Sunday, September 28, 2014

Language, influence and self-presentation: Lessons for the young therapist.

Z may participate in one way rather than another (choose certain options rather than others) as a way of letting C know what kind of person Z is.
If C has a given relationship to Z, C’s behavior potential is different from what it otherwise would have been.  Peter Ossorio, Place

Beyond the words themselves, what I say makes the difference it makes because I said it, and how I am appraised by you.  You could utter the same words with a very different result. What I represent to myself and to you informs and limits our influence on each other.

Consider, “I’d expect her to say that, but coming from you, it means a lot.” Or,  “She’s in no position to ask that of me.”

This is so intuitive that you might wonder why I am making this point explicit. Partly because I want to say something about the relation of language to social roles and self-presentation, and partly because there are times we seem to forget.  We might make the mistake of telling someone how we’d express something and expect they can do the same. Or, give the impression we'd like them to say it the way we did.  They then wonder how in hell that could work for them. Or worse, they parrot our speech with unfortunate effect. 

This reminder of the connection of speech to the speaker is especially important in psychotherapy and supervision, but it is just as relevant in teaching and parenting. It’s a general requirement for appropriate engagement in any venue. 

Take a question my psychotherapy students, typically in their twenties, might face. What is their credibility, what can they effectively say working with a late middle aged couple coping with disappointments in their marriage, struggling with their adult children, while silently questioning whether to remain married? Imagine my students watching a videotape of my intervention with this couple.

As a man in his sixties, married more than once, a father, a professor sitting in a well appointed office at a fashionable address, what I can get away with saying to this couple is different from what my students can.  I have both the wear and tear and a much nicer office. I speak from experience. Of course, so do my students, but as young adults they necessarily present themselves differently than I do. Even as they attempt the role of “professional” or “psychologist” they manifest a voice and an authority that differs from mine.  

How is the therapist supposed to appear? At this stage of life, I look the part. Many of my students and trainees don’t. 

At some point my students, informed by psychodynamic theory, bring up transference, counter-transference, role enactments and the “real relationship”.  They mention the “inter-subjective field” created between or among the participants. They become attuned to the nuance of what we consciously and unconsciously, deliberately or automatically, evoke in each other. They sense the couple has accepted me as a paternal or avuncular peer and allow me to speak in that fashion. My students notice that the couple treats my humor, funny or not, as a matter of shared respect coming from shared experience. 

I listen to my students' understandings of unconscious and out-of-awareness aspects of therapy.   I am glad they notice and wonder. But then I underscore that initially the most significant features of their therapeutic interactions will involve responses to their readily identifiable personal characteristics. What first meets the eye and ear counts not just as things get started, but carry over until people know more about each other or have reason enough to change their minds about what they first assumed. Initial impressions significantly matter in establishing trust, shared agendas, and the boundaries of disclosure. 

If my students find themselves working with a similar couple, with people more like their parents than their peers, what are they in a position to do?  They need to know their place. So, I remind them of two things. First, I ask them to speak authentically in their own voice, youthful but trained to understand and help. Second, since some correctly doubt they are old enough to have credibility, I remind them to wait, time will take care of that issue.  

I remind my students that simply requesting their client’s help in understanding their predicament can go a long way toward being helpful. “Can you help me understand what I need to know?” is both informative and respectful. Asking,  “How might I be of service?” works, too. This allows the client to frame the engagement. And it reveals a good deal about how the client sees their therapist's skills and eligibilities. It's a good idea to know on what footing we start.

What I want my therapy students to understand is that their intervention, even the one I may be modeling, needs to be performed in a manner that coherently follows from their actual personal characteristics and place in their client’s world. My way of speaking is probably not a good fit for them. Words, sentences, and utterances are only a part of what gives verbal behavior meaning.  Since I am paid to teach them “talk therapy”, this is central in my lesson plan. 

Therapeutic engagement involves an improvisational assimilation of the therapist and client’s interaction. How people fit together depends on who they actually are. When the fit works and authentically connects the participants, it is almost invariably satisfying. 

A bit of background to the lesson I teach:

Language, the symbolic verbal behaviors we share, provides at least four functions, and more. We speak to identify, to describe, to evoke, and to enjoin or instruct. “That’s an apple.” “It’s red and round”. “The taste reminds me of my mom’s apple pie.”  “To keep the tart, crisp, sweet flavor, be sure to cut it with a very sharp knife.” 

What we identify indicates what we notice as significant to consider. This can be very telling since it shows what we think matters. The way we describe provides evidence of our intelligence, sensitivity, nuance and perspective and who we take our listener to be and what we believe our listener can comprehend. The way we describe, the stance we take in speaking, can be especially accrediting or degrading and will serve as one measure of the therapist’s empathy. It is hard to underestimate the significance, the impact, of the status we assign ourselves and our listeners, wittingly or not, when we speak. What we evoke is a matter of what the message and messenger brings to mind. Here transference and counter-transference weigh in. And the value of our instruction will follow from whether or not we are viewed as a trusted source. 

When we speak, our stance can affirm or degrade, validate or invalidate the parties in dialog.  This will largely result from what the speaker is seen to authentically represent. You’re not the boss of me, unless you are. Who are you to pass judgment? (Unless, of course, I recognize or am made to succumb to your authority, your honor.)

So with this in mind, I ask my students to consider the significance of their initial presentation to their clients.  I ask how their age, race, ethnicity, speech, gender, attractiveness, manner of dress, and social class might be relevant to how they are heard, understood and felt. This is often difficult since if done awkwardly it might feel like stereotyping and dismissed as abusive, intrusive and politically incorrect. But they should know in their heart of hearts that stereotyping can fill in the blanks before a more adequate understanding is achieved. 

In a seminar on supervision with fourth year doctoral students, our initial sessions are often spent considering how therapy and supervision can be affirming or degrading. In discussing how our job involves identifying and validating the values and competencies of those we work with, I point out that it works in reverse, too. The client or trainee also validates or invalidates their therapists and supervisors. We look to see how we are seen in each other’s eyes and measure our worth accordingly. How we see the status and authenticity of those who see us determines the weight we give their appraisals. To be a therapist, it matters if my client sees what I am doing as an authentic offering of therapy.

So I want my students to keep in mind these questions and reminders.

1. What do I evoke in different people and what do they evoke in me?  What version of this is played out?

2. Given my easy to observe personal characteristics, what am I actually seen as eligible to accomplish?

3. Given my harder to observe personal characteristics, what will take more time to demonstrate or establish? 

4. Is the frame of engagement validating or degrading and of what? Is my client a volunteer, on more or less equal footing with me, or is their participation coerced? (And remember that volunteers decide if it is worthwhile to continue and coercion invites resistance or resigned compliance).

5. What do I need or appear to need validated about myself? Am I acting this out in my selective focus on the issues I identify as significant, or through competition, argument, coercion, compliance, seductiveness, one-upmanship, or something else?

6. What can I not tolerate hearing? Does my defensiveness or intolerance look like dismissal, avoidance, or disgust? Is my defensiveness or intolerance degrading or invalidating?

7. I ask them to keep in mind that some things we say or do are not easily forgotten, forgiven or undone and will guide further encounter. Expressions of desire and disgust are especially hard to undo. 

To be continued.

For more clarification and exploration of the Descriptive concepts of Individual Person and Behavior, please turn to A Short Course in Descriptive Psychology.  I work on the concept of degradation in the entry, Degradation Ceremonies in Everyday Life. And for a brief introduction to my understanding of the practice of psychotherapy, I have written, Mindful Uncertainty: What is Psychotherapy?

The therapist’s authenticity-in-action is a requirement for any brand of what constitutes effective psychotherapy. Anthony Putman’s work, Being, Becoming and Belonging is well worth your reading as a guide to authenticity’s non-mysterious meaning.

I also looked at these issues in Presentations of Self and the Status Dynamics of Psychotherapy and Supervision, American Journal of Psychotherapy, Vol. 62, No. 1, 2008

On the Descriptive Psychology of language:

Language is one of the four basic concepts of Descriptive Psychology’s Person Concept, interdependent on the other fundamental concepts of Individual Person, Behavior, and World. Language is Verbal Behavior expressed in the following pragmatic formulation:

Verbal Behavior =  < Concepts, Locution, Behavior as Social Practice >

The formula explicitly ties the meaning of language to its use.  Concepts are distinctions that have informational value. They represent distinctions that make a difference in behavior. Concepts are operating tools for our varied and irregular actions. They vary the way that tools in a tool chest vary. They are created and employed to do different things: To correspond in one way or another to all the things we do. Locutions or  utterances are expressed in speech or other symbolic form and correspond to or represent the concepts. The Behavior is the Social Practice where the uttered concept is employed and validated through shared social use. This is similar to Wittgenstein’s point that language is not private, that the meaning of a concept follows from its use in what he called language games. And, remember, we have all sorts of games we play in all sorts of different and irregular ways. We need a vast array of concepts along with a complicated grammar to get at the objects, processes, events, and state of affairs that constitute our World or Reality (the fourth fundamental feature of the Person Concept).  See, What is Reality?