The alchemy of love: Recent graduates’ lived experiences of psychotherapy training: A hermeneutic study Marilyn Morgan Thesis submitted to Auckland University of Technology in partial fulfillment of the degree of Master of Health Science February 2007 CONTENTS Page i. Attestation of ownership Page ii. Acknowledgements Page iii. Abstract Page 1. Chapter One: Introduction • Reasons for choosing this topic • Preunderstandings • Definitions • Context o History o The need for personal growth o Personal therapy and group therapy • Choice of methodology • Conclusion Page 13. Chapter Two: Literature review • Introduction • Baskets of Knowledge Page 14. The First Basket of Knowledge: Philosophy • Studying human experience o Phenomenology o A convergence Page 16. The Second Basket of Knowledge: Psychological Theory • Growth and development, and human change processes o Mindfulness and growth o Pain in the process of growth o Higher levels of adult development o Personal growth and developmental stage for psychotherapists o Table 1. The developmental theory of Rowan, with associated psychotherapies o Table 2. The developmental theory of Rowan and Kegan compared • Prescriptions for the nature, and outcomes, of the personal growth dimension of the education process o Tradition o Complex issues o Criticisms o Effectiveness of personal therapy o Levels of development for the psychotherapist o Personal growth specific to modality being learned o Personal growth in training is often painful • Cultural and gender perspectives on personal growth and psychotherapy Page 32. The Third Basket of Knowledge: Scientific Understandings • Neurophysiologic underpinnings of relationship, psychological change and integration o Grounded in science o Changing the brain o Inborn limitations for psychotherapy practice o Bringing back the body o Watch this space • Complexity and ‘health’ of complex systems Page 37. The Fourth Basket of Knowledge: Personal Experience • Psychotherapy journeys of growth and change: personal accounts, and reports of outcomes o Change in therapy • Unfolding described from a spiritual perspective • Maori concepts and experiences related to psychotherapy, personal well-being, and personal growth. • The experience of personal growth for the trainee o A journey o Stress and distress o Personal change processes • The nature and impact of the students’ personal development on the tutors and psychotherapy programme leaders o A complex task o Personal stories of trainers Page 45. The Fifth Basket of Knowledge: Love • Love, relationship and attachment, and how to develop the capacity to love o Love: the latest topic of interest o Love and change: vulnerability o Capacity to relate o Table 3: Greenberg’s analysis of congruence in the therapeutic relationship o Fostering relationship ability in training o Naming love • What is not included in the literature? • Summary and Conclusion Page 53. Chapter Three: Methodology • Introduction • The hermeneutic process • Research design • Methods o Sampling o Data Collection o Data Analysis o Rigour o Credibility o Transferability o Dependability o Confirmability o Ethical Issues o Te Tiriti o Waitangi o Do No Harm o Voluntary Participation/ Informed Consent o Truthful Practice o Confidentiality o Transparent Data Analysis • Conclusion Page 69. Chapter Four: The Journey • Introduction • The contour of the journey • Being lost • Setting out: innocence and dreams o Innocence o Ideals o Disappointments o The prophet’s wisdom • The sacred fire of love o Love and psychotherapy o The meaning of love o Free to talk of love? o Participants’ experiences of love during training o The hard face of love o Once subjected there is no escape • Falling, drowning, burning o Heartbreak o The world turned upside down o Bleeding willingly and joyfully o The roots of the tree are shaken o Pain and pleasure o Uncertainty o Is there an easier path? • Baggage carried: wounded healers o Wounded Healers o Wounds: body and emotion o Shame o Pleasing others and failing o Wounds of the heart; cultural perspectives • Keeping on walking; calling on resources o The practice of psychotherapy is challenging. o That which sustains us • Conclusion Page 97. Chapter Five: The Landscape • Introduction: the terrain traversed o Table 4: map of ‘the journey’ • Safety, belonging, being welcome o Safety o A place to belong o The marae and belonging • Guides: love and relationship (graduates’ experiences) o Teachers and therapists o The group o Relationship and longing o Love says no o The pain of the no o Unfinished business o Programme differences • Guides: love and relationship (trainers’ experiences) o We don’t talk of love o Transference or love o Love for students o Misuse of love o Loving presence • Holding o Hard to hold o A need to be held o A physical home • Course structure • Conclusion Page 117. Chapter Six: Leaving Home, Coming Home • Introduction o What does it all mean? o It was good • The mixed experience of leaving • Winds of change. o Sense of self o Embodied o Gift of the present o Changes affirmed by others o Behaviour changes o Ripples of change o Beyond self • Gratitude • Telling stories around the fire. • Moving inwards and outwards with love. o Love for self and love for others; cultural perspectives o From the love of the teacher o Love as a magic gift • Passport to a life • Conclusion Page 133. Chapter Seven: Discussion of Results • Introduction • Experiences of personal growth during psychotherapy education o They did grow o Participants became converts o Love was the key • The nature of love o Elusive to definition o Aroha and love o The place of love in psychotherapy education o You its only seed o The unexpected perspective o Why not be open about love? o Uncomfortable ground o Love and work o Gender influences • Implications and recommendations for psychotherapy training o Personal development happens, and is needed o Love and relationship as catalyst for growth o The pain involved in growth o Rituals, structures and environment o Mindfulness o Preparation and support of teachers o The hard face of love, boundaries. • Possibilities for further research • Strengths and limitations • Conclusion Page 148. References Page 165. Appendices Attestation of Authorship I hereby declare that this submission is my own work and that, to the best of my knowledge and belief, it contains no material previously published or written by another person nor material which to a substantial extent has been accepted for the qualification of any other degree or diploma of a university or other institution of higher learning, except where due acknowledgement is made in the acknowledgements. Signed: Date: 02/02/07 i Acknowledgements Firstly I wish to acknowledge the psychotherapy graduates who shared their experiences so willingly, also the trainers who responded to my questions and conversations with openness and enthusiasm. I deeply appreciate the patient, engaged, stimulating support from my supervisor, Margot Solomon, who ‘held’ me on the journey of this thesis; travelling alongside me all the way, encouraging, and sharing her experience, knowledge and wisdom. I also want to thank Mary, my partner, for her tolerance of a long process that was somewhat mysterious to her. In addition I acknowledge: Financial assistance and support from: New Zealand Association of Psychotherapists Eastern Institute of Technology Proof reading: Mandy Pentecost Ethics Approval: Approved by the Auckland University of Technology Ethics Committee on 19.05.05 AUTEC Reference number: 04/202 ii ABSTRACT Most of the research related to psychotherapy is about modality, treatments and therapeutic outcomes. There is little research on the psychotherapists themselves; their subjective experiences, their preparation or personal development. Personal growth, which leads to a developmental level permitting self-reflection and relational ability, is considered by the psychotherapy profession to be an important aspect of the psychotherapist’s education. This hermeneutic study focuses on students’ experience of personal growth during a formal psychotherapy educational programme. The core of the thesis is the presentation of the students’ lived experience during training. Recent graduates of psychotherapy programmes were interviewed and their accounts include the process of personal growth, in what ways the developmental journey was felt to be supportive and containing, ways graduates feel changed, the impact on their lives during and after the training, and the meanings they ascribe to the experience. The particular growth experiences of Maori graduates are to some degree explored, as are the experiences of psychotherapy teachers who facilitate personal development. Themes emerged from data analysis; personal growth did happen, was felt to be positive, and took place as a journey. The growth process was turbulent, painful, yet resulted in positive outcomes for the graduates. Love and relationship were experienced as the most significant catalyst in promoting growth towards key outcomes. It was felt that bicultural learning activities enhanced and supported growth for Maori and non-Maori. The nature and complexity of love is discussed; including the place of love in personal change, psychotherapy and psychotherapy training. The discomfort commonly experienced in the profession around describing the therapeutic relationship as one involving love is highlighted. Possible reasons are given for this, for not using the word love in psychotherapy. Implications for psychotherapy education arising from the research are presented; with questions about, and recommendations for, facilitating personal growth, and the utilisation of love in a more open and conscious manner as a part of psychotherapy training. Currently most preparation of psychotherapists occurs in mainstream academic institutions, with a movement in the profession towards more formal qualifications. It is a challenge for educators and students alike to continue to include in traditional academic structures and processes what is felt to be the essence of psychotherapy; love and relationship, the practice of which requires high levels of personal development. iii Chapter One: Introduction I began this research with the question; how do recent psychotherapy graduates describe their lived experience of personal growth during psychotherapy education. As I immersed myself in the stories of my participants, my curiosity on fire, I found myself wandering down pathways of enquiry into literature and poetry, and what had seemed a simple quest kept expanding into the vast, mystery of love. Each time I pulled myself in to look at a smaller, more manageable theme the question kept dissolving once again, and I arrived at the same serene spacious place of not knowing, but somehow glimpsing the essence of what it is to be human. It is as Mary Oliver (2005, p.72) writes in her poem, Bone: I believe I will never quite know. Though I play at the edges of knowing, truly I know our part is not knowing, but looking, and touching, and loving, which is the way I walked on, softly, through the pale-pink morning light. It has been my inspiration from a young age to deeply understand people. The method I chose for this quest is hermeneutics, the word itself echoing mecurial Hermes, the Greek god of perceptive leaps and inspired intelligence, which enables one to pursue a less certain, but fuller appreciation of people. Hermeneutics allows for the possibility of not gripping a mecurial essence in a tight fist, but lets one just be with the experience. Qualitative research is exciting and important. It is a highly rewarding activity because it engages us with things that matter, in ways that matter (Mason, 2002, p.1). My own personal growth journey has been fueled by wanting to really know, then allowing myself to both know and to not know. I have wandered, gaining experience, through the domains of hospitals as a nurse, sociology as a university student, parenting as a mother, and psychotherapy as a client, student and teacher. Psychotherapy has helped me to come home to myself. Like psychotherapy, this research journey has taken me on some unexpected twists and turns along the way, with novel territories stumbled upon, yielding unforeseen insights. In recent times in New Zealand the training of psychotherapists has moved from an apprentice-type model, with training also provided by various private psychotherapy institutes, to preparation within the academic system. Nowadays there is a growing expectation within counselling and psychotherapy professions for 1