Smith ScholarWorks Theses, Dissertations, and Projects 2008 Embodied practice : do social work therapists explore client strengths as expressed in the lived experience of the body? Duncan Nichols Smith College Follow this and additional works at: https://scholarworks.smith.edu/theses Part of the Social and Behavioral Sciences Commons Recommended Citation Nichols, Duncan, "Embodied practice : do social work therapists explore client strengths as expressed in the lived experience of the body?" (2008). Masters Thesis, Smith College, Northampton, MA. https://scholarworks.smith.edu/theses/1254 This Masters Thesis has been accepted for inclusion in Theses, Dissertations, and Projects by an authorized administrator of Smith ScholarWorks. For more information, please contact [email protected]. Duncan Nichols Embodied Practice: Do Social Work Therapists Explore Client Strengths as Expressed in the Lived Experience of the Body? ABSTRACT This study was undertaken to explore how seven social work therapists attend to client strengths, with an emphasis on embodied experience and embodied strengths where competency and resourcefulness are experienced. Besides asking questions about the obvious markers of a person’s physical experience (hobbies, work, etc.), questions about the psychoanalytic concept of body-self and attributes of certain popularized mind/body approaches or techniques social work therapists may use were also posed. Workers, whose practices are in community mental health, inpatient psychiatry, medical and private practice settings, provided experience-near narrative data. Major findings were workers’ belief in the clinical value of using a strengths perspective. Workers also offered a variety of experiences of, and reasons for, the barriers they commonly encounter to using this approach. In terms of embodied practice, however, most could not identify more than a few techniques they use currently. Techniques identified, while important, were under-articulated, such as "being present" with clients. (Other language used for this concept was "being grounded" and "mindful" in session, as well as the approach of using "experiential" treatment modalities.) One significant finding was that most workers identified a decreased use of embodied practice over the course of their careers. On a positive note, a significant finding was a belief that working in the clients' environment greatly facilitates and enhances attending to client strengths, particularly embodied strengths. EMBODIED PRACTICE: DO SOCIAL WORK THERAPISTS EXPLORE CLIENT STRENGTHS AS EXPRESSED IN THE LIVED EXPERIENCE OF THE BODY? A project based upon an independent investigation, submitted in partial fulfillment of the requirements for the degree of Master of Social Work Duncan Nichols Smith College School for Social Work Northampton, Massachusetts 01063 2008 ACKNOWLEDGEMENTS Firstly, I would like to thank my thesis advisor, Joan Laird, for her erudite guidance and editorial support. I would like to thank my writing teacher, Maida Solomon, of Vermont College, for her excellent tutelage in years past, and also as a role model for how to get this writing project right. I must also recognize the instruction of my two practice teachers at Smith College, Manfred Melcher and Cara Segal, for demonstrating what it means to be heartfelt and present clinicians. I also could not have conceived of this study without the experience of dance. With this in mind, I would like to thank my dance teachers, Melinda Gross Evans and Ford Evans. As a person who moves in space, they helped me feel the ground. Mostly, I would like to thank my children and their mother, Didi, for emotional support; my “intellectual” father, Bob, for repeatedly telling me to “get a trade” when I was a teenage boy; and my partner, Nicola, for understanding everything. ii TABLE OF CONTENTS ACKNOWLEDGEMENTS.......................................................................................... ii TABLE OF CONTENTS.............................................................................................. iii CHAPTER I INTRODUCTION................................................................................................ 1 II LITERATURE REVIEW..................................................................................... 13 III METHODOLOGY............................................................................................... 68 IV FINDINGS ........................................................................................................... 79 V DISCUSSION....................................................................................................... 114 REFERENCES ............................................................................................................. 131 APPENDICES Appendix A: Human Subjects Review Approval Letter.............................................. 143 Appendix B: Informed Consent................................................................................... 144 Appendix C: Letter of Inquiry ..................................................................................... 148 Appendix D: Interview Guide……………………………………………………….. 149 Appendix E: Case Vignettes………………………………………………………… 153 iii CHAPTER I INTRODUCTION Every day I walk myself into a state of well-being and walk away from every illness; I have walked myself into my best thoughts and I know of no thought so burdensome that one cannot walk away from it. Soren Kierkegaard (1847) Carl, a 52-year-old man, an inpatient in a psychiatric ward of a hospital, was admitted to the emergency room for detox. Carl is a veteran who has been previously diagnosed with PTSD. During his admission, one night at 3 A.M. he is making a puzzle in the lounge. A nurse on his ward tells Carl to stop working on the puzzle. He must go to his room, she says, sleep, and show up for group and individual sessions the following morning. Carl protests, but does what he’s told. The next day, Carl sees the psychiatrist for med management, and then attends a group. Later, he complains to the social worker that he was not allowed to do one of the only things he enjoys and which, he reports, truly relaxes him. Theresa, a 21-year-old woman who works part time in sales, is also a painter. She is in private therapy for severe social stressors and for help managing her bipolar disorder. Theresa is at home in her studio hard at work on several paintings for a small group show at a gallery. The days she works, her fingers, and occasionally her hair, have paint on them. She often wipes paint on her pants. The process of painting for the day ends with her pushing brushes into the tins with turpentine in them to get them clean. She stretches her own canvas for large pictures. She wonders, when she is at the gallery opening, will she see her therapist, whom she sent an invitation to and whom she really likes and trusts; will her therapist be there to witness the “embodied” client in an environment outside the therapy room? Sandra, a 55-year-old woman with diabetes who stays in bed at home most of the time, is depressed. It is difficult for her husband to care for her; she argues with everything he tries to do. He reports to the social worker that he loves her, but she has changed for the worse. Sandra enjoys only one thing, he reports. She finds a way to drag herself down to the bingo parlor each week where she enjoys playing with her friends. Her husband describes her there as an imposing figure at the table, as though a queen, with not a hint of depression. In fact, he reports, Sandra’s friends don’t know what her life—or his life—is like at home. Why is 1 Sandra being treated only for her diabetes? Neither the social worker nor other clinicians involved in their care explore the meaning or reality of this lived experience in which Sandra exists among her bingo buddies. One might ask, who is the Sandra outside of her depression and her medical problems? One might also ask, what is it about Bingo that fully engages, even transforms, Sandra? Michael, a boy of 14, is very disruptive at school. He is being reprimanded with a school suspension. The school psychologist is about to code Michael with a learning disability, lining him up for special ed. Michael’s mother is upset about this process. She is confused and angry and feels that the school does not know some important things about her son. For example, she knows that Michael makes braided hemp necklaces in front of the TV at home—a hobby he enjoys and engages in for hours at a time. His mother is aware that at these times Michael is amiable, cooperative, and focused in ways that she feels the school does not see. Further complicating the situation, Michael’s mother needs further education herself about the clinical practice of engaging kids with wandering thoughts like Michael in a sensorial, tactile activity to help them better focus. Additionally, Michael’s music teacher has special knowledge about Michael’s performance in his class, and has a similar take on him as his mother. Unfortunately, the music teacher, the parent, the school psychologist, and special ed teachers do not meet with one another at the same time. In fact, special ed teachers often do not attend special ed team meetings. How can they learn of Michael’s self-integrating interests? Is there an awareness that they all should meet and share different perspectives and work as a team? Joseph, a 71-year-old retired attorney, experienced a significant decline in his health when he stopped playing golf. He had