy.


What I found valuable in readings about working with trauma and children is the care taken to facilitate the building of “territories of identity” (Ncube & Denborough, 2008; White, 2006) which has helped children speak about trauma in a way that does not re-traumatize them.
I used this approach in a recent first time interview with a 17 year old gay teen whose mum described him as having been traumatized by an encounter with an adult male.  No other details were provided. Our conversations explored various parts of his life such as his love for children, his uncertainty over loving a best friend, and his own knowledge about his sexual orientation since age eleven.  I was wondering how to ask about the details of the trauma but after twenty minutes the details gushed out as he described how a man had tried to have unsafe sex with him without his knowledge.  The tellings about other aspects of his life had somehow equipped him to speak freely on this trauma event.  I am thinking my respectful and curious response as an audience to his tellings also contributed to his feeling safe enough to say more.
Michael White further wrote about avenues for therapeutic enquiry into children’s responses to trauma.  In the same interview, which I transcribed for a clinical consultation with Chris Dolman, I attempted to identify such a response and discovered that I had missed something subtle.  The boy spoke about an “uneasy feeling” and “didn’t want to do it”. After discussing with Chris, it dawned on me that somehow I held notions about the word “response” that were limited to action based responses.  I have now expanded my meanings of “response” to include expressions of feeling and intent that could indicate an entry into conversations about the absent but implicit.
Reading about the experiences of using the Tree of Life metaphor has also sparked off my interest in using it to invite conversations about difficult times in the coming out process of gay men (Ncube & Denborough, 2008).  My main consideration is how to invite meaningful conversations in a short span of time and being careful about re-traumatization. I am excited about the next two months when I facilitate a brief support group programme for gay men.
References
Ncube, N., & Denborough, D. (2008). Chap 4: The Tree of Life: responding to  vulnerable children In Collective Narrative Practice: Responding to individuals, groups and communities who have experienced trauma. Adelaide: Dulwich Centre Publications.
White, M. (2006). Chap 7: Children, trauma and subordinate storyline development. In Trauma: Narrative responses to traumatic experience. Adelaide: Dulwich Centre Publications.

Working with couples

I am doing a series of reflections as part of a post graduate course on Narrative Therapy. Overall there will be about ten reflection papers on various concepts and practices that currently form and shape Narrative Therapy.


I have always wondered since coming into contact with narrative ideas how might couples counselling be practiced.  Jill Freedman and Gene Combs’ writing (Freedman & Combs, 2002) provided me a comprehensive picture of how it could be done.  This helped validate that I was on the right track but somehow it did not address my doubts on the idea of “repositioning” in the definitional ceremony for couple work. It seemed daunting to begin on such a task especially with couples in “high and long standing conflict”.
After reading Michael’s paper on conflict dissolution (White, 2004), it became clearer to me that there was much to be considered and managed by the therapist.  It was a relief to read that it can be “extraordinarily difficult” to reproduce the tradition of outsider-witness responses between a couple.  So far my attempts have been getting into a re-authoring conversation with one partner while the other remains an audience, followed by a re-telling with the other.  This works when emotions are not so intense between them.  I also found the linguagram to be helpful in inspiring me to work with couples through externalizing their values, skills, and knowledges by placing them onto diagrams that can then invite further reflections to thicken the alternative stories (Løge, 2007).  I believe having words in print increases the effect of externalizing the words from the speaker, and thus enables couples to speak and notice the unheard stories about each other without escalating emotions.
I have always valued the strong emotions that are present between couples and amongst family members, and often wonder about how emotions can be part of the re-authoring process.  I noticed my practice had gradually shifted away from a “here and now” stance towards one that emphasized “journalistic enquiry”.  Perhaps this was influenced by what Michael White had mentioned during one workshop about his preference of not dwelling on emotions even though he may be touched by a client’s story.  Perhaps I had misunderstood what he said.  It was only recently that I found a fit for using the “here and now” practices after seeing how another narrative practitioner demonstrated her work.  I feel reconnected with what I value and this brings about greater possibilities for how I wish to work with couples and families.
References
Freedman, J., & Combs, G. (2002). Narrative couple therapy. In Narrative therapy with couples ... and a whole lot more! a collection of papers, essays, and exercises. Adelaide: Dulwich Centre Publications.
Løge, A. K. (2007). Conversations with divorced parents: Disarming the conflict and developing skills of collaboration. The International Journal of Narrative Therapy and Community Work, 1, pp 3-14.
White, M. (2004). Chap 1: Narrative practice, couple therapy and conflict dissolution. In Narrative Practice and Exotic Lives: Resurrecting diversity in everyday life (pp. 1-41). Adelaide: Dulwich Centre Publications.

Friday, June 4, 2010

Responding to trauma and abuse

I am doing a series of reflections as part of a post graduate course on Narrative Therapy. Overall there will be about ten reflection papers on various concepts and practices that currently form and shape Narrative Therapy.

It was rather timely that I had read Angel Yuen’s article (Yuen, 2007) and the interview with Michael White (McLean, 1995) about working with clients who experienced trauma and abuse.  It reaffirmed my own principle of how I wished to work with clients, and helped clarify for myself how I wished to practice. This was most relevant in a recent meeting with a gay teenage boy who had a traumatic sexual experience with an older man.
Before being introduced to narrative ideas, I value and still do value creating the space for clients to speak about their difficult experiences.  I am influenced by other schools of thought, especially around emotions.  In my earlier work in counselling clients for HIV testing, the effect of telling another person provides catharsis which clears the way for clients to think differently or act differently for their future.  When I first heard Michael White in 2007 speaking in objection to the Western ways of revisiting traumatic experiences, it struck me as something important in knowing there was more than one way to work with difficult experiences.  These were ways that were culturally relevant and powerfully acknowledging of client’s own resources.
I found this phrase to be significant for me: “Distress yes, re-traumatisation no” (McLean, 1995), because it is an encouragement that I can be influential in asking  questions about the trauma, and more specifically the response to it.  In the process of enquiry with the teenager, we uncovered the skills and knowledge that he already had in terms of negotiating with men on what he preferred, and an acknowledgement that this incident came about because of the unfair power difference exerted by the older man in withholding to send him home. His feedback that the session was “like having a wind to clear the haze” signified to me that he was gradually redefining his view about the traumatic experience.
The levels of enquiry described by Angel Yuen made my work easier as it pulled together questions that centred on client’s expertise, connection and contribution from significant persons, and identification of personal agency.  I recognized the scaffolding nature of this enquiry and in my limited practice have come to appreciate how it helps clients to reach a rich meaningful conclusion about the trauma that is not totalizing of their identity.

References

McLean, C. (1995). 'Naming abuse and breaking from its effects' an interview with Michael White. In Re-Authoring Lives: Interviews & Essays. Adelaide: Dulwich Centre Publications.
Yuen, A. (2007). Discovering children's responses to trauma: a response based narrative practice. The International Journal of Narrative Therapy and Community Work(4), pp 3-18.

Definitional ceremonies and enabling contribution

I am doing a series of reflections as part of a post graduate course on Narrative Therapy. Overall there will be about ten reflection papers on various concepts and practices that currently form and shape Narrative Therapy.

What I appreciate from the readings is the emphasis on enabling contributions and the discussion on hazards to watch for in outsider-witness practice.  In my training as a counsellor, I am more attuned to the first metaphor of “curiosity and mystery” used in outsider-witness practice (Carey & Russell, 2003).  When I introduced the outsider-witness practice in my organization and volunteer work place, the second metaphor of “acknowledging resonance and transport” drew a blank from colleagues and even invited some critique and words of caution on such a practice from clinical supervisors.  This was definitely something unfamiliar for them.
The current dominant discourse about reflecting teams, at least in Singapore, is centred on the traditional practice of “neutral observation”.  Other terms found in this discourse include “containment” and “boundaries” for therapists.   The practice of reflecting is also frequently positioned as a means to help “unstuck” a therapist.  In a way this is true because the effect of reflecting does introduce a breath of fresh air.  My first attempt at outsider-witness practice was in 2008, partly based on wanting to get “unstuck” by trying to move clients into new territories after seven sessions, and partly being enthusiastic in wanting to try out the outsider-witness practice. 
The clients were a mother-son dyad with a strained relationship due to concerns over his transgender identity.  I assembled an outsider-witness team consisting of a gay male counsellor, a straight female social worker, and a transgender female adult.  It did help clients through acknowledging their struggles and helped strengthen their resolve to journey onwards.  New imagery was also described by the clients in relation to coping with the problems.
What I found valuable was the learning experience about some of the unique hazards and challenges that I encountered:
·        Witnessing and the culture of “家丑不可外扬” (jia1 chou3 bu4 ke3 wai4 yang2)[1]
In most Asian cultures, such as the Chinese, family problems are often kept internal to family members.  The phrase “家丑不可外扬is a cautionary saying similar to admonishing the airing of dirty laundry in public. I got curious and traced the history of this to ancient teachings and discovered its original intention was to protect the family from external threats by not exposing its vulnerabilities.  Although I had informed the mother about the possible benefits of the outsider-witness session, I did not address this cultural aspect more adequately and believe it might have limited her participation in the telling process.
·        Recognizing the influence of other good intentions
Although that session went well, the sessions after that did not seem to connect with the themes brought out.  Reviewing the readings helped me realize that the outsider-witness practice is premised on helping clients build on their preferred stories and thus construct their preferred identities.
Besides “unstucking” the therapist, other notions had crept in, such as “providing a resource” and possible “role model” or “mentor” through introducing a transgender figure.  I believe these good intentions did not warrant the use of an outsider-witness group especially when alternative stories had barely emerged.
·        Supporting outsider-witnesses in responding to enquiries on transport
The outsider-witnesses felt the process was meaningful for them as they were privileged to make a contribution towards the clients.  I felt there was resonance when the witnesses could situate and link their personal stories to clients’ stories, however getting a response to my enquiry on transport was difficult (Denborough, 2008).  Thus clients did not get a sense that they were contributing towards others.  Together with other outsider-witness experiences, I have found that asking about transport often draws a vague or generalized answer.  I do believe spending more time in scaffolding questions is necessary to support outsider-witnesses in this aspect.
·        Determining when to use an outsider-witness group
Inviting a transgender person as outsider-witness was an idea that I proposed.  The mother expressed her reservation that the son could be negatively influenced, whereas the son welcomed it fully.  I believe this will be a constant dilemma when there is more than one client to work with. I have a sense that that the mother’s discomfort may be linked to the lack of development of a rich alternative story about the relationship with her son.  This is something which I need to be responsible and skilful about in terms of considering when to use an outsider-witness practice.  I am reminded of what Michael had written that “as these (re-authoring) conversations proceed, these alternative storylines thicken, become more significantly rooted in history, and provide people with a foundation for new initiatives in addressing the problems, predicaments, and dilemmas of their lives” (White, 2007).


References

Carey, M., & Russell, S. (2003). Outsider-witness practices: some answers to commonly asked questions. The International Journal of Narrative Therapy and Community Work(1), 63-90.
Denborough, D. (2008). Enabling contribution: Exchanging messages and convening definitional ceremonies. In Collective Narrative Practice: Responding to individuals, groups, and communities who have experienced trauma. Adelaide: Dulwich Centre Publications.
White, M. (2007). Chapter 2: Re-Authoring Conversations. In Maps of Narrative Practice (1st ed., pp. 61-128). NY: W. W. Norton & Company.


[1] Hanyu Pinyin romanization system for Standard Mandarin language
 

Monday, May 3, 2010

Considering the absent but implicit and addressing personal failure

I am doing a series of reflections as part of a post graduate course on Narrative Therapy. Overall there will be about ten reflection papers on various concepts and practices that currently form and shape Narrative Therapy.


I found the set of readings to be heavy going because the sheer volume of writing by Michael seems to point to something very important in narrative therapy and its practice (White, 2000, 2004).  For me it urges the opening of our sight on seeing people, including ourselves, as living outside the definition of norms, the dominant discourses that surround us, or universal truths -- that there is not a specific “substance” but a “form” of how we are.
In practice, it creates for me a deep sense of hope that there will always be something that escapes the dominant problem stories that clients and those concerned with them present to me.  This something could come from various acts, thoughts, or expressions in response to problems, including the response to personal failure.  Such responses to problems point to a violation of what is valued by clients.  Problems become an opportunity for a “cross-over” to preferred stories.
In reading about the ethics of living and professional ethics, I feel encouraged to continue to actively question the various traditional practices and systems that may limit helpful developments for clients and my own practice.  Reading Jane Hutton’s article in which she explored her personal failure in relation to being a mother also reminded me of how such questions can be used in my own personal life as an ethical way of living (Hutton, 2008)
Whenever I encounter problem narratives I try to tune in to what is left unsaid or abandoned by others.  A school counsellor recently told me that a student was continually defiant to his teacher and had been complaining about him to her.  She had referred the student to me because she could not access his emotions and thus advised me that getting through to his emotions would be difficult because of this “complaining”.  I got very curious about what he is complaining about as in what exactly is he responding to so strongly.  Culturally “complaints” were meant to be kept private or otherwise they were perceived as “distractions” or “defensiveness”.
The discovery was not surprising as he described how this teacher was behaving oddly in class, spending time sharing his personal stories, especially mentioning his mum being ill in hospital.  There were signs that the teacher needed help. In the school system, questioning the performance of a teacher seemed taboo when I consulted the school counsellor about this.  I sensed my discovery and intervention in this situation posed a dilemma for the school counsellor.
In wanting to negotiate the relationship between the teacher and student I am in the midst of setting the context for some form of dialogue between them.  It is somewhat daunting but I am beginning to appreciate what was described as “another version of ethics … not passively received … is an activity in which we find ourselves exercised and stretched” (White, 2004).


References

Hutton, J. (2008). Turning the spotlight on the normalising gaze. The International Journal of Narrative Therapy and Community Work, 1, 3-16.
White, M. (2000). Chapter 3: Re-engaging with history: the absent but implicit. In M. White (Ed.), Reflections on Narrative Practices: Interviews and Essays. Adelaide: Dulwich Centre Publications.
White, M. (2004). Chap 5: Addressing personal failure. In Narrative Practice and Exotic Lives: Resurrecting Diversity in Everyday Life. Adelaide: Dulwich Centre Publications.

Documentation of alternative stories/knowledges

I am doing a series of reflections as part of a post graduate course on Narrative Therapy.  Overall there will be about ten reflection papers on various concepts and practices that currently form and shape Narrative Therapy.


On reading Michael’s response to tackling the challenges of crafting therapeutic documents, it struck me as precisely addressing the kind of lethargy I feel about including this practice into my work (White, 1998).  I had attempted using documents on a few occasions and reviewing the work done helped me to consolidate a sense of achievement knowing what went well in some instances.
In 2008 I attempted my first therapeutic document. It was a document of declaration crafted from an interview with a 16 year old girl who sometimes felt frustrated with her studies. It documented why she wanted to go to school, how she hangs on to studies, how she relaxes when stressed, and who she would like to celebrate her exam results with. An audience for the document was also identified and this included her teachers, mother, and social workers.
When the document was ready, she was asked where she might place her own copy and it surprised me that she wanted to keep it under her pillow.  I realized the success of this project was something cumulative because it spanned two sessions for setting the “receiving context”, interview, and discussion of the final document (White, 1998)
Another document was based on a Transformer cartoon character named Jazz who was a hero in the eyes of an 8 year old boy brought in for anger issues.  The humorous and heroic traits of Jazz stood out for him as he identified himself closely with Jazz.  He was very pleased with the document that included a picture of Jazz.  Having brought Jazz into the discussion also enabled his mum to speak of his kindness via the voice of Jazz.  In this case the document not only helped document skills and knowledge in managing anger but also allowed externalizing conversations to take place.
There were also times when documents did not work well.  There was an attempt to send email summaries of sessions to an 18 year old client who came in for relationship issues with his mother.  He had been keeping typed records of his feelings and so I thought reading and writing emails would be meaningful for him.  After a few tries I stopped the emails because he later admitted he was not good at using email.  Looking back I had not set the “receiving context” and had let my enthusiasm run ahead of us.  Much later, I realized by accident that he was interested in reading my printed case notes rather than emails.
Email summary of sessions were also sent to a couple to invite reflections.  Though the emails were read, it never became an active part of the work.  In this case it was due to my less than deliberate attempt to weave documents into the work with them.
For me the dilemma has not been whether to use documents or not because they have been shown to work well, the challenge is for me to take an active influencing role in setting the “receiving context” and researching with the client on what type of “document” fits for them.  By this I mean the transmission mode, medium, frequency, presentation (words or pictures), and other acts that support the production and delivery of a “document”.
I am motivated by documents being a “gift of consultancy” from clients and how such gifts can be gathered into a collective “living document” that could make skills and knowledge available to future clients (Epston & White, 1990; Newman, 2008).  These ideas and the concept of “legacy” which I wrote about in the reflection on re-membering have given me more grounds to consider what project I might be able to embark on with the LGBT (lesbian, gay, bisexual, transgendered) community.

References

Denborough, D. (2008). Collective documents as a response to collective trauma. In Collective Narrative Practice: Responding to individuals, groups and communities who have experienced trauma (pp. 26-49): Dulwich Centre Publications.
Epston, D., & White, M. (1990). Consulting your consultants: The documentation of alternative knowledges. In Experience, Contradiction, Narrative & Imagination: Selected papers of David Epston & Michael White (2nd ed., pp. 11-26): Dulwich Centre Publications.
Newman, D. (2008). Rescuing the said from the saying of it: Living documentation in narrative therapy. The International Journal of Narrative Therapy and Community Work(3), 24-34.
White, M. (1998). Therapeutic Documents Revisited. In Re-Authoring Lives: Interviews & Essays (pp. 199-213): Dulwich Centre.

Saturday, April 24, 2010

Narrative Therapy Consultation I

I just had a consultation session with my course tutor, Sue Mitchell, in Australia and had to put this down for my own record.

I appreciate the "absent but implicit" in my work but find myself fumbling to uncover more of it for my clients. What I learned is that the presence of significant others in the session can distract me from being curious, from asking more about the importance of the absent but implicit.  In a mother and son session, the mum's complaints about the son distracted me into trying to defend the boy.  What might be helpful for me is to set the context for them so that the mum becomes an audience to the son's telling.

In terms of the practice of Outsider Witness Group (OWG), I thought I knew the differences between this and the traditional forms of reflecting.  The challenge for me was finding the right time to use it.  However, one fine distinction escaped my notice.  This difference was not in the therapy room itself but occured outside of it.  The traditional practice of reflecting was used to help "unstuck" a therapist, so when Sue was explaining that OWG is used to help strengthen and develop the evolving preferred story and to keep it alive, it dawned on me that it was not about timing the use of OWG but that I had unknowingly positioned it as an "unstucking" practice.  I'm now more aware of other counselling discourses that permeate my clinical practice and am more prepared to navigate my practice through the uneven terrains ahead.

In the conversations with Sue, she also supported me in finding out what I hope for my clients.  I hope that clients can be liberated from judgement, this judgement can be self-judgement or judgement by others.



Tuesday, April 6, 2010

Re-authoring Conversations

I am doing a series of reflections as part of a post graduate course on Narrative Therapy.  Overall there will be about ten reflection papers on various concepts and practices that currently form and shape Narrative Therapy.

This is my first encounter with re-authoring in a collective manner used as a means of achieving unity in diversity (Denborough, 2008).  I began to wonder how such a collective approach could be used in group work with a diverse group of youths who come from the same school but from different classes.  Thus their age, gender, ethnicity, education level, and family backgrounds are highly diverse.  These youths were referred due to the possible risk of early school leaving. 
One of the common themes that these youths experience is negative peer influence and reading the article opened up a possible approach for tracing the history of this peer influence in their lives.  Some of these youths wish to resist peer influence but seem to have only vague ideas.   Based on the use of collective timelines done by Alfonso Diaz-Smith (Denborough, 2008), I formed some of these draft questions that could be asked to facilitate a re-authoring process.  During the process of drawing out these timelines, I hope to uncover the vagueness to reveal a richer story around resisting negative peer influence.

Resisting Negative Peer Influence

·        When did you realize Negative Peer Influence can create trouble for you?
·        Who saw that Negative Peer Influence was creating trouble for you?
·        How did it affect the people who see you in trouble?

·        When did you start thinking about resisting Negative Peer Influence?
·        Why would you want to resist Negative Peer Influence?
·        Who would support you in resisting Negative Peer Influence?
·        How have such people supported you? And why would they support you?
·        What does all this say about you, your values or beliefs?

·        When did you try resisting Negative Peer Influence?
·        What have you tried and what are some ways you may want to try?
·        What would you do differently after hearing everyone’s stories?


I like the idea that a collective effort has the potential to dissolve some of the barriers between these youths through a shared sense of purpose.  Most of the times these youths may feel isolated, especially boys who are brought up in a culture where they are expected to act tough and handle their own problems.  When they try to tackle problems on their own it can lead to a sense of despair and thus they succumb to peer pressure. 
Youths are at an age where identity development usually takes place, and a collective timeline project is another avenue for socially constructing such identities.  There are possibilities for re-membering and outsider-witness group practices to further strengthen the plot (Carey & Russell, 2003).

References

Carey, M., & Russell, S. (2003). Re-Authoring: Some answers to commonly asked questions. The International Journal of Narrative Therapy and Community Work(3), pp 19-43.
Denborough, D. (2008). Chapter 7: Collective narrative timelines and maps of history. In Collective Narrative Practice: Responding to individuals, groups and communities who have experienced trauma.

Wednesday, March 31, 2010

Instrument metaphor

I find the metaphor of a musical instrument an apt one for the role that counselling plays in a client's life.  I can be like a master craftsman that produces a variety of instruments, helps clients to choose one that fits their preference, and assist them to calibrate the instruments.

What they need to do is put in the hours of practice, develop their style, and put up a good performance.  They may learn to play from people they admire or from friends and other sources. I become a backstage audience that takes pride knowing the instrument I made has supported the success of the musician.  As I make more instruments I can further improve my craft to help other musicians.
DSC01899

Where there is hatred let me bring love
Where there is doubt let me bring faith
Where there is falsehood let me bring truth
Where there is pain I'll comfort you

Where there is silence let me sing praise
Where there's despair let me bring hope
Where there is blindness let me bring sight
Where there is darkness let me bring light

And with these words I speak
Grant that I may not seek to be heard but to hear
To be consoled but to console
Not to be seen but to see, to be loved but to love

For when we give love we will receive
When we forgive love we'll find reprieve
It is in dying we'll be released
Make me an instrument of peace, of peace, of peace

Re-membering practices

I am doing a series of reflections as part of a post graduate course on Narrative Therapy.  Overall there will be about ten reflection papers on various concepts and practices that currently form and shape Narrative Therapy.

Re-membering Practices
Reading the article on common questions about re-membering moved me to consider who might have contributed to my own journey in becoming a counsellor, especially the skills, knowledges, and values that I currently have (Russell & Carey, 2002).  Initially I thought of a few persons that might have been significant but realized that there was a long list of people, books, and even films and songs that contributed in their own way to my life.  In the past I might have termed these as “subconscious” influences or even downplayed them.  I imagine if I told someone Superman was some one I admired, this idea may easily be diminished or overlooked.

I have found re-membering helpful when working with children because they often have a favourite cartoon or comic book character that can lead to a revelation of what they value.  Often I hear colleagues, who are youth workers, say they “chit chat” with youths based on common interests.  I feel it would be more influential if such common interests were traced to certain skills or knowledges that could be further explored in a re-membering conversation.

I have faced situations where a client does not link any persons through re-membering and the advice on “do not race ahead of the person concerned” is a good reminder for me not to be carried away whenever potentially significant figures appear in their story.  Sometimes I face a dilemma in deciding which plots or themes to explore and the reading has helped lay down two basic criteria: i) the chosen theme should help reduce a sense of isolation, and ii) the chosen theme should contribute to building a richer alternative story.

Grief and Loss
The writing on the Women and Grief Project reflected a similar situation I encountered in one client (Dulwich Centre, 2008).  She is an Indian mother whose husband died a few years ago and ever since then she was very concerned over her young daughter whom she believed to be deeply affected by the loss.  When I asked about her own grief she finally poured out about the bad memories she had of relatives who handled the funeral rites in a way that she disapproved of.  She had kept her stories bottled up for a long time without an audience.   I imagine a similar programme to the Women and Grief Project could have been helpful for her and other women who feel subjugated in their culture.

She also mentioned being by her husband’s side in the hospital and telling him to let go as she promised to look after the children.  In his unconscious state, he shed a tear before departing.  She did not spend time grieving and started working long hours since then.  Looking back, it might have been greatly healing to interview her in re-membering her husband.

Legacy
In thinking about legacy I am reminded about how I could be re-membered by those whom I know personally and those who may benefit indirectly through my work (White & Epston, 1992).  This alternative perspective on my work with people inspires me to think about how I wish to leave a bit of me with clients.

The issue of mortality and immortality is of philosophical interest to me.  Reading Michael White and David Epston’s conversation on dying introduced relief from the pervasive notions of material existence (White & Epston, 1992).  In most Asian cultures, the notion of lineage is often emphasized as an important means to continue the family blood line and most people accept that procreation is a dignified purpose of life.  Therefore having children becomes valued as a personal legacy in society. But in the local LGBT (lesbian, gay, bisexual, transgendered) community where adoption is not possible, there is little precedent knowledge about what else constitutes legacy for such individuals or couples.  A special project may help to create a new territory for such alternative knowledge to be shared within the community.  This project could be based on narrative practices to collect stories, skills, and knowledge of LGBT individuals and couples who construct their own special legacies.  I imagine such a project could also benefit some segments of the heterosexual community who are single or childless.

References
Dulwich Centre. (2008). Remembrance: Women and Grief Project. The International Journal of Narrative Therapy and Community Work(4), pp 60-71.

Russell, S., & Carey, M. (2002). Re-membering: responding to commonly asked questions. The International Journal of Narrative Therapy and Community Work(3), pp 45-62.

White, M., & Epston, D. (1992). 'A conversation about AIDS and dying' with Michael White & David Epston. In Experience, Contradiction, Narrative & Imagination: selected papers of David Epston & Michael White, 1989-1991. Adelaide, S. Aust.: Dulwich Centre Publications.

Externalising conversations & de-centered practice

I am doing a series of reflections as part of a post graduate course on Narrative Therapy.  Overall there will be about ten reflection papers on various concepts and practices that currently form and shape Narrative Therapy. 

The ethics of collaboration 
The ethics of control mentioned by Michael (White, 1997) stood out for me as it heightened my awareness of the dichotomies brought forth in the social service sector of Singapore.  One such dichotomy is between achievement and non-achievement of outcomes in the work that I do.  Such a dichotomy can exert pressures on how I work and sometimes I feel the “despair” of being caught in-between the voices of the client and the voices from a larger community who want to solve a problem that involves the client.


An example is when schools refer students and their families for counselling with me.  Often the desired outcome is one of problem solving to motivate students to return to regular schooling or to correct undesirable behaviours in school.  Teachers are often the ones to notice problems and make referrals but also often the ones who do not participate in subsequent meetings with the students or their families.  The result is that the outcomes desired by teachers and the outcomes desired by students and their families become distant or divergent.

When I read about the ethic of collaboration that goes towards building a “foundation of possibility”, I recall a recent meeting at a school with the student and his parent.  It was a rare occasion that the form teacher could join us.  Even though it was a short five minutes there was sufficient time to hear his expectations about outcomes, which were all about classroom behaviours. I could then clarify that my work ahead is more open-ended and not limited to the school context, and thus may not achieve such dramatic changes by the end of the counselling programme.  The teacher was a little surprised and realized that his expectations were being negotiated in the presence of the student and his parent.

I felt lighter after that dialogue in the family’s presence because there was a space for collaboration by organizing and inviting each party to speak.  After reading about the ethics of collaboration its significance is now clearer for me. 

Decentred practice 
The section on decentred practice described the micro-world of counselling and its potential to create monotony (White, 1997); I recall such monotony during one stage of counselling a client whom I had seen for over a year.  Because I had grown familiar with the client’s stories I gradually began to center my self in the therapy through the tradition of “self awareness”.  I began to wonder whether I could be better at the skills of counselling, whether I should see the client less often to prevent over-dependency, and so on.  Much of it became accountability for my actions rather than client’s.  There was indeed a sense of isolation.  A consultation with colleagues helped to dispel the feelings of isolation and helped validate my skills.  But still the focus was on me.

Now I have an acute awareness that various counselling traditions seem to contribute to the creation of this micro-world.  I am left with a dilemma about what to do with such traditions as “here and now” and “process versus content”.  These have been things that I valued from past knowledge and trainings. 

When I re-looked at the decentring practices, I found a way out of the dilemma.  The decentring practices were a way to harness the rich conversations between clients and others in their lives, including the therapist.  The conversations between client and therapist can be significant but I feel less burdened to make it so because it is only one alternative story in the counselling context. 

Externalising conversations
About a year ago I had this discussion with fellow practitioners on whether externalisation was an essential practice of narrative therapy.  We did not have a conclusion then.
A few things from the readings on externalising conversation stood out for me (Russell & Carey, 2002):
  • “We sustain externalising conversations throughout the therapy process.”
  • “That externalising is not a technique that we choose to use at certain times and then not at others.”
  • “It can take some time, and much practice (both within and outside the therapy room) for the different language practices to become a seamless part of one’s work.” 
My understanding of externalisation had somehow become a technique.  In fact I realized my reference to it as “externalisation” implies it is finite and not a continuous process. I usually attempt to get the problems named by the client before I attempt externalizing conversations.  When the attempt fails, I tend to drop the externalising approach. I need to rethink about externalising conversations as a way of working rather than just being a “part of” my work.

Furthermore after reading the article on personalising AIDS and CARE, I am struck by how the conversations “only occur after extensive periods of consultation”  (Sliep & CARE Counsellors, 1996).  Sometimes I may be too eager to grab at the words that clients use and thus invite a sense of failure when externalising.  The CARE counsellors of Malawi consulted the community on the externalising project with respect to experiences of gender, AIDS, and sexuality.  For future externalising conversations to be useful I will want to consult clients in an extensive manner that allows externalising to occur collaboratively rather than be dependent on my own knowledges.

Externalising conversations often seem to conjure fun and drama, and yet difficult dilemmas can be raised.  I feel encouraged to inject such fun and drama into my own work yet I am not entirely comfortable.  Perhaps I need to trace the history of fun and drama in my own life and re-invite them to join in my work. 

References 
Russell, S., & Carey, M. (2002). Externalising - Commonly Asked Questions. The International Journal of Narrative Therapy and Community Work(2).

Sliep, Y., & CARE Counsellors. (1996). Conversations with AIDS and CARE. Dulwich Centre Journal(3), pp 141-156.

White, M. (1997). Part III: The Ethic of Collaboration and De-centered Practice. In Narratives of Therapists' Lives: Dulwich Centre Publications.

Sunday, January 24, 2010

Dear MM ...

Taken from The Temasek Review, news of this also appeared in the Straits Times (ST, pg. A12, 23 Jan 2010):

Education Minister Dr Ng Eng Hen was asked a sensitive and difficult question during his dialogue session with NUS Society (NUSS) members.

Mr Dennis Tan, a 49 year old workplace safety and health trainer and NUSS member asked Dr Ng why MM Lee Kuan Yew is not stepping down.

Lee is currently the oldest member in the Singapore cabinet at 86 years of age. He was the first Prime Minister of Singapore from 1959 to 1990 before stepping down. He subsequently held the positions of Senior Minister and the Minister Mentor presently.

To his credit, Dr Ng gave a diplomatic reply without offending both Singaporeans and his political master:

“The question is, does MM add value to Singapore? I’m not talking about in history, I’m talking about now. That’s the question that should be asked, not whether he should retire or not. Singaporeans must decide. MM spots pitfalls, he tells you what to avoid. He pushed for F1, for the IRs. So you decide. At the end of the day, it’s the vote. If his constituents at Tanjong Pagar feel he’s not adding value, they are free to vote.”

Lee has attracted the ire of many Singaporeans by continuing to stay on in the Singapore government. Though he admited that he “is not doing much work except forecasting”, some still regard him as the “real power” behind the scenes.

He currently draws about an annual salary of $3 million dollars, more than 5 times that of U.S. President Barack Obama. The Singapore government is the only one in the world with a Minister Mentor, two senior ministers and two deputy prime ministers in addition to the Prime Minister himself.

Besides his portfolio in the cabinet, Lee is also the Chairman of Government Investment Corporation (GIC) which manages much of Singapore’s national reserves.

Lee’s son Lee Hsien Loong is currently the Prime Minister of Singapore. His daughter-in-law Ho Ching heads Temasek Holdings, Singapore’s other sovereign wealth fund.

One of his nephrew-in-law Wong Kan Seng is both the Deputy Prime Minister and Home Affairs Minister of Singapore.

The elder Lee has ruled Singapore with an iron fist since first assuming his position in 1959. He spent the later part of his political career traveling around the world to dispense his usual “pearls of wisdom” to other leaders on how to run their countries.

Lee has yet to reveal if he will contest in the next general election due by 2012. The last three elections had been walkovers for him. Perhaps the opposition can consider sending a young team to contest against him in the next election to see if voters still want him to “add value” to Singapore.

If I had the privilege to interview MM, I might be curious to ask the following questions:

Most people your age would have been contented to wind down and spend time away from work.  What are your personal life goals at this point of time?

If personal life goals are entwined with a duty to the nation, how do family and friends feel about this?

How would life be different for you if you stepped down from politics?

Life is unpredictable, what would you want to do for yourself before leaving this world?

Now, what drives my approach of questioning? Basically it's based on my counselling intuition that's informed by Mr. Lee's own writings, articles and recordings from his former political allies, and his public persona.  I could be really off the mark but my hypothesis is that "letting go" might be an issue here.  I'm referring to the theme of loss and grief familiar to counsellors.  Looking at Erikson's life stage development model as a reference, this is usually a stage for retrospection rather than productive social involvement.  

It's not meant to be a prescriptive model but it can be a useful map.  According to the model, the completion of each stage is important or otherwise the challenges of a previous stage can resurface later in life.   It may be argued that external factors left Mr. Lee with no choice but to stay active at work, and therefore "stuck" at an earlier stage.  Consider this, Mr. Lee could have chosen to walk away from it all if he felt he had already accomplished what he wanted in life, after all who could stop him?





Thursday, January 14, 2010

Displacement



I've been feeling troubled by the recent news of Singaporeans living in tents pitched at Sembawang Park.  On one end of the public housing spectrum, The Pinnacle@Duxton stands as an epitome of high living standards, on the other end there are make shift camping tents occupied by those labeled as "displaced" by the vary same providers of public housing.  It's as if the term displacement absolves guilt from the actual consequence of having homeless people.



I went down to Sembawang Park to take a look for myself.  Altogether I counted 22 tents of various sizes though it was more difficult to count the actual persons living there and the number of family units.  It is a sizeable problem because almost all the approved tent pitching space has been taken up.  I've been staying in Sembawang for 39 years and this is certainly a sight new to me.  I wonder what it signifies about the societal changes in my life time. 

Dusk has come along with rain clouds and cold winds.  I feel displaced.



Wednesday, January 6, 2010

Passion

Where or what is the source of my passion?  Some might say it comes from the joy of helping others who are lost, from a sense of fulfillment in contributing to society, or from doing good works that will lead me to heavenly rewards.  Somehow such generalisations don't seem to fit.

As a therapist, I am invited to a privileged position where I can facilitate another to explore different paths in life.  These paths may be small trails that were ventured into but long forgotten.  Or they could be paths currently taken but the scenery overlooked.  They can also be paths round the corner, unseen and therefore brings about anxiety. 


In this privileged position, I am also influenced by the stories of others as we jointly explore such paths.  There is a sense of intimate exchange taking place, intimate in the sense that it is something uniquely personal and therefore sacred.  Out of this exchange, new meanings are constructed.

Making meaning out of others' life also leads to the creation of new meanings in my own life.  And this is where my passion springs forth.

It only takes a spark

JBJ

I came home with many feelings and thoughts after attending the commemoration event to mark the birthday of the late Mr. J. B. Jeyaretnam (JBJ).  It was a weird feeling being there and later when Mr. Goh Meng Seng mentioned he came from the "lost generation" of those born in the 70's, it became clear why I felt that way.  I was a 39 year old among the crowd of younger people in their 20s and those in their 50s and older.  Mr. Goh is also 39 and he shared of how our generation grew up being chided by parents not to criticize the government.  Any discussion about the government was hush hush and I recall that some of my respect for Mr. Lee Kuan Yew contained an element of fear.

I never had to question about politics in Singapore, so besides fear, there could also be complacency as life flowed on smoothly from schooling to working life.  Overcoming a mid-life career switch had probably set off a series of questions about life; questions about my own philosophy of life, religion, and now history and politics.  Most questions are unsettling because it opens up the possibility for change.

Exploring the alternative and often silent history about Singapore agitated me as I learned of how voices had been suppressed for many years.  As a narrative therapist I believe that the dominant story often does not describe life in its full richness, and that the subordinate stories provide openings for greater meaning making in life.

At the same time, I also feel heartened that Singapore has many heroic figures in its history.  JBJ and many others like Mr. Said Zahari and Dr. Lim Hock Siew are heroic because they stood firm on their beliefs; beliefs which they held onto dearly in the face of lawsuits, bankruptcy, incarceration, and even threat of death.  I am hopeful they will eventually be recognized for their contributions.

At the commemoration I was touched by some personal anecdotes about JBJ, one of which is that he bore no personal hatred against any politician.  It was a stark contrast to the feeling of vindictiveness experienced by ex-political prisoners such as Mr. Said Zahari.

Ms. Sylvia Toh interviewed me on why I was there.  "I'm here to observe, to listen, and to respect someone  who offered an alternative voice."  Overall I feel energized and privileged to have been a witness to the event.

Monday, January 4, 2010

Who are we?

The Straits Times published a special report today, titled "Complications of a complex racial identity", that focused on the change in policy allowing parents in mixed ethnicity marriages to decide which race their newborn child can be registered as, whether following the father's or the mother's.

There are many implications tied to "race" in Singapore, one of which is the Ethnic Integration Policy that is a blunt tool to ensure racial mix in HDB housing estates. This re-definition of race seems to make any policies based on race rather meaningless. Indeed the whole concept of race and ethnicity deserves to be questioned in a world where boundaries between peoples are blurred.

Other factors influenced by race include school fee subsidies where it becomes necessary to determine which organization should be approached. This is already an ongoing issue though the policy change probably makes it more apparent with this special report on it in mainstream media.

Consider such a confusion: who should a Chinese Muslim student approach for help? The CDAC or Mendaki? If the parents contribute to Mendaki on a monthly basis, can the child still approach CDAC? To make it more confusing, suppose the parents also contribute to CDAC, what then? These are issues that baffle people seeking help because the major financial aid organizations (CDAC, Mendaki, SINDA) also categorize their clients by race (for Mendaki, the criteria is "Malay/Muslim").

The issue of equal contribution by Malays to Singapore's national defense continues to be a thorny issue even with the landmark appointment of the first Malay general in July 2009. Hopefully race will become less of an issue in determining who is suitable to stand up for Singapore.

Race can be a double-edged sword that unites groups of people and yet divides a nation. But with the blurring of racial lines, the question that bothers me most is this: what common identity holds Singapore together? And can it withstand other fiery swords that are being raised?