1 JYVÄSKYLÄ STUDIES IN EDUCATION, PSYCHOLOGY AND SOCIAL RESEARCH THE EXTENDED THERAPY ROOM COMING FROM AN AUTHENTIC PLACE… A phenomenological–hermeneutic study of my experiences as a psychotherapist in the Extended Therapy Room Carina Håkansson 2014 Esitetään Jyväskylän yliopiston yhteiskuntatieteellisen tiedekunnan suostumuksella julkisesti tarkastettavaksi Agora-rakennuksen salissa Ag Gamma syyskuun 12. päivänä 2014 kello 12. Academic dissertation to be publicly discussed, by permission of the Faculty of Social Sciences of the University of Jyväskylä,in building Agora, hall Ag Gamma on September 12, 2014 at 12 o’clock noon. JYVÄSKYLÄ 2014 2 Editor Carina Håkansson Publishing Unit, FAMILJEVÅRDSSTIFTELSEN i Göteborg Rengatan 8 426 71 Västra Frölunda Sweden Cover picture: Lars Lerin Translation: Camille Forslund ISBN 978-91-637-6525-4 Copyright © 2014, by FAMILJEVÅRDSSTIFTELSEN i Göteborg Print BOK & TRYCK 3 ABSTRACT Håkansson, Carina The Extended Therapy Room, Coming from an authentic place… Jyväskylä: University of Jyväskylä, 2014, 206 p. ISBN Many times over the years as I´ve worked in the Extended Therapy Room in situations with others I have asked myself what in the work we do touches and affects, and what part I as a psychotherapist play in that. In what way do I and my way of being-in-the-world contribute to what unfolds in the therapeutic meeting? Is it even possible to arrive at a conclusion through research or should the question be put some other way? A world in movement and an existence without generally accepted answers on one side, and the need to hold onto something on the other. This is the way life is for us human beings, and also the way it is in the therapeutic room. So how do we relate to this both- and? What kind of knowledge can you generalize about and how do you pass on your own experience so that someone else can use it? How do you create meaning from what I call ordinary life in therapeutic work? Over the years of working together with both family homes that provide an ordinary context and psychotherapists and other professional helpers I have experienced our clients become “something else” than the label they were given before we began working together. I´ve also experi- enced how those of us involved in the process; the client´s family, family home, therapist and supervisor have been affected by it. I have experienced a noticeable difference that has left mark on my work and perspective on psychotherapy. My years of experience have generated questions about the essence of the therapeutic meeting and how to bring to life and include the thera- pist, both as a human being and a professional, in practice and as part of the description of what happens. These questions and years of practice and studies have together led to the formulation of the research question: What is the most important in my experience as a psychotherapist in the Extended Therapy Room? This dissertation describes an experience-based knowledge that has developed from practice built on each and everyones presence and partic- 4 ipation. This practice combines ordinary life with therapeutic knowledge and is not primarily about theoretic perspectives and therapeutic tech- niques, but the meeting between people and how these meetings in differ- ent ways make an impact, not only on the one here called client, but on all of us included in the shared commitment and the organization in its whole. The research material is made up of fourteen stories where I’m part of the events that take place, mainly as a psychotherapist but in one story I´m a social worker and in another I´m a child. The investigation is based on a phenomenological-hermeneutic method which was developed in order to understand what emerges from one’s own lived experience (Lindseth and Norberg, 2004). By moving as a researcher between the naïve reading and the struc- tural analysis within the framework of the hermeneutic circle seven main themes have emerged and together they constitute the results of the re- search: Being present, participating, being part of an ordinary context, meeting, taking personal responsibility, communicating and enabling. These main themes are described and illustrated in the Critical re- flection section. In the section Theoretic Reflection and Discussion these main themes are reviewed in depth and discussed in relationship to other research and practice, mainly in the field of psychotherapy and philosophy, but also in relation to art and physics. The dissertation concludes with a Method reflection that describes the method´s effect on the research and the researcher´s approach. The question wheather it is possible to arrive at a conclusion about the importance of the therapists own lived experience through research was raised in the beginning, and as this project now has come to an end it has become clear that it is possible. Not only possible, but also important, as it is important how to ask questions and how to act. Through this research project it has become clear how traditional psychiatry and psychotherapy far too much focus on the one here called client and by doing so create a context which rather exclude than include, especially by the use of psychiatric diagnosis and descriptions of the other. The most important in my experience as a psychotherapist in the Extended Therapy Room doesn’t primarily concern different therapeutic methods or specific therapeutic doctrines or schools, but rather the impor- tance of a personal stance and to utilize lived experience in an organisation that enables people to be authentic and include themselves in vital meet- ings. 5 Author’s address Carina Håkansson Familjevårdsstiftelsen i Göteborg Rengatan 8, 426 71 Västra Frölunda, Sweden [email protected] Supervisors Jaakko Seikkula Department of Psychology University of Jyväskylä Anders Lindseth Centre for Practical Knowledge Nordland University in Bodö Reviewers John Shotter Arnt Myrstad Opponents John Shotter 6 7 ACKNOWLEDGEMENT A band of people - from near and far, from now and the past - together made it possible for me to write this thesis and to find an answer to my research question. Unfortunately, it is not possible here to mention all of them, it would take far too much time and space and still many would have been left out. So for now I will mention some of the most important ones, those who have had an essential impact on me and this investigation. My grandmother Stina and my grandfather Harry have been with me and, at times I have heard their voices inside of me reminding me of our history and the importance of the past. And not to forget where you come from. My father Lars and mother Ulla who always believe in me, some- times a bit too much, but still without their trust I don´t think this thesis would have been done. My beautiful sons Karl and Axel who bring love, pride, joy and mo- tivation to carry on with my mission despite the days when feeling hard to know how and what to do. My dearest friend Ingela, who as always has “been there”. Barbro who has been my supervisor and role model for many years. She has taught me so very much about the art of therapy and by supporting and believing in me. Tom who taught me to trust my feelings and to listen to my body, and who extended my network in a most amazing way. For that I will al- ways be grateful. Anders and Jaakko who accepted to be my supervisors even though I had very little knowledge about research. They have in different ways supported and challenged me, and by doing so helped me to deliver this text. When I asked Anders a while ago how on earth he could have seen some research in my first draft, he smiled and said that he already then saw that it would work. Thank you for that. Kjell and Björn at Smålandsgårdar taught me about the importance of ordinary life in professional work. So did Hellevi from Narkomanvård- sprojektet in such a passionate way that I from that point always have been dedicated. Lena who has helped me a lot with computer things, proof-reading and designing the text in a correct way. It has been so very important. 8 Patricia through wise mentorship and important conversations. Suzanne, Lasse and Annki who have read and commented and cre- ated new questions from their experience and perspective. It has inspired me a lot. A special thank you to Suzanne who always believed in the im- portance of this project and many times read it with new eyes and an open heart. Leticia who shows in action that it is possible to make the dream come true. Ulla for dear friendship with essential conversations and lots of laughs. Ingo who supported me to go for it and introduced me to many phil- osophical issues. Daniel and Bob who have inspired me a lot and through their own work shown the importance of taking a stance and to step outside main- stream. Camille who has translated and always tried to catch my expressions and words to make the text vivid. Authors and readers related to MadinAmerica not only inspired but also demanded me to extend the knowledge about what is most important when dealing with hard life situations. Ken who was there for me in a crucial moment, thank you. People from different places in the network International Meeting on the Treatment of Psychosis who have asked questions and been supportive by wanting to know about the progress and what is about to happen. Lars for your beautiful painting.