Welcome to all supervisors, psychotherapists, counsellors, coaches, mentors, managers and all those that are passionate about and hold a responsibility for their own and other peoples’ well-being at work, the well-being of the organisation in which they work and the society in which that work operates. This blog is here to share ideas and inspiration, articles and news. Please feel free to contribute and share.
(Article published in Self and Society Vol 45 No. 1 April 2017)
People have reported not feeling supported by their professional bodies around complaints. As one of the aims of ISN is to create a supportive and challenging community, I wanted to post this article which might throw light on some of the issues that arise. It would be good to hear from people.
Many professionals have a fear of a complaint being made against them. In this article my aim has been to throw some light on some of the dynamics that might be operating around complaints in order to move towards a more compassionate, systemic view that goes beyond blame. Some of what I have written could be applied to relationships of any kind.
In July this year (2017), I am helping to organise a conference to look at the dynamics of complaints in the so-called helping professions. I start with the premise that whatever position we take around complaints is a form of countertransference. In other words, whether we sit on an ethics committee, whether we start an insurance company for therapists, or even whether we organise a conference on the dynamics of complaints, we are trying to heal something in ourselves by the positions we take.,
I started with myself and found more authority issues, a tendency to split which I saw mirrored in how client and practitioner can be split when a complaint is made, and an omnipotent wish to protect “my” profession from going down the route of other professions where fear has dominated to the detriment of all concerned.
Discovering this has helped me be clearer, but I recognise my understanding will always be incomplete. What I want to do now is to share some of my understanding about what could be going on around complaints. You may disagree with some or all of it. You may feel supported in it. But it is the conversation that we might have after you have read it that will be important.
- Our society is becoming increasingly litigious. This is bound to increase fear. From a place of fear, we are more likely to be in survival mode, which lessens the opportunity to combine, to see a bigger picture.
- It also means we become increasingly defensive. If I defend myself against you, I am implying you are dangerous. I therefore am attacking you, which justifies your attacking me. We are caught into a vicious cycle.
- Whatever the content of the complaint, there is a process question of Why now? This may (or may not) be connected to a stage in therapy, like ending or where, just before a breakthrough, a major rupture from earlier in the client’s life is often re-enacted.
- A complaints procedure could be used as an avoidance technique. This does not mean we don’t look at the behaviour of the therapist, but we recognise that relationships are also co-created.
- When we teach supervision we encourage supervisors not to believe what the supervisee says about their client uncritically. “I have a very difficult client” would be translated into “I am finding this client difficult.” I would not believe a client’s version of their parents or of their partner uncritically – I would see it as their truth but not the In other words I am mindful of a bigger picture. I would want a complaints procedure to hold a bigger picture, however obvious wrongdoing might appear.
- People often mention so called bad therapists. So called bad practice exists in all professions and we may have an omnipotent fantasy it can be stopped.
- We are the bad therapists too. If there is someone who says he has never done bad therapy (whatever that is), then this is someone who is likely to be doing bad therapy (whatever that is).
- The people professions are different in that there is not an object involved eg a tooth or a car to be fixed or some product that can be exchanged or refunded. We are paying for a relationship not a product or something to be fixed. The criteria for success or failure are hard to judge.
- The therapy profession has not been going on as long as medicine, social work, teaching. It may have a wish to prove it has its own house in order. The desire to be accepted by mainstream has a cost, and this cost may be coming out in the approach to complaints where we over identify with the complainant.
- If we look at some of the processes involved in OCD, then the patient is unable to cope with their anxiety. They invent rituals to help them feel safe. The rituals do not deal with the underlying anxiety so become more pronounced.
- Are we caught in the same dynamic? A complaints ritual that does not deal with the underlying fears and anxieties, leading to an ever more vigorous complaints procedure.
- Many years ago there was a channel 4 programme called Doctors Mistakes. What this particular hospital found was that instead of going into denial and defence, when the doctors admitted mistakes and apologised publicly, suing rates went down, learning went up, and so accident rates went further down. Is there something that therapeutic bodies can learn from that?
- Do complaints offer a sense of offering to regain potency that is perhaps misguided? We know a lawyer who has successfully sued therapists and said it did not bring closure for the clients and he will no longer do it. There was suffering for the therapist and not the outcome the client really wanted.
- We have a complaints procedure about therapy, which does not seem therapeutic. Why? What is the need of the complainant? This is not about pathologising the client, but given as mentioned earlier about doctor’s mistakes, then a system that enables this kind of inquiry and subsequent acknowledgment would seem most fruitful.
- So by extension the first step in a complaint is to ask the complainant what they want. If it were a product it could be a replacement, or a fixing or a refund. For a relationship – what is wanted? If we again go back to doctor’s mistakes, is it acknowledgment rather than an identification with the complaint that might be needed? How can the question “What do you need?” be held? In other words the best support for the client might not be to pursue their client’s grievance at face value.
- Or it might be. This is not throwing the baby out with the bathwater..
- I think our relationship to what therapy is all about reflects our attitude to complaints. If we think it is about understanding ourselves, rather than being fixed, then whatever happens is an opportunity to reflect. A complaints process in the helping professions could go the route of reflection rather than pursuing the right/wrong process.
- And of course if we can’t prove the therapy works we don’t get funding so we really are caught in a double bind. There is a much bigger picture here about justification and money and fixing.
- In divorce courts, there used to be an adversarial framework, which created much distress. It is now recognised that it is more useful that the couple be held using methods like mediation. A complaints procedure which holds the practitioner and client would mirror the holding that is part of our work.
- Supervision holds the therapeutic relationship. A complaints procedure could mirror that.
- Society seems to be attracted to the Victim, Persecutor, Rescuer triangle We can fall into replicating that with initially therapist as persecutor, client as victim and complaints procedure as rescuer. This then turns into complaints procedure and client as persecutors and therapists as victims.
- Our work is about relationship and awareness and yet we can lose both foci in looking at complaints because it activates scripts like fairness, justice, power, betrayal and so on
- An understanding of parallel process is vital in our work. Can we apply this to complaints? Is there a replication of a client’s or therapist’s or complaints body’s traumata being reenacted? An understanding of some of the dynamics of shame in the victim, persecutor, rescuer triangle could help with that.
- Do both therapist and client have an image of a safe haven which gets betrayed by reality? Do therapists set themselves up to do more than we can, and thereby collude with a system that demands and blames?
- I am back to looking at our personal countertransference and that of our profession. I believe that doing this can lead to less polarised positions and perhaps help us to embrace an understanding, inquiry process model rather than a right/wrong content model. This may help us work towards all parties being able to voice the feelings, unmet needs, values and expectations which might lie behind a complaint.
This is a personal list (obviously). I originally intended to start with my top ten, but the list just grew. I would be interested in others’ favourites. Robin Shohet
Mostly 60’s and early 70’s. I still think they might have something to offer
- If You Meet the Buddha on the Road, Kill Him. Sheldon Kopp. In the mid-seventies, when I was new to therapy, I remember the sense of excitement in reading this classic. I think it stands the test of time.
- Uncommon Therapy. Jay Haley. Ditto. Describes the work of one of the geniuses of the therapy world, Milton Erikson.
- Impro. Keith Johnston. A pioneer in the world of improvisation drama which I think is one of the best trainings for a therapist in that it combines combining, spontaneity, imagination with shrewd insights as to what blocks us.
- King Lear. William Shakespeare. Brilliant. From school I was so resistant to Shakespeare, but this play broke through all prejudice.
- Summerhill. A.S. Neill. My first therapy book – describing his experimental school where pupils were allowed to choose whether they attended lessons. A huge influence on my ways of thinking
- You are not the Target. Laura Huxley. Another remnant from the sixties, a prelude to the growth movement. Exercises to expand consciousness from Aldous Huxley’s wife
- Doors of Perception. Aldous Huxley. You can see my interest in drugs for expanding awareness. A classic that belongs to a different era.
- The Divided Self. R.D. Laing. A classic for those of us around in the late 60’s and looking for alternative ways other than conventional psychiatry.
- The Dice Man. Luke Reinheart. A psychiatrist decides to live his life according to the throw of a dice. I have been inspired to take risks by surrendering to the throw of a dice.
- Myself and I. Constance Newland. A fascinating account of a cure by LSD written about 50 years ago. A very important book for me in the 60’s when I was studying psychology to give me the courage to challenge the system.
- Mister God This is Anna. Flynn. A moving tale of a relationship between a man in his thirties and a young girl who together explore the meaning of life. Describing the East End of London pre second world war, it takes you to an age of innocence as well as the incredible wisdom of little Anna.
- Dream Power. Anne Faraday. A book that made working with dreams accessible and took it out of the analytic field.
- The Third Reich of Dreams. Charlotte Beradt. Discovered when researching for my book on dreams. The author collects dreams from Nazi Germany 1933-39 and we see how the unconscious wish to conform and belong contributes to the rise of Nazi Germany.
- Foundations of Psychohistory. Lloyd de Mause. Connects world events with the world of therapy in a very compelling way, particularly looking at birth trauma. Both this and Beradt’s book shed light on what might otherwise be incomprehensible world events.
- Realms of the Human Unconscious. Stanislas Grof. Using LSD, Grof looks at the nature of consciousness including the effect of different stages of birth.
- How Can I Help? Ram Dass. A close look at the dynamics of helping and the ruthless honesty needed to be of help and the self deception that can fool us into thinking we are helping.
- Collected Papers on Schizophrenia. Harold Searles. Written in the 50’s, original papers on psychoanalysis, including the first one to write about parallel process in supervision.
- Shakespeare Comes to Broadmoor ed Murray Cox.. A spellbinding account of bringing plays like Lear, Hamlet to Broadmoor and how the inmates and the actors interacted with so much intuitive understanding of the plays.
- Love’s Executioner. Irvin Yalom. No-one for me matches Yalom’s ability to tell stories of psychotherapy.
- The Blind Side of Eden. Carol Lee. A refreshing perspective on male/female relationships sympathetic to both sexes.
- Writing Down the Bones. A classic on writing influenced by her Zen Master. She sees writing as a form of spiritual practice.
- Writing Your Life. Deena Metzger. I have a personal interest in writing for self discovery and this is one of the books I enjoyed most.
Non-duality, a Course in Miracles – general heading of spirituality.
- The Course in Miracles. Urtext. This channeled book (the Urtext is the clearest version) has so much wisdom and this too has influenced me hugely.
- The Disappearance of the Universe. Gary Renard. It seems strange to include the work of a man who quite frankly I did not take to, but much of this book goes into depth around the teachings in A Course in Miracles in a way I found very useful.
- The Work of Byron Katie. Any youtube clips. She challenges us to keep inquiring about some of our deepest held beliefs. I have used her four questions and the turnaround both in my personal life and in my teaching. The can blow your mind which is what they are designed to do.
- The Untethered Soul. Michael Singer. Written with great clarity, shines a light on who we are and the defences we erect to deny our true nature.
- I Heard God Laughing. Poems of Hafiz. A complete and utter joy to read the works of this 14C Persian poet.
- In Treatment. A DVD series of a therapist and his clients brilliantly acted by Gabriel Byrne with a very good script. Addictive as well as instructive.
- The Art of Possibility. Ben Zander. Does what it says on the tin. Encourages us to think that with the right attitude anything is possible. Zander is a conductor and this and his youtube clips shows how he inspires his music students.
- The Inner World of Trauma. Donald Kalsched. A brilliant exposition of how trauma is so difficult to treat from a Jungian Analyst.
- The Body Keeps the Score. Ditto with lots of practical suggestions.
- A Stroke of Insight. Jill Bolte Taylor. The author had a stroke and her recovery sheds light on the left/right hemisphere, the former corresponding to what is commonly called the ego. Also on a Ted Talk.
- Wilful Blindness. Margaret Heffernan. Another book that sheds some light on what might otherwise be considered inexplicable behaviour.
- Love’s Hidden Symmetry. Bert Hellinger. The Founder of constellation work. Always good to go to source.
- The Forgiveness Project. Marina Cantacuzino. The author has collected remarkable stories of forgiveness and put them together in a very powerful way.
- Intelligent Kindness. John Ballatt and Penelope Campling. A kind and intelligent book on helping to create a different culture in the NHS.
- The Music of Madness. Ivor Brown. An Irish psychiatrist in his 80’s describes his life. Fascinating, including descriptions of the therapeutic community movement in the 70’s. A lovely section on group dynamics which I use for teaching.
- The Thin Book of Appreciative Inquiry. Sue Annis Hammond. I have used appreciative inquiry very successfully with teams and organisations and this little book is an excellent introduction.
Over 40 years in the field have changed me a lot and I increasingly feel less inclined to describe what I do as “psychotherapy”.
What I offer is a space in which together we can explore who we are when not boxed in by our stories and emotions.
Contact Jochen using the form below:
I am an integrative Counsellor / Psychotherapist in private practice. I am a Certified Clinical Supervisor working with counselling therapists and those working in other mental health settings.
My particular interests are working with Trauma resolution, holistic approaches to understanding and addressing anxiety and depression. Currently familiarising with Polyvagal system and Trauma’s effect on the nervous system response.
Face to face sessions are in Wembley and Harley Street practices, while on-line sessions are provided via Skype and Zoom.
You may contact Chamari using the form below:
Mobile: 07872 953 061
Lynn Walters, black therapist
Although my initial therapeutic training was psychodynamic, since qualifying in 2007, I have had additional training in other modalities to enhance my knowledge and practice. As a qualified supervisor (2013) I have worked with individuals and groups, either independently or via organisations. My work is integrative and my experience has been with qualified as well as trainee counsellors/psychotherapists, covering different issues within time-limited and open-ended sessions.
You may contact Lynn using the form below
I am Kris Black (I use they/them pronouns). I am an Integrative Arts Psychotherapist, Child and Adolescent Therapeutic Counsellor, CSTD trained supervisor in Individual and group supervision. I work using an Intersectional framework and lens, when I’m not working clinically with clients and supervisees, I enjoy training therapists and counsellors as an Independent Trainer – via Radical Dialogues which I founded.
I am a clinical associate of Pink Therapy and ex leadership Associate of BAATN – both organisations work within the marginalised communities that i’m part of – they share my values, and perspectives on working respectfully with issues of difference and diversity. I work within both the LGBTQIA / QTIPOC and the Black African, Asian and Caribbean communities. I am registered with UKCP and BACP, and I’m a member of FSN, PCU and PCSR which reflects my political commitment as a psychotherapist and supervisor. I’m proud to be a Black Issues Masterclass graduate (1st class).
Find Kris via these links:
You may contact Kris using the form below:
Call or Text: 07761371088
Ben Fuchs is an organisational development consultant. His work is mainly focused on leadership development and culture change in the NHS. He is on the faculty of the Centre for Supervision and Team Development, with an interest in supervision in teams and organisations.
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Robin Shohet trains supervisors through the Centre for Supervision and Team Development (CSTD London) which he co-founded in 1979. He has written extensively on supervision and his next book ‘In Love with Supervision. Transformative Conversations’ which he has written with his wife, Joan Wilmot, will come out in 2020.
Now that he no longer plays football, his main leisure activities are learning the accordion and improvisation drama
Contact Robin using the form below:
Charlotte Sills is a psychotherapist, supervisor, trainer, consultant and a member of faculty at Metanoia Institute and at Ashridge Business School, UK. She is the author or co-author of a number of publications on counselling, psychotherapy, coaching and supervision including Skills in Gestalt (Joyce & Sills, 2014; Sage) An Introduction to Transactional Analysis (Lapworth & Sills 2011; Sage) Transactional Analysis – a Relational Perspective (Hargaden and Sills 2002; Routledge), and Coaching Relationships (Sills & de Haan 2012; Libri Press).
As a supervisor she is inspired by the words of the late Richard Wainwright, who said “Supervision should be a conversation you have never had before” (2017 personal communication).
She lives in West London with her husband and enjoys friends, good white burgundies, and being inspired by the Portobello Group. She has two children and five grandchildren.
Contact Charlotte using the form below:
David works half time as a holistic family doctor and half time split between being a facilitator, coach, medical educator and small team and organisational consultant. He is also a responsible officer, appraiser of other responsible officers, supervisor and trainer of supervisors including GP trainers.
Until recently he worked a day a week at the medical school in Southampton where he was lead on student personal professional development. David is a member of the Wessex deanery tutor group training GP trainers and providing clinical and educational supervision training. He offers both individual and team coaching that he has done for over 20 years seeing this as a highly effective tool for personal and team development and growth.
He co edited:
David has been working with doctors and health practitioner for many years and has experienced the benefits of regular facilitation, coaching and supervision in practice development, team management, practitioner wellbeing and patient care. David uses a model based on ‘five different realms of practice’ to explore the difficulties within groups and to enhance how groups and individuals respond to those challenges. For the last 5 years he has been working for Wessex Deanery to facilitate practice away days and has been working as an external consultant to ‘vulnerable general practices’.
Contact Dr. David Owen using the form below
Joan is a supervisor, psychotherapist and trainer and after a formative seven years as a residential social worker at Richmond Fellowship therapeutic community in 1979, she co-founded CSTD (Centre for Supervision and Team Development).
Her particular interest is in working with systems and complexity, using organisational and family constellations work. She has been running supervision trainings and working with individuals, couples and teams for over forty years. Her passion is enabling people to find the work they love and to love the work they do.
Joan is a contributor to ‘Supervision in the Helping Professions’: Hawkins P and Shohet R and ‘Passionate Supervision’ and ‘Supervision as Transformation’ both edited by Robin Shohet.
Her other book, to her surprise, is a cookery book written with her friend, Jacqui Jones, ‘The Boxing Clever Cookbook’. She is a member of Playback Theatre Company and is also learning Greek and the accordion (both very slowly!) She is amongst other things a sister, wife, mother, grandmother and friend and is ever grateful for what she has received and continues to receive from them all.
Contact Joan using the form below