Renegotiating Disturbances in Therapeutic Relationships

The epistemologies that are adopted and adapted throughout and within our lives play an immense role in how we navigate social relationships, personally and professionally (Luger, Lewis, & Stern, 2002). Within clinical practice, we come to learn that if personal emotional turmoil surfaces within a therapeutic relationship, these feelings are to be acknowledged and discussed in supervision (Edwards, 2010).

How effective is talking about the deep, visceral, and disturbing reactions that can erupt within us without warning? We are still expected to provide services for and work with people even if these types of emotional, physiological, and intellectual demons arrive. Many people in the helping fields do not give themselves and their reactions enough time and attention, possibly filing away and casting aside these emotions, resulting in not being able to provide the best care possible to clients at the same time as increasing rates of burnout and limiting self care for themselves (Figley, 2002).

Historically, it has been documented that countertransference issues can be used as a tool in treatment to help practitioners better understand their clients and offer them different treatment options when the associated reactions are explored and understood (Gil & Rubin, 2005; Hays, Nelson, & Fauth, 2015). Leclerc (2006) raised a great point in regards to our possible neglect of these emotional explorations when he stated, “If counter-transference is currently widely accepted and recognized as a useful clinical tool, this wide acceptance may also cause it to be easily taken for granted (p.131).” This suggestion assists in putting into perspective how often we may dismiss the need to explore emotions and feelings that are evoked from others within the field. To what degree can practitioners better understand themselves and then be able to re-enter the relationships with clients or colleagues if they are not engaging in processes to enhance and challenge our primary, secondary, and tertiary epistemologies? Can just talking about the body and mind responses to others be enough to work in, work with, and work through the disturbances that surface?

I am suggesting that just talking about these issues is not enough. I am proposing a multi-modal arts-based approach to addressing these emotions, opening the dialogues about these realities, and finding ways to renegotiate these relationships in our lives. This could be implemented into supervision for mental health practitioners, educators, social workers, and beyond. It could be offered into agency trainings in order to create awareness of the need to acknowledge and utilize strong emotions within navigating our social interactions. This model can even be incorporated into treatment with clients, as many people come for help due to having issues within their own relationships. These issues are often significant enough to be evoking psychological, social, and physiological turmoil for those seeking assistance. This process can be self-employed as an arts based mode of enquiry for research as well.

The model will begin by acknowledge when another human being triggers disturbing emotions within oneself. Once this occurs, journaling begins. What is occurring in the body? Where are the emotions located in the body? What are the emotions and what type of clusters can be created in regards to the flood of feelings being experienced? Journaling can happen in any form that the situation calls for. An art making process will then begin, while concentrating on the thoughts, feelings, and realizations that surfaced through the journaling portion of this exploration. Once artwork is complete and feels representative of what is happening within the relationship, the empty chair technique will commence. It is not possible to predict what will take place in this portion of the exploration.

That is what is so beautiful about the empty chair. Will people be addressing the person responsible for the initial emotional responses experienced? Will they be addressing the identified emotions? Will they be addressing components of the artwork or the artwork as a whole? Will they be addressing themselves? Role reversal within the empty chair can occur if the process calls for it. Engagement in other art modalities in response to the process may also occur, depending on the needs that may surface through any step of the overall process.

This multimodal arts based exploration will be examined through a constructivist lens. The constructing of something tangible out of the disturbances being experienced and acknowledged will take place. These tangible aspect will then be addressed by the deconstruction and exploration of the components within, through the use of different artistic modalities. This will engage the challenging of existing epistemologies and realities, which may then lead to the transformation and renegotiation of the originally experienced disturbances and relationship.

There is a narrative quality to this approach as well. Examination of the current narratives within a relationship will take place by constructing a story and creating a life of the intangible emotional interactions that are being experienced. This can lead to deconstructing and rearranging these stories due to the unhealthy possibilities that may occur if this relationship is left alone. Reconstructing the now tangible into a navigate-able, understandable, and working entity and story may be an optimal goal of this entire interaction. Through this, new stories of self, other, and the self and other interactions can be created.

Levine (2009) described Dionysus as a child that played within the ruins of time in regards to him building and destroying within these ruins, as well as mourning and celebrating as a part of this process. This is what we must do in order to understand these relationships, our roles and the roles of the other within them, and to renegotiate them through mourning and celebration. Levine went on to say that mourning cannot occur unless it awakens us again. The notion of awakening may just be that turning point in the renegotiating of these troublesome relationships. A variety of different types of awakening can possibly occur through this deconstruction, reconstruction, and narrative development of the once intangible emotions associated with troublesome interactions with others.

I plan to engage in this multimodal arts based enquiry over this next year within a pilot study on this topic. These steps will be taken but will also be visually recorded, transcribed, and artistically documented in order to provide me with data that may be able to reveal possible benefits (or the adverse) of exploring these concepts in the ways described in this blog. I invite people to share their thoughts, opinions, and insights on this upcoming research, as I am in the beginning stages of this journey.

References

Edwards, D. (2010). Play and metaphor in clinical supervision: Kepping creativity alive. The Arts in Psychotherapy, 14(2), 87-102.

Figley, C.R. (2002). Compassion fatigue: Psychotherapists’ chronic lack of self-care. Psychotherapy in Practice, 58(11), 1433-1441. Doi: 10.1002/jclp.10090

Gil, E., & Rubin, L. (2005). Countertransference play: Informing and enhancing therapist self awareness through play. International Journal of Play Therapy, 14(2), 87-62.

Hays, J.A., Nelson, D.L., & Fauth, J. (2015). Countertransference in successful and unsuccessful cases of psychotherapy. Psychotherapy, 52(1), 127-133.

Leclerc, J. (2006). The unconscious as paradox: Impact on the epistemological stance of the art psychotherapist. The Arts in Psychotherapy, 33, 130-134.

Levine, S.K. (2009). Trauma, tragedy, therapy: The arts and human suffering. London, UK: Jessica Kingsley Publishers.

Luger, G.F., Lewis, J., & Stern, C. (2002). Problem solving as model refinement: Towards a constructivist epistemology. Brain, Behavior, and Evolution, 59(1/2), 87-100.

#constructivism #projectconceptualization