Blackbox Thinking For Psychotherapists (Part II of II)
Updates by Daryl Chow, MA, Ph.D.(Psych)
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Blackbox Thinking For Psychotherapists (Part II of II)
By Daryl Chow, MA, PhD on Mar 31, 2018 09:39 pm
“My characterization of a loser is someone who, after making a mistake, doesn’t introspect, doesn’t exploit it, feels embarrassed and defensive rather than enriched with a new piece of information, and tries to explain why he made the mistake rather than moving on.”
~Antifragile, Nassim Taleb.
In the previous blog, I addressed the 5 primary “blackbox” systems to have in place to accelerate your learning.
In this blog, I highlight 3 postures you need in order to make Blackbox Thinking work for you:
1. Depersonalisation
I’m not talking about some psychopathological state, but one of strategically stepping out of yourself.
I heard the story of an Australian musician who grew up in a musical family. When she was a child, she would often sing to her family. One day, her family invited the relatives over. Her mom when to her room and said, “Honey, come out of your room. Bring your guitar and come sing for your uncles, aunties and cousins.”
“No way,” She replied.
“Why not?”
“There are so many people there! I can’t.”
She’d never forget what her mother said to her, that still stays with her when she performs on stage.
Her mother said, “Honey, it’s NOT ABOUT YOU. So pick up your guitar and come sing for us.”
When the artist goes on stage to perform, it’s no longer about her. It’s about the audience. When we talk about your professional development, it’s not about you. It’s about your clients.
Use what you’ve got, and get yourself out of the way. Remember: It’s not about you.
2. Acceptance
Many therapists like the mindfulness concept of radical acceptance[3]. We need that here.
What I mean is to accept the reality that we do make mistakes. The challenge is to be able to stand and see the situation with some distance (see #1 Depersonalisation) and spot it.
As Rolf Dobelli puts it, “If you can’t identify your mistake, you either don’t understand the world, or you don’t understand yourself… If you can’t spot where you put a foot wrong, you’re going to fall flat on your face again.”[1]
Nassim Taleb makes an important point on how we accept our errors. “He who has never sinned is less reliable than he who has only sinned once. And someone who has made plenty of errors—though never the same error more than once—is more reliable than someone who has never made any.” Taleb goes on, “Nature loves small errors (without which genetic variations are impossible), humans don’t—hence when you rely on human judgment you are at the mercy of a mental bias that disfavors antifragility.”[2] This avoidance of small mistakes makes the large ones more severe.
The measure of your weekly success should be if you’ve learned from experience. Because experience alone doesn’t get us better. Spot one mistake each week and writing it down.
Once you accept that you and I make mistakes, you join the humble tribe and break the myth that the practice of psychotherapy is an individual sport.
“Learn from the mistakes of others. You can’t live long enough to make them all yourself.”
~ Eleanor Roosevelt
On the topic of failings in psychotherapy, I highly recommend you read these two books:
How to Fail as a Therapist by Bernard Schwartz and John Flowers
Bad Therapy: Master Therapists Share Their Worst Failures, edited by Jeff Kottler and Jon Carlson
Acceptance sounds simple, but not easy. Difficult emotions can trigger anxiety.[4] And anxiety knee-jerks us into all kinds of defenses. When you are faced with a challenging situation in therapy, make room to welcome the wave of strong feelings. Your psychological capacity to bear these emotions come from your willingness to a) face them, and to b) lean in instead of back off from them.
3. A Learning Mind
Once you’ve taken some psychological distance and embraced the unfoldings of reality, put on your detective hat. Be critical without criticising yourself. Be forensic. Comb through segments of your recordings that you’re stumbling with; enlist a supervisor/coach that you trust.
Press play, and hit pause. Analyse. How would your supervisor handle that suitation instead? What would she recommend to you?
Ask yourself, “What’s going on? What can I do differently at this point? What can I learn from this?” And repeat, “What can I learn from this?”
If your answer is, “Next time, don’t be an idiot,” you’ve mistakenly put on the Judging Mind. We do not learn very well when we are chastising.
Instead, put on the Learning Mind and suspend the Judging Mind. Feed the curious cat.
“What can I learn from this?”
~~
Depersonalisation + Acceptance + A Learning Mind
Blackbox Thinking requires a commitment to your future self. Once you see from the future into the present, you will want to create your little own “blackbox”. After all, reality reminds us that we have a base rate of nearly 1 in 10 clients who deteriorate in our care[5], close to 1 in five clients drop out of treatment [6]and about 50% of clients not experiencing reliable improvement.[7]
Blackbox Thinking helps us scrutinise of our failings, so that we live up to our pledge of continuous learning and development. This is the ethic needed in our clinical practice. Not an ethic that is governed by fear, but an ethic of deep commitment to get better.
“If you don’t have time to do it right,
when will you have time to do it over.”
~ Coach John Wooden
Footnotes:
[1] Radical Acceptance by Tara Brach.
[2] The Art of the Good Life, by Rolf Dobelli.
[3] Antifragile, by Nassim Taleb.
[4] Co-Creating Change, by Jon Frederickson.
[5] Base rates of deteriortion is approximately 8%. See Hannan, C., Lambert, M. J., Harmon, C., Nielsen, S. L., Smart, D. W., Shimokawa, K., & Sutton, S. W. (2005). A lab test and algorithms for identifying clients at risk for treatment failure. Journal of Clinical Psychology, 61(2), 155-163. doi:10.1002/jclp.20108
[6] Base rates of premature dropout is 19.7%, but there is a huge variance between studies, from 5% to 70%! See Swift, J. K., & Greenberg, R. P. (2015). Premature termination in psychotherapy: Strategies for engaging clients and improving outcomes. Washington, DC: American Psychological Association.
[7] Here’s a recent study by the IAPT in the UK: Pybis, J., Saxon, D., Hill, A., & Barkham, M. (2017). The comparative effectiveness and efficiency of cognitive behaviour therapy and generic counselling in the treatment of depression: evidence from the 2ndUKNational Audit of psychological therapies. BMC Psychiatry, 17(215), 1-13. doi:10.1186/s12888-017-1370-7
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