Volume 16 l Issue 3 l Autumn 2016 Volume 16 l
Issue 3 l
Autumn 2016
• Psychotherapy and the DSM: What Relationship? The • Fear within the Supervisory Space • A Creative Approach to Human Bereavement Support in Groups Kaleidoscope • History, Heredity and 1916: A Jungian Perspective
Irish Association for Counselling and Psychotherapy Éisteach Volume 16 l Issue 3 l Autumn 2016 Contents
From the Editor 3 Our Title The word Éisteach means Psychotherapy and the DSM: What Relationship? 4 ‘attentive in listening’ (Irish-English Mary Peyton Dictionary, Irish Texts Society, 1927). Therefore, ‘duine éisteach’ Fear within the Supervisory Space 7 would be ‘a person who listens Karen Gavin attentively.’
A Creative Approach to Bereavement Support in Groups 12 Disclaimer: Breffni Mc Guinness The views expressed in this publication, save where otherwise History, Heredity and 1916: A Jungian Perspective 16 indicated, are the views of Orla Crowley contributors and not necessarily the views of the Irish Association for Counselling and Psychotherapy. The Letter to the Editor 21 appearance of an advertisement in this publication does not Workshop Review 22 necessarily indicate approval by the Irish Association for Counselling Conference Review 23 and Psychotherapy for the product or service advertised. Book Review 24
Noticeboard 25 Next Issue: 1st December 2016
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Irish Association for Counselling and Psychotherapy Volume 16 l Issue 3 l Autumn 2016
From the Editor:
Dear Colleagues
Welcome to the Autumn edition Are we lead by a client’s story, of for supporting people who are of Eisteach. One of the favoured which symptoms can be but a grieving. The power of peer support themes of WB Yeats, as a visiting small part? This article questions and the need for flexible, sensitive professor to Oxford in the 1930’s, the empiricism on which the DSM facilitation are highlighted here. when he would share words of purports to be based. The dynamic wisdom with staff and students experience of supervision is the Finally, Orla Crowley, shares with us was, ‘No work is ever wasted’. I context for Karen Gavin’s article a reflective piece which draws on took these words into my heart on naming and processing fear, the language used by the writers as a twenty-something and they when it arises, in the supervisory of the 1916 proclamation and helped frame my understanding of space. She reminds us that fear places this in the Jungian context plans thwarted, and an acceptance, is contagious and the goal is not of ‘cultural complexes’ that echo however reluctant, of hiccups along to ‘banish our fears but to tame through the generations. ‘Intense the way. The ‘work’ is in the tangent, them, to welcome them home’. All collective emotion is the hallmark the unforeseen and the unplanned. the areas touched on in Karen’s of an activated cultural complex’ article deserve further exploration. and we don’t have to look far in our All our contributors in this edition Are there other supervisors willing global village to see this process share the desire to explore the to channel their own experience, enacting. tangential, the shaky ground, the document it and share with unknown. Mary Peyton returns to readers? According to the IACP Sincere thanks to all our writers for the theme of an article by Dr. Denise website there are now over 520 sharing their learning. In closing Mullen, published in the Spring accredited supervisors in the words from the Sufi poet of the edition on the ‘marvellous book’, organisation. That’s quite a breadth 13th century, Rumi jumped out at the DSM, challenging us, from a and depth of collective wisdom; is me recently; humanistic perspective to reflect it being used? on its value in a truly therapeutic “Out beyond ideas of wrong doing, space. Is a diagnosis ‘lightly Breffni McGuiness takes us into And right doing, held’ or does it become a label the arena of group work and the There is a field, which predetermines treatment.? creative arts as an ideal medium I’ll meet you there”.
Aine Egan MIACP Aine Egan is a psychotherapist and group facilitator based in Co. Wicklow www.talkingsolutons.ie
Irish Association for Counselling and Psychotherapy 3 Volume 16 l Issue 3 l Autumn 2016 Psychotherapy and the DSM: What Relationship? Mary Peyton
first DSM was published in 1952. It contained 106 what were called ‘reactions’ which were based on a psychobiological view of mental health and contained a psychodynamic influence. Clearly articulated in the DSM was a group of disorders of psychogenic origin making up the majority of reactions contained in the manual; these were “without clearly defined physical cause or structural change in the brain.” (Sanders 2011) This was followed in 1968 by DSM-II which was similar to the first edition, with the addition of 76 disorders. Also, the word reactions was replaced by the word disorders. Abstract his article is a response to a previous article “Let’s make friends Moving on to 1980 and the Twith the DSM” published in the Spring edition of Eisteach, 2016. It arrival of DSM-III, there was a looks at the creation of the DSM, its change in direction from having a distinct shift in orientation towards psychobiological and social construct to becoming the symptom-based biological determinants. According construct of today. It takes a critical look at the methodology used in to Dr. James Davies, psychologist bringing about this current creation, the major concerns surrounding it, in University of Roehampton who and the fallout in relation to mental health that has ensued. The relevance interviewed Dr Spitzer, chairman of the DSM for psychotherapists is addressed and the question asked of DSM-III, there was a core team as to the place diagnosis holds or does not hold in the humanistic and of nine people whose task it integrative psychotherapeutic relationship. was to put the manual together. This revision added eighty new Introduction diagnoses to the DSM. It also I would like to respond to the article entitled “Let’s Make Friends with erased the psychoanalytic influence The DSM” which appeared in Eisteach Spring 2016. Perhaps it would of previous editions, and gave be useful to look at exactly what it is we are being asked to befriend. birth to the notion that there were The DSM (Diagnostic and Statistical Manual of Mental Disorders) is distinctive disorders that could the standard classification of mental disorders used by mental health be specifically categorised and professionals in the United States. It has expanded at a faster rate than distinguished from each other. In so any other manual in medical history. At its inception in 1952 there were doing, it diminished the significance 106 disorders described in the DSM, while the latest publication in 2013, of psychological and social factors DSM 5, contains around 370 diagnoses. in causing distress. The aim of all of this was to create a sense Creation of the DSM of an objective truth in relation to Before the DSM, there were a number of diagnostic systems, with little mental health and disease, in other consensus among the professionals in the area of mental health. The words the beginning of a specific
4 Irish Association for Counselling and Psychotherapy Volume 16 l Issue 3 l Autumn 2016 manual which has unfortunately crucially, what still remains is an diagnoses, DSM-5 will take lead to the medicalisation of absence of context, with lists of psychiatry off a cliff”. troubles of the mind/body, spirit symptoms predominating. There and soul. The reality is that the was much international controversy Relevance of the DSM only disorders in the DSM with a surrounding this latest edition, While it is difficult to see what proven biological cause are the with concern expressed in relation a ‘friendship’ would offer, an organic disorders (those caused to lowering diagnostic thresholds acquaintance with the DSM has its by disease e.g. delirium, dementia, in many disorders (British uses from a number of perspectives. drug intoxication) and these are in Psychological Society 2011), to say Firstly, our clients may well have the minority. There are no biological nothing of the concern regarding its been on the receiving end of a markers for most of the disorders validity in the first place. diagnosis, and it can be helpful named in the DSM. knowing what that diagnosis means With the DSM III “There was Fallout from the DSM at least in medical circles, even very little systematic research, and The DSM has led to the when we, as psychotherapists much of the research that existed medicalisation of many people’s have a different relationship with was really a hodgepodge-scattered, inconsistent, and ambiguous. I think the majority of us recognised that think the majority of us recognised that the the amount of good, solid science I amount of good, solid science upon which we upon which we were making our were making our decisions was pretty modest.” decisions was pretty modest.” Theodore Millon, psychologist and Theodore Millon, psychologist and DSM III task force member. DSM III task force member. There was little research to support any of the diagnostic suffering and the concomitant the whole concept of diagnosis. labels, yet their inclusion medicating of suffering rather Indeed, many clients are not served purports to offer them a validity. than the understanding of it. We by a diagnosis, and some are Paradoxically, in order to have a now have huge increases in the significantly harmed. I am thinking diagnosis removed from the DSM, diagnosis for example of ADHD, with here particularly of the diagnosis there has to be scientific evidence children being medicated with drugs of bipolar disorder, once a rare to support its removal. Research which have the long term effects of disorder, the incidence of which has to prove that the disorder decreasing their physical growth, has increased significantly in the does not exist! So we have the educational attainments and United States; its prevalence in the scenario of clinicians putting a curiosity (Currie et al 2013). Add to U.S. now being 2.6% of population case for a diagnosis, arguing and this the on-going concern amongst in 2005 (Kessler et al 2005), The eventually deciding by a vote. psychiatrists themselves in relation reasons for this are many and would The voting method was a show of to the reliability of diagnosis. really be the subject of another hands, which of course begs many Studies have shown agreement article, but it is probably not a questions not least the influence on diagnosis in experienced coincidence that the manufacturers of one person on another. DSM-III clinicians occurs in between 54% of “mood stabilizers” have was the product of opinions of nine to 60% of cases (Beck et al 1962, experienced significant increases people rather than research. Williams et al 1992, Aboraya et in their sales (Healy 2005). I In 1994 the publication of the al 2006). The gap is even wider have seen people who have been DSM IV with its 297 disorders was with non-experienced clinicians. misdiagnosed with bipolar disorder followed by its revision in 2000. Many psychiatrists themselves are and as a consequence, restrict their The DSM 5 was published in 2013, deeply concerned about the DSM. lives significantly and unnecessarily and while there have been some Allen Frances, an editor of DSM- in order to prevent another manic revisions in diagnoses, the delivery IV is quoted as saying “by use of episode. of what was initially promised the proposed diagnostic category, Empowering our clients to including a more dimensional ‘psychosis risk syndrome”, as understand themselves and relate view just has not occurred. Most well as other newly constructed to themselves in the totality of
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their humanity is what we are experiencing extreme difficulty in Currie J., Stabile M., Jones L.E., (2013) about, and being able to facilitate self-regulation who may have been Do Stimulant Medications Improve an individual in this is crucial. given a diagnosis of Borderline Educational and Behavioral Outcomes Having some knowledge of how Personality Disorder. Here we are for Children with ADHD? NBER Working Paper No. 19105 Issued in June 2013 psychiatric diagnosis comes meeting a person with extreme about enables us and our clients complex trauma and its attendant Davies J., (2015) More Harm Than Good: Confronting the Psychiatric Medication to question it and look beyond challenges. The article by Monica Epidemic. International Conference. medicalisation, pathologisation Carsky and Frank Yeomans (2012) and medication. Being acquainted entitled “Overwhelming patients Frances A. quoted in Read J., Dillon J (2013) Models of Madness: with diagnosis also enables us and overwhelmed therapists” where they speak of how utterly lost both Psychological, Social and Biological to have conversations with other parties can become where there is Approaches to Psychosis (The mental health professionals, and a borderline construct in the room International Society for Psychological bring another eye to what are seen names this territory well. Having and Social Approaches to Psychosis simply as symptoms of a disorder, some knowledge of the chaotic Book Series) 2nd Ed. p 404. and to challenge the labelling of primitive structures our clients Kessler RC, Chiu WT, Demler O, Walters human suffering. EE. (2005) Prevalence, severity, and comorbidity of twelve-month DSM-IV s humanistic therapists we are not in the disorders in the National Comorbidity Survey Replication (NCS-R). Archives of A business of diagnosis, diagnosis takes no General Psychiatry, Jun; 62(6): 617-27. account of subjectivity or relationship. Millon T. Quoted in Angell M. (2005) Drug Companies & Doctors: A Story of Corruption. Random House Trade may work from can help us stay Paperbacks. New York. Diagnosis and psychotherapy present, name, understand, and The question also needs to be work relationally with the chaos that Nolan P., (2012) Therapist and Client. A asked whether there is ever a is present. Relational Approach to Psychotherapy. Wiley-Blackwell. role for diagnosis? There is no At the heart of this debate, is the Sanders, James L. (2011) A distinct doubt that the recognition of post- whole notion of ‘psychopathology’ language and a historic pendulum: traumatic stress disorder (PTSD) and the use of words and as an entity saved many from the evolution of the Diagnostic and categories which dehumanize and Statistical Manual of Mental Disorders. being shot in wartime for what had pathologise the human condition. Archives of Psychiatric Nursing: Volume previously been seen as cowardice. So I would say that a friendship 11, Issue 25, 394-403 As humanistic therapists we are is not what a humanistic and Williams. W et al., (1992) Archives not in the business of diagnosis, integrative psychotherapist would of General Psychiatry 49:6306 The diagnosis takes no account seek, but in the interests of the Structured Clinical Interview for of subjectivity or relationship. client, having some knowledge of DSM-III-R (SCID): II. Multisite Test- However, there is something to the DSM can have a value. Retest Reliability. Archives of General be said for having a framework Psychiatry, 49 (8), pp. 630-636. with which to work with clients. References There is a usefulness to having M, Mock J.E, Erbaugh J.K. (1962) Mary Peyton MB BAO BCh, FFARCSI, tentative formulations which are Reliability of psychiatric diagnosis. MIAHIP, MICP held lightly by the therapist and 2. A study of consistency of clinical are constantly open to revision. judgments and ratings. Am J Psychiatry: Mary Peyton works as a Humanistic I am thinking here particularly of 119:351–7. and Integrative psychotherapist in the fragile client (Nolan 2012) for British Psychological Society statement private practice and is an accredited on the open letter to the DSM-5 example the client endeavouring Supervisor. She studied Medicine Taskforce (2011) available online to live life while experiencing the in UCD and has a Fellowship in Carsky M & Yeomans FE. (2012) Anaesthesia from the Royal College of extreme end of the spectrum of Overwhelming Patients and Overwhelmed dissociation, Dissociative Identity Therapists. Psychodynamic Surgeons in Ireland. She is a graduate Disorder, (DID) or the client Psychotherapy 40 (1): 75-90. of ICCP.
6 Irish Association for Counselling and Psychotherapy Volume 16 l Issue 3 l Autumn 2016 Fear within the Supervisory Space Karen Gavin
be a block in our relationships, enjoyment and careers, even to extremes of phobias e.g. agoraphobia, glossophobia. It can carry a stigma, be a source of shame and be difficult to express. “Fear immobilizes and fear motivates” (Sullender 2014: 124). Absorbing fear and anxiety on a daily basis can be contributing factors to frustration, stress, anxiety and eventually burnout. “All these fears surround and permeate the supervisory hour” (Sullender: 2014:123). My experience is that there is a dearth of exploration of fear in supervision, while many theorists devote a lot of attention to anxiety. “Fear and anxiety are closely related states. The question is what is behind the “ arkness is the absence of light, where light anxiety, what is the core fear? “It D shines, there is no darkness, and awareness is our relationship to the fear that is that light.” (Rutledge 2002:20) determines the choices we make” (Rutledge 2002:93).
Introduction Supervisor’s Fear of Power ear is a necessary lived feeling, emotion and experience, which While I work in a collaborative Fcan save us from danger and even save our lives. “The oldest and manner with my supervisees, strongest human emotion is fear and the oldest and strongest form I also have to acknowledge of fear is the fear of the unknown” (Svendsen 2007:32). Fear can be the power imbalance in the a hindrance or a motivating factor in our lives. “Fear can have both a relationship. Owning my own destructive and a constructive aspect; it can break you down or open a power to have a positive impact new, better relationship with the world” (Svendsen 2007:91). on my supervisee and on their It is important to acknowledge fear within the supervisor, fear in profession takes courage. “Power the supervisee, the people we work with and the organisations we differentials are inherent in work within and therefore it is reasonable to question how potentially supervisory relationships, therefore supervision can handle fear? In this article, I will examine how fear a common source of fear” impacts on all parties involved in supervision and on how fear can be (Sullender2014:125). Our core brought into the supervisory space. belief about power will influence how we use power in supervision. Fear is defined as: “An unpleasant emotion caused by the threat of “The idea of the one down position danger, pain or harm” (Oxford English Dictionary 2012). Fear can also triggers the inner child response”
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(Breene 2011:170). Therefore, the question that could be asked, is ur assumptions around power, and how power a source of fear for some O gender, culture and society influence these supervisors? Can our assumptions assumptions, can impact on our ability to manage around power be negative? Is power in the supervisory relationship. power a means to hurt or is it viewed positively as motivator, to and ethical dilemmas are all areas evaluation and gatekeeping and an persuade and encourage? “Much of great uncertainty” (Carroll & awareness of the power dynamics of the conflict around the role of Gilbert 2011:13). Uncertainty between us” (Creaner: 2011:153). the supervisor emerges from the can cause fear, the not knowing, In evaluation, while collaboration difficulty that many supervisors and the fear of getting it wrong. is essential, the supervisor has an have in finding an appropriate way “Fear is closely associated with ethical responsibility to be honest of taking authority and handling uncertainty” (Svendsen 2008:41). with him or herself. Evaluation can power inherent in their role” In the not knowing, we revert to impact on our core assumptions (Hawkins & Shohet 2012:55). our past experiences, whether and learning from our past Critical reflection on our positive or negative. If we are able education and work experience. If assumptions around power, and to recognise our fears in these these experiences are negative, how gender, culture and society situations, we will be able to we may try to compensate by being influence these assumptions, respond to them in an informed way too complimentary therefore not can impact on our ability to rather than unconsciously working identifying beneficial areas for manage power in the supervisory out of these fears. “Healthy fear growth. offers us guidance; neurotic fear relationship. If the idea of power Even when our experience is tries to control us” (Rutledge frightens us, how can we hold our positive, we can find evaluation 2002:162). If the supervisee is own power? If we work out of fear, difficult. “Evaluation is difficult, aware that they are bringing an it may cause us to resist using even for those who love the our power, or we may use power ethical dilemma, when they come challenge of supervision”, (Bernard games. Hawthorn cited in Hawkins to you, they could be facing their & Goodyear 1995:109). When we & Shohet (2012) talks about own fears. In addressing these value the supervisory relationship, abdicating power or manipulating fears, space will be created to we can be afraid to damage it power. In bringing awareness to explore a possible course of by challenging our supervisee, our fear around the use of power, action. “Our reactivity, anxiety and finding it easier to stay in the “cosy we can change our thinking and general problematic feelings can relationship” and thus avoiding transform power into a positive be usefully held within the space challenge. “People whose primary aspect of supervision. In doing this so that they can be understood degree has been as therapists we can model a positive use of in all their complexity before any power for our supervisees. course of action is decided upon”. may therefore find switching to (Hawkins & Shohet 2012:141). the role of evaluator particularly Ethical Issues Bringing awareness to our fear difficult” (Scaife 2001:215). The Ethical issues can create anxiety offers us choices in how we deal word ‘challenge’ can create fear, and fear for the supervisor, “What with the fear. “Face the fear, images of confrontation, winner or is the right thing?” “Do I need to explore it, accept it and respond to loser, or provocation, as opposed report this?” or “Will this damage it” (Rutledge 2002:151). to encouragement, motivation and our relationship?”. Vicarious liability transformation. It is important to is acknowledged in the literature Evaluation critically reflect as a supervisor (Bernard & Goodyear 1992:132) Bernard & Goodyear (1995) what challenge means for me and (Bond 2000:121). The supervisor and Carroll (1996) highlight the to acknowledge how this will impact has a responsibility not only to the gatekeeper role of the supervisor, on my supervisee. If I am afraid supervisee but also to the client. the occasions which requires us to of challenge I may avoid it in the “Ethics, ethical decision making use our power. “There will also be supervisory relationship.
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“Supervisors cannot take disturbance from clients” (Hawkins often be experienced in ways someone to a place they & Shohet 2012: 4). The concept that we don’t even acknowledge themselves have not been” (Powell of “not good enough” is also as fears. “The feeling of fear is 2011:175). Acknowledging my exacerbated by the supervisee not always the same, it varies own assumptions, core beliefs, comparing themselves to others, not only in intensity but also in quality” (Svenson 2008: 46). If understanding my fears and their colleagues and even the one is unaware of one’s own fear vulnerabilities and critically supervisor. “One common threat it can be expressed in various reflecting on them in my own is fear of inadequacy; although forms. “Fear can take many forms; supervision, will continue to supervisees want to succeed, dread, worry, panic, anxiety, self- increase my own awareness there is a prevalent concern of not consciousness, superstition and and my ability as supervisor. “measuring up” to the supervisor’s negativity” (Rutledge,2002:88). “Attending to my own anxieties, fears, frustration, mistakes, feeling ear can take many forms. It can be an intense of inadequacy, overwhelming F feeling, it can be familiar, or strange and it responsibility, and lack of sufficient can often be experienced in ways that we don’t even self-awareness is all part of the acknowledge as fears. process” (Rowe 2011: 43).
Supervisee’s Fear standards” (Bradley & Gould Shohet talks of “aggression as a The supervisee will come with 2002: 2). Comparing oneself to form of fear” (2008:191) he also different levels of fear, doubts and others usually results in a negative identifies other expressions of fear; vulnerabilities. The trainee will response to oneself it can make withdrawal, blame, intellectualizing have fears of failing evaluation, us feel inadequate, and it can also and resistance. Therefore, to fears about taking risks with remove our own responsibility for help the supervisee transforms their new knowledge and fears of our decisions. “To look out is to these behaviours; the underlying fear needs to be addressed. supervision itself. “Given all the blame; to look in is to own” (Holton: When we help the supervisee misconceptions that surround 2014). acknowledge their fears, it can be “supervision”, it is probably no Fear of taking responsibility for the disorienting dilemma, which surprise that our fantasies give our own actions e.g. “manager can bring about transformational rise to fears – which will also have said to do it”, “it’s the policy learning. Fear usually permeates their roots in past experience in the organisation” all leads into relationships and can present and past relationships” (Breene to a lack of accountability. It is as a parallel process therefore addressing the fear can have wide 2011:170). This is also true for only when we examine the fear ranging benefits. more experienced supervisees. that prevents us from making a The fear of inadequacy or “not decision, that we can we make the If the supervisor is unable to help being good enough” is a common necessary judgement on how to the supervisee bring their fears into theme in the workplace with higher proceed. In my experience we can the supervisory relationship, the demands placed on workers, have a tendency to focus on the effectiveness of the supervision with value for money, standards, negatives rather than the positives can be severely impacted. Non- accountability, all regular issues of ourselves. In supervision can disclosure is one outcome of a raised by managers with their we acknowledge our strengths, supervisee’s inability to be open employees. Doubt in one’s ability knowledge and experience or do and honest with their supervisor. may also be caused by interaction we fear appearing conceited and “Within a single supervision with those we work with. “We have arrogant? session, 85% of trainees withheld often seen very competent workers information from their supervisors” reduced to severe doubts about Manifestations of Fear (Mehr et al 2010:107). They go on themselves and their abilities Fear can take many forms. It can to explain their finding, “the results to function in the work through be an intense feeling, it can be supported the hypothesis that the absorbing distress, dis-ease, and familiar, or strange and it can greater the anxiety experienced by
Irish Association for Counselling and Psychotherapy 9 Volume 16 l Issue 3 l Autumn 2016 the trainee, the greater amount of the power that would be removed 2000:21). There can be many fears non-disclosure and a lower overall from that fear. “The goal is not to in the aftermath of an assault or willingness to disclose in the banish our fears but to tame them, other physical injuries in the line supervision session” (Mehr et al to identify the truth to focus their of work, “Am I seen as weak?” 2010: 111). energy, to welcome them home” “Did I provoke it?” “What did I do to deserve it?” “Did I follow the hrough dialogue with my colleagues fear of the policy?” “Will it happen again?” unknown, fear of getting it wrong, and fear of are all questions people might ask T themselves in this situation. criticism/challenge were acknowledged. If I had hidden all my concerns and fear, I believe they would The non-disclosure or resistance (Whitehead & whitehead 2010: have continued to cloud my to engage fully while a natural 173) Hiding the fear creates the judgement, negatively impacting response is a major block in the isolation and the panic. “When on my relationship with clients and supervisory relationship. “The key we hide our feelings about how colleagues and I would be working here is to accept our resistance the work is impacting us, we out of fear. In revealing myself in and then finding a supervisor we separate ourselves from others, supervision, I was able to learn can trust, despite our resistance, disempowering all of us in the from the experience. “They wanted concerns and fears” (Breene 2011: process” (Adamson 2011:88). to be allowed to re-discover their 168) It is important as a supervisor sense of self in the company of Physical Safety to be aware of the resistance, another” (Smith 2000: 24). It is I have discussed emotional acknowledge and work with it vital that fear doesn’t take over our responses to fear, but what about to understand the fear behind lives or our professions. “Fear is the fear of our own physical well- it. “Supervision-induced anxiety contagious. If someone becomes being and safety? I was physically causes supervisees to respond in afraid of something, this fear has assaulted and verbally abused a variety of ways, with some of the a tendency to spread to others, when leaving work, by a client responses being defensive. It is who in turn spreads it further” with whom I felt I had a good (Svendsen 2008:14) these defensive behaviours, which relationship. This was a frightening serve the purpose of reducing experience; I was concerned for my Conclusion the anxiety that are referred to own safety and the safety of the Fear is a very real issue in all our as resistance” (Bradley & Gould client, who was intoxicated at the lives, from our perceived threats, 2002:1). In a safe supportive time. I was alone, scared, uncertain to real threats to our physical and supervisory relationship, the of what was going to happen. There mental health, our professional supervisee can be supported were so many feelings afterwards, image, our financial rewards and to work though their resistance, embarrassment, shame, our promotional opportunities. Fear “Bring areas of darkness into light” questioning; how I could have is a factor for the supervisor, the (Conroy 1995: 14). handled the situation differently? supervisee and the organization. Through dialogue with my What could have happened? In establishing that fear is a factor colleagues fear of the unknown, “Very often what was imagined for all and often difficult to admit, fear of getting it wrong, and but did not happen was harder to how can supervision help? Many fear of criticism/challenge were deal with subsequently than the theorists and researchers on acknowledged. “Fear of the reality of what actually happened” supervision acknowledge a strong unknown is actually fear of my (Smith 2000:20). It was difficult supervisory relationship as key imagination” (Huber 1995:75). afterwards not to mistrust all my to effective supervision. “A good If it was possible to discuss in clients; I was also concerned about supervisory relationship is the supervision, a worker’s greatest how my colleagues perceived me. best way to ensure that we stay fear, to explore ways they would “There is always that fear. How will open to ourselves and our clients deal with that situation, imagine it be perceived by others?” (Smith and continue to learn, develop
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they not telling you?” Counselling and any theorists and researchers on supervision Psychotherapy Research, June 2010; M acknowledge a strong supervisory 10(2): 103-113 relationship as key to effective supervision. Oxford English Dictionary (2012) Powell, D. J. (2001) Clinical Supervision and flourish in our work” (Hawkins it is important to acknowledge in Alcohol and Drug Abuse Counselling & Shohet 2012: 255). This safe recurring themes and see what lies principles, Models, Methods. San non-judgemental space is the ideal beneath them, this is also true of Francisco: JosseyBass place to bring awareness to our fears. “Recurring fears are clues” Rowe, A. (2011) It’s at the Heart of Our fears. “The first part of looking (Rutledge: 2002:92). Practice in the Family Nurse Partnership at fear is just inviting it into our Programme in: Shohet, R. Supervision awareness without judgement” as Transformation a passion for (Thich Nhat Hanh 2012: 4). References Learning. London: Jessica Kingsley However, if we are resistant to Bernard, J M. and Goodyear, R.K. Rutledge, T. (2002) Embracing Fear and acknowledging our fear, unable (1995) Fundamentals of Clinical Finding the True Courage to Live Your to critically reflect on the root Supervision, Boston: Allyn and Bacon Life San Francisco: HarperCollins 2002 causes of our fear we may act Bond, T. (2000) Standards and Ethics Shohet, R. (2008) Passionate unconsciously out of our fears. This for Counselling in Action 2nd edition Supervision, London: Jessica Kingsley. can have a negative impact on our London: Sage Smith, M. (2000) “Supervision of relationship and work in general Bradley, L. Gould, L. J. “Supervisee fear in social work. A re-evaluation of and also our own wellbeing. “Fear Resistance” The International Child and Youth Care Network January 2002 reassurance”. Journal of Social Work is the biggest block to intimacy and Issue 36 1-5 Practice, Vol. 14, No. 1, 2000. communication” (Shohet 2008: Breene, C. (2011) Resistance is a Sullender, Scott, R. (2014) “Fear as a 197). If one talks of being afraid, Natural Path, an Alternative Perspective Dynamic in Supervision”, Formation and the impulse is to reassure the on Transformation in: Shohet, R. Supervision in Ministry. person, when often the fear is very Supervision as Transformation - a real and reassurance won’t take it passion for Learning, London, Jessica Svendsen, L. (2007) A Philosophy of away. “The belief is that anxieties Kingsley Fear. London: Reaktion Books Ltd and fears need to be uncovered Carroll, M. and Gilbert M. C. (2011) On Thich Nhat Hanh (2012) Fear Essential Being a Supervisee: Creating Learning rather than driven underground Wisdom for Getting Through the Storm. Partnerships 2nd edition London: New York: Harper Collins by reassurances” (Smith 2000). Vukani Publishing Whitehead, E. E. Whitehead, J. D. Rutledge discusses four steps to Carroll. M, (1996) Counselling transforming our relationship with Supervision Theory Skills and Practice. (2010) Transforming Our Painful fear “Face it, explore it, accept it London: Sage Emotions Spiritual Resources in Anger, and respond to it” (2002:15). Conroy, M. (1995) Looking into the Shame, Grief, Fear and Loneliness. New York: Orbis In a collaborative, safe, Well Supervision of Spiritual Directors. Chicago: Loyola University Press non-judgemental supervisory Creaner, M. (2011) Reflections Karen Gavin, MA, MIACP space these four steps can be on Learning and Transformation worked through. In allowing the in Supervision; a crucible of my Karen Gavin is an accredited counsellor supervisee the opportunity to experience, in Shohet, R., Supervision psychotherapist and supervisor as Transformation, a Passion for work through their own meaning with IACP. She holds an MA (hons) and understanding of how fear Learning London Jessica Kingsley in Supervisory Practice, BA in is affecting them, there will be Hawkins, P. and Shohet, R. (2012) Supervision in The Helping Professions. Counselling and Psychotherapy, Dip in a greater opportunity for broad 4th edition Maidenhead: Open Addiction studies and Dip in Nursing learning. “The essential thing is University Press Management. She has experience in a to allow the person to find their Holton, G. 2013, Public Lecture, All wide range of settings including abuse, own meaning in their own way in Hallows College, Drumcondra, Dublin 9 addiction, trauma and adolescence. their own time” (Smith 2000: 24). Mehr, K. E. Ladany, (2010) in. Caskie, In the supervisory relationship G. “Trainee nondisclosure: What are Contact: [email protected]
Irish Association for Counselling and Psychotherapy 11 Volume 16 l Issue 3 l Autumn 2016 A Creative Approach to Bereavement Support in Groups Breffni Mc Guinness
such as that by Shakespeare, is a resource that can help us to know that we are not alone in our grief. It also provides something more. Along with other art forms such as music, art, drama and movement, literature can offer us creative options for expressing our grief. Robert Niemeyer (2014) highlights his experience of working in psychotherapy with people who are bereaved and how they naturally use the “vocabulary of the arts” to help them find their way in a changed world. Sometimes words are not enough, or perhaps there are no words to describe the experience of our grief. Yet we can Abstract be moved by a piece of music we hear, a painting or photograph that This article gives an overview of the role of the creative arts therapies we see, or a creative activity that when dealing with bereavement. It outlines the value of bereavement we engage in. The arts provide us support groups in supporting people through loss and it includes a brief with creative, yet indirect, ways case study of group bereavement support, based on the Dual Process Model of Strobe and Schut. of engaging with our grief. This indirectness is important. It allows us a certain distance from the Introduction In another of Shakespeare’s plays rawness of our pain-and this is not Macbeth, the character Macduff, illiam Shakespeare, the necessarily a bad thing. WEnglish playwright, knew after hearing of the death of his wife and children states; something about the landscape The Grieving Process of grief. His only son Hamnet died “Give sorrow words: the grief Stroebe and Schut’s (1999) Dual aged 11. In the play King John, that does not speak, whispers the Process Model (DPM) of coping written shortly afterwards, a woman, oer-fraught heart, and bids it break.” with significant loss highlights Constance, distraught at the death (1992, Act 4, Sc 3). that effective grieving involves a of her own son, describes her grief: Interestingly, Shakespeare natural oscillation between two “Grief fills the room up of my here talks about male grief and types of coping. Loss coping deals absent child, the importance of finding ways with engaging with the pain of Lies in his bed, walks up and down to ‘give sorrow words’. This has the loss, while restoration coping with me, relevance for all who are dealing deals with adjusting to life now Puts on his pretty look, repeats his with a significant loss. His point, as without the person who has died. words, therapists will readily understand, Effective grieving involves a natural Remembers me of his gracious is that if you do not, or cannot, find oscillation between these two. parts, ways to express your grief, it will This means engaging with the pain Stuffs out his vacant garments with come out in other ways. It will end of our loss and also separating his form” (2009, Act 3, Scene IV) up breaking your heart. Literature, or distancing from it. If this
12 Irish Association for Counselling and Psychotherapy Volume 16 l Issue 3 l Autumn 2016 natural oscillation gets blocked or Bereavement Support Groups used in each session. It also interrupted, people can experience While many of these activities are describes the emotional distance difficulties in their grief (Costello, used on a one to one basis, the provided by the art activity as either 2012). The aim of bereavement focus of this article is on their use low, medium or high. support in such cases is to help to in a group context. Groups are an The use of creative arts activities re-establish the natural oscillation established means of providing in these groups was shown to be between engaging with, and care and support to people who are effective in enabling participants separating from, the pain of the bereaved (Corey and Corey 1997; to move between engaging with loss (Stroebe and Schut, 2010). Lorenz 1998; Kirk and McManus their grief and separating from it 2002; DeLucia-Waack, Gerrity et (Mc Guinness et al., 2015), as the Creative Arts and Grief al. 2004; Rogers 2007; Maruyama following participants’comments The creative arts can help people and Atencio 2008; Dyregrov et al. indicate: with this process by providing 2013) Some of their advantages “My experience of grief is not varying levels of indirectness or include: something that will stop but that distance from our emotional pain. 1. The normalisation of one’s it is now part of my life; it will be For example, in a bereavement grief experience through an ongoing process from now on. support group context, discussing meeting others in similar Although it may change with time the lines above from the plays King situations but it will always be with me and John or Macbeth enables a bereaved 2. Peer support and learning this is what I have learned to expect person to engage with grief but from each other and accept.” (Participant 12), (Mc at a certain level of distance from Guinness et al., 2015). their own loss, whereas bringing in 3. Reducing isolation ‘By understanding that grief (is). . . a memento of the loved one who 4. Information exchange a continual journey of carrying the has died will provide less distance 5. Gaining knowledge and loss forever but with good times and and bring the person much closer to learning new skills. bad times. It’s a constant adjustment their own grief. Bereavement support groups can to the changes. Plus, that it’s ok to go There is evidence that this type take time and effort to set up, but with the tough days and be accepting of intentional use of individual arts once properly established and run, and gentle with myself. It’s also ok to forms can be effective in helping they can be an effective support be happy also’. (Participant 17), (Mc people cope with bereavement. environment for people who are Guinness et al., 2015). Music is perhaps the most bereaved (Dyregrov, Johnson et al., established with a number of 2013; Mc Guinness et al., 2015). Case Study - The Bereavement studies highlighting its value to In 2010 the Irish Hospice Bake-off Group children (Rosner, Kruse et al., 2010), Foundation and St Francis Hospice In 2015, this creative arts adolescents (McFerran-Skewes and Dublin piloted a number of bereavement support group model Erdonmez-Grocke, 2000; McFerran bereavement support groups using was run in a community setting 2011) and adults (Hilliard, 2001; creative arts (McGuinness and outside of a hospice environment. Yun and Gallant, 2010; O’Callaghan, Finucane, 2011; McGuinness et The group was run in collaboration McDermott et al., 2013). Art al., 2015). The model used was with a local bereavement support is similarly recognised (Ferszt, an eight session closed group organisation. Seven people; two Heineman et al., 1998; Chilcote, based on the Dual Process Model men and five women attended the 2007), as is Drama (Curtis, 1999; of Stroebe and Schut (1999) group. One participant had lost a Dayton, 2005), though to a lesser outlined above. The sessions also sister, another a mother and the extent. There is also some evidence included a psycho-educational remaining five had lost partners or of the combined use of different arts component and were designed to spouses. The group engaged well activities in bereavement support help participants to move between with some of the arts activities – interventions (Kirk and McManus, engaging with, and separating from journal writing, use of photographs, 2002; King, 2003; Near, 2012), their grief. A range of different memento ritual and salt jars, while while Rogers (2007) and Thompson creative arts activities were choosing to postpone or not do and Neimeyer (2014) provide used to facilitate this by varying others (six-part story making, use helpful guides to the use of different the emotional distance from of literature). types of creative arts activities in participants’ grief. Table 1 below Some of the sessions were quite bereavement support. outlines the themes and activities difficult for some of the members
Irish Association for Counselling and Psychotherapy 13 Volume 16 l Issue 3 l Autumn 2016
Table 1: Themes for the 8 sessions arts activities in this bereavement Session Psycho Educational Creative Arts Activity Distance support group was helpful in Theme from grief enabling participants to explore experience their grief in a safe way. These 1 General points on Introduction to Journal writing High activities may also have helped Grief, Introductions Verbal expression participants to access their own and getting to know creativity and resourcefulness. each other 2 The grief process and Exploring loss through High In hindsight, while the bereavement why it is different for Photographic images. group set out to use creative arts each person. activities to help people come to 3 Theories of grief Exploring loss through the six part High terms with their grief, it was the creative story making method members’ own creativity; expressed 4 Secondary losses The use of literature e.g. C.S. Medium through their baking and caring for Lewis A Grief Observed (1961) each other - which was the most 5 The importance The use of ritual through bringing Low (Fulcrum memorable feature of this group. of remembering - personal mementoes (e.g. syringe Session) The use of creative arts activities Sharing mementoes driver, cigarette packet, piece of and memories. jewellery, photos) and creating a can certainly make a contribution sacred space. in supporting people who are 6 The impact of grief Using excerpts from drama Medium bereaved, especially in a group on the family. scripts to explore family context. They are not though, an end relationships, e.g. scenes from in themselves, and need to be seen Dolly West’s Kitchen by Frank Mc and used in the service of the person Guinness(1999) or persons who are bereaved. In this 7 Spirituality - How Participants bring and share High have your values and personal spiritual aids which help context, one of their most useful beliefs been affected them – e.g. prayers, readings, benefits may be in enabling clients by your loss? poetry – walking in nature – to access their own creativity and meditation resources. 8 Preparing for Final ritual - art making through High Using different creative arts transition. Looking the creation of a memory jar ahead and ending using coloured chalks and salt. activities in bereavement care ritual. can be of help to a client in their grieving process. However, a (use of photographs and memento in the sessions. This became an counsellor or therapist needs ritual). During the photographs important part of the group’s identity to be mindful of how an activity session when participants were and the way that it worked. For the may impact on a client and very aware of their loss, one of the last session, the group decided to also the timing of its use (See members who had brought along have a celebration and everyone Rogers, (2007) and Thompson some cakes that she had made, brought something in to share with and Neimeyer, (2014) for advice offered to share them with the the others. It was like a bake-off on the use of different creative arts activities). As in counselling group. As a facilitator I wasn’t sure - there were so many cakes and and psychotherapy in general, it whether to go with this or not. As treats, and people ended up taking is important to remember that facilitator, one voice in my head was home more than they came with. saying “this is not quite what the the client(s) know best. This is particularly so in the use of creative plan is - maybe we should stay with Process Evaluation the pain” and another was saying arts activities. Some people In their evaluations after the group, “this might be just what people like certain activities and others all of the participants said that they need”. In the end, I decided to go don’t. It is important to discuss found the group ‘helpful’ and that with sharing out the cake and it any potential use of creative arts it was ‘just what they needed’. As turned out to be a pivotal moment activities with clients and allow for the group. In subsequent one person commented on what their free choice in whether to sessions, without any prompting, was most helpful to her: “The partake or not. different members of the group comfort and support of other group brought in cakes or treats that they members and facilitators.” Conclusion had made and shared them out I believe that the use of creative Bereavement and grief are in many
14 Irish Association for Counselling and Psychotherapy Volume 16 l Issue 3 l Autumn 2016 ways about change and things ideal grief group: a qualitative study.” Including Preloss Music Therapy, for Eight coming to an end. While this is a Omega 67(4): 363 - 377. Bereaved Caregivers.” Death Studies natural and normal part of life – it Dyregrov, K., Dyregrov, A., & Johnsen, I. 37(2): 101-125. is not necessarily an easy process (2013) Positive and negative experiences Rogers, E., Ed. (2007). The Art of from grief group participation: A qualitative Grief - The Use of Expressive Arts in a – particularly when that ending study, Omega, 68 (1) 45-62. Grief Support Group. Death, Dying and involves the finality of death. Coming Ferszt, G., L. Heineman, et al. (1998). Bereavement. New York, Routledge. to terms with a significant loss in “Transformation through grieving: Art and Rosner, R., J. Kruse, et al. (2010). our lives takes time and a lot of the bereaved.” Holistic Nursing Practice “A Meta-Analysis of Interventions for adjustment. In these periods of 13(1): 68 - 75. Bereaved Children and Adolescents.” adjustment there are many twists Hilliard, R. E. (2001). “The use of music Death Studies 34(2): 99-136. and turns and at times they can feel therapy in meeting the multidimensional Shakespeare, W. (1992). The Tragedy of like they will never end. The creative needs of hospice patients and families.” Macbeth. Washington, Washington Square Journal of Palliative Care 17(3): 161-166. Press. arts can help us to navigate and find King, P. (2003). “Listen to the children and Shakespeare., W., (2009), King John, our way through these experiences. honor their pain.” Oncology Nursing Forum London: Digireads. Using creative arts activities in a 30(5): 797-800. Stroebe, M. and H. Schut (1999). “The bereavement support group can Kirk, K. and M. McManus (2002). Dual Process Model of Coping with provide participants with elements “Containing families’ grief: therapeutic Bereavement: Rationale and Description.” of a map for navigating the strange group work in a hospice setting.” Death Studies 23(3): 197 - 224. landscape of grief. They can also International Journal of Palliative Nursing Stroebe, M. and H. Schut (2010). “The help participants to access their 8(10): 470-480. Dual Process Model of coping with own internal compass of creativity. Lewis, C. (1961). A Grief Observed. bereavement: a decade on.” Omega: London, Faber. Journal of Death & Dying 61(4): 273-289. For those who have the privilege Lorenz, L. (1998). “Selecting and Thompson, B. and R. Neimeyer, Eds. of working with people who are Implementing Support Groups for (2014). Grief and the Expressive Arts - bereaved, the creative arts offer Bereaved Adults.” Cancer Practice 6(3): Practices for Creating Meaning. The Series many approaches that could be 161-166. in Death, Dying and Bereavement. New helpful. Perhaps their greatest benefit Maruyama, N. C. and C. V. Atencio (2008). York, Routledge. is in helping people to access their “Evaluating a bereavement support Yun, S. H. and W. Gallant (2010). own creative sources to integrate group.” Palliative & Supportive Care 6(1): “Evidence-Based Clinical Practice: The 43-49. Effectiveness of Music-Based Intervention their losses and find new life. McFerran-Skewes, K. and D. Erdonmez- for Women Experiencing Forgiveness/Grief Grocke (2000). “Group music therapy for Issues.” Journal of Evidence-Based Social young bereaved teenagers.” European Work 7(5): 361-376. References Journal of Palliative Care 7(6): 227-229. Chilcote, R. L. (2007). “Art therapy with McFerran, K. (2011). “Music Therapy with child tsunami survivors in Sri Lanka.” Bereaved Youth: Expressing Grief and Breffni Mc Guinness MA, MIACAT Art Therapy: Journal of the American Art Feeling Better.” Breffni is the Training and Development Therapy Association 24(4): 156-162. Prevention Researcher 18(3): 17-20 Manager in the Irish Hospice Corey, G. and M. Corey (1997). Groups McGuinness, B. and N. Finucane (2011). - Process and Practice, Brooks/Cole “Evaluating a creative arts bereavement Foundation. He is a dramatherapist, Publishing support intervention.” Bereavement Care educator and facilitator who specialises Curtis, A. (1999). “Communicating with 30(1): 37-42. in the areas of bereavement support Bereaved Children: A Drama Therapy McGuinness, B., Finucane, N., and and workplace bereavement. He has Approach.” Illness, Crisis & Loss(April): Roberts, A., (2015), A Hospice-Based worked with hospices, bereavement 183-189. Bereavement Support Group Using organisations and community groups Dayton, T. (2005). “The Use of Creative Arts - An Exploratory Study, Psychodrama in Dealing with Grief and Illness, Crisis and Loss, vol. 23 no. 4 323- to set up and run bereavement Addiction-Related Loss and Trauma.” 342. support groups. He has developed Journal of Group Psychotherapy, Near, R. (2012). Intermodal Expressive eLearning courses on bereavement Psychodrama & Sociometry (15453855) Arts. Techniques of Grief Therapy - Creative support as well as workplace guides 58(1): 15-34. Practices for Counselling the Bereaved. R. on bereavement policies and providing DeLucia-Waack, J., D. Gerrity, et al. Neimeyer. New York, Routledge: 201 - 204. support after suicide. Breffni is a (2004). Handbook of Group Counseling Neimeyer, R. and Thompson, B., (2014), and Psychotherapy. J. DeLucia-Waack, D. Grief and the Expressive Arts - Practices member of the Irish Association for Gerrity, C. Kalodner and M. Riva. California, for Creating Meaning, New York, Routledge Creative Arts Therapists (IACAT). Sage Publications. O’Callaghan, C., F. Mcdermott, et al. Dyregrov, K., A. Dyregrov, et al. (2013). (2013). “Sound Continuing Bonds with “Participants recommendations for the the Deceased: The Relevance of Music,
Irish Association for Counselling and Psychotherapy 15 Volume 16 l Issue 3 l Autumn 2016 History, Heredity and 1916: A Jungian Perspective Orla Crowley - to unforeseen places, wherein we may find ourselves wiser but sadder. “Whoever protects himself against what is new and strange… regresses to the past [and] falls into the same neurotic condition as the man who identifies himself with the new and runs away from the past. The only difference is that one has estranged himself from the past and the other from the future. In principle both are doing the same thing: they are reinforcing their narrow range of consciousness instead of shattering it in the tension of opposites and [thereby] building Daniel O’Connell Cathedral, Cahersiveen, Co. Kerry up a state of wider and higher consciousness.” “The serious problems in life, however, are never fully solved. If ever they should appear so it is a sure sign that something has been lost. The This state of wider and higher meaning and purpose of a problem seems not to lie in its solution but in consciousness arises, as we our working at it incessantly…” see, from the fragmentation of (C.G. Jung CW8) the previously-existing polarities which drives us forward from our Abstract previous position. This article looks at Ireland’s historical struggle for independence through the lens of Jung’s concept of complexes, deepened here into What is a Complex? the realm of cultural complexes, which, by their very nature, are at It was Joseph Henderson, a once both unique and collective. His idea that complexes contain both founding member of the C.G. Jung positive and negative poles (one identified with, the other projected), Institute of San Francisco, who offers us the construct of the “necessary other” that spurs - or first described, in a 1947 letter to constrains - our development. The implications of identification with Jung, the concept of the cultural powerful cultural complexes are contrasted with the particular way complex (Singer, 2004). Jung had something new may be born when the tension of opposites can be long recognised the uniqueness endured rather than collapsed into one or other of its poles. of different cultures - indeed, his less-than-wisely-timed writings Introduction on the differences between ung saw the tension generated by opposing entities as crucial for “Jewish” and “German” psyches Jdevelopment; it acts similarly to the charge that runs between the opened him to accusations of positive and negative poles of a battery; should one pole collapse, no anti-Semitism that still echo down energy flows. Holding such tension builds up energy which then seeks the years - and it follows that a creative outlet. As a sort of internal motor, it brings us - with a cost acknowledging the existence of
16 Irish Association for Counselling and Psychotherapy Volume 16 l Issue 3 l Autumn 2016 such differences in cultures must Individuation cultural unconscious, scraping inevitably mean recognising their For Jung, the journey of bloody influences from it as it separate cultural complexes. His individuation meant to realise as passes, arriving, baggage in hand, papers on the Word Association much of our potential as possible, as it were, to form the individual Test (experiments based on and was, for him, the great task of psyche. And that is the easy bit! timed responses to lists of life. He described four stages: What follows is turmoil as the words), published between 1) to separate from the mother struggle for consciousness begins. 1904 and 1909, gave birth and father complexes (in to his theory of complexes. Ego other words, to form our A hundred years of clinical own judgements, being able “Of course to win for oneself a experience has demonstrated to discriminate rather than place in society and to transform that these are powerful forces unconsciously identify with one’s nature… is in all cases a in the lives of individuals and family or cultural mores - with considerable achievement. It is remain a cornerstone of analytical all that this struggle implies) a fight waged within oneself as work, providing a structure for well as outside, comparable to the understanding the nature of 2) to form better relationships (to struggle of the child for an ego.” intrapsychic and interpersonal become more aware and more (Jung CW8). authentic) conflict. When challenges arise, it Put simply, a complex is a 3) to become more of who and is easier to turn to denial or mainly-unconscious, emotionally- what one is (take responsibility distraction rather than endure charged group of ideas and for our own development) the tension long enough to allow images drawn from personal 4) to make a connection to what Jung termed “the self- (or cultural) history that cluster something greater or Other than regulating function of the psyche” around an archetypal (or ourselves (forge a link to the to take over. This demands that impersonal) core. Jung wrote: spiritual or transpersonal). a sufficiently-functioning ego, “The complex has a sort of grounded in a sense of identity, body, a certain amount of its Cultural Complex be in place, otherwise there is own physiology. It can upset the Henderson defined the cultural danger of toppling or collapsing, of stomach. It upsets the breathing, unconscious as an area of becoming unbalanced, one-sided. it disturbs the heart-in short, it historical memory that lies When we disregard, ignore, or behaves like a partial personality. between the collective unconscious consign issues to the unconscious, For instance, when you want and the manifest pattern of the pieces of ourselves and our to say or do something and culture. (One of Jung’s unique collective humanity become unfortunately a complex interferes contributions to psychology was atrophied. Both collectively and with this intention, then you his formulation of the concept personally, this soul loss is a say or do something different of the collective unconscious, a by-product of the tremendous from what you intended. You deep layer, a motherlode even, capacity we have developed to are simply interrupted, and your common to all, from which one’s disregard, a capacity that drains best intention gets upset by the individual personal unconscious the life force of every living thing. complex, exactly as if you had arises as flowers do from an For some, the complex (personal been interfered with by a human underlying rhizome.) Henderson’s or cultural) is their identity; for being or by circumstances from cultural unconscious resides at more fortunate others, there outside” (Jung CW8). the collective level of a particular develops a healthier identity One of the primary aims culture, and is expressed through (personal ego), separate from, in Jungian work is to make the customs, art, architecture of but related to, the contaminating complexes more accessible to that particular society. complexes. Tasked with relating, consciousness, thus freeing up The personal unconscious discriminating, enabling reflection, some of the trapped emotional arises, like the Shannon from the and the weighing-up of choices, energy for other psychological Shannon Pot, from its source, the the personal ego is the workhorse development in the service of collective unconscious; it travels of the psyche. For the first group, individuation. through the birth canal of the the complex-identified, the complex
Irish Association for Counselling and Psychotherapy 17 Volume 16 l Issue 3 l Autumn 2016 rules, and in a totalitarian frenzy, oppressed or victim mentality. Long- brooking no dissent, makes submerged traditions are frequently arbitrary decisions; for the second, mined in order to construct such the ego painfully makes and an identity. (“IRISHMEN AND holds space for the consideration IRISHWOMEN: In the name of God of alternative viewpoints before and of the dead generations from coming to a decision. Jung (CW8) which she receives her old tradition described the characteristic of nationhood, Ireland, through us, patterns of an activated complex - summons her children to her flag repetitive, autonomous, resistant and strikes for her freedom.”) to becoming conscious, and driven This struggle can, and frequently to collect experiences that confirm does, get entangled in different its historical point of view. underlying powerful cultural As personal complexes can be complexes that have stored up said to emerge out of the level historical experience and memory of the personal unconscious (in over centuries of trauma. (“In every interaction with deeper levels generation the Irish people have of the psyche and with early asserted their right to national parental/familial relationships), so freedom and sovereignty; six times cultural complexes can be thought during the last three hundred years Cultural complexes are based of as arising out of the cultural they have asserted it to arms. on frequently-repeated historical unconscious (as it interacts with Standing on that fundamental right experiences that have taken root both the archetypal and personal and again asserting it in arms in in both the collective psyche levels as well as with the broader the face of the world, we hereby of a group and in the psyches outer world of school, community, proclaim the Irish Republic as a of the individual members of a social and other media, and all Sovereign Independent State, and group. They express archetypal other forms of cultural and group we pledge our lives and the lives of values for the group, and as life). our comrades-in-arms to the cause such tend to be unexamined and of its freedom, of its welfare, and of Singer and Kimbles (2004) taken-on wholesale. So, cultural its exaltation among the nations.”) further develop the concept of complexes can be thought of as the large-scale social complexes fundamental building blocks of a Fresh trauma may energise which form in the layer of the particular inner sociology - but one sleeping monsters, awakening cultural unconscious of groups and that is not objective or scientific in them, freeing them to rampage. become cultural complexes, writing its perception of different groups Jung, presciently, said that we do that and classes of people, a perception not have complexes, but that our “another level of complexes read or filtered through psychic complexes have us; the splinter exists within the psyche of the lenses coloured by generations of personality takes over the whole. group and within the individual ancestors. This received attitude The resulting identification with at the group level of their psyche. (or the psychic atmosphere into the emotionally-charged complex We call these group complexes which we are born) carries a inevitably means that our vision is “cultural complexes,” and they, powerful emotional charge, just narrowed, our personality reduced, too, can be defined as emotionally as it also contains an abundance the vital space for reflection lost; charged aggregates of ideas of information and misinformation we become mere agents of the and images that tend to cluster about the structures of societies. colonising complex. around an archetypal core and Its essential components are (“The Irish Republic is entitled to, are shared by individuals within cultural complexes. and hereby claims, the allegiance an identified collective...[While] When a group is emerging from of every Irishman and Irishwoman. personal complexes and cultural long periods of oppression, it must The Republic guarantees religious complexes are not the same, they define a new identity (a new ego) for and civil liberty, equal rights and do get mixed together and affect itself in order to move on from an equal opportunities to all its citizens, one another”. and declares its resolve to pursue
18 Irish Association for Counselling and Psychotherapy Volume 16 l Issue 3 l Autumn 2016 the happiness and prosperity of the negative, so that when activated, existed before they were defined whole nation and all of its parts, the ego (group ego or individual and were thus defined by their cherishing all of the children of the ego of a group member) becomes very existence, those states such nation equally and oblivious of the identified with one part of the as Ireland, attempting to emerge differences carefully fostered by unconscious complex while the from occupation, dispossession, or an alien government, which have other pole is projected out onto denial, have a very different form of divided a minority from the majority a suitable hook (another group, growth. in the past”). or one of its members). Intense “Most dispossessed peoples Singer (2006) suggests the collective emotion is the hallmark fought a different fight. Under psychology of cultural complexes of an activated cultural complex. occupation, they could never be operates both in the collective Students of 20th century history will their distinctive selves but had to psychology of the group as well also recognise in this the pattern seem so by an adopted attitude, an as in the individual members of the McCarthy Communist “witch assumed style. This they would later of the group. He observes that hunts” of the 1950s. proceed to justify by a recovered or individuals and groups in the grips Conscious efforts to broaden the discovered content” (Kiberd, 1995). of a particular cultural complex grounding of an Irish identity were In The Broken Harp: Identity automatically take on shared body made by Douglas Hyde - who strove and Language in Modern Ireland, language and postures, or express to base the foundation of Irishness biologist Tomás MacSíomóin their distress in similar somatic on more than mere opposition to presents the decline of Irish as one complaints. Historical examples of England and Englishness; WB Yeats of the most insidious outcomes such possession by group/cultural dreamed of “enlarging Irish hatred” of multi-faceted colonisation from complexes abound; the “witches” so that Ireland would be more the 16th century through to the of Salem, Massachusetts (1692), than not-England, would start from present day. He describes the where vulnerable individuals, somewhere other than a negation, residual effects of post-colonial exhibiting similar behaviours, would construct an identity born of trauma perpetuated not only were deemed to be possessed its roots and ideals. through intergenerational imitation by demons brought by other of behavioural patterns, but also members of the community, who The Irish Split in the hereditary transmission were consequently tortured and The psychic division engendered of the colonial condition via DNA executed - the basis for Arthur by the existence of two competing structures and epigenetic profiles. Miller’s play, “The Crucible. Similar languages, evident in the post He sees three distinct agents tales of possession, debauchery, Famine years, caught many of colonisation - initiated by the group coherence, torture and native Irish in the bind of needing Tudors, perpetuated by the Irish execution, in the small French town to abandon Irish, while not yet Catholic Church’s movement into of Loudon in 1633, are written having mastered English. Even the power vacuum left at the end of up in Aldous Huxley’s non-fiction the Emancipator himself, Daniel the Irish War of Independence, and novel, “The Devils of Loudon”; O’Connell, considered Irish a barrier subsequently consolidated in the and, perhaps closer to home, the to progress, holding his meetings imposition of the English-inspired epidemic of late 19th century/early everywhere in English – status quo. 20th century hysteria described by “I could witness without a sigh In the particular psychological Charcot and Freud, which we now the gradual disuse of Irish …I am profile of the Irish - as a people conceive of as a corollary of the sufficiently utilitarian not to regret its who for generations suffered cultural and sexual repression of abandonment” (Berresford Ellis). genocide, famine, and sexual women in the Victorian era. Thus, Declan Kiberd suggests, crime as consequences of the Such an unconscious and Irish writers wrote “with one eye first two waves of colonisation - he autonomous nature lends the cocked on the English audience notes a catastrophic vulnerability complex the ability to spread like …painfully imitative of English to the third and present wave of wildfire and to infect vulnerable literary modes… practised with colonisation, that of Anglocentric subjects, demonstrating what Jung the kind of excess possible only to neo-liberal globalisation, of which had also pointed out - the bipolar the insecure”. He goes on to say our tendency towards, and toleration nature of a complex, positive and that, while most nation-states have of, alcoholism is symptomatic.
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Suggesting that Ireland has a Donegal, arises out of the political general infatuation with, and and cultural struggle between References assimilation to, the cultural norms England and Ireland. Focussing Berresford Ellis, Peter, (1985) A History of of other Anglophone cultures (closer on (mis)communication as the the Irish Working Class, Pluto Press to Boston than Berlin, perhaps?), engine of the turbulent and he proposes that adopting the desperate situation between the two Burke, Edmund, (1790) Reflections on language of the coloniser exposes countries, Friel uses language as the Revolution in France the colonised subject to a world-view a device to highlight the problems Friel, Brian (2010) Plays, Faber and Faber in which he is a mere junior partner, of communication — lingual, Jung, C.G., (2000) CW 8 The Structure a Johnny-come-lately. Consequently, cultural, and generational. Both and Function of the Psyche, Routledge colonised peoples appear perversely Irish and English characters in Kiberd, Declan, (1995) Inventing Ireland: willing to internalise unflattering the play “speak” their respective The Literature of the Modern Nation, colonial conceptions of themselves languages, but in actuality it is Vintage - to introject the cultural complexes English that is mostly spoken by the Mac Síomón, Tomás, (2015) The Broken of the coloniser, with all their actors. This allows the audience to Harp: Identity and Language in Modern concomitant negative associations, understand all the languages, as if Ireland Nuascéalta Teoranta vis-à-vis, the colonised. He a translator was provided. However, Monty Python, (1979), Life of Brian, IMDb compares the peculiarly Irish onstage, the characters cannot “disjunctive dialogue”, aka “the gift comprehend each other. Neither Proclamation, 1916, An Post, facsimile, of the gab”, with the fragmented is willing to compromise and learn www.anpost.ie testimony of traumatised survivors the other’s language, a metaphor Singer, Thomas, (2006) The Cultural of the 2001 AirTransat crash, whose for the wider barrier between them; Complex: A Statement of the Theory and excessive attention in reporting tragedy ensues, and the play ends its Application, Psychotherapy and Politics minute details while lacking a ambiguously. Int. 4(3) 2006 cohesive narrative is typical of post- Singer, T, Kimbles, S, eds. (2004), The traumatic stress disorder. It is sobering to recall that the 1916 war of independence was Cultural Complex: Contemporary Jungian Although many of the traumatic swiftly followed by civil war, an Perspectives on Psyche and Society, episodes of Ireland’s past occurred outward expression, perhaps, of Brunner-Routledge generations ago, MacSíomóin successive internal psychic wars? Scruton, Roger, (2014), The Soul of the contends that the past is not really World, Princeton University Press past since there is an ever-present In conclusion, the lesson Jung hereditary factor in susceptibility to tries to impart is that eliminating PTSD. Thus, since the majority of the Other, the opposite pole, does Orla Crowley Irish people have lived in conditions not lead to development, but rather Orla Crowley trained as a clinical favouring PTSD for many centuries, to stagnation and rigidity. Just five biochemist and spent several years in and indeed, may still do in Northern years after being released from clinical and research positions until she Ireland, the entire populace of nearly three decades in prison, became interested in psychotherapy, Ireland are heirs to what he terms, Nelson Mandela’s espousal of the particularly in the thinking of C.G. Jung. ‘Super Colonised Irish Syndrome,’ (previously-hated) Springboks as After graduating from the Tivoli Institute, demonstrated by an inability to be “One team, one country”, proved she trained as a Jungian analyst. She internationally assertive, comparing to be an inspired move that united has a private practice in Blackrock, Co. our apathetic surrender to European South Africa for the very first time. Dublin where she works with individuals Union austerity with the ferocious The ability to endure such terrible and couples and as a clinical supervision. opposition of Greece, a nation tension offers a chance for a She has lectured and taught on Jungian possessing an unbroken intellectual more creative outcome. Wars on themes for over twenty years, in Russia heritage unscathed by cultural terror, on “Axes of Evil”, jihads - all as well as here in Ireland. colonisation. strive to eliminate and remove the Other from consciousness. Jung’s She has a particular interest in trauma Literature challenge to us is to find new ways work and incorporates EMDR and The drama in Brian Friel’s play, of relating, to continue to “[work] at sensorimotor approaches into her “Translations”, set in 19th century it incessantly”. practice.
20 Irish Association for Counselling and Psychotherapy Volume 16 l Issue 3 l Autumn 2016
Letter to the Editor
9 Roger Casement Park Glasheen Road Cork City
8 July 2016.
Dear Editor, I am writing this letter in light of the current exposure of the “history of deception” and questionable financial controls at the suicide bereavement charity, Console. At the heart of Console and similar charities is a dedicated and professional psychotherapy staff providing an exceptionally good service. A large proportion of these staff are members of the IACP. Our organisation represents the interests of both client and psychotherapist. Our core values include one of “Valuing the Individual” and I would ask that in relation to this we could reappraise the value we place on our membership. We cannot avoid the conversation of how our membership, in particular our pre- accredited members, are seen, valued and treated across the Charity Sector. While some charities respect and value our member’s contribution there is growing evidence that others regard our pre accredited membership as a steady and cheap unregulated service. This is wrong and money that is specifically donated to fund counselling services is going elsewhere. I want to be clear, this letter is not about pre - accredited psychotherapists versus accredited psychotherapists. And it needs to be understood that what impacts one group affects the other. Charities who predominately engage pre- accredited psychotherapists exclude accredited members from the possibility of long term paid work. Also, in this case, the client is deprived of a more versatile and experienced service. The IACP has the opportunity to put forward guiding principles and policy as regards to how it wants its membership treated as they engage with the Charity Sector. There is a significant level of separation and detachment between Head Office and the members on the ground as outlined in the Strategic Review. While the recent “Purpose Statement” is welcome, action is needed. It is simply not good enough anymore to not get involved in light of what is happening. Although the newly established Charity Regulatory Authority is attempting to monitor the sector it is obvious that it is under resourced and lacks power. I suggest that part of what the IACP can do is to inform the regulator of concerns regarding the treatment of our members. Regulation must include wage standards for all of our membership. Maybe we could be proactive in terms of suggesting minimum payment rates for pre- accredited members. We might consider proposing a need for charities to engage one accredited member to match a stated number of pre-accredited members. This would create a balance to our membership’s involvement in the Charity Sector. It would also open up opportunities and increase morale. Last but not least it would provide those seeking counselling with a more complete and experienced service. I am aware that I am presenting proposals that need time to be digested. My hope is that this letter will open up a discussion on how we can be proactive on the issues presented. There is a need to create a balance between IACP psychotherapy support for the Charity Sector and the protection of all our members. This means respecting what we offer to charities including placing a value on our work in terms of fees. In saying that I want to be clear, this is not simply about money but about respecting our profession and maintaining professional standards. To conclude, I am not a lone voice in terms of what I have outlined in this letter. This is a conversation we need to have and the IACP membership provides the perfect platform for this. I look forward to our membership’s response to this letter.
Yours Faithfully
William Quirke Pre - accredited member IACP
Irish Association for Counselling and Psychotherapy 21 Volume 16 l Issue 3 l Autumn 2016
Workshop Review
ATTACHMENT THEORY – THE JOY OF CONNECTION
Presenter: Dr. Denise Mullen Reviewed by: James McDonagh MIACP Date: 28th May 2016 Venue: The Spencer Hotel, IFSC, Dublin 2 Organised by: Dublin Regional Committee
Attachment theory and its implications for us as therapists 2. The Ambivalent Pleaser style explored aspects including: would require many days or weeks to address and the facilitator • Anxiety based ‘feelers’ opened by acknowledging this at the start of the day. A one- • Not as developed in thinking day workshop can only be a flavour, and if provocative enough, • Chaotic and externally focused perhaps leaving more questions than answers. Regardless • Rabbit trails in response to questions of time constraints, Denise brought herself to the day with • Minimally aware of their feelings enthusiasm, light heartedness and worked in a collaborative • Perpetually pleasing others manner with attendees, while questions flowed freely and • Likeable… but too nice were generously answered. 3. The Ambivalent Vascillator style explored aspects We opened with participant interaction, which involved including: looking at emotions, pairing the audience in a role play on • Idealization – devaluing… good/bad splitting providing attachment comfort using the MATS model: Mention, • High degree of anger and reactivity Ask, Touch & Stay. Denise set out to look at the complete • Experienced sporadic, unpredictable connection growing Attachment Model of up • A = Avoidant • Deep need for consistent, predictable connection • B = Secure • Chase can be the most exciting part for them, then • C = Ambivalent – Pleaser reality sets in. • C = Ambivalent - Vascillator • Mom may have preferred babies, but dropped the child • D = Disorganised/Disoriented – Controller as they began to develop • D = Disorganised/Disoriented – Victim • Dads with Vascillator imprint: allows his moods to Time constraints meant it would not be possible to explore dictate – not the child’s interests each aspect of the model and the focus of this day was the • Erratic interactions with parents leaves child confused, Avoidant and Ambivalent types. A video of the 1980’s sitcom, hyper-attuned to sign of connection/ abandonment. the Gilmore Girls, was used to demonstrate aspects of each Denise brought an open and collaborative environment of attachment type and how our responses are developed from enjoyment and engagement into the day. Using the attachment family and childhood. Using a power-point presentation to model she brought practical exercises to us as a group of inform, she developed the imprint for each type and then therapists, that helped us to be aware of how our attachment explored presenting traits and tendencies. This exploration styles impact us as therapists and those we support. The was followed by offering us growth goals for each type to writings of John Bowlby and Mary Ainsworth were flagged as facilitate more mature awareness and development. A flavour critical to any understanding on attachment. Supplementing of the different styles/imprints presented: this as recommended reading are: 1. The Avoidant style can happen in a number of ways: How We Love, Milan & Kay Yerkovich, Three Rivers Press, Detached Mother, Death/Illness, Consistent Distraction, How We Love Our Kids, Milan & Kay Yerkovich, Three Rivers too early into Crèche, Premature babies – Incubator. Press, The Avoidant style explored aspects including: Handbook of Attachment, Edited Jude Cassidy & Phillip R. • Appear level – steady (attractive to chaotics) Shave, Guilford Publications • Lost desire for connection, limited range of emotion • Low grade, chronic depression Becoming Attached, Robert Karen, Oxford University Press Inc. • Left brain, analytical Attachment Disorganization, Edited by Judith Solomon & Carol • Competent, but creativity often stifled C. George , Guilford Publications • When hurt – isolate Talking With Children About Loss, Maria Trozzi, Perigee Books
22 Irish Association for Counselling and Psychotherapy Volume 16 l Issue 3 l Autumn 2016
Conference Review
SEPI – WHERE RESEARCH MEETS CREATIVITY
Date: 16th-18th June 2016 Reviewed by: Clair-Bel Maguire, MIACP Organised by: The Society for the Exploration of Venue: Trinity College, Dublin Psychotherapy Integration (SEPI)
Back in June, I had the pleasure of attending the 32nd practice-research integration, so that both practitioners SEPI Conference in Trinity College on behalf of IACP and researchers can work together toward a common as we were one of the Conference’s platinum sponsors. goal and this was evidenced in the presentations. The Society for the Exploration of Psychotherapy Past president, Dr. John Norcross, has stated that Integration (SEPI) is an international organization and “For psychotherapy integration in general, we require over three days I attended pre-conference workshops, more compelling research and practice advocacy. mini-workshops, structured discussions, symposia Although theoretical debates continue, the seismic and panel discussions along with the Poster session. shift has been in the direction of empirical evidence”. Here some IACP members presented imaginative, What did I learn? Actually lots; too much to mention creative and informative research on Friday evening. in this short piece but here are some interesting short The goal of SEPI is to provide an opportunity to quotes I picked up along the way. listen, learn, discuss and compare a wide range of “Therapy is not about change it’s about the PROCESS perspectives, promoting innovative applications of of change” – Dr. Henny A Westra, York University, integrative psychotherapy. This year’s theme was “The Toronto, Canada. Therapist in Integrative Therapy: Implications for “Instead of asking a client about their strengths Practice, Research and Training”, and attracted over and weakness try asking them about their ‘strengths 370 delegates from almost 40 countries who were and vulnerabilities’” – Dr. Arthur Nielsen, Northwestern open, curious and creative as they were brilliant, who University, who has a new book coming out: ‘A were not only tolerant, but embracing of ambiguity. Roadmap for Couple Therapy: Integrating Systemic, The idea to have the conference in Dublin grew two Psychodynamic, and Behavioral Approaches.’ years ago in Montreal and preparations began “Instead of referring to the ‘emotional baggage’ our immediately. Finally, on Thursday the 16th of June, clients carry, try thinking of it as the client’s ‘legacy Dr. Marcella Finnerty, SEPI and IACP member, on behalf issues’ instead” - Ellen Wachtel, private practioner of the local committee, along with SEPI’s International and author, New York. Her book is: “We Love Each President, Dr. Beatriz Gómez welcomed everyone in Other But..” the Edmund Burke Hall while SEPI’s admin team with SEPI provides its’ members with access to research friendly faces and genuine enthusiasm ensured that and small grants. If you are interested in joining as things ran smoothly every day from 8.30am until very a full or student member or want to take a look at late in the evening. their programme of events, log on to: There was a great collegial atmosphere with http://www.sepiweb.org/ programmed discussion sessions, opportunities to brainstorm ideas and connect in an effort to support existing and new collaborations across the scientific fields of psychotherapy as well as informal gatherings in the evening to meet new friends and catch up with others. SEPI recently expanded its mission to embrace
Irish Association for Counselling and Psychotherapy 23 Volume 16 l Issue 3 l Autumn 2016
some cases were relieved because the years of tension Book Review and conflict they had witnessed were ending, most children were shocked that their parents were separating. Title: Marital Separation in Contemporary Non-initiators, both men and women, were also shocked Ireland; Women’s Experiences (2016) and in denial that the relationship had reached a point Author: Lucy Hyland of no return. Six of the women identified themselves as Published: 2015 non-initiators and in these cases the separations were ISBN: 978-3034318365 triggered by the husbands’ affairs. The book provides a number of informative tables which provide the statistics Reviewed by: Pauline Macey, MIACP, ICEEFT, M.Sc. Family Counselling around these and other findings. In almost all cases, the women were left to deal with the impact of the loss This informative and timely book is an essential on their children, while the men disappeared and were sociological study based on the experiences of fourteen either not willing or not invited to participate in family women who have been through events and rituals after the separation. marital separation in contemporary Lack of organisational support Ireland. It is a must for all couple’s systems that offer specific help counsellors, relationship and family around separation (particularly therapists and anyone interested in outside of Dublin) and lack of how patterns, roles and expectations communal rituals compounded the in marriage are changing. It is difficult emotions, shock, denial, and structured around the following key heartbreak. Mixed results in terms areas: the attitudes of Irish culture of counselling are referred to with and families to marital breakdown; many of the women acknowledging typical events that lead to breakdown; that it was too late for counselling to losses and gains as part of the save their marriages. transition of separation; While most of the women in the reconstruction of relationships and book said they would never marry family post-separation again, Hyland (2016) provides These questions provide a structure valuable insight and hope around the that assist the focus to move back process they went through in and forth from detailed personal experience to the rebuilding themselves and their lives, and shaping a broader impact of culture and family systems in which new future. She reminds us that regardless of our liberal experiences are embedded. The uniqueness of each views, those of us who have been through separation woman’s individual experience is sensitively engaged often end up with a sense of internalised shame. She with and deeply respected, as themes unfold. also reminds us that we have to stop blaming ourselves Increased awareness of gender equality in the 1970’s and adopt a more positive construction of separation. and 1980’s influenced how women and men failed to Most of the women in the book left their marriages adapt to the changes in traditional roles assigned to because of not feeling loved. This book implores and them. They were unable to communicate their needs supports the need for us to start exploring exactly what and expectations. Because most of the marriages in kind of love sustains relationships and marriages. this study lasted twenty years or more, the impact was We need to offer more loving respect and support to greater and more complex than in the case of marital those who experience separation, whether it comes as breakdown after a shorter time period and the biggest a shock, or the incredibly difficult end point, of a decision- loss was often one of self-esteem and identity. making process based on courage, emotional honesty A distinct pattern in each case forming a series of and a strong enough sense of self, to step out of the events led to the eventual breakdown. While children in pain of a broken marriage.
24 Irish Association for Counselling and Psychotherapy