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William Glasser, in his Choice Theory, says this –

I disagree with the usual psychiatric thinking that you can learn from past misery. When you focus on the past, all you are doing is revisiting the misery. One trip through the misery is more than enough for most people. The more you stay in the past, the more you avoid facing the present unhappy relationships that are always the problem.

I’m with him on that – “One trip through the misery is more than enough for most people” – what a great quote! Whilst telling the story of the past can be important part of making sense of an experience and of understanding something of another person’s life, the solutions to the present suffering or distress don’t lie in revisiting. It’s not enough to just “get it out”. What matters is what you are choosing to DO today. How are you coping with life NOW as you are living it. That’s an empowering point of view because you can’t change the past, but you sure can change something about what you are doing today. Glasser believes that “present unhappy relationships that are always the problem”. Well, I’m always wary when I see that word “always”! It’s unlikely that there is a single cause, or type of cause, for all problems. He says –

What I will teach him is that he is not satisfied with a present relationship, the problem that always brings people to counselling. His past could have contributed to the problem, but even though most current psychotherapies initially focus on it, the past is never the problem.

I do think he’s onto something here, even if he’s pushing  things a bit with his “always” and “never”. There are, of course, a number of psychological approaches which focus on the present as opposed to spending hours digging through the past but not all so explicitly attempt to uncover the present unsatisfying relationship as the thing to focus on. The following three quotes make this very clear –

There is no need to probe at length for the problem. It is always an unsatisfying present relationship.

Since the problem is always in the present, there is no need to make a long intensive investigation of the client’s past. Tell him the truth: The past is over; He cannot change what he or anyone else did. All he can do now is, with my help, build a more effective present.

In traditional counselling, a lot of time is spent both enquiring into and listening to the clients complain about their symptoms [which makes it harder to get to the real problem]……..what the client is choosing to do now.

I remember the first time I realised I was on the wrong path when counselling a patient with postnatal depression who had been sexually abused as a child. On one of the one hour sessions she said to me “Look, I really do appreciate you taking all this time to listen to me, but every time I spend an hour talking to you about the past abuse I feel worse. I think I need a break from this. I think I need to live now.” Well, that woman taught me an important lesson about counselling – that it wasn’t enough to just let someone talk about the past, and that the present is where we live now so we all need better tools to live now, not better tools to remember the last miseries. I also realised at that point that different people had different needs and there was no one model of counselling which would fit everyone.

As I’ve learned from patients and learned from further reading and training, I’ve discovered I’ve a great affinity for focusing on what’s in life NOW and what coping strategies we’re using NOW. But I haven’t had the thought before that the problem ALWAYS lies in a current unsatisfying relationship. Maybe that’s worth exploring a bit more, but, what has made sense for me so far is that there are different areas of focus (and therefore different priorities) for different people. Sure, for many people, the most significant area is relationships, emotions and feelings. But for others the most significant area is something physical, practical, maybe work-oriented. And for yet others, the focus is on something spiritual, their disconnectedness to whatever is greater than themselves, or their search for meaning.

What do you think? Do these theories ring true for you?

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One of the most powerful, and most challenging, characteristics of Reality Therapy, is Choice Theory. When you are suffering, or upset, it seems pretty normal to use what William Glasser calls External Choice Theory and blame somebody for it. But, as he points out, in all circumstances we have choices. Bad things still happen, and Choice Theory does not mean that we choose to have bad things happen. However, in any circumstances we can choose between different actions, and we can choose to change how we think about something. (There’s something here in common with Viktor Frankl’s logotherapy I think. He said that what matters is what “stand” we take – how we respond in the various situations which we find ourselves in, and what actions we take)

It’s strange how challenging and apparently harsh it can seem to focus on making choices. I think there is an assumption that if you can make choices then you must have chosen the suffering you find yourself experiencing, but I think this is a seriously misguided interpretation. There’s a world of difference between making choices and being in control of everything. The world is not only full of random events, from accidents, to earthquakes, tsunamis and floods, but it’s also full of other people, all following their own agendas and taking their own actions which affect both other people and the environments in which we all live. Making choices as a continual process is an incredibly empowering exercise. It’s the use of external choice theory which paralyses, despairs and makes victims of us all.

So, next time you’re not so happy about something, instead of looking for someone to blame, think what you’d like to do now instead – in other words, focus on not only making choices, but seeing them through. It feels completely different to do something positive instead of complaining and blaming!

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I think you can understand what health is by considering the three main characteristics of healthy organisms – adaptability, creativity and engagement. In France, probably every town and every village has its “boulodrome” – a patch of sand where people play “petanque”. It seems completely informal. Just a space to use by whoever wants to use it. I think it’s a great example of designing social engagement into the spaces where people live.

Look at these guys enjoying themselves. It’s not hard to understand the importance of social engagement for human beings, is it?

petanque
petanque
petanque

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I came across two very different examples of weaving yesterday

nets
nets and ropes

and, then, further on, outside a shop

baskets
baskets

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The other night there I had a strange dream. I was trying to diagnose what was wrong with a patient but his symptoms kept changing. They didn’t change one by one, but in whole sets. It was like he was flipping from one disease to another over a matter of minutes, making it impossible to pin down what was actually wrong with him. I was thinking (in my dream) that I’ve often seen rapidly changing and vague collections of symptoms but this was different. Then I realised there was something additionally strange about this man. At one moment he seemed to be distant, aloof, faraway, as if not in this world at all, then the next he would be fully present, talking and answering questions. It was as if in addition to his rapidly changing sets of symptoms there was a flipping in and out of the world. At that point in my dream I heard a voice inside my head (you know the way we do sometimes in dreams – a clear voice but without an obvious source, a voice from within your own head but somehow everywhere around you at the same time). The voice said “He’s got dimensional slippage”. Pardon? “He’s got dimensional slippage. I think this may be the first recorded case” Well, then that other thing happened that only seems to happen in dreams – I knew exactly what the voice was talking about (suddenly I had knowledge I hadn’t had before). I knew in that instant that the problem this man had was that versions of himself from parallel universes were seeping into each other; that “normally” parallel universes are inaccessible from within each other and not only did this man have something wrong which had undermined those normal boundaries of existence but that his very illness was a proof of the existence of a multidimensional multiverse. (Bear with me here. If these terms are unfamiliar to you, believe me, they were unfamiliar to me too – well, not totally of course, but at that moment I couldn’t have explained to you, had you asked me, what it meant to have more than 4 dimensions in the universe, what a parallel universe actually was, or what the term “multiverse” really meant!). That’s the point where I woke up. Now, normally I probably dream every night but only have that knowledge of dreaming that we often wake with, a knowledge that is totally absent of detail. But every now and again I have a vivid dream, and every now and again (much less often) that dream comes with a feeling of significance. I wake thinking “that was an important dream”. But, of course, I’ve no idea why! That’s the feeling that dream gave me. I feel it was important but I didn’t understand it and I don’t know why it’s important.

So, what did I do?

Well, I started to try and find out what more than 4 dimensions would look like, because I really wasn’t sure I’d grasped that idea very well at all. And I did a bit of reading to see if I could understand the concept of multiple parallel universes – “multiverses”.

First I found this short video –

then, this fascinating interview with Lisa Randall –

So now it became clear to me that when mathematicians and physicists talk about dimensions, they are referring to dimensions in space. And as Lisa Randall points out, there’s really no way for us to picture more than the three dimensions of space (up/down, right/left and back/forward) along with the fourth dimension of time.

But somewhere in my musings about the dream I got to thinking “what is a dimension anyway?” Isn’t a dimension something we represent with an axis on a chart? Every axis represents a spectrum, doesn’t it? Thinking that way, consciousness is a kind of dimension. Every day we move up and down the axis of consciousness from sound asleep to awake and aware. When I thought of my dream patient becoming more or less present, I thought of a dimension of presence. People are like that, aren’t they? They move back and forward between being fully present and having drifted off, as if to some other planet. What if each of us moves back and forth along an axis of presence? And what if, just like visible light is only a small part of the electromagnetic spectrum, the visible body is only a small part of the axis of presence? Then maybe we fade away, as old people often seem to, and, maybe ghosts (if they exist!) are people beyond the visible part of the presence spectrum? Hmm….

There are many dimensions we can imagine this way. I know, of course, this is not what physicists mean by dimensions, but if co-ordinates along a number of axes situate an object or a person, then maybe imagining where we are beyond the spatial and temporal dimensions, gives a different way of considering our lives here and now.

I thought of the dimensions of consciousness, of presence, of emotions like happiness/sadness, and of a 3 dimensional group  (like space is 3D) of body/mind/spirit.

Which dimensions would you consider important in your life, and where are you along each of them now?

Maybe my dream was just a way of getting me to think about the multiple aspects of a human life, and to consider that we are all in a constant state of flux and change, moving back and forth, up and down and along multiple axes or dimensions. And maybe the diagnosis I was looking for wasn’t “dimensional slippage” but the dis-integration of the whole self. After all, that’s probably the closest I get to understanding what illness actually is…..a dis-integration of the whole self.

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I can’t remember how I stumbled over William Glasser’s Choice Theory or his Reality Therapy, but when I did I was interested enough to buy his “Choice Theory. A New Psychology of Personal Freedom” ISBN 978-0-06-093014-1.

I really enjoyed reading this book. It appeals to my personal philosophy in relation to psychology. One of the basic tenets of this book is that digging over the past to recount and relive old wounds and hurts is not helpful. Instead, the author claims, it is better to focus on your current relationships, your current thoughts and actions. His idea of “total behaviour” is holistic and highlights the connections between aspects of mind and aspects of body which enables us to make a better understanding of illness. It’s a psychology of hope because it rails against the dominant stance of “external control theory” – this is what most people do, most of the time – when things go wrong, people who use an “external control theory” feel like victims. This paralyses, disempowers and demotivates, and seeks to blame others for personal experiences.

I see parallels between this Choice Theory/Reality Therapy and Existential Psychology, Solution-Focussed Approach, Logotherapy and Positive Psychology. Together, these approaches build a framework of understanding behaviour and the mind which I find both useful and appealing.

Here’s the summary from the last chapter of Glasser’s book –

  1. The only person whose behaviour we can control is our own.
  2. All we can give or get from other people is information.
  3. All long-lasting psychological problems are relationship problems.
  4. The problem relationship is always part of our present lives.
  5. What happened in the past that was painful has a great deal to do with what we are today, but revisiting this painful past can contribute little or nothing to what we need to do now: improve an important, present relationship.
  6. We are driven by five genetic needs: survival, love and belonging, power, freedom and fun.
  7. We can satisfy these needs only by satisfying a picture or pictures in our quality worlds.
  8. All we can do from birth to death is behave. All behaviour is total behaviour and is made up of four inseparable components: acting, thinking, feeling and physiology.
  9. All total behaviour is designated by verbs, usually infinitives and gerunds, and named by the component that is most recognisable.
  10. All total behaviour is chosen, but we have direct control over only the acting and thinking components.

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Now and again I read a book that significantly changes things for me. Sometimes, it’s because the author describes new concepts I had never previously encountered. Sometimes, it’s because the author makes something I wasn’t sure about suddenly very clear. And, yet other times, it’s because the author’s words or ideas take my understanding of something to another level.

Books like The Joy of Philosophy, Linked, and Why Do People Get Ill are all good examples.

Recently, I stumbled across the work of William Glasser. His idea of Reality Therapy and Choice Theory immediately appealed to me so I bought one of his books. Choice Theory: A New Psychology of Personal Freedom. I’ve just finished reading it and I’m going to share a few things with you in a number of posts.

One of his key ideas is captured with the term “total behaviour”. What he means is that all behaviour is “total behaviour”.  All behaviour is made up of four elements –

  1. Acting
  2. Thinking
  3. Feeling
  4. Physiology

We can control our acts, and our thoughts, but we can’t directly control our feelings or our physiology. However, what we do and what we think affects our feelings and our bodies – for example, if you step into a dark empty house you might start to think about ghosts or people hiding in the darkness. Such a thought will make you feel scared and set your heart racing and quicken your breath. If you’re thought on entering the dark empty house is just “where’s the light switch” you won’t be feeling the fear and your heart and lungs won’t be speeding up. OK, that’s a very simplistic example, but I’m sure you get the idea. Everything in interconnected. The flows are two way. Just as a thought can influence your body or your feelings, so can a bodily change influence your feelings and your thoughts (and so your actions).

This holistic concept of whole being changes in different situations reminded me of the work of the General Semanticists of the mid 20th century.  They too talked about these links between the body and the mind. They used a different term from “total behaviour” – they used “organismic changes or responses”. But it was a similar idea. In much more recent times we’ve begun to see emerging areas of scientific study termed “psychoneuroimmunology” and “psychoneuroendocrinology” which are helping us to understand the mechanisms of these two way influences between body and mind.

I think it’s a great concept to keep in mind – that these four aspects of behaviour are always present and connect the many diverse parts of ourselves so that our whole self always works in unison. When you’re feeling bad, or your body is playing up, this understanding will help you to realise all is not lost. You can work on your thoughts and you can choose different actions and your feelings and your body will respond.

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Writing your self

Two of my best blog friends have posted interesting writing ideas yet. I’m going to point them out to you so you can go and check them out.

First of all, mrschili, across in her inner door blog, picked up an idea from a fellow blogger (wordlily), about writing a six word autobiography. The results are fascinating and enlightening. Try it for yourself. What would your six word autobiography be?

Secondly, Dr Tom Bibey, posted about writing a single paragraph entitled Where I Come From. His short paragraph about his origins and influences has gone on to inspire several others. Check them out. And, then……..yep, try it out for yourself. What would your write for “Where I Come From”?

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New research from Edinburgh University claims that happiness is partly determined by your genes.

In fact, they claim that

genes may control half the personality traits keeping us happy. The other half is linked to lifestyle, career and relationships

This study was one of those identical twin studies where the researchers compare identical twins. These studies are great favourites with psychologists and are used to highlight traits which each twin (who has his or her own uniquely different social setting) shares – as the twins have different social backgrounds, the commonalities are reckoned to be more to do with their shared genetic make-up.

The Edinburgh researchers looked at the presence of three traits – tendency to worry, sociability and conscientiousness – all three of which have been linked to happiness and well-being in other studies.

“Although happiness is subject to a wide range of external influences we have found there is a heritable component of happiness which can be entirely explained by genetic architecture of personality.”

So, is this a depressing study? No, not at all. It strikes me as very logical that part of who we are is influenced by our genes – we are dealt a hand we have to play. And part is determined by modifiable factors in our lives. This conclusion is supported by those who promote positive psychology techniques. Dr Alex Linley of the Centre for Applied Positive Psychology said –

“What it means is that, rather than a single point, people have a range of possible levels of happiness – and it is perfectly possible to influence this with techniques that are empirically proven to work. “Simple things, like listing your strengths and using them in new ways every day, or keeping a journal where you write down, every night, three things that you are grateful for, have been shown to deliver improvements.”

I agree with him. There’s a lot of mileage in understanding what our range is (the hand we are dealt) and learning how to grow within that range to have the best experience of life we can.  In fact, I think this is a more defensible view than the New Age kind of thinking promoted in the likes of the “you can be anything you want to be” brigade.

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snow seat, originally uploaded by bobsee.

Some people are very sensitive to change. I’ve met people who become unwell at every change of the weather (quite a problem for someone living in Scotland I can tell you!). There are even people who are sensitive to the melting of the snow. The melting of the snow? Yes. Strange, huh? But really such a sensitivity is a particular hypersensitivity to change.
The reality is that everything is always changing. It’s the one constant in the world. Nothing, but nothing, stays the same.
We’re all different though. Some people relish change. They love it, thrive on it. Others are terrified of it and pour all their energies into trying to keep as much the same as possible.
How about you?
What changes do you relish? And which do you try to prevent?

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