REFLECTING PROCESSES; ACTS OF INFORMING AND FORMING
«Concerning the psychology of the creative act itself, I have mentioned the following, interrelated aspects of it: the displacement of attention to something not previously noted, which was irrelevant in the old and is relevant in the new context; the discovery of hidden analogies as a result of the former; the bringing into consciousness of tacit axioms and habits of thought which were implied in the code and taken for granted; the uncovering of what has always been there. This leads to the paradox that the more original a discovery the more obvious it seems afterwards. The creative act is not an act of creation in the sense of the Old Testament. It does not create something out of nothing: it uncovers, selects, reshuffles, combines, synthesizes already existing facts, ideas, faculties, skills. The more familar the parts, the more striking the new whole.»
Arthur Koestler: 1964: p 119-120
My telling about the origin and development of the reflecting processes has shifted over the years. At first there were much referring to theories, as if these processes were born out of intellectuality. Now I do not think so. I think they rather were consequences of feelings. Without being aware of it at the time when the reflecting process first appeared in March 1985,1 now think of it as a solution to my own feeling uncomfortable as a therapist. Being a therapist is first of all being with others, and it is hard to be with others when they and I feel uncomfortable about that being-together.
My understanding is that the reflecting processes are very different from my writing about them. These processes comprise much more than I am ever able to see or hear. The writing is therefore a simplified version, and relates to what I (according to my prejudices) found useful to look after and listen to. What I heard and saw, when put into writing, is described in my metaphors and my language, and I can never take it for granted that the words of my writing create the same images and thoughts in the readers as they do in me.
What I will try to do in this chapter is to be in a language that is as close as possible to the everyday language of «ordinary» people.
I expect that the readers will integrate what they hereby read within the frames of their own experiences, and what such a chapter might offer is a chance for readers to reflect upon their own work and their own understandings.
The «aim» of the chapter is not only to describe the reflecting processes, but also to describe the contexts in which they emerged and developed further. Since parts of those contexts are my own* prejudices', space will be given to elucidate how being part of various reflecting processes turned back upon, nu- anced and changed my prejudices and my being-in-the-world as therapist. The reflecting processes can be seen as hermeneutic circles.
Noticing the feelings of discomfort
Being a medical country doctor in the north of Norway taught me about ordinary life and ordinary bodily complaints. Aches and pains and stiffhess in the various parts of the body (e.g. neck, shoulders, lower back etc) were the most common complaints in general practice, but «too ordinary» to be of interest in the academia. The medical school I came from did not prepare us as doctors for how to deal with it, so we were left to our own wonderings. My fortune was to meet with a Norwegian female physiotherapist Gudrun 0vre- berg who introduced me to her teacher Aadel Bulow-Hansen, an other Norwegian female physiotherapist.
They both let me see into a world I had not looked into before. Bulow- Hansen’s work over the years taught her that breathing and movements are two crucial sides of life; our breathing influences our movements and our movements influences our breathing. There are two words in Norwegian for breathing; one the more physiological word: to breath' (norw.: a puste), and the other a more solemn, maybe even a sacred word: to spirit (norw: a ande). When a person passes away, Norwegians most often say: she or he spirited out. We also say that we spirit the air when we are up in the freshness of the mountains or in places similar to that. Being-in-the- world is being-in-breathing. All our expressions come with the exhaling phase of breathing; all our spoken words; our laughing lets go of our happy feelings; our weeping elicits sad feelings; our barking voices convey angry feelings etc. And all the thoughts and feelings are brought to the open during the exhaling part of breathing. Our movements, sometimes nuanced and fine, sometimes rough and coarse, are part of the interplay between those muscle which stretch various parts of the body (e.g. the knee) and those which bend the parts. The stretchers in front of the knee and benders on the back side are opponents. When they both work, their communal work will balance the knee. We need them all, both stretchers and benders, in order to balance the various parts of the body when we walk or sit or get up or turn around, etc.
Bulow-Hansen noticed that in difficult periods (e.g. when being worried or angry or sad and not wanting to let others see that), a person is brought out of balance in the sense that the benders increases their activity and the stretchers are constrained (by the benders) in their activity. The person as a whole tends to «creep together» and the body tends to be «closed». The reader have most probably seen those who cross their arms over the chest and lean forward, as an act of «closing» the body. In this «closing» act do f.i. the benders in front of the shoulders and upper arms, those in the back of the neck, those in the stomach, those on the front of the hip and the small closing muscles of the face take part. Bulow-Hansen noticed that simultaneously with the stretchers being constrained also the breathing was constrained. What she learned was that if she was able to help a person stretch and open up the body something interesting occurred. There comes a spontaneous inhaling when the body stretches, and with that inhaling there is a certain urge to continue the stretching, which in the next run stimulates, more inhaling. This circle goes on until the chest is filled, and when the air passively leaves the lungs, some of the tension in all muscles (also in the benders) vanishes.
In this process, of stretching and breathing and letting go of tension, the muscular balance of the body as a whole is changed, and one can actually see the posture of the person changing. Watching this work closely which I did in order to write a book about it (it is written in norwegian), contributed to a certain knowledge «creeping under» my skin. Writing the book, which happened between 1983 and 1986, slowly let me understand that how she worked determined what she could reach. And how she worked was in relation to the other. One of the ways for her to make the other person stretch a part of the body, was to let one of her hands clench a tense muscle (e.g. the calf muscle), such that the clench produced pain. Pain is followed by a spontaneous stretch (of the knee) which is followed by inhaling. When her hand was too soft she could not see any response in the other’s breathing. If the hand got a bit tougher, making more pain, she could see increased inhaling followed by the-letting- go-of-air during the exhaling part. If however her hand was too rough, making too much pain or clenching too long, the other would inhale in a gasping manner and thereafter not let the air go, but hold on it. Bulow-Hansen followed intensively the process by watching the other’s breathing all the time. If her eyes saw that there was no increase of breathing, her hand worked harder, and if she saw that the breathing stopped in surprise of her hand being too tough, she let that clenching hand go immediately. During this process she often encouraged the person by saying: «just let air come!» As if she said: «just let life come!», be a receiver of life. She never said: «inhale!», as breathing should not be part of a struggle or fight. This taught me at least two things. First of all, it made Gregory Bateson’s ideas about change visible. Bateson saw change as a difference that occurred over time. He also thought that a difference does not come by itself, but it comes with an other difference; e.g. if the temperature falls one put on one’s jacket. In few words he expressed the famous statement: « — a difference makes a difference —» (Bateson, 1972: 453). According to Bulow-Hansen’s saying: «just let air come!», one might change Bateson’s sentence to:« — a difference that comes from a difference —». Bateson’s statement and Bulow-Hansen’s work taught me that there are three differences of which only one makes a difference. What is too usual does not make a difference. What is too unusual neither does make a difference. What is appropriate unusual makes a difference. These nuances are widely applicable in many situations under many circumstances, including conversations.
The other thing I learned from her was that she looked (and I assume she also heard and maybe even smelled) how the other responded to her hands before her hands continued to work. In psychotherapy it means that I have to wait and see how the other respond to what I say or do before I say or do the next. The next thing I say or do must be influenced by the other’s response to what I just said. I have to go slowly enough to be able to see and hear how it is for the other to be in the conversation. If it is too unusual the other feels uncomfortable and lets me know through one or many signs that it feels uncomfortable. The are many signs and I shall just briefly mention some examples that will remind the readers of what they already know; the person talks less; looks down or away; conveys the feeling that it would be better to leave the conversation than to stay in it, and so on. We can see the other feeling uncomfortable.
We can also notice one’s own feelings of discomfort in moments when one pushes the other(s) into something too unusual for them. If we are aware, our bodies will tell, and some say they feel it as a tension in the stomach, some as a pressure behind the eyes, some as an ache in the forehead, some as a spasm in the lower back, etc.
The idea of being appropriately unusual to the others brought a more calm atmosphere to the therapeutic conversations I took part in. That idea was one of two preludes to the first reflecting team in March 1985, and I believe it influenced the next prelude, namely a new way of giving interventions.
Our team initially worked using the Milan approach, and in hindsight I can see a shift in 1984 in the way of giving interventions to the families. We started to say: «in addition to what you saw, we saw this», and «In addition to what you tried to do you might try this (what we suggested)».
This was to underline that both what the families and what we had considered was of value.
Before we had a clear tendency to try find the correct interventions, and if the families disagreed with our interventions a dispute easily broke out: either they or we were right. This shift from an earlier either-or stance to the new both-and stance made everything more «democratic».
In hindsight it seems that these two preludes were significant preparations to let the idea of open talks (reflecting processes) happen. The idea about such open talks emerged already in 1981, and I mentioned it to Aina Skorpen, MHN, who I worked with at that time. However, our fears that we might talk nasty or in a hurtful way about the families in front of us, restrained us from trying. When it finally happened, there was a big surprise how easily it was to talk without using nasty or hurting words. Later it became evident that how we talk depends on which context we talk in. If we choose to talk about the families with them not present, we easily talk «professionally» in a detached manner. If we choose to talk about them in their presence, we naturally talk everyday language in a friendly manner.
The idea of an open talk had, as been already said, been a dormant idea during four years before it was brought out in March 1985 (the team was Magnus Hald, Eivind Eckhoff, Trygve Nissen (the therapist) and myself). The therapist talked with a mother and a father and a daughter about their sad family life. The mother who had difficulties seeing a positive future had been to the mental hospital several times. Some times because she had tried to kill herself. The therapist was drawn into their hopelessness and could not find questions to elucidate an alternative future. We, those of the team who followed the talk from behind a one-way-screen, called the therapist to our room and gave him our optimistic questions. He brought them back to the family talk, only to be drawn back to pessimism immediately. We tried the same three times, with the same pessimistic consequences. Then, after a short talk behind the screen, we launched the idea to the family and the therapist, that we might talk with them listening to us. Our fears made us hope they would not accept the offer, but they did.
In those rooms we worked in there happened to be loudspeakers and microphones in both rooms. We therefore turned on the light in our room, and they dimmed it in their room. We turned on the microphone in our room and they turned off their’s; we turned off our loudspeakers and they turned on theirs’. And there we sat in the enlighted room: visible to whomever and not protected. (We finally realized how these arrangements might have been experienced by the families with whom we had previously met: frightening and exciting at the same time.)
At first we started to stumble through our words; we wondered whether there were possibilities the family, for various reasons, had not yet seen? Our speculations became more and more lively as we envisioned an optimistic future. When we turned back sound and light the family was totally changed: they talked eagerly about what they might do in the time to come. They even laughed. My immediate thought was: this is very different and this gives me a good feeling.
It did not take long before we stopped the switching of sound and light. We instead swapped rooms. The · therapist and the family talked in one room with the team listening to that talk from the room behind the one-wayscreen. Then there was a shift when the team walked over to the «talking-room» as the therapist and the family walked to the «listening-room». When the team was through with their talking the rooms were swapped again, and the family commented on the team’s talk from the «talking-room». The therapist is always together with the family, always separated from the rest of the team.
Some descriptions of the reflecting process
It took some time before it was possible to describe the process we were using (Andersen 1987, Andersen 1990). At first it was described with the word heterarchy. Many have not heard that word before, but everybody have heard the opposite word: hierarchy. Hierarchy governs from the top and down, and heterachy governs through the other. Therefore the feeling of relief in March 1995 was most probably related to leaving the hierarchical relationships of therapy and entering the heterachical ones. More daily words for a heterachical relationship might be a «democratic relationship» or an «even relationship» or a relationship with equally important contributors. Some times later another description came to mind, namely that the reflecting team process comprises shifts between talking and listening. Talking to other(s) can be described as an «outer talk», and during listening to others’ talking one talks with oneself in an «inner talk». If one lets a particular issue be passed from outer talks to inner talks back to outer talks, etc, one might say that the issue is passed through the perspectives of various inner and outer talks. Bateson was very occupied with the significance of multiple perspectives; one might understand the same issue differently in the various perspectives, and these different ways to understand, when they are put together (as in this reflecting process), might create new ideas about the issue in focus (Bateson, 1980).
I third description is that the reflecting process is a communal process where all parts have their different descriptions of one and the same issue, and that every part give their description and also give their respons to the others description. In this shifting sharings of descriptions it is of great value that the various persons that speak do NOT interfer or interrupt each other.
Different reflecting processes
If one has grasped the idea that the shifting between inner and outer talks is an important element, one might set up these processes in many ways in many different contexts. Here are some few examples:
i) There could be a team in the next room behind a one-way-screen, or one might use only one room with the team listening and talking from a comer in the room.
ii) A therapist without a team could have one colleague present to talk with during «reflecting» intervals.
iii) If the therapist is alone without
and later turns to person X for comments
and eventually further talk. In this case
a team, he or she could speak with one (person X) in the family for a while with the others in the family listen to that talk. Then the therapist talks with these others while person X listens to that talk, the family and the therapist become a
- If the therapist is alone with one client, they might talk about an issue from the perspective of one who is not present, e.g. a mother; the client is asked to talk about what she thought her mother would think (inner talk) and say (outer talk) about this or that. When the mother’s thoughts have been presented, the client might be asked, «what are your thoughts about your mother’s thoughts?»
- If a workshop or conference-consultation goes on in a large room with an audience listening to it, the whole audience might serve as a reflecting team. The applied forms are infinite and I assume that the limiting element is our own inventiveness. These processes might also be applied in several contexts besides therapy. Here are some examples:
- In supervision, the supervisee might talk with the supervisor while other supervisees listen to that talk. Then the other supervisees and the supervisor talk while the supervisee listens, whereafter the supervisee and supervisor talk.
b) Staff meetings could be organized such that one half part of the staff talks about a certain issue while the second part listens, whereafter the second part talks while the first part listens and thereafter back to the first part etc.
c) Management leaders might come together to discuss certain issues. The group could be divided into groups. One group could start talking about one particular issues while the other groups listen. Thereafter the discussion is passed over to the next group which talks for a while before the discussion is passed over to the next group, etc.
- In qualitative research the researcher might talk with an other e.g. about his «data» and his attempts to search for something in his data, either a specific category or something unknown which not is yet «discovered». Others who listen to that talk can then talk about what they were thinking when they heard about the researcher’s search and about the not-yet-known, before the researcher gives his comment on what he heard.
I think I would be the first to warn about a particular practice of a reflecting process. The less planned the process the greater the possibility of letting the situation determine its form. It is important that those who take part in the process can say and do what feels natural and comfortable.
When I am the person who speaks with the family, I never take it for granted that there shall be a reflecting team’s talk even when a team sits ready to give it. I always ask the family: «There have been some people listening to our talk. Would you like to listen to what they have been thinking or what will be the best for you? We could stop our talk here, or we can continue without the team’s talk. What would be the best?»
If the team’s reflections (speculations) are wanted I usually say to the family: «When the team talks you might find it interesting to listen to them. How e ver it might happen that your thoughts go other places. If so, just let it happen since you do not have to listen to the team. Or maybe you rather want to rest and not listen or think so much. Or maybe you would like to do something else. Do what you feel comfortable with.»
I would never tell another teammember how they should be as part of a reflecting team’s talk.
However, I have three guidelines for myself. The first is to talk (speculate) from something I saw or heard in the family’s talk with the therapist. I usually start with referring to what I heard or saw: «When the mother said that she still thinks much about her father who just died, I could see her husband discretely nodded in agreement and I could see the children listened carefully to their mother even though they did not look at her.» That might be the starting point. Then I try to talk in a questioning manner, e.g., «I wonder if that talking or thinking of him is easy for all of them or if it still is painful for some. If it is still difficult for some to talk about him, what could they do so that those who wanted to talk about him had that possibility and those who are not yet ready for it do not need to take part in those talks?»
Statements or opinions or meanings are avoided. Meanings can very easily
be heard by the family as something they should consider or even should do, and if the team's meaning is different from their own, they might easily feel it as «better» and their own as second best. If that happens some families might even feel criticised.
If I am on a team where one of the others on the team comes up with a strong meaning, e.g., one says: «I absolutely think the father should this or that—», I might ask that person: «what did you see or hear in the talk (the family had with the therapist) that made you come up with that opinion?» That gives a possibility to discuss what was heard or seen. If that which was seen and heard was discussed other opinions might be launched in addition to the first one. If the other sticks to his or her opinion we might discuss how that opinion fit in the various family members perspectives: «what do you think the father himself think of that opinion? — what would the mother think of it?—the father's brother?—». These few exchanges might remind everybody about what everybody already knows, namely first; that if one saw or heard something else one might come up with another opinion, and second; an opinion shifts its meaning according to the context (perspective) it is part of. The second guideline is that I feel free to, comment on all I hear, but not on all I see. If a person in the family tries to cover something, e.g., the mother bites her teeth in order not to let the others see how sad she is, or the father tries to hide his angry feelings which might be seen in his clenching fists, I never comment on that. I often remind myself on the talk between Zeus and Hermes, when Hermes took the post as a messenger god (to pass further the messages): Hermes promised Zeus not to lie, but did not promise to tell the whole truth. Zeus understood and accepted. Mothers and fathers and others should have the right of not talk about all they think and feel. I have noticed that I over the year to less and less degree comment on what I see, and more and more comment on what I hear only. My third guideline is used when all happens in the same room; both the family talk and the team’s talk occur in the same room. I usually say to the team (with the family listening), particularly when there are members on the team that have never been in such open talks before, that: «I shall not instruct neither you nor myself, but I have collected some ex- cperiences over time that I would like to share. When you are to talk I would recommend you to talk with each other and not include the family in your talk. If you include them in your talk, either by talking with them or by looking at them, then you force them to listen to you, and they cannot let their mind go other places if that is what they prefer (and I think: if that is impossible it is impossible, so let it happen).»
Four questions emerged from these processes. One is only raised to myself
in my inner dialogue, two always in the open and one sometimes in the open and sometimes only to myself.
The first one is constantly repeated to myself: «Is what is going on now appropriately unusual or is it too unusual?» If there are signs that tell me that it is too unusual I have to change, either by talking about something else or talking in another manner. The second and third question are much tied together and they are usually asked in the beginning of a session, and seem particularity important in the first meeting. The second question is about the history of coming here today. Who had the idea? How did the various other respond to the idea? Were all in favor of it, or were some reserved? The idea in this question is for me to learn which of those who are present would like to talk, and to learn if any of those present would not like to talk. That helps me to be sure that I talk with those who want to talk, and do not talk with those who do not want to talk. The third question is simply to ask all present how they would like to use the meeting, and everybody is invited to give an answer. Those who were reserved about coming to the meeting have often no answer, but those who wanted to come usually have. This question is the most open I have found until now. It allows for very different answers: «I want to discuss my life philosophy», or: «I understand that I cannot proceed my life without making a confrontation, and I would like to discuss how that might happen», or: «I am so tired and so exhausted that I want to just sit here and rest without thinking or talking.»
It is most important in responding to the answer to the question («how would you like to use this meeting?») that I talk about what they would like to talk about, and that I do not talk about what they would not like to talk about.
The fourth question might be asked if one feels that a new issue that is raised creates a certain tension. One shall not take it for granted that everybody can talk about everything everyway at any time. Therefore this question, either raised in the open or only to myself, be of value: «Who might/can/ought to talk with whom about which issue in which way at which point in time?» It might be that the original group is better divided into smaller talking units. This is to ensure that those who want to talk about the issue will have a chance to do so, and that those who at the moment are not prepared for it are excused from that talk.
Harold Goolishian and Harlene Anderson launched the concept of the problem-created-system (Anderson et al, 1986). They saw that a person in problem often attracts attention from many other persons. These others might be family members, friends, neighbors, colleagues, official persons and even therapists. These others create meanings, a whole system of meanings, about how the problem can be understood and how it can be solved. If these meanings are appropriately different, the talks between those who hold the meanings, may create new and even more useful meanings. If the meanings are too different, the talks between those who hold the meanings will easily close down. Goolishian and Anderson say that the big problem arises when the conversations stop. When a therapist enters such a scene, already full of meanings, she or he should be careful to bring more meanings. It is safer to ask questions and be interested in the meanings which are already there. If the therapist connects friendly with the persons in the meaning-system, these will more easily put their meanings into conversation. Maybe such conversations might loosen up and even change the various meanings, such that the stopped conversations can start again.
Going to the meaning-system
When a local therapist wants my assistance I go to him and work together with him and the client(s) in his office, and he and I can be a reflecting team during the meeting. They, the therapist and the clients, determine if I shall continue working with them, but very often one meeting is enough for them to continue the work without me.
Following the others
Those family members who want to speak, talk about what they like to talk about as long as necessary.
It has felt intuitively right that clients should be given the time they need in order to tell me what they want me to know. That means that the listener must be cautious and not interrupt. It has been interesting to follow the various monologues of the various clients, as the undisturbed monologue seems to comprise shifts between inner and outer conversations.
The inner talks occur when the client stops talking (to the other) and makes a «pause». This is however not a really pause; the client just «withdraws» or «moves to an other place» or «meets someone else». That can be seen when her eyes move away and look somewhere else. My imagination is that she searches through all the «pause», or stops and «rests» at something somewhere; searches for meaning(s). Then, after the «pause», the eyes turn back to the other-(s) present and the outer talk can continue. (Andersen, 1993 a) The talk therefore comprises something that can be seen in addition to what is said and can be heard. These shifts between outer and inner talks are most meaningful if there are other(s) there to see and hear. Peggy Perm and Marilyn Frankfurt call the other(s) contribution as «witnessing» (Penn and Frankfurt, 1994). (Also see later Lev Vygotsky’s (1988) mentioning of the so-called «ego-centric talks»).
To hear is also to see
Not only the «pauses» can be seen, but also the «openings» that we, the professionals, might take as the points of departure for our questions. I used to think that the questions more or less were intuitively chosen. Now I do not think so; the person who listens, besides listening to all the spoken, also sees how this is uttered. There are the small shifts in the way to utter that might make one think: «what I just heard, which was followed with what I saw, seems to be meaningful for her. It might be worthful to talk more about that.» These small shifts can be so many: a look in the eyes; the head drops; a cough; a moving on the chair; the hands folded on the neck; the one hand searching for something in the other hand without finding it, etc. These moves seem to occur when the person, when saying some words, hear the words as particular meaningful; the person’s own word(s) move her. And the verb to move has in all languages two meanings; a physical and an emotional aspect.
One will often notice that the person, who is given the possibility to talk undisturbed, quite often stops and starts over again; as if the first attempt was not good enough. The client searches for the best way to express her- or himself; the search for the best words to tell what one wants to tell; the best rhythm; the best tempo etc.
The expressions that come (of which the words are a part) and the simultaneous activity (the way the words are expressed) have attracted my interest much. Therefore it has been natural not only to discuss the utterances themselves but also the way to utter. One of the questions that has emerged is: «I noticed that you said this or that. If you were to search for something more in that word, what might you find?» One particular example was a woman who said that independence was the big word in her family. She not only repeated the word independence, but she said it with such a look on her face that it was natural to let it be a starting point for the next question: «If you were to look into that word, what might you see?» She: «I don’t like that word very much»... «What is it you don’t like when you look into the word?» ... Crying, and with her hands covering her face she said;»... for me to talk about loneliness is so hard... yes it means staying alone...» An other example was a young father who had left his wife and son of seven years old. Some time after this happened he said that both he and his son felt often sad. When he said sad there was an audible and visible sigh, and he was asked: «When your son is sad, is his sadness totally filled with sadness or are there other feelings in his sadness?» The father, who said there was also anger in his sadness, was asked: «If your son’s anger could speak, what would the words be?» He said: «Why did you leave me? You said I was the most important person for you. Why did you leave me?» A third example was a man who spoke about the relationship between he and his wife. It was such that, in the middle of fear and uncertainty, war (anger) broke out. He was asked: «Is the fear in the anger or is the anger in the fear?» He sat long, bewildered and thoughtful before he could answer. This question remained with him all the time for three months. A fourth example is a question that was related to a man who in fierceful anger and without word hit another with his fist. The question was: «If the fist, as it was in the move towards the person it was to hit, could speak, what might the words be?» There were several answers: «I feel stupid.» «I am not listened to.» «Nobody understood that I was hurt.» A fifth example was a woman who spoke about peace and when asked said that «peace» was a very big word for her. She was then asked what she would see and hear if she walked into the word, and said she walked into a landscape where she heard the final part of Gustav Mahler’s second symphony. She was asked if she was together with someone or if she was alone. When mentioning who she would have liked to be with she began to cry.
A commonality of these questions is that one searches for what is inside the expression; in the word; in the feelings; in the movements etc. One does not ask for what is behind or under or over, but what is in the expressed. And that requires that the listener sees and hears what is expressed.
These questions, which the clients suprisingly often like, are actually very sensitive, in the sense that the focusing on such words is sensitive. I do not take it for granted that one can talk about these words right away, because the emotions m them might be very strong. I therefore find it more safe to introduce a couple of «outside»-questions before «looking into the words»-questions, e.g., was the lady who talked about independence was first asked; «How was that word independent expressed (in your family), what is in the open or was it implicit?» She said in the open. Then a second question: «Was it such that you should be independent or was it independence in general?» She said she should be independent. As she replied to both of the two questions she stayed with the word; she did not avoid speaking about it. Her ability to stay with the word told me that she was ready for the next question: «What do you see if you look into the word...»
An important prerequisite to be able to both hear and see carefully and precisely, is for the listener (e.g., the therapist) to avoid thinking that the person who speaks means something else than what is spoken. There is nothing more in the utterance than the utterance; there is nothing more said than what is said, and there is nothing more shown than what is shown. Nothing more.
Other, even more simple questions also have value, namely after an introduction: «I noticed you said this or that..», and thereafter: «.. can you say more what you were thinking when you said that?», or; «... what flew through your mind when you said this or that?», or even more simply; «..can you say more?» Other possibilites are; «If you were to choose a word which is very similar (this or that) word what might it be?» or; if you should choose the opposite word what would that be?» All are questions that can bring forth nuances such that one might see and hear more than one previously could see and hear. These questions do however not escape the overriding question: «Is this an appropriate unusual question or is it too unusual?» And the answer to that question is found, as the reader hopefully has grasped, in the small signs the other person expresses to let the therapist know if it feels uncomfortable or not. If one accepts the idea about the appropriately unusual, how can we increase our sensitivity to the other? A simple procedure, which will be mentioned now, might be useful.
The clients as co-researchers on the therapists contributions to the therapeutic talks
During the last three years I have, in collaboration with a team in Harstad, North Norway and a team in Stockholm, Sweden 1) tried to find a way that hopefully will increase the therapists’ sensitivity for their own contribution in therapy (Andersen, 1997). Briefly mentioned the procedure is that the therapists, a while after therapy has ended, e.g., one year, ask the clients to come back to discuss how it was to be part of the therapeutic meetings. In addition to the clients and the therapists, a visiting professional is present. The meeting starts with the therapists underlining that they wanted the discussion, and they, or the visiting professional, refer to reports about evaluation of various treatments that indicate that the collaboration that develops between clients and therapists contribute much to the therapeutic outcome, either to it being better or worse (Lambert et al 1986, Lambert 1989). That makes it reasonable to re-search the therapeutic sessions together with the clients. The visiting colleague thereafter talks with the therapist about what they want to focus on and clarify during the meeting, while the clients are listening to this talk. In the next step the visitor invites the clients to comment on the talk they just heard (that between the therapists and the visitor), and also asks them if there is something from the therapeutic sessions they want to discuss.
Thereafter the visitor talks again with the therapists what they thought when they heard the talk between the clients and the visitor. The reader will probably have noticed that this is a variation of the reflecting processes.
There is something the visiting professional shall bear in mind, namely that his task is to talk about the process of the therapeutic talks and not the contents of these talks. If the issues of the therapeutic talks are touched, that should only be to clarify the process.
If the clients want to talk more about the issues they once talked about in therapy, the visitor should recognize that as a wish to resume therapy and leave that to the therapists. The visitor should in other words withdraw.
In dealing with the process of therapy the visitor should feel free to raise whichever questions. However, it seems most interesting for the therapists to talk about those parts of the therapy in which impasses occurred or where there were tense and uncomfortable periods or when they were uncertain and in doubt or where they (the therapists), in hindsight, felt they failed. The clients comments on such issues might be very valuable. Maybe the visiting colleague is guided by the idea that the therapists now have the possibility to hear what might have been too unusual for the clients; what might have come at an improper point in time; what might have been talked about in a improper context; etc, and thereby become more prepared what they in their future work should not do again. There have been quite some interesting comments from those therapists who have taken part in this «evaluating process».
One said; «The process is as unique as the therapeutic process, but only those questions are relevant which all present can talk about. Standard-questions which belong to standard-evaluations would be felt as artificial, and I would not have been part of that.» One other said: «The experience, the feeling, to sit there and hear how difficult it was for a client to be part of a way of talking that she had not had any impact on, has led me to understand how important it is for the client(s) and me to find a way of talking together we both appreciate, before we start the «real» talk.» A third said: «After being part of this I feel more and more convinced that the clients are the best supervisors. This is alternative to professional supervision. Actually, hereafter I want both.» A fourth said: «This experience has taught me to be inside the therapeutic relationships and also for me to «move» out of it and look at it all, inclusive myself, from outside.» A fifth said: «Its was very special to be in this particular kind of triangle; in the sense that I felt we came so close to each other. When I was listening and felt so close to the clients I thought: maybe we should dare to talk more openly what we feel in those moments when we (the therapists) fight with them.» A sixth said: «I was so surprised how much they remembered from the (therapeutic) talks. I had forgotten most of it.» A seventh said: «It was an unique experience to feel so close and be on a basis of equality.» The clients have not been asked what they have felt about this process, but some have spontaneously said that they appreciated to learn what the therapists thought about the therapy they once had together. For some, namely those who left therapy with the feeling that both the therapy and themselves had failed, experienced this after-talk as a repairing process which brought dignity back to them. The process seemed to do them well.
The circle is closed
The reflecting processes appears to be a useful practice that is relatively easy to apply and can be used in many different circumstances. It is also a practice that studies itself. Clients and therapists are not only collaborators but also co-researchers. In many ways I believe this is a good evolution.
1) The members of the team in Harstad were: Leif Hugo Hansen, Ingeborg Hansen, Torill Ida Aandahl and Torgeir Finsas, and in Stockholm: Annica For- smark, Marianne Borgengren and Bo Montan.