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WINDOWSILL WINTER 2011

jonblend

Using the Oaklander Method in England and A Case History of Rapping as Self Nurturing and Self Regulation

By Jon Blend, VSOF Foundation Member

The Oaklander method has been a great source of learning, inspiration and support for me. It’s  so useful to have a child-directed, embodied approach that helps me understand more fully about where young persons are coming from, their needs and wants . In many ways it provides me with scaffolding and useful tools that enable me to build a safe, trusting relationship within which I can begin to work with youngsters’ whole selves.

I find that young persons really appreciate a conversational approach to therapy, especially one that uses a light touch when tackling difficult, emotionally draining worries and concerns.  I remember how I started in 1995 working with children in the State children’s clinic where I still practice. At that time I was more familiar with working with adults: I was rather wooden and probably a bit starchy in my interactions with young persons! Violet’s’ book Windows to Our Children (and my own work therapy and my training in Gestalt) proved incredibly useful in orientating me towards working with young people.  I was also lucky enough to attend some weekend workshops in London by Frances Verrinder, a Gestalt Professor who was teaching Child and Family Therapy at university in San Francisco. I began seeing some seventeen year olds with self-esteem issues and gradually worked down to age 5 or so.  The use of creative arts work through projection exercises that Violet advocates has often been a boon in breaking the ice early on in therapy.  I find that the young person can ‘escape’ into the task, whilst sneaking a peek at me periodically to see how I’m reacting. So many of the kids most of us see may have experienced adults as unpredictable, unreasonable, dangerous even – so that this way of avoiding intimacy head-on offers a safer way in- like dipping your toe into water before you launch right in. 

Back to the idea of working with a light touch. The world truly has become a global village; in London we’re fortunate to receive visits from Dan Hughes, a wonderful American attachment–focused family therapist who helps train child and adolescent therapists. I see similarities in the way Dan approaches children with the stance adopted by Violet.  Dan talks about the importance of therapists and counselors working with an attitude of  “PACE”. This stands for playfulness, acceptance, curiosity and empathy.  Why is this so important for counselors and therapists working with children to take on board?   Here in the UK, humanistic and integrative therapies that work specifically with children and adolescents are a comparatively recent addition to the therapy world- although psychoanalytically oriented institutes continue to offer training in child therapy.  Over here many counselors working in schools and youth settings originally undertook adult-oriented trainings that didn’t necessarily include elements related to child development, play, creative arts methods and such like. That context is however changing: in the last decade or so there has been increased interest in the UK in integrative trainings developed specifically with children or adolescents in mind.  It’s become a serious, academically rigorous business. And play therapy is growing here too. 

So back to my comment about PACE. It seems to me that the first and the third of these elements that is, playfulness and curiosity are often underplayed in the training of therapists. Yet we need to befriend and cultivate both our playfulness and our sense of curiosity especially when working with children.  Like Dan, Violet teaches us that when working with young people it helps to have a light touch, to introduce difficult subjects sometimes or build a bridge between the child’s world and our own without being overly sombre or serious.  It’s hard enough for kids to talk about the difficult parts of their lives.  Being playful doesn’t mean flippant or comic. I notice from my own practice how essential it is to stay curious, to be able to say: ‘tell me more about that’ rather than simply taking what the child or teen says as gospel and leaving it at that. This is particularly important with adolescents who are going through the process of critiquing the world they are living in.  They are curious about how things work (or don’t!), how relationships fare, what’s real or sham.  They face questions about the kind of personal morality they want to uphold, how can they become intimate and eventually find a mate, what can they do to survive economically, amongst other things.   Though some teens seem to take this in their stride, the young persons I see are often struggling with one or more of these big questions. Many often need me to be a mentor with whom they can dare to raise issues that worry or shame them, knowing that I will respect their views and keep them private, within the bounds of confidentiality.  Sometimes difficult conversations can be conducted through role play using figures made out of play doh; or the young person may draw, say, his ambivalence about asking Jenna to go on a date.   Stories of bids for independence abound along with musings on first love, managing rejection, coping with peer pressure, panics and separation worries are all grist to the mill.  I feel truly privileged to be part of a young persons world at such times. 

For us as counselors and therapists it can be difficult in the current environment where short term therapy and results oriented cognitive therapy are fast becoming the norm to feel that one has time to be playful and curious!   Yet using ‘pace’ in its other sense i.e. of attending to how we pace our therapy sessions, we may find a rhythm that works well for us and the client.   I learnt from Violet to take my time where this is needed, we don’t have to rush. Equally, we may want to go faster, to meet and engage with the relational style and energy of the young person before us – according to context.  Here I’m thinking about how when exploring a range of different emotions with a young person through music making in a session we may play slowly and gracefully in ‘sad’ moments, and scribble hasty sounds when exploring  ‘anxiety’ or going at full tilt when contacting moments of  ‘jubilation’.   And if I can meet the client where she or he is, in a grounded way holding the boundaries loosely, and not thinking about lunch or what I have to do in the afternoon, then the client really gets something from me and I really get something from him.

Particularly when working in an institution–like a school or clinic it’s important to be able to defend the space of the session so that people have enough time and there’s a rhythm to the session.  The work our training group did with Violet and the work I’ve seen see her do in videos are rather like a good yoga class:  there’s a warm up, a period to get into work, and then an ending with “stretching” and winding down.  It’s really helpful for young people too to have a sense of the pace of the work they do with us –not to hurtle blindly on to the next activity. 

Sometimes finding one’s own rhythm presents a major challenge; that’s something I often encounter with children who have special needs.  Some children who have attentional problems experience particular difficulties in getting their needs met. They may struggle to interact with others, often experiencing the world around them as confusing and frustrating.  I want now to give an example of some work I did a year ago, with one such youth:  

 Tony (not his real name) had Attention Deficit Hyperactivity Disorder (ADHD).  He started therapy when he was16 years old.  I first met Tony with his parents who seemed extremely irritated with him. At that time Tony was being routinely rude and aggressive, trashing his room, hitting kids at school, etc.  My view on the use of medication for attentional problems is that they are useful and needed at times, but that ADHD is over diagnosed so there are cases where I encourage less use of Ritalin.  Tony, however, coped better on Ritalin than off.  He was in the middle of a turbulent adolescence and he was very into music.  His parents were a bit old fashioned; they had him later in life and were having a hard time dealing with him and his music.

On his first session Tony told me, “I don’t wanna work on anger, mate, I –if you make me do that I’m outa here!  I just wannna rap.”   “Ok, and how’re you going to do that, Tony?” I asked. Tony picked up the guitar in my room and asked if I could play a bass line for him on the bottom string.  When I picked out a simple rhythm he nodded assent and we started jamming together, Tony swaying with the rhythm as he composed his rap. Tony proudly showed me a collection of different rap ‘beats’ he had stored away on his mobile phone, from which he could select his accompaniment.  Initially I blanched at the sound of his words, which were violent, aggressive and misogynistic.  Yet if I tuned out his lyrics and observed the process–focusing on his delivery I noticed how the music was helping him spit out the angry thoughts he was having, helping him get rid of something that had lodged inside him.   Quick rhyming facilitated his thinking.  I thought, well, Shakespeare did this, too!  In some ways it wasn’t that strange.   As the weeks passed and he got more into rapping with his music, the violent lyrics ebbed away. At first his words were about how everyone else was bad.  Now his words spoke of remorse, how he felt bad about what he’d done to others.  This was a big switch.  Then he got into how he wished he’d been nicer to his family:  “I am sorry for pushing you away… I want to start again.  I want you to know I’m really doing my best.” 
  
Tony’s parents needed help to meet him where he was. I find that it’s really helpful if the parents can also receive some counseling input to gain insight and skill in connecting with their child while their child is in therapy.  There was a period that Tony didn’t want to come to his sessions, or to talk to me ‘or anyone in particular’.  His parents became fragile and reactive again as they experienced life with Tony becoming more challenging.  During this time I supported Tony’s mother with weekly telephone calls, which she found helpful.  After a while we shifted this to a monthly call as things had improved somewhat.    About four months later we ceased the telephone conversations as Tony’s behavior had reached a plateau stage and parents were handling the situation better.

Recently I had a conversation with Tony for the first time in ages.  He was reflective and appreciative and he told me what he was doing to try to hold down some college classes whilst working as a groundsman at his father’s golf course two days a week.  Tony acknowledged that his therapy had been helpful.  I told him:  “Don’t give up rapping:  It’s your survival tool.  When you write your words and ‘spit your beats’ (rap) that helps you to stay in touch with yourself.”

Rap is self-nurturing for Tony.  It’s his way of refunding his rhythm, have self-regulating.    Much therapy theory has moved away from focusing on personal autonomy towards a more interpersonal, relational stance: nowadays we talk of co- regulation.   How you are with me has an effect on how I am with you, and so on.   If I am with someone who is acknowledging and helping me survive my being hyper, this really helps me settle.  In Tony’s case the gestalt concept of the paradoxical nature of change really applies:  when he can allow himself to stay with what is, he changes.  Tony would come in quite shaky and hyped up and ungrounded and by the time he’d gone through rapping he’d be glowing.  He’d say, “This is incredible! I really want to come back for more.”  He could really feel the difference it made in him.  He could come in and express himself, feel wanted and accepted and then feel good about himself again. 

This is what I love about the Oaklander method: there’s something about Violet’s notion of the healthy baby as essentially good, joyful, zestful, relational, curious, sensual and sensory that helps me move towards the young person in front of me with empathy and acceptance, with curiosity and a light touch.  And with this in mind s/he and I may manage to weave the first ‘threads of relationship’ that Violet talks about, a precious essential tapestry that is prerequisite if we are to really understand each other.  Many kids like Tony have lost that sense of trust along the way. Yet the Oaklander approach helps us come back into relationship, you with me, me with you. It lies at the heart of what I do and has helped me so much; I recall Violet and her comprehensive approach to training with considerable fondness.   None of us are Violet, nor could we be:  however we can learn to use her work to help fashion our own styles and find our own ways. 
 
Jon Blend MA
 
Jon is a psychotherapist, author and trainer with a background in social work . He has worked in a State Child and Family  Consultation Service  (CAMHS) for over fifteen years . He is a non-executive Director of the Gestalt Centre, London, a performer with  a therapeutic theatre company (www.playbacksouth.org) and a community musician. Jon teaches an annual  five day creative- arts based course for counselors, psychotherapists and other practitioners . Entitled A Gestalt Approach to Working with Children and Adolescents, dates are: April 4-8, 2011.  The venue is the Gestalt Centre, London.  (For information see www.gestaltcentre.co.uk  (click on link for short courses. Or contact Jon c/o: life-changes@ntlworld.com).

 

 

 

 

ASK VIOLET

Please send your questions for Dr. Oaklander to violet.oaklander@gmail.com

I have a file of the many, many questions that people have asked me.  Sometimes there were so many people in a workshop that I would ask people to write their questions and turn them in.  I have kept all of these thinking that I might write a book called “THE QUESTIONS PEOPLE ASK ME” some day.   
Here’s one that was asked several times: 

“You had stated that you see the parents and child together at the first session.  I have been leery to do this because, when I have, the parents’ comments were hurtful for the child to hear.  I thought that it was more harmful to the child than helpful.  Please comment.”

Answer:

On the contrary, I found it most helpful to do this.  If the child thinks I don’t know about his parents’ complaints, then this interferes with the relationship.  A division has been set up between us.  Believe me, he already knows how his parents feel about his behavior.

It’s important that he knows that I know.  If I smile at him, he doesn’t think, “If she only knew how bad I was, she wouldn’t smile at me!”

Here’s a sample:

An eight year old boy—I’ll call him Danny—is brought in to see me because the school people threatened to put him in a special class due to his aggressive, disruptive behavior.  The parents were told that if they tried counseling, they would wait before doing this.  The parents were extremely angry at Danny for forcing them to seek counseling, as well as his behavior.  At the first session I generally do an “intake” asking the child various question from a form on my clip board.  I told the parents they could add information after their son answered the questions, such as, “Do you sleep O.K.?  How is your appetite?  “Do you have your own room?”  “Do you have a favorite TV show?”  and so forth.  If he is reluctant to answer anything, I then turn to the parents.  Danny was willing to answer many questions for himself.  As you can see, our relationship is beginning to form.  Finally I asked the parents to tell me why they are here.  Dad responded in a very angry voice describing Danny’s transgressions and talking about how much trouble he is, etc.  I turn to Mom, and she agrees, albeit somewhat reluctantly, (probably because Danny is in the room.)  She begins to cry.  I notice that Danny is cringing as his Dad speaks and his Mom cries, and lowers his head.  I turn to Danny and say, “This must be hard for you to hear all this!”  He nods.  I sometimes will ask the child if he or she agrees with what the parent is saying.  I did not do this since I could see that Danny is pretty upset and turned into himself.

Finally I tell the parents that I will need to see Danny alone for about four sessions and that after that we will come together again.  At that time I will let them know if I think we will need to continue, or I may want to just see the parents, or have family sessions.  I explain how I work, and give them my handout called,  “A Description of the Therapy Process.”  (See our Resources page for a copy of this handout).  This handout pretty much describes each phase of the therapeutic process along with a description of my use of projective, expressive techniques.  I say to Danny,  “You might not agree with me, but just hearing your parents today I would say that you are not too happy in life.”  Then to the parents, “My job is to help him feel happier.”   (I have never met a parent who doesn’t want their child to feel happy.)   I say to Danny, “Again I don’t know if you agree with me or not, but I would say that you don’t feel too good about yourself.”  To the parents, “My job is to help Danny feel better about himself.”  Then I say that I imagine that Danny keeps a lot of his feelings to himself and I hope to help him express those feelings.  We use many of the expressive techniques to help him do this.  Sometimes the inappropriate behaviors drop away through all of this.  ”You can be sure that if I decide to see Danny for individual sessions, we will be in close contact, and I would want you to come in at least every 4 to 6 weeks.”

Then I turn to Danny and say, “Will you be willing to come in next week?”  In this case, Danny, who has been eyeing some of the equipment in my office, especially some jars of paint, I notice, vigorously nods.  If he should say no, or not answer, I would then tell the parents they need to make this decision.  I generally say something like, “If he needed to go to the dentist, you would decide for him!”

I saw Danny weekly for four months.  He painted and drew pictures, did sand tray scenes, pounded clay, and generally was quite responsive. His father, who was in the military,  was shipped out and I never saw him again.  His mother dropped Danny off regularly, but was reluctant to see me.  We did talk on the phone often.  She was pretty depressed herself, and Danny became her somewhat therapist.  When he talked about his loneliness, I asked him if his mother was lonely, so he went home and asked her and this prompted a wonderful discussion between them.  He even asked her to do some of the drawings he liked, such as the “Safe Place.”  One day his Mother said he was so busy with life (baseball particularly) that she thought he was finished with counseling.  I called the school and the counselor almost didn’t remember who he was.  She spoke to his teacher who said he was doing just fine, that he probably was going through a stage!
I have had many experiences such as the above.  This family (there was a younger sister) had moved many times and Danny had been in several schools before his present one.  In fact he had never finished a school year in one school.  There were many issues to deal with and we dealt with them one by one.  “Draw a picture or make a sand scene about what it’s like to always be the new kid in school.”  “Make your family out of clay and say one thing to each that you like, and then what makes you mad.”  (Working with anger was an important part of his therapy.)  I think our first session set the stage for a successful relationship and productive work.

 

 

 

 

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