NEW WAVES BREAK AROUND PSYCHOTHERAPY IN THE PACIFIC
A.Roy Bowden.

Psychotherapy is well established in the dominant cultures in Australia and New Zealand. It has yet to establish a strong base in indigenous cultures within Australasia and the South Pacific. In the Pacific region traditional psychotherapeutic theory needs expansion and enhanced practice skills. Modalities and methods need review as healing concepts within different cultures are acknowledged. In order to study culturally based healing practices in the Pacific region new research methods need to be developed. It will be important to listen to narratives that suggest different ways of working and rely on wisdom from culturally informed practitioners and clients. By acknowledging the importance of concepts which challenge us to revise our current practice we will enhance psychotherapy as a discipline making it accessible to a wider consumer population, especially those who have a different understanding of the word ‘psychotherapy’.

Key Words
Reviewed theory, Enhanced practice, Cultural focus, New narratives

NEW WAVES BREAK AROUND PSYCHOTHERAPY IN THE PACIFIC

Psychotherapy in New Zealand is changing as culturally based practitioners encourage Pakeha therapists to review traditional psychotherapeutic theory and skills. The New Zealand Association of Psychotherapists is building a partnership with Waka Oranga, the Rununga, (national collective) of Maori therapists and is faced with two important questions: “What words can we use to describe psychotherapy practices within culturally based settings?” and, “How can we retain traditional psychotherapeutic theory and methods and add new perspectives from Maori and Pacific therapists?” We need a new focus for our region now that we have come of age. In Australasia people contribute new cultural beliefs from the South Pacific, Asia and other regions. People in these settings have profound philosophical approaches to hardship, despair and suffering quite different from the belief systems which produced psychodynamics or psychoanalysis. The tendency has been to separate spirit from matter, meaning from analysis and abstraction from reality. The Pacific way is more like a fine mat, full of colour, threads and interconnection. Maori and Pacific based approaches to healing have separate differences which challenge many of the principles built into psychotherapy practice. Psychotherapy has developed in New Zealand by importing ideas from research carried out in other countries and most of the psychodynamic principles that are relied on place the individual at the centre of therapeutic process. I am suggesting we consider traditional psychodynamics as one way of approaching clients and expand our practice to include more dimensions.

It will be important to ensure Maori and Pacific therapists retain ownership over their cultural practices.
In New Zealand, Te Ao Maori, the world of Maori, enshrines history and meanings we should not borrow in order to support Pakeha environments. I write as a Pakeha New Zealander fully aware that I am moving from my own understandings into a different world, the world of those who allow me to walk on land which is Papatuanuku, mother earth. When I attempt to align traditional psychotherapeutic theory with information my cultural partners share with me I must keep checking with them in order to review my understandings.
Makere Stewart-Harawira writes, “For Maori...sound has deep metaphysical and creative connotations that go beyond its use as the practical instrument of ordinary communication. The cadences of ancient songs, of ritual calls, of sacred chants, through which the world is sung into existence, the flesh is sung onto the bones, and the relationships are sung which bind all together within the Cosmos, express what Knudston and Suzuki refer to as ‘bringing a measure of harmony to the Cosmos’ and breathing ‘life into the network of subtle connections between human beings and the entire natural world.” (Stewart-Harawira, M. 2005) (i)
The dimensions Makere Stewart-Harawira brings to our attention can be woven into psychotherapy practice if we think beyond accepted psychodynamic concepts and listen to voices within cultural environments.
Those of us who have lived around Pacific shores sometimes know what to listen for. When people withdraw into themselves in Aotearoa we know the causes may not be the same as classical symptoms of depression described in psychological theory. We know to listen for damage to the spirit, failure of family systems, loss of identity and no place to call home. We are likely to listen for songs that need to be sung, poverty that cripples family life, prejudice that ignores potential and aroha withheld during important moments. We listen for sounds of anger at not belonging and words from those who feel marginalised. We know there is huge emotional turmoil but instead of structuring therapy we try to approach it with a combination of improvised understanding and challenge. If we listen for shifts of register in the moment we are likely to listen for longer. The unhurried tempo of the Pacific has much to offer clients who have not been heard. The natural environment is one of ebb and flow, seasonal energies and close connections.

Psychotherapists whose training is based on foundation theorists with cultural roots in other parts of the world have been trained to honour the soul of the individual. I am a Pakeha psychotherapeutic healing practitioner who was originally taught to explore the individual psyche. The history of psychotherapy highlights pathways in the mind, layers of feelings and complicated desires embedded in the body of one person, one separate soul. The pursuit of knowledge about the person of each individual has often been the sole focus of traditional psychotherapies and, in Aotearoa, New Zealand, I have been part of an emerging movement which challenges this view. Over the years in New Zealand, therapists have broadened their vision to include systemic influences which surround each person. Movements such as family therapy have made some inroads but many therapists remain intensely fascinated by what happens inside the skin and inside the mind and heart of a single human being.

Insights from within Aotearoa

When I cross the bridge from my culture to the indigenous Maori culture in New Zealand I need to honour something different from my own experience. I am encouraged to honour a belief system which sees each person not only as an individual but as someone who is interwoven with the natural world, ancestors who are still alive in the community of the living and unseen influences often named as spiritual. Maori have taught me that Tangata Whenua, the people of the land, place importance on relationship, interconnection and interdependence. While there is individuality, personal identity is taken from the land, the iwi, the hapu and the whanau, which are names for the tribe extended family groups and the family unit. Identity is interwoven with the cultural grouping. When I begin to cross the cultural bridge I am about to encounter an atmosphere in indigenous culture that is a huge challenge to the way I see my ‘self’. Accordingly, I am increasingly impatient with the view that psychotherapy only heal individuals.
When consulting therapists for my own therapy I have been encouraged to view my ‘self’ as a separate identity which no other person has a right to touch without permission, intrude upon or manipulate by ignoring my personal preferences and boundaries. That kind of therapy satisfies my need to understand the complicated pathways set within my own skin but fails to acknowledge the way I merge with every other important influence. The challenge to think differently comes not only from indigenous people. The idea that the skin is a permeable membrane is found in philosophical, psychological and spiritual writings. It is an insight which moves me away from isolated individualism and helps me move traditional psychotherapy closer to healing paradigms based on interdependence. Ken Wilber’s words have had a lasting influence on me: “The most common boundary line that individuals draw up or accept as valid is that of the skin boundary surrounding the total organism. Everything on the inside of that skin boundary is in some sense ‘me’, while everything outside that boundary is ‘not me’”. And later, “Any sort of boundary is a mere abstraction from the seamless coat of the universe, and hence all boundaries are pure illusions in the sense that they create separation (and ultimately conflict) where there is none.” (Wilber, K 1979) (ii). My thesis is that when we draw boundaries between individualism and interdependence the bridge between traditional psychotherapy and indigenous people is very difficult to cross.

An ever changing sea of meanings

What lies between the emphasis on the internal psyche which underpins most psychotherapeutic modalities and the indigenous culture which surrounds me in Aotearoa is an ever changing sea of meanings. To cross from one to the other I will cross as it were, by sea, and not through the sky or over land. If I cross by air I will not experience ocean currents that teach me to carry my ‘self’ with me. If I travel over land I will be comparing the landscape with what I know already. If I move through the waters of meaning I must be content to allow them to come and go, for they are fluid and defy definition. The shores of the culture I reach will also be changing as the sea of meanings works away at the boundaries of the land.

In New Zealand Pakeha have often asked the question, “How should psychotherapists who are non-Maori work with Maori?” It is a question that ignores an important insight. The insight is that there is no such phenomenon as a static set of cultural meanings. To decide that there is a static Pakeha culture and a static Maori culture is to make the same error as psychotherapeutic theorists have made throughout history. Theorists have decided there is ‘an individual’ and ‘a group’ as if there is a time to be an individual and a time to be psychically connected to a group or culture. Of course there are meanings which arise when a person is alone and different meanings when a person meets with a group but they exist within a sea of meanings and one framework ought not to be at the expense of the other. The divisions in traditional psychotherapy emphasise separateness. Each modality chooses an aspect of human development to highlight. Some highlight an aspect of mind, others emotions, and the body is, of course, another choice. Many offer behavioural formulations. The fascinating array includes methods based on the work of historical figures while others centre around living legends whose work is copied by practitioners. The anomaly is that these separatist paradigms exist in a profession that purports to be focused on the whole person in a connected universe surrounded by multiple cultures, belief systems, and values.

Crossing the bridge in Aotearoa

The bridge from Pakeha culture to Maori culture in New Zealand cannot be crossed if I am already a convert to a particular approach to psychotherapy. Singular belief systems perpetuate the myth that client persons can be successfully approached using a premise first and relationship as a secondary consideration. In New Zealand this separatist process sits uneasily alongside the indigenous culture which has the notion of interconnection as fundamental. Nothing stands alone in Maoritanga, no one part of the person can exist without every aspect of existence cooperating to provide impetus for the life force. While the mind (hinengaro), the body (tinana) spirit (wairua) and the family (whanau) are named separately one cannot be highlighted or studied without reference to the other three. Maori have a concept called Whanaungatanga. The idea that one is an individual is complicated by the fact that “....the basic responsibility is that one must be prepared to sacrifice one’s individual interests and gratifications to those of the whanau, and, “the place of the family in Polynesian society is difficult for Pakeha to understand when the measuring rod is the concept of individualism”. (Jackson, M. 1988) (iii) Whenever human development is discussed the focus is on weaving threads together. Almost without exception the symbols in Maori art and carvings are based on ideas woven together, there is no stark separation of body mind and spirit and no separation of the individual from community or history. One cannot be a psychotherapist in this cultural setting and work towards health by focusing on parts of the personality or by using separate concepts such as behavioural change, emotional catharsis or body centred therapy. Therapists who decide that Jungian therapy has links with Maoritanga or assume that Gestalt, Hakomi or Transactional Analysis have ideas in common with the way Maori see the world are moving quickly down the path of colonisation. It is important I move towards indigenous people in my country with an open mind. My mind needs to be so open that I am ready, if necessary, to change my mind about some of the basic tenets of psychotherapeutic process.

To work with an overall model promoting the idea that human beings have separate parts which function independently and can be treated independently of each other is often culturally inappropriate. I am not suggesting we abandon focused research into the human brain, the body or emotional chemistry. Nor am I suggesting we abandon theoretical paradigms. I am suggesting we begin to imagine psychotherapy as a process which reflects the interdependence of human knowledge. The knowledge we are privileged to own in this millennium highlights the point that meaning and health are embedded in connections that may be indefinable. Psychotherapy modalities choose defined portions of human systems and expect adherence to methods which are definitive about human systems. To move away from definition and structured premise is to move into uncertainty. An un-certain approach leads to creativity and challenges therapists to work without pre determined ideas.

No prescribed agenda

As I step off the cross cultural bridge I can retain the person and the therapist I am but I must greet the other culture knowing I might have to question all I know. There cannot be an agenda, there cannot be certainty or evangelism. The challenge is to allow meanings to merge and resist analysing. Many traditional approaches to psychotherapy depend on an analytical framework focusing on taking wholeness to pieces in an attempt to understand intra psychic, inter personal or systemic connections. If I am to make good connections with my cultural partners I will need to suspend analysis and define therapy as the contemplation of multiple insights. These multiple insights are different in each place in the world. A single modality cannot propose a way to connect with the diversity of insight which is first formed within culture. Modalities assume insight is first formed emotionally, physically, intellectually or spiritually. Now that we have a global awareness the truth is that insight can be grounded in culture.
The facets of the diamond I contemplate with clients in New Zealand are flash points filled with cultural meanings. There are a number of cultural truths in our multi cultural society which capture insights. Insights are mirrored in ancient stories, rituals watched by children, experiences in peer groups, adolescent transitions, marriage and family observances. The multi faceted diamond which beckons in the moment of insight is affected by ancient ancestors who are living in the present. Any attempt to introduce a designed intervention method while an ancestor is speaking to the heart of the client may be overly intrusive. Maori clients, like people in many other cultures, know their mountains, rivers and land forms are speaking, acting, reminding and calling while the therapist joins them in contemplation. Psychotherapy can be made out of a tradition stretching back to the beginning of time, to Te Kore, the void. In this cultural environment it is also possible that historical events are being replayed in the present. Psychotherapy is made within the context of cultural moments. If it is pre designed and pre formatted, it will ignore the sea of meanings which are always changing. To make psychotherapy in moments when myth and legend are being relived is a process I cannot design and must not surround with theory. There is something much more exciting to do. I can establish cross cultural therapeutic moments when I suspend definition.
We need psychotherapists in different cultural settings around the globe to believe in their own creative ideas as they learn from cultures different from their own. These ideas will change as each client appreciates a therapeutic connection initiated by the therapist without being gleaned from a textbook. These connections arise out of an appreciation of each moment, permission for the client to discover their own world of meanings and a willingness to work with what Maori insight has called ‘the nothing and the not nothing’.
Psychotherapeutic formulations will always exist in world class libraries, digital environments and teaching rooms. It is good to read them but it is important to close the door of the library before we meet our clients. Clients have a world wide web in their hearts and minds and pages filled with surprises which are worth downloading in the moment. They should never be saved to a file. A culturally based psychotherapy will rely on description rather than analysis. Once an analysis is made the cultural truths have been colonised. Throughout the history of psychotherapy we have done little to investigate the therapeutic power of description. The descriptive therapist will be curious and reflective without relying on formulations. Attempts at understanding are born of the desire to capture and to possess. A culturally sensitive psychotherapy reflects the world it senses and describes what it observes. Imagine the power of allowing description to be sufficient. In our communities we have the opportunity to meet with people from a variety of cultures. If we met in psychotherapeutic moments with no pre-designed parameters, no assumptions about who we each happen to be and no attempts to capture meanings we might discover merged edges of understanding.
The future of a psychotherapy which creates good cultural connection lies in the willingness to describe psychic and social associations rather than analyse them. “There is no progressively refined story to tell about the human condition which leads to a single view of the nature of reality. There is, instead a concept of truth as a mobile army of metaphors that capture our minds so we see the world in certain ways. The increasingly rational view of the world trumpeted by scientific realism is characterised as an illusion, and particularly when we try to understand human beings, a much more fluid formation is suggested.” (Gillett, G. 1999) (iv)
Making it work
How might this work in the New Zealand situation? I have been taught to imagine each person with an individualised psyche holding personal historical information best released (or integrated) through some form of psychologically based therapy. My training leads me to focus on client emotions, thoughts and physical responses to their relationships. I also look for causal relationships thinking that one historical event or trauma causes another to occur later in life. In addition, I have been trained into an expectation that unhappy, disturbed or unsettled people can be ‘helped’ or ‘treated successfully’ by meeting with a sensitive therapist. I will have a very narrow experience and learn little if I cling to those injunctions.

The psychological view of mind is often presented as a definitive reality. This is however, capable of a wider vision as instanced in the connections between two worlds, one psychoanalytic and the other transpersonal. Before offering the gift of psychological knowledge it is important to establish relationship, to test the meaning of the meeting about to take place and to accept that what will be given in return is just as powerful as any insights fashioned in my culture. It is tempting to build a bridge between psychotherapy and cultural concepts. Pakeha have no right to build the bridge without first entering the sea of meanings and risking not knowing. The connections I have made already are part of my slow movement across the sea from the culture of psychotherapy to my experiences with Maori. I do not have a need to be definitive and that helps me stay curious. I am strongly of the view that psychotherapy will progress further in a mixed cultural environment only by relinquishing the drive to define moments, develop fixed theories and establish modalities. There is no openness to culture when definition is the goal. Ideas need to flow like the sea.
How then might we proceed? I draw your attention to a belief which is centuries old in the indigenous culture of Aotearoa New Zealand. “The Maori traditional belief is that the whole of creation is a dynamic movement I te kore, ki te poo, ki te ao maarama, ‘out of the nothingness, into the night, into the world of light”. (Patterson,J. 2000) (v)
It is, in a less profound way, a description of the way I work. It involves the desire to focus on ‘the nothing and the not nothing’. What is the nothing and the not nothing? I have been told by people willing to share with me that it can be described as ‘the void’, ‘potential’, or ‘energy’ in Maori understandings. It can be represented as ‘the void in which nothing is possessed’, ‘the void with nothing in union’,‘the space without boundaries’. It can also be ‘the void in which nothing is felt’. If I establish a relationship with people from another culture psychotherapy is created in moments. The moments must begin as if there were nothing apart from the light and perhaps the darkness we both bring. As I hold the sum total of who I am in my being and wait for my ‘self’ to be met by ‘the other’ we make psychotherapy for that spontaneous meeting. The psyche is merging with therapeutic process, the soul is surprised by relationship. Within that relationship moment every strand of knowledge I have absorbed, each conditioned aspect of my existence, every cultural icon and intangible spirit affects the foundation of my being. I dare not allow my mind to conjure a theory of personality or a therapeutic method. If I search for explanation or method I will stifle my own creativity, I will lose my ‘self’. Recall a theory and connection is lost. Apply a method and the other person will be imprisoned.
Skills beyond method
Psychotherapy may offer something to cultures which is beyond method. Perhaps we offer the innate skill that forms in the heart of every therapist; the ability to be present and vulnerable. Therapists practice different rituals to maintain vulnerability. They are more important than rituals which maintain certainty. Therapy is, after all, an art form. Artistic endeavours create magnificent bridges across cultural divides. Therapy as an art form makes way for ‘not knowing’ from which arise creative moments that produce understanding. Another gift is, perhaps, our awareness of word meanings. Earlier I mentioned that words have been the main focus of psychotherapy and suggested a wider perspective to include other channels for expression. Our gift is perhaps the ability to teach the importance of nuance and the tracking of pathways called associations. We know how to listen for meanings beneath the surface of the mind which are not only important in the psyche but may be important in cultural formation. “The skill of the therapist lies in the ability to expect the universe to speak. The spiritual formation that is occurring will leave both therapist and client speechless. The silent therapist has already made a difference”. (Bowden, A. R. 2001) (vi)
What we are trained to listen for is what Gillett calls discursive narrative. This is story that cannot be defined only in scientific terms. He says “The human psyche is a remarkable creation born of the impingement of word on flesh, or, if you prefer, discourse on the body. This soul or psyche is a unique metaphysical species which, in itself, has given birth to both metaphysics and epistemology. Unfortunately the psyche has a tendency to become bewitched by the beauty of its own creation. The light of reason can, however, allow us to take an ironic or even gay (in Nietzche’s sense) attitude towards our epistemic offspring-philosophy, psychiatry and psychology-and it is in that attitude that this (Gillett’s) book has been conceived” (Gillett, G. 1999) (vii)
The psychological meanings of words in their cultural contexts may therefore take us into realms we participate in by being content with the way the stories are told. This is an area where we need to tread with caution as theorists often claim ownership of meanings and take them away from cultural contexts. The process is more important than the ownership of meaning. The skill lies in being able to describe and let lie, highlight and listen for response. It involves giving up the desire to capture words and allow them to fill moments in time. The gift from the trained psychotherapist ought to be offered unwrapped. It might mean suspending knowledge. In Aotearoa-New Zealand ‘Maori have kete or baskets of knowledge which are highly valued. My challenge to psychotherapists is to keep our baskets of knowledge open beside us instead of using them as shields. As our cultural partners lift their taonga or treasures from their kete it is a sign of trust. Psychotherapists know that the moment of trust is the moment to release profound truths for only in those moments will therapist and client be united. Relationship can function only if both people are being themselves in the moment. I return to the word ‘moment’. It is the creative moment, the moment when two people trust themselves and the universe so well that old paradigms are reborn and ancient myths have new meanings. Cultural understandings begin, and may end, with not knowing. If we are to spread the influence of psychotherapy in the Pacific region we need to gather what we have already learnt and experienced and build new libraries of knowledge. New collections of knowledge will include that which has gone before and we will slowly gather that which is yet to come.




References
(i) Stewart-Harawira, Makere, The imperial order –Indigenous responses to globalization. 2005 p38 Huia Publishers
(ii) Wilbur, K., No boundary.1979, p40 Shambala Publications
(iii) Jackson, Moana The Maori and the criminal justice system, a new perspective: He Whaipanga Hou. In: Patterson, J. Exploring Maori values, 1992. p146-147, Dunmore Press, New Zealand
(iv) Gillett, G., The mind and its discontents-an essay in discursive psychiatry. 1999 p 38 Oxford University Press
(v) Patterson, J. People of the land. 2000 p112 Dunmore Press, Palmerston North New Zealand
(vi) Bowden, R. A psychotherapist sings in Aotearoa 2001. p57 Caroy Publications, Plimmerton, NZ
(vii) Gillett, G. The Mind and its discontents-an essay in discursive psychiatry 1999 p426 Oxford University Press
(viii) Nga Waka Tohunga (Canoes of the Tohunga). A work by John Bevan Ford, International Maori Artist and Carver. The kahu or cloak over the water represents mana
Note: Cultural understandings in the paper were initially reviewed by John Bevan Ford
Glossary
Aotearoa Whole of New Zealand Wairua Spirit, Soul
Aroha Love, Sympathise Whakapapa Genealogy, Cultural identity
Hapu Sub tribe, Pregnant Whanau Extended Family
Hinengaro Mind, Intellect Whanaungatanga Relationship
Iwi Tribe, People Note: Definitions were sourced from
Kete Carrier, bag Ryan, P.M. The Dictionary of Modern Maori
Mana Prestige, respect 1999 Heinemann Education, Reed Publishing
Maori People of the Land Meanings vary and are approximate
Maoritanga Maori culture, Maori perspective
Pakeha Non-Maori, European, Caucasian
Papatuanuku Mother earth, the land which sustains
Rununga Group
Taonga Traditions,Treasure
Tangata Whenua` Local people, Aborigine, Native
Te Ao Maori The World of Maori
Tohunga Specialist in ancient Maori lore, traditions, religions and rituals
Te Kore The Void
Wairua Spirit, Soul, Attitude >>
Whakapapa Genealogy, Cultural identity
Whanua Extended Family, Delivery, give Birth
Whanaungatanga Relationship
Source: Ryan, P.M. Dictionary of modern Maori 1999. Heinemann Education, Reed Publishing, NZ

Shifting ground in Christchurch

"Why?" is the word that comes to mind when the earth moves, taking lives and life away. I have been reflecting on my expectation that the earth will stay still, as if it has no life in it and its only purpose is to support life above the ground. That expectation comes from seeing things stay as they are for ages. It comes from moments when I have revisited homes, buildings, and environs I knew in childhood and early adult years. It comes from visiting historical sites in countries where humanity has existed for centuries. My understanding of scientific insights in this century is that we cannot expect anything from the smallest cellular structure to vast spaces in the universe to stay still or move in an isolated fashion. Everything we know and touch is likely to change and is changing in every moment. The earth is full of life to the greatest depth and is constantly reshaping itself. Life on earth is small compared with universes around us and very little can be predicted with certainty, if there is such a thing as certainty.

My life each day seems to have a certain predictability around it. Even though the earth has convulsed in Christchurch I find myself planning for tomorrow as if my own environment will stay the same. That tendency in humans is important otherwise we would turn in on ourselves and fail to be creative, love each other and make a difference in this world. I am at the stage where there is much less time in the future for me than there used to be. The question is, "How can I live with firm intention knowing the ground might shift at any moment?" I suppose I will continue to do what I have always done which is assume safety and continuance. Treasured moments are what I have and I am fortunate to have opportunities to create more of them.

For many people in Christchurch it will be very hard to keep going when people they treasured and lives they nurtured have disappeared so suddenly. There are ways to recover but they take time, they do not happen without resources and they need to be accompanied by human touch.

This week is another time in my life when I cannot answer the question, "Why?" It will keep occurring in my mind and in my conversation. It asks me to keep searching and inform myself even though in the end I must learn to live with uncertainty. It also provides a certain empathy I must cling to and offer.

I lived and worked in Christchurch for four years in the 1960s. It was one of the cities in Aotearoa that looked like the English past we had read about in history books. Solid stone churches and my university building made me feel strong and secure. When I was uncertain I leaned against them and listened to wisdom from the past that spoke of long standing traditions. It is so hard to see these symbols of assurance crumble into the earth. The Pyne Gould Guinness building stood on ground where Cambridge Methodist Church and Mission stood, opposite the peaceful Avon river. I was the clergyman responsible for that church (1966 - 1969)and sadly it was burnt to the ground in 1981. Now the ground itself has shifted and people have died in what was a sacred place for me. We used to pray there for life to continue and remain secure.

But the stories of people in Christchurch who cannot touch their loved ones any more and those who must build new homes in places they may not want to live in are much more disturbing. In grief I look for causes, explanations and reasons. It is important I contemplate why things happen that take people from us and leave us struggling to understand. It helps to know I am afraid and let that happen without trying to eliminate my natural tendencies. That which shifts within me mirrors the way the ground of life shifts, without warning and without explanation.

Our community choir ended our practice last night singing a version of the beautiful African-American spiritual "There is a balm in Gilead". In the Old Testament book of Jeremiah there is a verse with the words, "Is there no balm in Gilead?" and one interpretation suggests it means "Is there no physician there?". Our conductor Julian Raphael kept over 100 of us singing until we were murmuring the words and sounds and ended with a long silence. He knew we needed to acknowledge our feelings quietly and think about people we love. I must find the physician in myself and keep believing there is a balm to sooth the future and make healing possible.

Arohanui to the people of Christchurch and to all those who know and love them.

24th February 2011

Steering sober

You can work out how old I am when I tell you I began driving in one of these Austins. It was my first car in 1959. Perhaps I am now at a stage in life when some rules seem appropriate. Perhaps I am not aware of all the implications of making a 'once and for all' rule regarding alcohol and non prescription drugs when driving. However, I am having difficulty imagining a situation wherein it is necessary to drive a vehicle after using alcohol or drugs. We have alternative means of transport at our disposal in all large centres and if we are socialising it ought to be possible to arrange a lift home after an outing. If it is the kind of occasion where everyone has used alcohol then public transport or taxis would be the answer. Many of us survive during daylight hours without drinking and driving and it seems to me we could carry our daylight habits into the evening. I have moved to the view that New Zealand could lead the way when it comes to expecting people to be totally free of alcohol or drugs when responsible for a vehicle. Those in isolated areas might find it difficult to find their way home if they have attended a function without a sober driver to hand. The answer lies in predicting situations and sharing group transport arrangements timed to take everyone safely home. I have the same opinions when it comes to boating. I am astounded at the use of alcohol amongst people who are responsible for boats, vehicles and other means of transport.

We have spent enough dollars trying to educate people in our country. As long as there is some tolerance of alcohol or drugs before someone gets behind a wheel I do not believe we will ever reduce the road toll and associated health costs, let alone the tragedies so many families face.

I am not opposed to alcohol and enjoy some on occasions. I am opposed to the assumption it is possible to drive a vehicle or a boat safely after one or two glasses of wine. Alcohol impairs, it does not increase our powers of concentration especially when unexpected challenges appear in front of the windscreen.

I am really interested to discover whether there are reasonable arguments against what I have written...let me know...

Who are we to decide?

The month of December 2009 was filled with awe in my small world. Our identical twin granddaughters were born in November. Sophie and Molly are a mystery to me as they slowly become aware of the world by developing sight, touch and awareness of their environment. Their brother is attentive and proud. Their parents are calm, loving and totally committed. I wonder at the links these two souls have between them. When we hold these two precious bundles they move, smile and get bothered sometimes. We respond with laughter and pleasure believing they know we are there and hoping they can distinguish between us as individuals. Psychologically sensitive professionals start making assumptions. They speak of developmental stages as if they were set in concrete to guide us through parenting and grandparenting. Wise admirers start offering advice such as the instruction not to treat these girls as twins but make sure they are respected as individuals. We look for differences, search for signs that one is not the same as the other and in the next moment express pleasure at their sameness. We compare them with their ancestors, their immediate family and our own history. Speculation is the name of the exercise. Meanwhile the babies signal their desire for food, comfort and attention. Each time one of these signals are given we make more assumptions, find more patterns and establish more certainties. Gradually the stories build and may even be written into history to be unearthed later in the life of these two lovely girls who become women. It is also natural to turn to gender difference and compare granddaughters with grandsons. Family and friends can now make predictions and imagine a new balance in the family because granddaughters have arrived. We will all approach each young life with an innate sense of gender preferences which reflect our own upbringing, preferences and priorities. The way we were parented will probably dominate our instinctive reactions and in a strange way pave pathways for our granddaughters. It is important to pass on stories and give our impressions to the next generation. We could not parent or grandparent without establishing some certainties in our minds. We need inner guides and mind sets in order to be mentors for the precious lives entrusted to us.

The best guides may lie in the fabric of myths and legends. They may be found in intricate meanings which make these kinds of stories last through the generations. Human development knowledge changes rapidly and what we think we know about growth needs constant review. Some theories our own grandparents clung to were discarded years ago. Psychological insights come and go because they are gleaned from research based on limited data. Value based principles from culture, religion and community often last longer but they are also subject to change as the years roll by. Meanings in stories we cannot pin down, ideas passed faithfully from one generation to another for centuries and legends about people who may or may not have existed hold important lessons. The truth for each developmental moment probably lies somewhere in between fantasy and reality. Between legend and known history. Between science and spirituality. I am not sure how I will grandparent our granddaughters in ways that are different from our grandsons. I will draw on something inside me that tells me to tread carefully and at times firmly. I will listen to the opinions of others and wonder about their meanings. I will suspend belief until I have confirmation from my grandchildren that one way or another seems right. They will tell me in their own way. I will know when they smile, chide me or appreciate me, that a new truth has been born.

A cure for what ails you?

Our psychotherapy association is again in discussions with the Sensitive Claims Unit of the Accident Claims Corporation in New Zealand. There is pressure from the unit for therapists to provide more significant outcomes from the work they do with sexual abuse victims and a move to make therapy more economically viable because ACC is struggling to resource counselling and therapy. Many thousands of people have been significantly helped by therapy for these issues and sadly many more will qualify each year. One of the difficulties emanates from the way we separate trauma out from the totality of our lives and fund our rehabilitation services in a highly specialised manner. Specialists train and focus on one problem sector. The tendency to set up a label for a set of psychological symptoms and then make that set into a speciality has, on the one hand, helped many people to access excellent help and, on the other, resulted in divided professional services and battles for funding. Health professionals rely on labels, research to provide evidence that categories such as attention deficit disorders actually exist (as if they have a life of their own), and then we watch the category expand until it includes behaviours we had previously thought were quite normal. The worst feature is that labels become part of family life to the point where parents and family members are labelling each other with all sorts of disorders. Then those who believe disorders can be 'cured' ply their trade forgetting it is the whole of life situation that inhibits our readiness to be healthy. There is, of course a real market for instant and guaranteed 'cures'. All manner of parallel health practitioners focus on 'treatments' for single issue ailments and customers sing the praises of 'the treatment that increased my energy', the intervention that finally relaxed me', 'the machine that changed my thinking' or 'the touch that did away with my virus'.That will never change because, when desparate, we look for answers urgently. My own experience with main line medical practitioners has also been variable. At times I have been convinced I was 'cured' of an ailment and at another time I was rushed to the ermergency department because a practitioner had been prescribing dangerous drugs for me for five years. I have also had huge pain relief and health improvements after consulting acupuncturists, natural health practices and homeopaths. There is a need to balance health services and find ways of researching 'traditional' medical science alongside insights emanating from parallel health practitioners. I wonder if the day will come when government health budgets fund professionals who are prepared to work together in teams using social science insights to link the vast array of elements combining to make us unwell. Perhaps we live our lives in ways that attract those elements to us. Of course tragedy must always be funded urgently and in a targeted way. It is the quick response to selected symptoms and the search for instant ameliorations that concerns me. Preventive health measures are not attractive for many people. There is perhaps a solution. Imagine the impact if we visited health centres and were placed into a programme instead of being allocated 'a doctor'. Members of a professional team would advise us according to their research into different aspects of our lives. With input from each one we would end up with an intricate picture linking mind to body, emotions to relationships, spirit to intentionality, viruses to the way we live and tragedies such as sexual abuse to interventions built around more than psychology. We know we live within interconnected systems as individuals and as communities. If social workers were linked with general practitioners, natural health practitioners with psychologists and spiritual advisers, psychiatrists with counsellors and cultural mentors and you and me with convincing preventive health advice, the health and trauma budget might be targeted to reality.

Perhaps the question is the answer

My journey through the variety of therapeutic approaches has lead me to resist joining any one particular group of like minded therapists. In other areas of my life I can say “This is what I am” but I prefer to leave questions open in my professional journey.
This informative journey has helped me think about the search for definition and answers. I have taken part in workshops and therapeutic settings where people have been encouraged to find “the causes” for their behaviour or their distress. I took part in that period in New Zealand when counsellors pressured people to own up to their past in order to discover answers which would explain their present. I have sat in groups where catharsis has been the focus and where people have struggled to name a cause or reveal an answer. Many times it has been assumed the discovery of an answer or the naming of a cause will provide a cure. Sometimes it does. At other times the cause remains as a life long focus perhaps as destructive as the original distress. I have listened in case conference settings where labels are applied to explain people’s behaviour or disturbance. Once the label has been agreed on there is often a sigh of relief as if that person is now explicable in some way.
These experiences have lead me to ask more questions. Questions such as, “Is the search for an answer or a cause going to reset the person within their complicated universe or is it going to keep them closeted in a partialised state?” “Who is it that needs the answers, therapist or client?” “Once answers have been established what contribution do they make to creativity in people's lives?” Each facet of life can be held up to the light alongside all the others. Once we do that shadows are illuminated which impinge on each other. They move as we move, appearing and disappearing in each moment. To capture them in theory, definition or treatment seems to me to deny the way the universe works. Connection, movement and fascination might be better words to describe successful therapeutic endeavours.

Monitor treatments carefully

Therapists and counsellors have often been trained in 'methods'. Some of these are helpful some of the time. The best therapists and counsellors will focus on the relationship between counsellor and client and draw on their methodological knowledge very selectively providing 'treatment' or techniques after gaining permission from the client. They will also advise the client ahead of time as to every step of the method being used. There should be no surprises for the client and there should be complete acknowledgement by the therapist as to why a particular method seems to be suitable for a particular client. The question for clients to ask themselves is, "Is this session focusing on the way all facets of my life interact or is there a tendency to focus on one part of me, for example, my inner world?" It is also worth asking oneself whether the counsellor or therapist is making a diagnosis of the client story and how valid this is under the circumstances......more about that topic later...

A. Roy Bowden, July 009

Improvised meanings

My parents encouraged me to sing and play music through my childhood. Classical music influenced my life and thought. Over the last 18 years I have been fascinated by the creativity of improvising musicians. Jazz is a genre where musicians improvise. I am indebted to improvising musician Simon Bowden who gave me these insights in conversation, “In live performance musicians work at a subconscious level to collectively realise music created through a mixture of chance and individual expression. They follow the music as if it has its own ability to come into being and musicians are the means for releasing it. Consciousness aside, all musicians must be tuned into the moment contributing to the whole by simultaneously being a leader and a follower. There is often a basic structure for what happens but unlike scored music it moves in unpredictable directions because it is formulated spontaneously in the moment. Instrumentalists leave the stage knowing they have been inside a vast array of meaning but it is not captured or copied into the next performance. Some say doing so would reduce meaning. For the next performance to be a success it requires the same conditions as the first, any attempt to recreate music created in the moment will not have the same power.” (Simon Bowden,2007).

The way Simon describes improvisation in music is like a metaphor for the way I believe we can help people. Whether through therapy, friendship, intimacy, or at a distance, helping moments are fashioned from spontaneous insights based on consumate skill. The idea we can formulate meaning in moments has captured my attention in life and in therapy. Music is a mirror where images appear and help me reflect on my practice.

Can we be definitive and establish causation?

Health professionals who diagnose physical ailments help us recover from disease in important ways. Health professionals who diagnose people needing psychiatric help often make a huge difference to their lives. Health professionals who diagnose emotional difficulties and apply psychologically based labels are in a much less certain arena. If I address ‘mind’ I am addressing connections which are woven tightly together. A diagnosis which has its foundation in the separation of mind, body, spirit and emotions assumes disintegration has occurred. How can there be disintegration when there is no separation? How can I make a diagnosis which addresses emotional forces within one person when those emotions are intricately bound to the emotions of another and to a spirit world woven into the world we call reality? Personal pain, described as emotional pain or trauma by European-based theorists, is not confined to the present moment and may exist on a timeline reaching deep into a timeless continuum. Associated events, relationships and formative intrusions may have happened to an historical figure in a cultural setting whose influence affects ‘the client’ in ways that remain in the shadows of anonymity. How can I form a diagnosis of human pain which sets it within a specific time frame or views it as existing only within the lifetime of one person? That which gives rise to personal pain or inhibition may not have a defined beginning. The idea that causes exist as separate entities is questionable within the context of life surrounded by constant ebb and flow. A diagnosis which postulates causes is likely to ignore the complexity of one life being a woven tapestry. To ask when pain began or when dis-ease was first formed is to ignore the interconnections scientists are examining and to reject the idea that there is a powerful collective unconscious.

Changing therapeutic perspectives

I was once asked to answer the question, "Does psychotherapy meet basic human need?" I began by thinking how we would answer that question from within our New Zealand setting.

To meet basic human need psychotherapy will need considerable expansion. When we meet with with clients in New Zealand we need multiple lens focused on infinite possibilities. In place of therapeutic enquiry to assess the person in private moments I am suggesting the creation of space to listen for ancestors, imagine the pulse of the universe and stay with the thought there may be no single cause for trauma, pain or disturbance. It means viewing clients as if there were many mirrors reflecting the present, the past and the future. Basic human need in our country is one of connection. The therapist becomes the conduit for connections to be established. Traditional psychotherapeutic theory, which places the client in the centre of the picture, does not always help in this cultural environment. We need a significant departure from the way most of us were trained. The challenge is to imagine each person moving within cultural scenery made up of legendary figures. In addition, the challenge is to work with spiritual forces which are both internal and external determinants.It is my belief that psychotherapy is art and we make psychotherapy by describing rather than defining. Imagine the therapist viewing the complete scene, moving around the scenery with the client and highlighting facets which depict movement, symbolism and hope.Once I see it as an art form I don’t have to define what need I am meeting. I can live with the challenge that therapy acts within humanity rather than acting upon it. Therapy meets basic human need when it takes all facets of life into account moving beyond the limitations of psychological formulations towards a more existential and culturally informed view.

Spirituality: An arena often ignored

The spiritually sensitive counsellor will be available to clients having examined their own ties to voices which dictate beliefs, dogma and moral imperatives. Spiritually centred relationships demand openness in a unique way. In order to be completely open in the moment we need to track the inhibitors embedded in our psyche. We are searching for the truth about us.
This is quite different from any external truth proposed by religious dogma. While we can never discover the whole truth about ourselves because it does not present in the mind’ s eye as a total picture, we can sense when we are resisting, avoiding or having an internal psychic argument. If there is a struggle to be spiritual it lies in the struggle to accept what we decide is the truth about us. If the truth about ourselves is denied we cannot be available to our clients spiritually. Counsellors have often been told they need to resolve their own issues but it is seldom suggested they need to know the psychic truth about themselves which is quite a different matter. I use the phrase ‘psychic truth’ deliberately. The psyche claims a wider view than views found in psychological language or in spiritual guides. Psychological language depends on frameworks and summaries of the way people think, act and live together. It doesn’t address the uniqueness of individuality or unique patterns in each person’ s conscious or unconscious mind. Spiritual guides have a tendency to begin with a premise followers need to accept before they are lead to the inevitable conclusions. Psychic truth, on the other hand, permits individual insight, unproven belief, imagination, wish fulfillment and visits from ancestors. It is the stuff dreams are made of and a foundation for creativity. It is a perspective which mirrors possibility and reflects it back to the curious mind. There are important debates in scientific and philosophical literature with regard to the conscious and unconscious mind, debates as to whether consciousness is connected to mind and whether the mind is within or without the brain. These debates point to the impossibility of defining how the psyche works, where it lies in the human system and what purpose it serves. What is common, however, is that there is something present which currently defies definition. In my view the connections between the conscious and unconscious mind contain and give expression to what we call spirituality.

Pathways to enlightenment?

There is a resistance in me to being told by others how to live my life or how to improve it. The resistance comes from my days as a clergyman when it slowly dawned on me that 'preaching' 'teaching' and the application of moral imperatives all worked as immediate interventions but usually failed the test of time. When I entered the health professions I found a different set of 'secular' attempts to persuade me about aspects of my life that were seen to be in deficit. I explored many of them including what were known as encounter groups and self awareness opportunities. A number of experiences followed in workshops promoting a variety of therapeutic modalities. They worked in the immediate sense and then failed the test of time. Now I notice an increase in the number of movements which claim to know the best pathways to self enhancement and the best principles to live by. They appear as seminar opportunities, quasi religious movements, movements based on religious fervour, formulae for changing behaviour psychologically and promises of enlightenment. They are in corporate environments, the therapy world, adventure, physical achievement arenas and in tempting processes for people who desire change in their lives. I notice they have an immediate positive effect for many people and many are spending extensive amounts of money and time as they invest in the promises. The question to ask is, "Will this stand the test of time?" Another important question is "Where and why did this movement begin, who benefits and in what manner?" If the process can be explained in detail before it begins, outcomes proven outside the movement as well as from within and no -one is expected to "wait and see in an atmosphere of faith" then the promise might be worth exploring. If there is acknowledgment that other pathways might be helpful at least the vision is expansive. As we search for answers we are easily persuaded. Perhaps, after all, the question is the answer.