Beyond Empathy A Therapy of Contact-in Relationships London Routledge.png

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2022-04-17

Inquiry - in Beyond Empathy

Integrative psychotherapy, the method of therapy upon which this book is based, focuses on relationship.  psychologically healthy - is to be in relationship.

Contact is the touchstone of relationship; it is what makes relationship possible.

In a psychologically healthy individual, internal and external contact interact; each depends upon the other, and neither can exist in isolation.

three therapeutic elements can further this process: inquiry, attunement, and involvement; help the client to integrate his or her self:

Inquiry: the process by means of which the therapist invites the client to explore his or her experiencing.

Inquiry

Integrative psychotherapy, the method of therapy upon which this book is based, focuses on relationship. loc: 58)

psychologically healthy - (loc: 59)

is to be in relationship (loc: 59)

Contact is the touchstone of relationship; it is what makes relationship possible. (loc: 64)

In a psychologically healthy individual, internal and external contact interact; each depends upon the other, and neither can exist in isolation. (loc: 69)

three therapeutic elements (loc: 78)

can further this process: inquiry, attunement, and involvement. (loc: 78)

help the client to integrate his or her self: (loc: 83)

Inquiry (Page: 16)

the process by means of which the therapist invites the client to explore his or her experiencing. (Page: 16)

The therapist inquires about every aspect of the client’s growing awareness. (Page: 16)

the therapist must be attuned to the client’s here-and-now experience (actually, the past and the present flow together and are often indistinguishable in the moment of experiencing) (Page: 16)

With careful inquiry, sensitive attunement, and authentic involvement, the therapist will be experienced as dependable, consistent, and trustworthy. (Page: 17)

It has been our observation that good therapists, regardless of theoretical orientation, engage in inquiry, value attunement, and are concerned that their involvement be genuine and appropriate. (Page: 18)

Inquiry (Page: 19)

The ultimate purpose of inquiry is to help clients discover the ways in which they have learned to interrupt internal and external contact. As they recognize their patterns of contact interruption, they can develop new and more authentic ways of relating to themselves and to others. (Page: 20)

Therapeutic inquiry, however, is much less concerned with the answer itself than with the process of getting to an answer. (Page: 20)

Discovering a previously out-of-awareness response to the therapist’s inquiry is much more important than the actual content of the answer. (Page: 20)

Characteristcs of Inquiry (Page: 22)

Respect (Page: 23)

Genuine Interest (Page: 23)

Open-Endedness (Page: 25)

Theory Does Not Bias the Inquiry Process (Page: 26)

Theories about how people grow and change and what sorts of relationship qualities will facilitate growth will always govern the way we conduct ourselves with clients. And yet in the inquiry process our theories must not limit the client’s exploration (Sullivan, 1953). We must make sure that we do not, deliberately or accidentally, conduct our inquiry in such a way as to nudge the client to meet our own theoretical expectations (Naranjo, 1993). (Page: 26)

“There’s a real important reason. …” In one sense, that is an obvious comment: it is highly unlikely that such a shift would be made for no reason, or for an unimportant one. Yet making the comment, and getting Cheryl’s agreement, allows the therapist to ask the next question: “Is there anything you’re prepared for?” Without confirmation that there was an important reason, that next question would have imposed, presupposed, the therapist’s ideas. It would have gone beyond inquiry into (Page: 26)

interpretation. (Page: 26)

When we do not impose our theory on our clients, we are free to follow them wherever they need to go. (Page: 27)

clients find this somewhat confusing. After all, isn’t the therapist the authority? (Page: 27)

truly paradoxical: implicit in the inquiry process is the instruction to not do what I say, but to follow your own way. But if the client does that, he or she is following instructions. (Page: 27)

constant thread that leads both client and therapist through the confusion is contact. (Page: 27)

if the therapist (Page: 27)

misses something important, (Page: 27)

the therapeutic relationship provides an opportunity for therapist or client to make the needed correction (Page: 27)

Nell: (pause) I’m trying to stay with you. I don’t know what to do with the silence. Therapist: You don’t need to stay with me. My job is to stay with you. (Page: 27)

Constant Attention to Contact (Page: 27)

contact between is the bridge to contact within (Page: 27)

attuned to the quality of the client’s internal contact, constantly asking questions that will increase the client’s awareness of feelings, needs, memories, perceptions. (Page: 28)

the questions are asked and answers received in a way that enhances the relational contact (Page: 28)

Expanding Awareness (Page: 28)

inquiry concerns itself with whatever will invite the client to become more aware— (Page: 28)

But therapeutic inquiry is not about social chatting or even ordinary problem-solving. (Page: 28)

is about becoming increasingly aware of oneself and of one’s interactions with others. (Page: 28)

therapeutic inquiry (Page: 28)

refuses to be distracted by the social exterior presented by the client. (Page: 28)

Therapeutic inquiry consistently asks about what lies below and beyond the social exterior. (Page: 29)

difficult things for beginning psychotherapists to do is to put to one side the conversational conventions that they have used all their lives. (Page: 29)

the goal of inquiry is not to help clients feel comfortable, or shore up their defenses, or provide them with an enjoyable 50-minute interlude (Page: 29)

It is to help them discover things they have been unable to discover on their own, (Page: 29)

interest, respect, and willingness to learn from the client undergird the inquiry process. (Page: 29)

The client is in charge; the client decides how far he or she is willing to go in the process of exploration. (Page: 29)

Inquiry lies at the core of therapy; it guides the process yet leaves the client free to choose his or her own direction. (Page: 29)

The Techniques of Inquiry (Page: 29)

Contracting (Page: 29)

Working with the client, rather than working on the client, makes the client a partner in the therapeutic enterprise. Resistances and dead ends become problems to be solved jointly (Page: 30)

The client’s sense of efficacy and control are enhanced, and with efficacy and control comes a greater sense of safety and willingness to risk (Page: 30)

No Presuppositions (Page: 30)

Even if correct, though, therapist presuppositions still detract from the primary purpose of inquiry (Sullivan, 1953). By acting on a presupposition, we imply to the client that we have “got it.” The client does not need to explain any more; the therapist understands. But the therapist really does not understand— (Page: 31)

Not, “You must have been furious,” but rather, “You look angry right now. What are you feeling?” or “It looks like that incident was deeply meaningful to you,” with a voice tone and a pause that encourage the client to talk about his or her meanings. (Page: 31)

Everything Is Important (Page: 32)

Every word, every gesture, every shift in voice tone or posture is connected to some aspect of the client’s experience and is thus worthy of exploration (Page: 32)

While inquiry most often deals with phrases, sentences, even entire stories, there are times when inquiring about a single gesture or an individual word can open whole avenues of awareness. (Page: 32)

Respect the Client’s Perspective (Page: 34)

The client may deny the significance of something that the therapist is interested in, or he or she may choose not to follow the therapist’s suggestion for how to move past some stuck place. (Page: 34)

Such resistance is significant and deserving of respect; it is serving an important function in the client’s whole self-protective system. (Page: 34)

integrative psychotherapists welcome the resistive behavior as a signal that the client may be at the edge of some new awareness or some previously unaware area of experiencing (Brisser, 1971). (Page: 34)

So what do you do when the client resists, ignores your suggestion, or does what you think will not be helpful? Follow the client’s lead. Continue to inquire. (Page: 35)

An Inquiry Menu (Page: 36)

1. Physical sensations. (Page: 36)

Ask about what the client is experiencing in his or her body. (Page: 36)

Physical feelings are often the pathway to emotional feelings. (Page: 36)

2. Physical reactions. (Page: 36)

these questions have to do with how the client’s body is behaving, quite possibly outside his or her immediate awareness (Kepner, 1987). (Page: 36)

Physical behaviors—clenched jaws (or fists), tilted heads, or swinging feet—may also be part of an old pattern that has been learned and then pushed out of awareness. (Page: 37)

3. Emotions. (Page: 37)

the most common topic of therapeutic inquiry. (Page: 37)

skilled inquiry goes beyond simply asking about the surface quality of a feeling. (Page: 37)

inquire not only about the feelings that are being expressed, but also about those that do not seem to be present: (Page: 37)

4. Memories. (Page: 38)

anything from the out-of-therapy world that is discussed in therapy is a memory, even though it may be a memory of what happened only a few hours earlier. (Page: 38)

Memories, (Page: 38)

are shot through with feelings, meanings, script beliefs, all of the texture that makes life three-dimensional. (Page: 38)

an example (Page: 38)

“So tell me what you remember about what you experienced, what you thought at the time, and then the different things that happened after that.” (Page: 38)

5. Thoughts. (Page: 39)

we must not lose sight of the cognitions that accompany those emotions. (Page: 39)

It is important to ask about thoughts; (Page: 39)

6. Conclusions and decisions. (Page: 40)

Disruption of contact with self and with others usually involves some sort of decision, conclusion, or survival reaction. (Page: 40)

these decisions and reactions trace back to early experiences that have taught us some survival strategy (Page: 40)

Because the conclusion or decision is often either out of awareness, or is experienced as a natural and inevitable response, it cannot be challenged or updated; (Page: 40)

Asking a client about decisions and conclusions helps to bring these responses back into awareness, where they can be reexamined from the perspective of an adult’s knowledge and experience. (Page: 40)

7.Meanings. (Page: 41)

People assign meaning to experiences and decisions and words in such varied ways that it is always risky to assume that we know what a statement really means (Page: 41)

nearly everything can have a meaning, and even when it does not, the very absence of a meaning can be meaningful. (Page: 41)

(Hmm, what a complicated sentence. … I wonder what it means!) (Page: 41)

8. Expectations. (Page: 42)

activities we engage in are shaped by our expectations about what will happen next (Page: 42)

As with so many other things, though, these expectations are often out of conscious awareness: (Page: 42)

Inquiring about expectations—about themselves, about others, about life in general—helps clients to become aware of how they make choices as well as to recover the context in which their expectations were developed. (Page: 42)

this inquiry is often most profitable when it concerns expectations about the therapy itself or about the therapeutic relationship (Page: 42)

These expectations are right here; they can be discovered from the client’s own phenomenology and checked against the reality gauge of what the therapist will actually do. (Page: 42)