November 11th, 2022
- make this clip about panic attacks / anxiety, into its own vid
- "gentle marketing" or "authentic marketing"
- George Kao has a bunch of courses on "authentic business" etc
- Marketing for Hippies
- Tad Hargrave
- (kinda woke)
- > also -- i am continually amazed at the competence of the people around me. i've never done couples counseling before but i'd guess you are among the best. you really helped us untangle a big knot with many parts, made me (us?) feel safe and open, diffused us when we were starting to trigger each other or go too far on a tangent
i think this feels like the first fight where often when we'd talk we'd make it worse instead of better. like we were going deeper into the fight instead of finding our way back out. which seems like the perfect use of a skilled facilitator
- notes on couples counselling etc from reading
- therapy pre 1950s etc was original very opinionated about not working with more than one family member
- > We base our ethical discussion on a system commonly referred to as principle-based or “prima facie” ethics. These terms refer to a system developed by English philosopher W. D. Ross (1877–1940), who tried to resolve the problems associated with both utilitarian and deontological theories of philosophy. According to Ross, the best ethical theory rests on certain basic moral principles he referred to as “prima facie duties.” By this he meant that an obligation would be maintained unless it was overridden by a superior one (Knapp & VandeCreek, 2006). There is now common agreement that there are five such principles: autonomy, nonmaleficence, beneficence, justice, and fidelity.
- huh, interesting principles, although I can't figure out which direction the superiority would go haha
- doesn't really feel adequate
- > what are we to do when certain therapeutic techniques require deception?
- well, you might consider that maybe those techniques are unethical!
- > Another aspect of fidelity is the notion that we must place the welfare of clients above that of our own and work for their benefit. In a legal sense, this creates a fiduciary duty between the therapist and the couple, but the goal of fidelity can be quite difficult to achieve when couples present with opposing interests that are not readily solvable.
- this is a very fascinating puzzle!
- systems theory
- > 1. In its most basic formulation, systems theory holds that a group of interrelated parts functions as a larger unit of analysis (Becvar & Becvar, 2006). Systems theory maintains that families, like other systems, are greater than the sum of their parts, and that change in one part of the system can create changes elsewhere.
- yep, obviously trivially true from my perspective
- > 2. Systems theory emphasizes the contextually based nature of human behavior. Rather than maintaining a focus on individuals in a decontextualized manner, as do certain individual therapy approaches, systems theory focuses on interdependence and the notion that, based on the circumstances in which we find ourselves, our behavior varies. Because our primary relationships establish a basic relational context for our behavior, we assume that working with couples is a more ecologically valid and effective approach to relational problems.
- yep, seems right
- > 3. Human behavior cannot be understood in a logical or linear fashion, such that we can explain C if we know how A caused B. Rather, systems theory emphasizes the circular and recurring nature of behavior, which makes the search for ultimate causes impossible. As a result, systems approaches to therapy entail interrupting dysfunctional behavioral patterns to provide an opportunity for healthier ones to emerge.
- not false but "dysfunctional" likely ends up being judgy, and more than "interrupting" is required for healthier ones to "emerge"
- > 4. Systems theory does not explain how behavior changes. Rather, it teaches us how behavior remains the same; that is, presenting problems often represent a way couples have found to maintain problems rather than to solve them. Systems-oriented practitioners understand that the solution for the couple may lie in addressing issues of which they are unaware by disrupting dysfunctional interactional patterns rather than helping clients to understand them better.
- I was gonna say yes to the first half, but on re-reading it it's also counteractive and missing the "the presenting problem is a solution to a worse (from some perspective) problem"
- very much not my approach
- I'm all about better understanding. the behaviors emerge from the understandings
- > 5. “Triangulation” refers to the notion that when two persons are in conflict, each will try to align with a third person (or, at times, with a philosophical principle, value, or standard) to avoid or to gain assistance with the stressful dyad (Nichols & Schwartz, 1998; e.g., by increasing that person’s influence in the dyad). For example, a husband might intensify his relationship with his son as an alternative to addressing a problematic relationship with his wife. Minuchin (1974) noted that this structure frequently places children in the uncomfortable position of being unable to satisfy both parents, because alignment with one is seen as an attack on the other. Systems-oriented practitioners remain mindful of this idea and work to maintain neutrality, because failing to do so may erode therapeutic effectiveness.
- hmm neutrality seems different than maintaining a sense of being allied with both, which seems to me possible and worth cultivating frames that reinforce it
- the 7 problems
- definition of the client: to whom am I primarily responsible?
- > How is the practitioner to work on behalf of both parties when they have competing goals and actions that might benefit one but harm the other?
- there's a bunch of frame assumption going on... I feel like they're failing to adequately take the systems perspectiev
- presumably John doesn't want to be with Mary if she doesn't want to be with John (even if he can't quite conceive of that possibility, let alone what he'd want in it)
- and so there's a truth to be found of "what do these people want?"
- and from there an obvious answer emerges
- this is not a hostile legal debate where each side is just trying to get as much from each other as possible
- > Whereas the therapist has no legal duty to nonclients, systems-oriented therapists cannot ignore the potential adverse impact that a divorce might have upon the children
- great point though! but systems-oriented therapists ALSO cannot ignore the potential adverse impact that a couple staying together resentfully might have on the children
- like, keeping the relationship together can never be THE aim
- they have another example... and I'm kinda like "fuck I basically just don't want to work with such a client"
- > It is not advisable to initiate treatment without first making a professional assessment of the presenting problem and recommending a course of treatment.
- way of thinking is incompatible with SSOK ([client is the] single source of knowledge)
- confidentiality
- they talk about "no secrets" agreements, which seems decent
- not a direct concern for me since as a coach not a therapist I'm not engaging with legal versions of this, but rather agreements based on shared understandings
- they name an example of one client disclosing an affair, and intending to tell their partner then deciding not to
- and I'm just like "uhhhh yeah I would want a shared understanding with my clients that some stuff is going to be broached and we are going to deal with it"
- but that could absolutely be kept secret for an appropriate period required in order for the client to disclose to their partner! just not indefinitely
- neutrality
- the way I seem to approach this is by fairly early on giving each client an experience of me advocating for them towards the other
- so not neutrality whatsoever but omnipartiality
- again, maybe this is nigh-impossible when dealing with a system that is too dysfunctional, but it's not my intention to deal with those systems
- and if I do, I'll figure out what the leverage points are
- might involve working with people one-on-one until they feel really understood by me, then articulating to everyone something that works for everyone's frame, to find & build common ground
- case study re "can't just work for the good of the whole"
- > Sandra and Lisa come to treatment regarding a conflict over family resources. Sandra and Lisa have sacrificed themselves and their economic resources to no avail in an attempt to help their son Robert, who has a chronic, severe, disabling, and rare medical condition. They were recently informed that a new medical procedure might help Robert. Because it is still experimental, their insurance carrier will not cover the cost of treatment. The only available funds are those in their daughter Jill’s college fund. Sandra wants to use the remaining funds to try and help their son, whereas Lisa feels that Jill has already sacrificed enough for her brother and should not be penalized further.
- this is a good puzzle!
- my focus would be on helping each person take the perspective of the other
- if they can't come to a shared sense of the landscape, their individual & collective values, and what to do, they need to separate I think
- if that seems really drastic, well, then, I guess it's a sign that the relationship is really worth having persist, and therefore it's really worthwhile for them to figure out how to take each others' perspectives
- omnipartiality
- > Although [multipartiality] is appealing, it is not without its disadvantages. First, one must frequently align with one member of the couple or another. Maintaining neutrality in this way requires much skill. It can be difficult for the therapist, because it requires great personal flexibility, intense concentration, and an ability to repair relational ruptures, so that neither member of the couple feels attacked or ignored for very long.
- uhhh I would simply develop much skill, personal flexibility, intense concentration, and an ability to repair relational ruptures 😅
- > A second problem is that multipartiality assumes that the couple will come to understand the continual shifting of allegiances as indicative of the therapist’s neutrality. Such an assumption presumes a certain degree of insight and intellectual sophistication that all couples may not possess.
- you know, you're not wrong here
- one response I have to that is that I'm mostly interested in working with people who are at that level — it's someone else's job to level them up
- or we'd have to look at those assumptions directly, which I think I would be relatively able to notice and direct attention to
- change of format - shifting between couple & individual work
- seems like a lot of the issues here are caused by rigid confidentiality, inability to adequately achieve multipartiality, and layery counteractive approaches
- live supervision
- I don't see how this is relevant to couples, let alone my work
- record keeping
- ooooooh interesting
- yes, this is a mess
- one partner obtaining records after there's been a separation
- lawsuits and stuff here
- pragmatically, one answer is in my informal work, I'm simply not bound by an agreement to share my notes, so I'll only do so if that seems wise to me
- including that my notes might contain reflections that are personal to ME
- testifying
- similar issues
- well, it's my intention to work primarily with people who are better able to sort out their issues outside rather than inside of court, given the nature of win-wins etc
- although I guess if I end up working for a wider range of people, perhaps that won't hold