Responsivity Principles
The Language of Change, the Dialect of Toys
“What do I know? I’m just a bunch of brain chemicals responding to stimuli.”
My former partner and I used to own an apartment in Madrid, Spain. It’s in a very old building that has a carriage track right through the middle of the building with ruts worn into the stone from centuries of use-back to the 1500’s. My former partner, Susana, is a professional Flamenco dancer/choreographer who will undoubtably retire some day, probably later than sooner. She once talked about wanting to live in Spain, preferring the ambiente there, the greater sense of street life, the politics, the beauty of medieval architecture, etc. But I always wondered, what would I do for a living? I was still in my early fifties and had no cache of stocks and bonds to retire upon. How could I support myself and put my youngest children through college while living in a foreign land?
Susana had explained that Spain is just now discovering the problem of sex offenses and it’s a hot topic. She believes I could have been a sex offender therapist there and would have translated for me, and I could then have made tons of money doing training and directing programs. I pooh-poohed this idea because I couldn’t imagine succeeding as a therapist in Spain. I consider myself a good therapist, but it wouldn’t mean much in a place where my grasp of the language is infantile at best. Sure, it would improve, but my Spanish language skills were too rudimentary to carry the nuances that characterize my professional work at this mature point in my career.
It stuck me that this is exactly the problem with utilizing responsivity principles and Hermes’ Web: this whole approach is really a language in itself and therefore requires extensive study and practice to develop a sufficient level of operational proficiency.
I once offered a workshop entitled “The Pitfalls of Psychodynamic Work.” The gist of the presentation was that Psychodynamic Psychology has often gotten a bad name -- not because it is bad psychology, but because many people who use it haven’t made a sufficient study of it, don’t possess mature skills, are only dabbling and grabbing techniques here and there and thinking they have grasped the genre. They then fly under the flag of Psychodynamic Work and those who criticize them attribute their lack of effectiveness to the theoretical base, not the inadequate preparation of the clinician.
I consider Psychodynamic Psychology to be a language: to be accomplished and competent at it, to achieve the results possible from that approach, requires a firm grasp of object relations, developmental psychology, psychoanalytic psychology, psychological testing, brain research and several other components. Then one must integrate clinical knowledge and skills with that theoretical base to produce a new level of therapeutic expertise. It takes many years to accomplish this, assuming one is concurrently operating in the field as a clinician the whole while, developing an experiential baseline.
Thus, we come to a whole new dilemma. A majority of clients who have serious difficulties, whether emotional, correctional, or both, also tend to have learning disabilities, do not learn well cognitively or intellectually, and have learning styles that are more visual, tactile or kinesthetic. In order to even pay attention, these clients need therapeutic learning to be interwoven with images and objects from their daily lives: movie plots, TV and comic book characters, fairytales and sports figures. In essence, they speak a different language from that which we learn in the course of a graduate school education. To adequately help people (and avoid burnout), we have to learn a new language – the language of change. It is not easily acquired. No one warned us it would be essential to our future travels in the professional world. We certainly do not need it to communicate with our colleagues, insurance companies or other professionals.
Why do we need it? Well, the psychological reality of many of our clients is like a foreign land. The language spoken there may be totally foreign to us. The language we speak as therapists is likely foreign to them. All our training, theory and experience could be impotent in that foreign land unless we learn the language. Becoming fluent to the point of learning nuances and colloquial speech takes a long time and immense dedication. What should we do?
Imagine you’re just finishing graduate school and are eager and raring to go into practice and utilize your hard-won skills as a psychotherapist. You are called into the Dean’s office and he informs you that there is one major hurdle left: you have to learn the language of change. He explains that this is the final bridge between knowledge and application, training and effectiveness. The Dean informs you this is also the most difficult step because it doesn’t just rely on your intelligence and drive, which are clearly sufficient but not germane to this new challenge. He asks you to imagine being required to move to a foreign country to practice therapy, one where you don’t even know yet how to ask for bread or wine in that tongue. You sit there and consider hiring an attorney to fight this new requirement no one told you about prior to this moment. You feel cheated and frustrated, yet, you have a hunch that this language of change is the real deal and something you can’t do without.
The reality is that today’s education entirely forgets the principles of responsivity, just throws you into the fray without that last, essential chapter in your training, the one that helps you translate your skill and knowledge into the language your clients actually use. Responsivity has been called “the most important and most overlooked element of effective treatment.” In the computer world the concept is easily understood: conversion programs. If you want one software program to talk to another, or Apple computers to talk to IBM computers, you have to have conversion programs. People from different countries who are not bi-lingual need translators in order to conduct business. But in Psychology we seem to forget about this problem and plunge right in.
Graduate school psychology teaches us an arcane language, one which has little value for our clients. College life also removes us from proximity to the lives of the people who most need our services. Plus, the rigors of study limit our access to contemporary culture. And, if we can afford college, we likely are far removed from want and need, addiction and tragedy, gangs and violence.
So, sit back for a moment and consider the 10 principles of Responsivity: 10 elements we would do well to gain a command of if we wish our therapy to be more effective. But keep in mind it is a language and will take years of practice to gain fluency in, every bit as much of an education as your social service degree itself.
THE TOP 10 ELEMENTS OF RESPONSIVITY
1 - LEARNING STYLES
Those with the worst psychological difficulties are least likely to learn well intellectually and cognitively. They tend to learn best visually, tactile-ly, through story and imagination. This may require the therapist to move outside their own comfort zone. Regardless of a therapist’s own best learning style, he or she will need the Hermetic ability to adapt to the learning styles of others, to translate from their main frame of language to the other languages and dialects that best inform the consciousness of their clients.
2 - BRAIN THEORY
Modern brain research is providing more and more information about how we learn, process information and change: positive and negative linkages are one fascinating way to understand how our brain works. Linkages are associative networks that cross all the major brain areas, containing emotional, cognitive and memory-based links that combine to create an automatic response to certain stimuli. These linkages can operate like internal firewalls that activate when threatened , automatically preventing input or output, positive or no. Individuals with abuse histories can be extremely sensitive to certain tones of voice or movements. If they hear that tone or see that particular movement, it will not matter what the other person’s motivation or purpose is – they will simply go into defense mode and shut down. Positive linkages, on the other hand, are built up through therapy and can counteract or replace long-acting negative linkages. Trauma, as you can well imagine, tends to put negative linkages in place and to often be impervious to cognitive intervention. Critical thinking and cognitive-behavioral programming are often attempts to create counteractive positive linkages that can over-ride old negative patterned responses.
EPIGENETIC RULES – lifetimes of experience bias our response to various stimuli and challenge us to take more internal leadership. Our brains are a memory bank, not just of our personal experiences, but of millennia of experience by generations of human beings. Migration routes are an example of this in the animal kingdom: newborn birds have the information in them already, know how to navigate. Some human beings are deathly afraid of a snake or mouse the very first time they ever see one, even though they’ve never personally had a bad experience with either. Even sexual attraction has epigenetic factors such as breast size, shape of the hip and other factors which can exert powerful instinctual pulls on human beings and sometimes land them in trouble when the response to breast size overrides one’s awareness of personality factors that are incompatible. Knowledge of epigenetic rules could help a therapist educate an offender or help a client recognize problem behaviors.
HOW EMOTION AND INFORMATION ARE PROCESSED – panic can cause shortcuts to be taken in the brain that bypass conscious scrutiny. It takes discipline to develop the capacity to think before reacting. Unless more advanced neural pathways are developed, signals relating to flight and fight can rush to the amygdala and demand immediate action and reaction. In time a client hopefully learns to link to his frontal lobes and their conscious processing to instinctual and emotional reactions in order to make more informed choices.
3 - TRAUMA THEORY
Trauma is often incurred during the pre-cognitive phases of life and its maladaptive emotional patterns are set in place at that time. Effective therapeutic change must utilize language that more easily reaches the older parts of the brain where trauma is seated. Bottom line, trauma and its roots are hard to reach, difficult to impact. Metaphor, stories, images, and tactile tools are all methods that promise effective treatment of trauma as they are more likely to impact the parts of the brain where the original traumatic effects reside.
4 - MATCHING OFFENDERS AND THERAPISTS
Clients often get only what’s available, unless they have exceptional health insurance. But matching for compatibility enhances the end results and shortens the time necessary to achieve effective treatment. The wrong therapist can easily exacerbate pathology or prolong the process. Considering issues like typology, adaptability to learning styles, language, knowledge of contemporary culture are all crucial factors to consider when choosing which therapist to assign, especially when working with more disturbed individuals who respond poorly when therapy is primarily cognitive or academic.
5 - A LANGUAGE OF CHANGE VS. GRADUATE SCHOOL LANGUAGE
Denzel Washington, as an attorney in the movie, PHILADELPHIA, told a witness to “explain this to me as though I’m a 6-year-old!” We have to recognize that our professional language is just that – a professional language – and of little use to the majority of troubled clients. We need to develop a language of change that can translate important concepts into a form clients can utilize. This might mean utilizing more slang or colloquial phrases, incorporating themes from contemporary movies and TV programs, and backing up psycho-educational units with film clips, toys and tools that allow clients to see, touch and feel what it is they need to learn on multiple levels rather than feeling dumb inside and pretending to understand when they really don’t.
6 - OFFENDERS’ DEVELOPMENTAL LEVELS
A client’s developmental level determines to a large degree what they’re capable of learning and processing, especially on a core level. One’s therapeutic strategy needs to be adapted to that level. Distinguishing between developmental levels on both ego and core levels is also essential and elucidating as to whether the ego and core levels have any connection or working relationship. The core level developmental level is also the default setting, indicating with what level of maturity an individual will operate on when pushed to his or her limits. The Jessness Inventory gives the most specific breakdowns of developmental levels available through assessment instruments. Our core-level psychological age is often in single digits.
7 - REPETITION AND MULTI-PRONGED PRESENTATIONS
Modern education has the bias that if you hear something once, you should “get it.” Actually, we need many repetitions in order to learn something, and, we benefit from multiple forms of presentation that illustrate a point or concept from several perspectives. Thus a concept can be explained in three or four bullet points, then an example given of how it might play out in someone’s life, then the instructor can ask for examples from the clients’ lives. To shift direction, one can then show and describe an action figure from contemporary culture that helps illustrate the point in an everyday context. Finally, utilize a film clip or feature film that shows the concept embedded in a larger drama as a way to teach clients how to discern that issue in context, in places they wouldn’t have noticed it before, to open their eyes to perceptive discrimination and implant images that will help keep their eyes open.
8 - LEADING FROM INSIDE
Milton Erickson’s work makes it clear that the ego is often too damaged, too defensive or too insular to be a good ally in treatment. Many troubled youth no longer are impressed by role models and mentors and don’t even care if they have a functional, conversant ego of their own. Leading from inside means joining a client in their lost-ness to see what steps, if any, are possible to eventually move out of that lost place towards health and integrity. It is the opposite of the word insight – which often means to stay at a distance but keep the pathology in sight and pass information over to the client in hopes they’ll be able to utilize it down there in their mess. Many troubled clients don’t offer a therapist the respect of listening to them unless they feel the therapist has some capacity to see the world from their perspective, a task much more difficult than the tactic of Rogerian empathy.
9 - GOOD ASSESSMENT & TESTING
Testing is a good way to map the core, to visualize the terrain of change. The Millon (MCMI-IV) is especially helpful because it can show what a person is likely to be like at their worst, under pressure. After all, many offenders display qualities during an offense that are not visible at any other time. In addition, Axis II traits are often a better clue to future behavior than Axis I symptomology. It’s important to use those psychological x-rays and explore pathological backwaters that don’t necessarily meet diagnostic thresholds. Clients need a map, not an executive summary. And this is another situation where grad school language needs to be explained as though talking to a 6-year-old!
10 - IQ vs. the other Q’s
IQ is a poor predictor of success. EQ - emotional intelligence – the ability of values to hold up under pressure - is a good predictor, and it can change and increase over time, whereas IQ does not. But EQ must also be distinguished from SQ (street smarts) and CQ (criminal intelligence), not to mention the other Q’s. Also, it is important to point out to clients that there is absolutely no correlation between IQ and EQ. Redefining intelligence is a good way to open communication lines with a client who secretly feels inferior regardless of the bluster they put forth.
IN SUMMARY
If you wish your work to be more effective, you have to build the bridge of responsivity and learn the language of change. Otherwise, you will be more susceptible to burnout and more likely to create resistance in your clients, despite your best efforts, good education and training. Responsivity is about creating an operable arena of change where therapist and client can engage and exchange information in a meaningful and even playful way. Responsivity helps prevent therapy from descending into warfare. Responsivity is the language that links the high-tech world of psychology and the primitive world of emotional largesse.
