Forums 2020-2021 India Narrative Therapy and Community Work Training Program Forum On Being a Wonky Ladder- A Reflection on Externalising Conversations

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    AvatarJyothi Ravichandran

    I was recently watching a programme in which two psychotherapists were analysing romantic relationships in popular Hollywood movies. There came a scene where a comedienne (the hilarious Wanda Sykes), playing the role of a couples’ counsellor tells a warring couple she is consulting, “I’m really not allowed to tell you what to do. This space usually helps couples to sort out their issues and move on to have a healthier relationship but I’m afraid that’s not going to happen for you two. You must get divorced right away!” It was a really funny scene and one of the TV Therapists commented that the comedienne might make a good life coach but is failing miserably as a counsellor. The reason she attributed to this was that she was “too direct” which according to her, psychotherapists are not allowed to be. It was at this point that I turned off the programme, dismissing it to be part of the Idle Afternoon Trash TV canon.

    I started thinking about the role of a psychotherapist as an emotional analgesic and the selection of readings on externalisation provide a really powerful amalgamation of the “pain-reliever-facilitator” roles. What stood out to me is that by being a facilitator and scaffolding partner, the psychotherapist reduces pain for clients AND self!
    The importance of reducing defensiveness and painful emotions is apparent in regular practice as clients come with overwhelming difficulties and preoccupations into the therapeutic alliance. It is understandably an important skill to not induce negative emotions in clients through challenging questions and expert insights that invalidate one’s own knowledge of their lives and meaning, leading to difficulties in accessing a safe therapeutic space and engaging with the “work” itself. The narrative conversation however does not shy from psychotherapy’s very important mandate of creating opportunities for clients to think deeply and explore their experience of adversity in order to be left with empowering directions towards problem resolution and beyond that, really enriching their activities to attain a higher quality of life. It is direct, compassionate, playful and full of possibilities, mirroring the some aspects of the essence of living itself. The TV Therapist’s idea of “directness” seemed to belie a certain frustration with traditional practice where “patients” frustrate “clinicians” and how she wished there could be a way to be direct with them as cocky coaches get to do in films like “Hitch”.

    As I continued to engage with learning about scaffolding questions in the readings that lead the client towards a simple deconstruction of very complicated experiences only to put them back together in medium and medium-high levels of distancing tasks in their own experience-near words and emerging realisations and meanings, I couldn’t help but feel an overwhelming sense of possibility for clients AND therapists. The frustration of the TV Therapist seemed to arise from a hope that “directness” (of the rude, expert-position, “do as I tell you and don’t waste my time being stuck” brand) will help her break client resistance and get them outcomes than one can then be proud of leading the way to; the tough love that sometimes (supposedly) seems to work with close family and friends. I recognised that her simple differentiation between a psychotherapist (the benevolent, indirect analgesic) and coach (the direct, honest outcome achiever) both come from an unhelpful, damaging and colonising refusal of client’s right to remain the expert of their own lives. I became worried, as the month of reading wore on, that the idea of social collaboration, characterised by decentred, non-influencing therapist stance is not a topic of keen discussion when psychologists I know congregate to speak about their work and challenges by the proverbial water-cooler. This made me sad. And did I mention worried?

    Michael White’s emphasis upon the importance of taking stock of one’s therapeutic skills and working on the ability to provide reliable and empowering scaffolding to invite clients to approach the unpacking of the problem and its vast impact on their lives with playful, respectful, nonjudgmental curiosity is a very critical call to action. In our work in schools, providing social and emotional learning (SEL) sessions to adolescents, our facilitators are always encouraged to think about facilitator actions that blocked or weakened participation than taking the route of blaming children and adolescents for being “distracted”, “disengaged”, “uninterested”, “disrespectful of learning”, etc. To find a modality of therapy that explicitly includes therapist self-evaluation and continuous learning was a point of great appreciation, convergence with our current work and relief and hope for the larger psychotherapeutic community.

    Speaking of hope, in a recent therapy session, I noticed myself engaging in some astonishing clumsiness in asking externalising questions. The client, a woman of 30, was reaching out for help in dealing with excessive worry and fears about being unable to make a decision regarding having a child in the future with her partner. She brought up many areas of concern from her estranged parents, her health conditions, fear of pain and the immense uncertainty that is future. She used many words to characterise herself such as lazy, under-confident, inconsistent and so on, offering many opportunities for me to eagerly clutch at every internalised, painful quality and get started with asking her questions around low level distancing. The client was going from issue to issue and the conversation was soon quite far from the point at which she started. The client was very enthusiastic in naming her “incompetence” complex of being lazy, inconsistent and under-confident as “The Relative”, coming from her highly culturally-determined experiences with disapproving family members. After exploring The Relative’s agenda, she was also very articulate about her activities, attitudes towards herself and others when The Relative is absent or lurking about elsewhere. After what I evaluated as being a rich conversation full of laughter and poignancy, she asked me “So this was really energising but what happened in the session?” For a second, my mind replaced the TV Therapist with my own face, with a big X on it. Undeterred, I ploughed on with clumsy cementing of segues in the conversation, finding it very hard to connect The Relative with her concerns around being a parent without imposing expert views on it. The client did not join these dots on her own. The conversation was not experience-near even if parts of it were. I was being a wonky ladder, climber is somewhat disoriented.

    Never before has the benevolence of a client impressed upon me so much as this time. She was appreciative of my summarising, asked excitedly for “homework” for the next session, cheerfully scheduled the next session and left the call, leaving me to ponder on White’s acknowledgement of the contributions of his clients on his therapeutic practice (probably a sacrilege to compare my experiences to what he meant!). I am now left with two versions of me: the one that “gets” the parts and pieces of externalising conversations on paper, neat and elegant and the eager “opportunity-clutcher” that must temper her inner TV Therapist to use pauses, more questions that exhaust the realm of problem and its effect on clients and check for readiness before jumping rungs on the scaffolding because it is evident from the words of my client, as much as she could lope up the scaffolding enthusiastically and articulately, our readiness to move away from problem exploration was not matched, rendering the client “out-paced” in her own process.

    I now realise the frustration in therapeutic process is closely associated with therapists occupying undue space in the alliance and wondering why the client isn’t able to “keep up”. Catching myself this time, I am reflecting on my zone of proximal development so as to be a ladder that is helpful and empowering, not demanding clients to jump feet in the air without supportive rungs. Sturdy Ladder. Happy Climbers.

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