I spoke to the Business and Professional Women’s Club in Belleville with the intention of introducing some of my knowledge about psychotherapy and information about our work, to a smaller Ontario community. There were twenty-five women at the talk. The age range was from twenty to seventy five. I was invited to be a guest speaker by my sister Donna and to me, this was an honour and privilege. I felt very proud to be a part of her life in her work environment. She expressed the same sentiment to me.
I asked if anyone was aware of the practice of psychotherapy and only one person answered yes. I found that some people were very interested and that others would drift in and out. I learned that I needed to explore further how to capture the attention of people who have no knowledge about the psychotherapy profession. I know that there are more lessons to learn from this experience.
I am glad that I gave the talk. I gave the women my speaking notes and my e-mail address and we shall see if there are any further inquiries.
I wanted to publish this talk in Esprit as it sums up my understanding of our work and I would be interested in dialogues with others on this speech.
SPEAKING NOTES
For Barbara Dewar’s Address at BPW – The Business and Professional Women’s Club
Belleville, October 21, 2002
Overall Objective
An important goal for BPW is to encourage and assist women to stretch into new territories in order to lead more meaningful lives. I will speak about how therapy can, for some women, be a resource that supports this goal and how it can encourage them to have the strength to fight to achieve a just and equal status in all levels of society. I will explain how women can learn the skills of building co-creative relationships to enrich their lives.
What kinds of resources are available to assist us in improving our mental health?
I would like to share with you the kinds of support and help that are available for women. There are distinct groupings, each with a niche and a particular view on mental health issues, and each is important for specific reasons. Women have a right to shop for the resources most suited to them and most likely to provide the support that they need.
Working on a health model and not a disease paradigm
I hope to dispel the erroneous myth in our culture, that reaching out for help for our mental well being is a weakness. Quite the opposite, I believe a woman demonstrates courage, strength and health when she reaches for a resource that can help her with further growth.
I want to emphasise that we need to help women learn that it is not wrong or shameful to reach out for these resources. We are not a wrong that needs to be fixed. Wanting to improve your mental health should be a normal, non-stigmatised possibility.
How has the disease paradigm been changing historically?
I am going to talk about stigmatised judgements and their impact on mental health care historically in our culture. Many psychological workers are now making great efforts to operate from a health model rather than a disease paradigm.
The work of The Psychotherapy Association of Toronto – Who are they?
I will answer the following questions:
- What do we feel brings women into therapy?What do we feel are the roots of self-esteem breakdown?How do we work with this challenge?What generally in our experience happens to women after in-depth therapy and how does it foster a health model rather than a disease paradigm?
This last segment will be a demonstration of a co-creative exercise and a question and answer period.
What is available as a resource for our mental health?
If you were considering going for help for emotional support and for your mental well-being or want to make a referral to a mental health professional, you need to know who is out there and how they work. The most common question that people ask me is what is the difference between a psychiatrist, psychologist, counsellor, social worker or psychotherapist? This question is important as each specialist works completely differently and holds very different philosophies. You can shop and feel that you have a right to choose the most suitable person for you.
Although the following are dictionary definitions and a bit dry, it is my heartfelt belief that psychiatrists, psychologists, counsellors, social workers and psychotherapists are all great lifesavers in our communities.
Psychiatrist
A psychiatrist is a medical doctor with a speciality in abnormal psychology who is engaged in the diagnosis, treatment, and prevention of mental disorders. Most psychiatrists follow a medical model in that they hold the belief that mental illness is caused by chemical imbalances in the body. In other words mental illness is seen as a physical disease. The preferred method of treatment is medication and discussion around whether it is working or not. Illnesses are classified according to a cluster of symptoms for example; schizophrenia has a specific set of symptoms. Medication often helps women relieve their symptoms.
Psychologist
A psychologist is an individual who, by means of a course of training at least through the level of the master’s degree and in most cases through the doctorate, has made a specialised study of the science of psychology. They are scientists who study human and animal behaviour in all of its complexities and nuances. They seek to understand the nature of living organisms and their ability to adapt to the environment. They seek to understand the conditions that cause the behaviour. A speciality could be, for example, industrial, human behavioural, or psychological testing. A psychologist draws conclusions and offers suggestions on how to improve the presenting problem.
Counsellor or Social Worker
Counselling is a broad name for a wide variety of procedures for helping individuals achieve adjustment, such as giving advice, therapeutic discussions, the administration and interpretation of tests, and vocational assistance. Basically a counsellor supports an immediate conflict or crisis, providing relief with the discussions of solutions. You fix the problem. Social workers operate with the same premise. Social workers and counsellors hold more of a belief that environment affects a women’s psychological life.
Psychotherapist
Psychotherapy refers to methods of doing therapeutic analysis with clients in short- or long-term therapy. I believe it is important to ask the therapist in an interview how they work and how do they view the roots of issues. The psychotherapy that I will be referring to is therapy that is geared to women who are looking for an in-depth exploration of their inner world. More often than not, people are looking for long-term solutions to problems that they feel they have suffered from for a long time. Our psychotherapeutic association sees the therapy as a journey to the self, in order to release hidden wounds by exploring the family of origin and current relationship communications. We strive to help women to feel self-confidence in their relationships.
Working on a health model and not a disease paradigm
Overall we are taught in our culture that problems with our emotions have to be fixed because something is wrong. It is shameful and wrong if we have a problem and we must get rid of it as soon as possible. There are experts out there that can help us.
This view of experts can set up an unequal relationship for women who are looking for the resources of a psychological worker and can lead to hierarchical and patriarchal abuses. In this view, the health expert has the right answer and has a financial and professional investment in keeping away and distant from the person with the problem. This is what keeps a God-like complex around the expert intact.
I would like to encourage all of us to consider our own expertise in terms of our own life’s experiences and anyone else’s as a shared exchange of skills and that one is not any better than the other.
All workers in the psychological field should have the healing qualities of empathy and kindness, and hold an attitude of normalcy and health around the process of personal discovery. As a consumer you should feel that you are with your psychological worker to try and sort out issues together in a co-creative spirit. Your worker has to convey to you that she or he doesn’t have all of the answers but that together you can figure it out – you are equal partners and participants in the exchange.
In reaching for this resource, I encourage women initially to operate on a gut feeling as to whether they can open up and trust this worker. The psychological worker has to work hard to earn your trust and view vulnerability as strength and not as a weakness. You should feel that you are going for a resource that is non-stigmatised and your chosen mental health professional should create a feeling of health around the experience.
How has the disease paradigm been changing historically?
Over the past hundred or so years the most influential person in the field of psychological work was Sigmund Freud.
Everyone has an everyday opinion of Freud. You hate him or love him. His work became both a springboard to develop the science of psychological work, and a platform to be challenged in order to develop a new model of healing work. He was a scientist of his time who proved his theories by scientific methods. According to his teachings, you teach students of psychology the right techniques and give interpretations that are right for the theory. You are a blank neutral canvass and a non-interactive worker who studies the mind of your patient. You ask your patients to accept your interpretations and if they do, they are cured. If they don’t, then the therapy doesn’t work for them and they are too disturbed for psychoanalysis. This is a blueprint for a patriarchal infrastructure and sustenance for a disease paradigm.
Unfortunately this approach, not only in the psychological field, has a much stronger hold on our culture than a model based on the equality of relationships.
On the other hand, I believe that Freud provided fuel to challenge the scientific patriarchal paradigm in two ways. First he carved a space for therapy to happen for the average person and not only the mentally insane. The second is his belief in lay therapy and that it didn’t have to be the privilege of doctors to carry out this work. Psychotherapists sprang from these two fountains. Any of us could reach out for a resource for our mental health and the healers didn’t have to be medical doctors.
Freud’s theory went through an evolution of change over the last century as to the causes of our mental health struggles. It moved from patients seen as totally encapsulated and isolated units responsible for their mental health issues, to our mental imbalances being attributed to environmental surroundings and our relationships.
We now have huge openings to challenge the scientific paradigms of cause, effect and corrections. We now believe that we are responsible for our dynamics in relationships and that we need to understand the sensibilities of a process model so that relationships of any kind can be based on a mutual exchange of skills and not the expertise of one person over another.
The Psychotherapy Association of Toronto (PAT)
The Psychotherapy Association of Toronto is an association of four psychotherapists who share similar like-minded directions in life and in the therapeutic process. Supervision and co-creative dialogues are its steady diet.
What do we feel brings women into therapy?
The issues that bring women into therapy are as complex and colourful as all of our individuality. Some special stress examples are adolescent adjustment, issues around addictions, assertiveness, body image, creative blocks, eating disorders, mid-life issues and childhood sexual abuse. In my experience these are all presenting issues.
I believe that the common deeper struggle is with a need to strengthen self-esteem. How we feel about ourselves, is key to how well we function in the world. Self-regard issues represent a road that can lead to an exploration of how we feel in relationship to others.
What are the roots of self-esteem breakdown?
We work with the template that fragmentation in our self-esteem has to do with the breakdown in relationship communications. Breakdowns happen in a patriarchal and hierarchical dominated society, and in our family homes where our nuclear families are often not provided with enough rich soil, by society, to prevent communications breakdown.
With balance in our relationships at home we can meet the world’s problems with a stronger sense of self.
We follow the philosophy that human beings are motivated in early life by the need to have meaningful relationship connections. Feeling understood by those who love us strengthens us for adaptation to adult life. We are born, live and die in a state of relationship. We internalise our childhood family and this influences all of our communications. Every endeavour in our adult life involves our relationships with people.
If early learning in the home is taught in the sprinkle of fear domination, then parents and children carry hidden or overt anger and get separated from the goodness of each other and the fact that they love one another. Divide and conquer is the glue of patriarchy. A healthy model for everyday living in our families should be the same model we experience outside the home.
Unfortunately, by osmoses, family life is not separated from society and society is not separated from family life.
How does The Psychotherapy Association of Toronto (PAT) work with this challenge?
When someone comes to a psychotherapist for support, the backdrop that the therapist holds is key to the experience that takes place. In the initial interview, it is important to share your background and encourage the client to ask you questions. This immediately begins the process of building the relationship together.
Your client comes to you in a state of vulnerability and you must communicate the strength there is in vulnerability by offering your own humility and fallibility. You work from the client first, rather than offer answers that you think are right. You offer, that you don’t know the answers for the person at that moment but that you will figure it out together. You ask the client if they are comfortable with you. You tell them that it is okay is they are not, and if not, you will work together to find a therapist who is the right psychological worker for them. You must always privilege the client’s story first otherwise you steal their personal story and put your own spin on it. This is a hierarchical modus operandi, in that their story is wrong and on the bottom you are right and on the top.
How dare we pass judgement on a person’s story?
The psychotherapists of PAT hold the client and the people in the client’s story with love so that they can work towards healing the divide and conquer values that they learned to have toward their original families and surrounding relationships. We tell them about this holding so they can have an open space to explore their conflicts. We are not there to agree or disagree; we are there to help them sort it out. Because a therapist has influence, it would become very easy to abuse this power in order to build up the therapist’s ego. It would be easy to side with your clients when they feel for example, that their parents were bad or their boyfriend was mean. This does not help them sort out communication breakdowns but offers a split, black and white view and fuel for a culture that operates categorically, with a right and wrong way.
How do we hold the scaffolding of love for our clients and the people that the client has conflicts with?
All of the therapists of PAT have gone through a self-discovery pathway and have grappled with the tools that are needed to build co-creative relationships in their own lives.
The two essential process tools that we need are empathic listening and finding attunement with your client. These tools have helped us hone the skills needed to create a safe environment for the work at hand.
Empathic listening involves knowing that we first filter everything through our own personal lens and from there only, do we then struggle to find an attuned response to your client. Your own lens may also tell you how you might be affecting your client. You know whether your response resonates with your client by honouring their feedback. If you are able to take negative feedback and dialogue about any ruptures in your work together, then your client truly knows that you carry and air of fallibility and are willing to struggle with them rather than for your rightness. This is the co-creative model that you want your client to absorb.
You work with your client for as long as it takes for them to internalise the model of communication that the two of you have learned together and for them to transform the roots of their communication breakdowns with their significant relationships into healthier ways of relating. Dynamics with others can be worked out and not left in a great black and white divide.
How does this address a health model and not a disease model?
The Psychotherapy Association of Toronto tries to find a way to work that breaks down the structures that hold patriarchy, hierarchy and any form of discrimination together. It tries to melt the glue of right and wrong, have to be fixed or changed, and the expectation that you have to be perfect in life. We offer a model of communication between therapist and client that involves preserving the integrity of both parties through on-going dialogue. This involves mutuality of exchange until you and your client are equal and yet separate persons in their own right. Your client comes to know that their personal offerings are a valuable and meaningful contribution to the growth of our society.
We bust the fantasy of perfection and work from the reverence of our human experiences.
What, generally, in our experience happens to women after therapy and how does it apply to the goals and vision of BPW?
We have found that most women, who have internalised the knowledge of co-creating relationships via the therapeutic relationship, want to find places to channel their newfound growth. Many women search for or create communities that are based on this model of communication. The BPW clubs across Ontario, for example, may be a community resource where a woman can reach out for support for her professional life and find a place where she can help other women to realise their potential.
The Psychotherapy Association of Toronto, for example, has joined with two other women who have been in connection with one another in a process of self-discovery via therapy for fifteen years and have recently formed a community circle called Esprit. Basically, we support each other in our personal and work endeavours and encourage each other to stretch our potentials. Four of the women, Jo-Anne Corbeil, Mary Walton-Ball, Judy Farquharson and myself, work as psychotherapists and the other two women, Sandra Campbell and Isabel Caceres work respectively as a writer and an administrator. All six of us have worked hard together, to learn the communications skills that are involved in co-creative relationships. We are learning to share our acquired knowledge, using the model of our stories to co-create with a larger community, by putting out a publication twice a year. We do not place ourselves apart and above anyone’s human struggles. We feel that this model encourages health based on the equality of mutual exchange that respects individuality and difference. We invite others into the dialogue if they choose to do so.