Tuesday, November 29, 2022

The End in the Beginning of A Process Model

A Process Model (APM) by Eugene Gendlin is a book I will be making sense of for a long time. It is, at this point, the most sophisticated and ambitious attempt I've seen to move past some of the most fundamental problems in both philosophy and psychology. In particular, it manages to explain or bypass many difficulties inherent in the analytic-continental divide (scientism and postmodernism), or their analogs within the world of psychology (behaviorism/cognitive psychology, as opposed to humanistic or existential psychology). The fundamental issue in all of these divisions is the relationship between experience and nature or reality. Analytic/scientistic/behavioral orientations are more willing to sacrifice the phenomenon (i.e. experience) in the name of a reductive or deterministic account of nature. The "scientific" (i.e. unitized/reductive) explanation is more important than the integrity of the experience. Pomo/existential orientations generally laud the irreducibility of experience and, in various ways, posit some sort of discontinuity between nature and human beings (i.e. history/culture as a screen or cage). As Gendlin observes, however, both agree that human experience cannot be both studied scientifically and retain its phenomenological integrity.


The core of APM is thus to develop an account of humans, language, culture, and science that is consistent with our experience of the world. We experience ourselves, for example, as choosing, deliberating, being active in the world. Gendlin pursues this account in a two-pronged fashion that could be discussed as content and form.


In terms of content, Gendlin's philosophy begins with the concepts of body and environment. The basic, irreducible existence and interaction of living bodies and their environments is his starting point. As he says in an essay on imagery, "Every living event is a body-environment unit." From this dyad he builds a series of interrelated concepts intended to describe and explain different kinds of living processes: from plant growth to living animals and finally to human language and culture. Thus in terms of the content Gendlin is telling an evolutionary or emergentist story in which plant life becomes animal life which becomes human life. 


The form of Gendlin's account, however, is what is more significant. Gendlin is no doubt offering a theory, but it is a different kind of theory, he claims. Most theories, he claims, try to break things down into units and then reconstruct reality from those units. Even theories that try to describe processes (like life), he claims, often fall back on unitizing things. In this way most 'logical' theories leave out significant aspects of reality (are Procrustean). His sort of theory, then, is one that exhibits process. The concepts change as the text develops (this happens in all good writing). I suppose Gendlin would claim his thing is different because it explicitly describes dialectic while also enabling dialectic. But I feel myself getting annoyed, sympathizing with Keir, over this neomania and how Gendlin buys into it.

 

He puts all this explicitly and briefly at the end of  an essay on the body:

"Elsewhere (A Process Model, available from The Focusing Institute) I have built a new theoretical model of the body, its vegetative life-process, behavior, and the role it plays in language and culture.

The model has dual powers: It has the power of logic, of precise interrelated concepts, but it also has a new power. The concepts are not only ordinary logical ones. They are also a new kind. They are concepts that bring the experience I have been describing along with them. The concepts stem from and retain in them that kind of experience. One can move from these concepts in two ways: One can move from them in a logical way, but one can also and differently move from the bodily-sensed ..... which they bring."


This sort of theory, then, includes the logical dimensions of concepts, but also includes a deeper aspect that could be called process or experience. They are process concepts and experiential concepts. They have both of these relations.


Similarly, Gendlin says on page 114 of APM that he is indeed telling a story of natural history of how body process in plants 'becomes' animal life' which 'becomes' human symboling power. The purpose of this story is not only to develop a systematic theory, but to develop the kind of concept that can systematically incorporate lived experience or process. "In developing the symbol power, as it seems, from animal behavior and body-process, I am not trying to do a natural history. I think, quite in the opposite order, that those who study actual developments of this sort will be aided by the concepts developed here. Why? Because these concepts stem from out of what symboling is." What Gendlin means in this last statement, that his theory 'stems from out of what symboling is' is deeply important.


When most theories rely on units, Gendlin claims, they are relying on a very thin portion of what experience and language really are and do. Our unitized concepts are only one, and a very thin and impoverished form, of what language is in a deeper sense. In a deeper sense, language is something that emerges from and carries forward ongoing living processes. Language is part of the total activity of living bodies, comparable to an animal's growl or a bee's dance. Indeed, Gendlin begins his discussion of symbols by talking about 'body looks' and dances of animals.


We therefore need concepts about life and embodiment that allow us to appreciate the deep intertwining of language and living process. Gendlin thus explains on 114 "To think clearly, one needs concepts that share an internal structure, that develop together, so to speak. What each is, and what the others are, constitute a single structure so that one can grasp what each does in relation to the others." Concepts, in their embodied life, don't appear to us as singular units, cleanly separated, but more often as clusters and networks. When describing an experience or situation we may find an variety of words that reveal different facets. The real significance of concepts is in this network or mesh that they constitute in relation to one another. 


Engaging concepts in this way, as an embodied mesh, is truer to the nature of language. The real life of language is in our embodied felt sense of things. It is in a felt sense, a unique form of body process, that words cluster and present themselves to us. It is through a felt sense that we know we have the right word that expresses precisely just that thing that we wanted to say


It takes Gendlin about 25-30 pages before he begins speaking about his account or model in itself. Up until then he is just building concepts. It isn't until 114 pages in that we get a more explicit statement about how the book is proceeding. And it isn't until the final pages of the final chapter that we realize that felt sensing was involved the whole time. The end of the book, an account of the felt sense as where clusters or webs of concepts come from, was implicit at the beginning.


The opening line Gendlin says: "Body and environment are one, but of course only in certain respects." With this initial qualification, 'of course only in certain respects,' introduces us to the basic dialectical structure of the whole book. Concepts are built in precise ways by being dialectical, by saying 'well we could put it like that, but that is misleading because of XYZ... but if we put it like that then we see this aspect of it...' The whole text is an exercise in such dialectic. 


It is a felt sense that allows dialectic to proceed. Dialectic proceeds by detecting or sensing the fault in statements. This means that statements are being evaluated in some way outside of the statement. The felt sense is the place outside of language from which language both emerges and can be evaluated. 


Gendlin makes this explicit in the final chapter of APM (VIII). Gendlin notes that his concept of 'eveving' (everything interaffecting everything, in  chapter VI-A-e) was possible only from a felt sensing space, which isn't described until chapter VIII. The book, therefore, is using its own conclusions as presuppositions; the end is implicit in the beginning. "In IV-A-e, our concept there of 'eveving' already employed this kind of 'direction' [discussed immediately above] when we formulated how an evev becomes stable. Only now can this be said clearly. The concept of 'eveving' is from direct referent formation [felt sensing], from VIII." The text employs throughout the type of concept that can only be described in the final chapter.


Because it is only in the final chapter that Gendlin tells the developmental story of science and philosophy. Up until then he has to tell the story of plants, behavior, traditional human culture. Only then can he describe how traditional "VII" style concepts can be creatively redeployed for the purposes  of felt sensing and complex concept development. 


The permanent choice, of course, remains whether we use those concepts in a unitized "VII" way, or we return to felt sensing, try to move deeper into the process.


Put differently, do we allow our concepts to become frozen units, or do we return them to the more fluid space of experiencing.


This feels like an unruly post, I am grappling with a difficult text that is claiming to present radical or revolutionary concepts. I'm generally skeptical of such claims. But I am deeply impressed by this book.


It seems to me that the process of therapy contains a similar question about the end being present in the beginning. As therapy deepens someone has access to more, can do more felt sensing, can check in with themselves more. People become, in short, more skilled at process, less attached to structures or rigid forms. This corresponds fairly coherently onto the difference between logical or experiential concepts. 


As I've said to friends, and as someone who knew Gendlin confirmed for me, everything Gendlin ever wrote can be understood as an attempt to answer the question "How is psychotherapy possible?"

Friday, November 4, 2022

Community mental health, presence, and technical theories of life

Before I became a therapist I had brief stints at some different community mental health agencies. These were experiences that I sought out in order to get into grad school. I worked for about 6 weeks at a housing facility that also served as a women's shelter at night. Sometime like 30 units and 25 beds in the shelter. 


I was making minimum wage and left partly for financial reasons, but also partly because I was under-prepared for the intensity of what I encountered. I had never worked in mental health. I had never encountered individuals that had experienced intense trauma and long periods without housing. It was jarring. It was an experience of long stretches of quiet and boredom punctuated by intense moments of conflict and often threats of violence. My therapist at the time likened it to being like a firefighter, sitting around with nothing to do, until suddenly there is something urgent to do. From boredom to adrenaline and back, just like that.

 

One of the things that was so surprising to me was that my role had both very low and very high expectations. As a 'residential counselor' my main task was to be a presence. I had clients with particular needs that I interacted with regularly (dispensing medication, chatting, computer time), and there were clients who lived there that I barely ever encountered. I was mostly just hanging out. Me and one client would play scrabble together every day. I always felt like I was doing something wrong when I was playing scrabble. But I remember my boss telling me that I was there to have a positive affect on people, to be present and have relationships, and that if me and this person felt good about playing scrabble that totally fit within my job. These are the low expectations. There were also very high expectations in terms of deescalating very intense situations and interacting with individuals that were both experiencing psychosis and presenting hostilely. (I think of a client who was delusional about being a lawyer and would 'use the phone' for some time each day to work on her cases. There weren't any actual cases. At one point another (more lucid) client needed to use the phone and she was 'using' it. I think he took it from her, she was upset, and came to find me. I tried to negotiate for her to have some time to 'use' the phone. He said 'Man, you and I both know she's not actually talking to anyone!' I empathized, "I know... I know..." and negotiated some deal where both parties could be appeased. Wild stuff, real human situations).

 

 I didn't stay at this job long enough to really internalize all this about presence. I am still making sense of it.


I had a similar experience in my graduate school internship when I was working with intellectually and developmentally disabled folks. I mostly ran groups, but also did a fair amount of 1 on 1 work (especially with non-verbal people). Groups were chaotic at times. I would often have 12-20 people in a room with vastly different presentations. In the same room I'd have people living with: traumatic brain injuries; schizoaffective disorder along with learning disability; downs syndrome; autism; and a variety of vaguely defined intellectual disabilities (mild, moderate, severe, a la the DSM). 


I was doing my best to be therapeutic with these folks, but that meant hanging out, eating together, doing puzzles, playing games, making jokes, gesturing, playing. I requested to work with non-verbal individuals because I was working on getting deeper into my own body. I worked with one guy in particular that was often disruptive during groups. He was a big dude. His language was super limited. He was really eager to interact with others, but he didn't understand how big or strong he was. I noticed how disruptive he was in groups and I offered to take him out for walks during those times. We would walk together in a 3-5 block radius, encountering lots of things: mail carriers, overturned trash bins (which he insisted we clean up), dogs, people. I had a lot of fun with him and was surprised by the depth of our communication. No words, or very very few words. Lots of gesturing, lots of moving together, lots of pointing and groaning: "Ah! Aha! Mmmmm..." We were just walking. 


With other clients I would paint, listen to music, or just talk. In groups I would talk about emotional regulation and social skills, but I was really trying to get people to interact with one another and tell stories. This was also my approach during my groups during my forensic job. I ran a 'socialization and social skills' group. I really leaned into the socialization part, I just wanted to talk to people and get other people talking to one another. 


These experiences introduced me to the irreducible importance of presence. Presence is not flashy or fancy. It is hard to even see it. But sitting and playing scrabble with someone, walking, painting, listening to music, really being involved and connected while doing these things. The depth of it is strange. I'm trying to write about the deep experience of being close to people that I didn't really speak with. It is hard to write about, and now I'm merely gesturing at it. 


I want nothing more than to be close to actual people that I can touch and talk to. I see nothing so important in life as other people and my relationships with them. Tonight I was hanging out with a friend and I told her that the things I've published don't feel real compared to my living relationships. I had dinner with her and our other friend, celebrating a recent success of his. That feels real. These two people that I've come to know and love, having a nice meal together to celebrate a victory. We talked about how it was a relief and how it was hard. We've all been going through it this year. 


The meal is nice and costs money but relationships can't be bought. Even therapy, which is paid for, is contingent upon something other than the money to actually happen. 


I'm comparing this sense of presence to other ways of being that are more technical or control oriented. Presence, as I'm using it, is about allowing or welcoming aspects of an ongoing process. Other ways of approaching life are more managerial or defensive: we want to predict, plan, and control. Technical ways of thinking of course have their place in life. I still predict my routes when I travel and use a calendar to plan my days and weeks. 


Sometimes presence can be lost in this technical orientation. 


It was relatively easy for me to present during my internship because I was settling into the fact that I'd glimpsed in my first mental health stint: it is okay, no, essential to be present with people when working in any therapeutic capacity. I suppose I don't mean merely present, as in just a physical body plopped into some physical space. I mean real presence, one soul genuinely interested in and actively attuning to another. 


After my internship, after graduation, I got a job in forensic mental health. I was working with clients who were either exiting incarceration or avoiding incarceration. Part of their conditions of exit/diversion was court-mandated mental health treatment. As you might be able to guess, a lot of these people weren't very happy to be speaking with me. This made sense. As far as they know I'm just another manipulative person working the mysterious levers of the manipulative institutions they'd been navigating for god knows how long. They have no good reason to trust me. And, to be fair, as a matter of course I was plugged into a variety of monitoring and reporting systems. I was required, for example, to complete 'compliance reports' for probation officers of mental health court clinicians on a monthly basis. I was required to be a narc (unless I found ways to be creatively compliant rather than merely conformist).


I therefore had to spend a good deal of time and energy gaining people's trust, essentially undoing or working through the expectations put upon me by the role and situation. It was very hard to achieve presence with client's in that environment. The entire situation is so inherently unsafe, taking place in such manipulative institutions, how could you possibly be presence? It is worth saying explicitly: in my understanding, presence requires a sense of safety (in the deepest and broadest sense. Not just physical but emotional and personal safety).

 

The whole forensic environment was far more technical than my current therapeutic situation (a lovely group practice). I remember when I got to this practice I was shocked that people just wanted to talk to me. I had gotten so used to doing so much case management, so much reporting, so much bureaucratic and institutional work. Suddenly I have a single person in front of me that just wants to talk and for me to listen and interact


It is in private practice that I've been able to understand presence more fully. I've been writing a lot about, maybe I'll post some of it.


But I'll just note that there is some tension between presence and having a technical orientation towards life or its problems. My experience in forensic mental health leaves me comfortable claiming that institutions become most technical when it is punitive, manipulative, and aimed at control. I think I'm passing my experiences through the new perspective I have from reading Illich and going further.