Writing in theory and therapy.

Of course I’m very far from the first to discover the therapeutic power of writing. No doubt it had been recognised for centuries even before the illustrious English poet George, Lord Byron (1788-1842) made his famous observation that “if I don’t write to empty my mind, I go mad.”

Though many would argue that Byron and many others have seemed far from sane despite – or even as evidenced by – their literary productions, many others have expressed similar testaments to the mental and emotional benefits of writing.

Novelist and screenwriter Graham Greene (1904-1991), for example, claimed that “writing is a form of therapy; sometimes I wonder how all those who do not write, compose or paint can manage to escape the madness, the melancholia, the panic and fear which is inherent in the human condition.” 

Rather less dramatically, American author Anne Morrow Lindberg (1906-2001) commented that “I must write it all out, at any cost. Writing is thinking. It is more than living, for it is being conscious of living.”

And Gao Xingiian (b.1940, winner of the 2000 Nobel Prize for Literature, spoke for countless of us lesser scribblers in declaring that “writing eases my suffering…writing is my way of reaffirming my own existence.”

A further and even more compelling link between creative writing and counselling or psychotherapy is that revealed by Sigmund Freud’s British disciple and biographer Ernest Jones, who conjectured that Freud may have derived his technique of ‘free association’ from “The art of becoming an original writer in three days”, an essay written in 1823 by Ludwig Börn (real name Baruch Löb), whose collected works the young Sigmund was given at the age of 14, and kept all his life.

Another celebrated theorist, the ‘neo-Freudian’ Erik Erikson, was inspired by the ‘seven ages of man’ soliloquy from Shakespeare’s “As you like it” in first postulating seven stages in his ‘psychosocial’ theory of development across the human life span, only much later adding an eighth stage to encompass the great age to which he himself lived.

Such historical links between writing and psychology, and hunches as to the therapeutic effectiveness of writing, are of course hardly sufficient basis for incorporating writing into professional counselling.

But now there is considerable and ever-growing evidence of the efficacy of writing therapy and its close relative, reading or so-called ‘bibliotherapy’. In fact one of the pioneers in the field, Pennebaker, demonstrated that the benefits of therapeutic writing extend beyond the mental to the medical, apparently achieving significant improvements in patients with conditions including arthritis and allergies.

To confine ourselves here to the emotional realm, however, prolific author on writing therapy, Gillian Bolton, declares that “writing is different from talking; it has a power all of its own”. And following an exhaustive review of the academic literature on writing therapy, the aptly-named researcher Jeannie Wright concludes that “there is no other system of psychotherapy in which the client has so much control over the rate, depth and intensity of his or her therapeutic work.”

But of course, as write-minded as I am, and as a practitioner of writing therapy to boot, I’m far from impartial and thus not necessarily to be trusted.

So whatever you do, don’t take my or anyone else’s word for the benefits of writing for whatever might trouble, perplex or worry you. You can always try it for yourself first, in your own fashion and of course totally free of charge. Or take a punt on at least an initial session with me or another writing therapist and from there make up your own mind.

Write.Mind Therapy deanjohns@hotmail.com  0412 035 183.

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The fee (and free) story.

There’s a cynical and politically-incorrect old saying that goes “Neurotics build castles in the air, psychotics live in them, and psychotherapists collect the rent.”

It may even have had a basis in truth back in the old days of daily psychoanalytic sessions that sometimes continued for years.

And even in these more enlightened times it’s true that private-practice psychiatrists command very hefty fees. But then, considering that they’ve spent all those years acquiring a medical degree and then still more years qualifying for their specialty, I feel they’re by no means over-paid.

Especially in cases of serious mental illness, in which their diagnostic skills and capacity to prescribe appropriate medications can be literally life-saving.

Most clinical psychologists charge somewhat less than psychiatrists, but though they also are qualified and licensed to diagnose mental illnesses and mood disorders, they can’t prescribe medications.

And cheaper still are most counsellors, who are permitted to neither diagnose nor prescribe, and whose services are not eligible for the Medicare rebate.

So we counsellors by and large have to keep our fees as affordable as possible for our clients. In any event, quite contrary to spirit of the hoary old one-liner with which I started this discussion, I and my counselling colleagues, or at least all the ones that with whom I’m acquainted, are not money-minded but mind-minded.

But like our clients and everyone else we have to earn enough to keep body and soul together, and thus must have the brains to ensure that we’re at least adequately compensated for our training, experience and, as soppy as it might sound, dedication.

I personally charge on the lower end of the range of counselling fees, at $100 per session for those who can afford it, and negotiably less for pensioners, students and others of slender means.

Even more reasonably, I feel,  is that the my first session with any and every prospective client is absolutely free. If after this first, free session we mutually feel that it’s likely that we can productively work together further, that’s fine. But if you or I or both of us feel that you could be better served by a psychiatrist, psychologist or another counsellor, or even no more counselling or psychotherapeutic support at all, that’s fine too.

I’m ethically bound, after all, to act in good faith in what I consider to be my clients’ best interests. And so, if I feel you would be better served by another counsellor or psychotherapist, working with a different approach to my writing therapy, I’m delighted to recommend them.

Some of these colleagues you can check-out for yourself by clicking on the links on the right-hand side of this site, and I would be happy to provide you with the details of many others offering a wide variety of counselling methods and specialties.

So if you have a problem, or a dilemma, or a puzzling or distressing  life situation you’d like to discuss, please feel free – in both senses of the word – to call to make an appointment. It could be your first step in making your present and future life story happier, more fulfilling, or whatever else you’d dearly love it to be. Or in your making your castle in the air a far more enjoyable place to live, with very little increase in rent.

Write.Mind Therapy deanjohns@hotmail.com  0412 035 183.

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Spelling it out.

As a passionate believer in the power of being heeded, heard, accepted and understood, I’m extremely grateful for all the validation I’ve been receiving from people who have taken the time and trouble to visit this blogsite and to respond to its contents so positively.

And I’m equally thankful to the reader who recently replied with not a comment but a question. Or rather a series of questions that alerted me to the fact that I’ve been less than explicit in what I’m offering prospective clients in my practice of ‘writing therapy’, and thus should spell this out more specifically.

Here are the queries she kindly emailed me:

Are you offering face to face counselling interspersed with written material, or are you offering counselling based entirely upon the written material of the person wanting assistance?  Are you offering an electronic service, or a mix of face to face and electronic?”

To respond to these questions in order, the answer to the first is, yes, I am offering face-to-face counselling sessions interspersed with or enhanced by the client’s writing if he or she wishes.

In other words, my clients and I meet in private, face-to-face sessions to create the ‘therapeutic alliance’ characteristic of most of the so-called ‘talking therapies’, and in between these meetings clients are encouraged to reflect on our conversations, or on any other issues they may choose, by writing.

It is vital to note here, however, that the client’s writing is entirely voluntary. He or she is entirely free to write or not write, and to share or choose not to share his or her written words in our face-to-face sessions.

As I have written in one of the other blogs on this site, the point of therapeutic writing is not the product, but the process. The very act of writing, or thinking about writing, or even of thinking about it and not actually doing any, in the weekly or other intervals between talking, is what adds such a vital extra dimension to the therapeutic process.

Michael White, the Australian co-founder of narrative therapy, once claimed that the incorporation of writing into therapy increases its benefit four-fold.

How he arrived at this precise figure I have no idea, but I do believe that there can be a marked increase in effectiveness, or a considerable decrease in the number of face-to-face sessions required, or both.

This somewhat lengthy and discursive reply to my correspondent’s first question has by implication answered the second: no I am not offering therapy based entirely on the written material of the client. But as I have mentioned in several of my other blogs on this site, I do consider writing to be potentially valuable self-therapy for people who prefer going it alone to the extra effort and expense of seeking out and seeing a professional.

The only downside I can see to what I guess you could call DIY writing therapy is that the person who pursues this course doesn’t enjoy the comparative safety that a trained counsellor can provide if extremely troubling issues or emotions become triggered. And for many people, especially those at risk of self-harm, this lack of another’s calming presence and informed support can be extremely risky.

This caveat applies also, it seems to me, to electronic or “e-counselling”. So, to answer my correspondent’s two-part third question, I personally don’t offer this, either alone or in combination with face-to-face sessions.

This preference of mine is by no means intended to deny the possibility that counselling by email – or perhaps better still a web-based combination of ‘live’ voice and vision like Skype – can be effective, just as the telephone has long proven invaluable for crisis intervention.

It is just that I happen to prefer real, live human contact and interaction to the virtual variety, however ‘realistic’ it may seem to be. In fact, perhaps because I’m not a child of the e-era, I find SMSing, emailing, Twittering and such to be too superficial and impersonal to be of use or interest for anything but telegraphic contact.

As John Freeman  (2009) writes in this regard in his book Shrinking the world, “we have all the [virtual communication] tools in the world, yet we’ve never felt more alone. By depriving ourselves of facial expressions and the tangible frisson of physical contact, we are facing a terrible loss of meaning in individual life.”

Similarly, far from seeing a future in the practice of cyber-therapy, whether writing-enhanced or otherwise, I perceive the digital revolution as more potentially productive of cyber-problems like loneliness, isolation and alienation than promising as a medium for delivering cyber-counselling or therapy.

Possibly time and future technology will prove me wrong. But meanwhile, I’m sticking to the version of ‘writing therapy’ that I have spelled-out above in response to my reader’s questions: good, old-fashioned face-to-face conversations, interspersed with, and richly informed and inspired by, the client’s own self-examination, self-reflection and self-discovery through writing.

Write.Mind Therapy deanjohns@hotmail.com  0412 035 183.

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Prose or Prozac?

I suppose that, as a practitioner of writing therapy, I might be expected to propose it as a panacea for whatever problems or confusions of the psyche that happen to present themselves.

But far from it. In fact I have a horror of the kind of extremist, exclusivist and frequently erroneous thinking that leads a great many people into passionate advocacy of one possible approach over another, or even all others.

For example, while by no means denying that some doctors can be accused of over-prescribing pharmaceuticals, or that some ‘natural’ or ‘traditional’ nostrums may have some value in some cases, total rejection of modern medicine in favour of ‘alternative’ therapies or even no treatment at all is patently ridiculous, not to mention dangerous.

Thus, in the spirit of the age-old primary ethical caution to those in the healing professions to “do no harm to the patient/client,” counsellors and psychotherapists of every persuasion are duty-bound to be aware of the perils of neglecting or denying the fact that medications can have a vital and even essential part to play in assisting their clients.

Indeed, as the prominent counselling educator, Gerald Corey (2009) states, therapists have a “clinical, legal and ethical obligation” to refer clients to qualified medical practitioners for screening for suspected or even possible contributory, causative or potentially life-threatening organic conditions, as well as such serious mental problems as bipolar disorder, suicidal depression and psychoses.

In other words, with particular reference to my practice of writing therapy, it is absolutely vital that I bear in mind that, while the pen may be proverbially mightier than the sword, it is powerless against the ‘s’ word, schizophrenia, as well as many other mental illnesses and mood disorders.

In fact writing therapy may be positively counterproductive in many such cases, in light of the warning by authors including Berry and Haddock (2008) that “counselling and supportive psychotherapy are not recommended for clients with schizoid conditions.”

Even such very serious concerns aside, however, it would be entirely dishonest of me to claim that writing therapy is the best option for people with milder problems, or the kind of clients often referred to in psychotherapeutic circles as ‘the worried well’.

There are said to be currently well over 400 counselling and psychotherapy methods, many of which I have never so much as heard of. And even the principal ones of which I am aware and have some knowledge are so different from each other that I would be foolish to claim that any one of them would be more effective for any particular person.

In any case, given that a great many methods have features that recommend them, there has been a concerted move towards ‘integrative’ practice, in which, as Norcross and Beutler (2008) state, the therapist’s approach can be “flexibly tailored to the unique needs and contexts of the individual client.”

But whether theoretically pure or integrative, the question of which method(s) the therapist employs could prove to be somewhat beside the point, as there is now considerable evidence that client factors like resilience, intelligence, self-insight  and optimism are far more powerful determinants of therapeutic outcome than the therapist’s theoretical orientation.

So much so that leading investigators of therapeutic effectiveness like Duncan, Miller and Sparks (2004) proclaim that “it is time to recast the client as not only the hero or heroine of the therapy drama, but also the director of the change endeavour.”

This brings us to my own, personal rationale for incorporating writing by the client into therapy. Like Jeannie Wright, who I have already quoted earlier in “Writing theory and therapy”, I believe that the writing between sessions, in addition to talking within them, gives the client unparalleled “control over the rate, depth and intensity of his or her therapeutic work.”

And Michael White, the Australian co-founder of the now widely internationally-accepted practise of narrative therapy, claimed that the addition of writing into the therapeutic process increases its effectiveness four-fold.

Nevertheless, as I’m morally and ethically bound to remind you, there is no guarantee or even suggestion that in any particular case, or in any particular circumstance, writing therapy is definitely more desirable than any other kind. Or, to refer back to the title of this piece, nobody can definitively claim that prose is preferable to Prozac, or to any other appropriate pharmaceutical that a GP or paychiatrist may prescribe, either alone or in conjunction with any kind of counselling.

Write.Mind Therapy deanjohns@hotmail.com  0412 035 183.

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Age rage.

When I turned sixty I couldn’t believe it.  “Impossible”, I thought, “there must be some mistake.”  But no, the arithmetic checked out, and my disbelief turned to dismay.  “Sixty isn’t an age, it’s an outrage”, I felt like screaming at myself.  “Six decades down the drain, and so little to show for it. Have you any idea how little time you’ve got left?  Or some plan for making the most of it?” 

Faced with questions as daunting as these, you’d think I’d have been panicked into pulling myself together.  But now, years later, I feel I’ve done nothing about acting my age or becoming more sage, but simply stumbled on blindly maintaining the rage.

But rage at what, exactly? Rage at all the precious time I’ve wasted, for a start. Year after dreary year of school lessons I’ve long forgotten or never learned in the first place; university lectures I should have had the wits to skip more of; and business meetings most of which I wish I’d had the wisdom not to turn up to.

Rage at all the countless hours, days, weeks, months and years frittered away in every futile activity you can think of, from chasing females I often regretted catching to earning the cash to buy trash I didn’t need.

Rage at all the time, energy and passion I squandered pursuing success in the stupid, superficial world of advertising instead of having the sense to switch sooner to journalism.

Rage too at not spending enough time relishing the all-too-rare right choices I made. Like indulging my addiction to reading, cultivating my love of gardening, and following a few of my dreams like driving a Ferrari, learning to fly a plane and even, for six fantastic years back in my 30s, going bush for a stint as a farmer.

And rage right now, as I write this, at the fact that I’m so much older than my wife, daughter, sons and grand-children that my time with them must be fast running out.

But at least I should be thankful for the fact that I’m still churning-out words and encouraging students and clients to do likewise, instead of pushing-up daisies.

Death, as I often remind myself, has put premature full stops to the careers of far greater writers than I could ever aspire to be, including John Keats (who survived to just 26), the Bronte Sisters (29, 30 and 39), Lord Byron (36), Jane Austen (42), Oscar Wilde (46), William Shakespeare (56) and Charles Dickens (58).

Unlike these and many other immortals, I’ve been fortunate to survive long enough to read the great poem that Dylan Thomas wrote encouraging his failing 76-year-old father with the deathless refrain:

“Do not go gentle into that good night,

But rage, rage against the dying of the light.”

So however old I get I’ll always have a goal. To rage, rage, not so much against the dying of my own dim glimmer, but against wasting any more precious life.

Instead of squandering any more time raging against my sins of commission and omission, for example, as I’ve been doing for the past 12 paragraphs or so, it’s time I got to work on trying to forgive myself for as many of my errors and transgressions as possible.

Plus, of course, in light of the impossibility of re-writing the past, at least attempting to make amends for it and resolving to do better in the future by devoting myself to some worthwhile projects.

Like on the one hand keeping on writing my weekly column in support of human rights; and on the other treating my clients to the personal rights to which all are all entitled: the right to express our own true stories; to have our true stories heard, accepted, respected and comprehended; and to be supported and encouraged in whatever desires we may have to re-author our ongoing autobiographies in hopes of achieving happier endings.

Not that any of us can hope for a fairytale ending like ‘living happily ever after’. But at least we can possibly assuage the guilt, regret and rage that can rattle our cage whatever our age, by penning the next, more uplifting chapter in our life story on a fresh and thus so far unsullied page.

Write.Mind Therapy deanjohns@hotmail.com  0412 035 183.

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Sick of thinking? Try inking.

Do you ever find your mind full of so many competing or conflicting thoughts that you can’t get your head around them all? Or so swirling with notions and emotions that you feel you’re about to spin out? Or so overcome by mental multi-tasking that you fear you’re headed for meltdown?

For your sake I hope you can honestly say ‘no’ to these questions, in which event all I can say is that I envy your uncommon intellectual serenity.

But I’m kind of hoping you’re saying ‘yes’, ‘yes’ and ‘yes’, if only because that would give me comfort in confessing my own frequent confusion, in keeping with the old proverbial wisdom that ‘misery loves company.”

Or, to express this sentiment in psycho-speak, I would be greatly relieved to feel ‘normalised’ by the realisation that  you and perhaps many or even most if not all people sometimes think themselves into as mind-boggled a state as I do.

But hey, no worries whichever way, as here I am heeding my own counsel to confront confusion, not with more and increasingly chaotic thinking, but a spot of cool, calm inking.

Writing to and through the confusion has a wonderful way of clarifying things. Or, to resort to metaphor, instead of making futile attempts to examine butterfly thoughts as they flutter by, it helps to pin them to a piece of paper with the point of a pen or pencil.

Or as I happen to be doing at this minute, to put my finger on them by means of a keyboard and post them letter by letter, word by word, line by line onto my laptop screen, where they can be examined individually and at leisure.

One of my most distracting dilemmas in recent days, I realise, has been which of two pressing projects to proceed with first: my political column for this week, or a new blog for this writing-therapy site. In two minds about this, I found myself thinking simultaneously about both, and of course making no progress whatever on either.

But as you can see, the very process of starting writing has made the decision for me by bringing me into the reality and immediacy of what many therapeutic methods consider the ideal time and space: ‘the here-and-now’ between ‘I and thou’.

Or, to put it another way, the act of writing has focused my attention on the task of discerning precisely what’s on my mind at his very moment, and making sense of it for its intended audiences – myself and you and any others who happen to read this.

Of course I could have chosen to try and put my thoughts in order by voicing them out to a friend or colleague. And indeed this might well have worked wonders, as do so many of the counselling or psychotherapeutic methods that have evolved from or in reaction to what Sigmund Freud’s famous patient, Anna O, called the great psychoanalyst’s “talking cure”.

But to my mind, the process of a person’s writing is even more powerful than his or her talking, in that it permits and even demands deeper and more considered contemplation, perhaps even proceeding beyond mere ‘thought’ to the more rigorous dimension of self-examination and awareness that educational and other professional theorists term ‘reflection’.

And all the extra effort and energy that goes into writing as compared with talking also seems to help dredge-up forgotten, unfelt, ignored, unacknowledged, unprocessed or what Freudians might call ‘repressed’ thoughts or emotions.

This self-revelatory aspect of writing, as I have mentioned elsewhere, is what inspired Rebecca West to remark that “I write in order to discover what I think,” and E. M. Forster to very similarly ask the question “how do I know what I think until I see what I say?”  

And because writing is by nature captured on paper or preserved in Word – just as oral conversations can be but seldom are recorded on audio or video – it can be endlessly revisited, reviewed and revised, and can serve as a record of the author’s state of mind at various stages of his or her life story.

Which brings us to the final benefit of therapeutic writing that I propose to touch on here, the fact that it results in a tangible product. Something original and unique, that the author has produced out of thin air, and thus an achievement, however trivial or lacking in literary merit.

Like the 700 words or so that I’ve strung together so far in this attempt to stop myself thinking in circles about too many topics at once. Words that, however well-chosen or otherwise, have at least served their purpose of helping me get my butterfly thoughts back in the right – or at least the write – order.

Write.Mind Therapy deanjohns@hotmail.com  0412 035 183.

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A few words about ‘counselling’.

Of course I have nothing  but good to say for the concept of counselling, having studied long and hard for a post-graduate qualification in its theory and practice, and greatly admiring the talents of many of my counselling colleagues. But I do have trouble coming to terms with the actual word.

It clearly implies the giving of ‘counsel’, as in advice, despite the fact that advice-giving is generally considered a no-no in the practice of counselling.

There are several very sound reasons for considering the giving of advice as a professional vice.

The first and most fundamental of these is that, as the counselling ethic of ‘respect for client autonomy’ implies, the client is the only person who knows what is good for him or her, and others proffer their opinions at the peril of ruining the therapeutic relationship.

A second and closely connected reason is that, however well-intentioned and insightful a counsellor’s or anybody else’s advice may be, the client may not be capable of following it even if he or she wanted to.

And the third and final reason I’ll venture here is that in any case, and as everybody knows, very few people follow advice, even when they’ve actually requested it.

OK then, I hear you ask, if counselling doesn’t or at least shouldn’t involve the giving of advice or counsel, why is it called…counselling?

The answer to this, as far as I can discover, is that Carl Rogers, the sainted originator of the ‘person-centred’ relationship considered so essential to the practice of most of today’s psychotherapies, needed a term to describe his new, humanistic approach. And because he didn’t have a medical degree and thus couldn’t claim to be a practitioner of psychiatry or psychoanalysis, he adopted and popularised the term ‘counselling’.

At the same time, he took to referring to people coming to counselling as ‘clients’ in preference to what he considered the unduly medicalising and even pathologising term ‘patients’.

While his intentions were evidently honourable and his heart in the right place, however, and despite the fact that Rogers happens to be one of my idols, I still have misgivings about his ‘counselling’ word.

Which, as I now realise on closer examination, contains not only the therapeutically inappropriate concept of ‘counsel’, but perhaps even worse that of ‘selling’, with all its high-pressure, arm-twisting implications.

In short, the word ‘counselling’ is clearly inwardly troubled and would be well-advised (oops!) to consider making some changes to itself.

Starting, perhaps, by not taking itself so seriously, as REBT founder Albert Ellis and many others have remarked that most of us humans do, and injecting a touch of humour by incorporating an extra ‘l’, as in ‘clownselling’.

Too frivolous for words? OK, then how about ‘co-unselling’, with its connotations of two people working together to revise or get rid of some ‘erroneous beliefs’ of the kind we’ve all been sold by our parents, pedagogues, pastors, pundits, politicians and other peddlers of purported ‘gospel truths’ that conflict with our own perceived realities?

Or if that’s too clunky, complex or outright esoteric a construct, what about a variation that, like narrative therapists and many others of us do in practice, incorporates writing into ‘counselling’, as in ‘counsellink’?

That looks and sounds kind of cute, don’t you think? But hey, what am I thinking of, driving both of us crazy with my efforts to contort the word ‘counselling’ into an entity that makes semantic sense, when I can simply switch to describing my particular kind of counselling as ‘writing therapy’?

And as for my prospective clients, as long as they’re aware that I’m not in the counsel-selling business, I couldn’t care less what they call what I do, just as long as they remember to call me.

Write.Mind Therapy deanjohns@hotmail.com  0412 035 183.

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