The dialogical self and the change processes in psychotherapy: Theory, research, and practice. Joensuu

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1 The dialogical self and the change processes in psychotherapy: Theory, research, and practice Joensuu João Salgado (ISMAI University Institute of Maia, Portugal) Introduction A dialogical approach to the human mind 1

2 Images (still prevalent) of the human mind Individualistic A-social A-cultural (Salgado & Clegg, 2011) Disembodied 2

3 And isolated Isolated or lonely? 3

4 Society Human mind Mutual influences the mind as influenced by other levels but taken as an independent object of study Why do we need an alternative conception of the mind? 4

5 False mirror - Magritte dialogue central and primary, and the old opposition of self and society a secondary abstraction (Morson and Emerson, 1990, p. 53) 5

6 The mind as a membrane of contact The outside world is actually also inside, and there is no inside without the outside world The mind as a membrane of contact, in which human beings interact with the social and material surroundings (Valsiner, 2008; Salgado & Valsiner, 2010) Claiming for a relational alternative The mind is Relational Social We can say it is dialogical, from the very beginning of life 6

7 The contact with the world is Socially-guided Janet-Vygotsky law: the interpersonal precedes the intrapersonal Semiotically-mediated Language and other symbolic means mediate our contact Responsive: It demands a constant response to the social and material world It is a dialogical existence (Bakhtin) always assuming a position towards others (see Zittoun et al, 2013, Melodies of life) Examples of positions They are constantly emerging liking a political candidate not liking the boss greeing with the spouse disagreeing with a colleague tasting a coffee,! We are doomed to a constant process of position and reposition 7

8 Minimal elements for a dialogical account The position The object The addressees (Leiman, 2004) Levels of analysis of dialogical perspectives I-position A Inner audience I I-position B Inner audience OBJECT INTERLOCUTOR (real or virtual) The interpersonal intrapersonal level (self-other) (self-self) e.g. One Inner person divergences discussing about a the project project with another 8

9 Application to psychology The dialogical-self theory (Hermans and collaborators) Focused on the intrapersonal level (self-self dialogical activity) However, some other researchers have been giving highly important contributions to psychology and psychotherapy M. Leiman (mixing the intra- and interpersonal level) J. Seikkula (favouring the interpersonal level) The dialogical self theory 9

10 24 The first presentation of the dialogical self-theory we conceptualize the self in terms of a dynamic multiplicity of relatively autonomous I positions in an imaginal landscape. ( ) The I has the possibility to move, as in a space, from one position to the other in accordance with changes in situation and time. The I fluctuates among different and even opposed positions. The I has the capacity to imaginatively endow each position with a voice so that dialogical relations between positions can be established. (Hermans, Kempen, and van Loon, 1992, p ) OUTSIDE Therapist EXTERNAL Therapist INTERNAL safe Supporting grandmother controlling Panicking Threatening others Unpredictable mother Adapted from Hermans,

11 Dynamic and hierarchic organization interaction among self-positions is not random but involves the continuous switching or establishment and dissolution of temporary hierarchies among selfpositions. For example, in response to overlapping situations, say, a chance encounter, a memory, and an ensuing joint project, several self-positions might come into play and require ordering, such as self-as-friend, self- ascompassionate, and self-as-social critic. In our view, a kind of internal richness accrues when movement among these positions is fluid and coherent. Lysaker & Lysaker, 2006, p. 175 Positioning Microanalysis In order to depict positions or voices throughout the process, we have developed a method (Salgado & Cunha, 2012; Salgado, Bento, & Cunha, 2013) Positioning Microanalysis Aims To characterize self-positions and their development throughout time To describe cycles of positioning and to identify changes on those cycles Based on the coding of small units of analysis (response units) microdimension which are later aggregated in patterns (cycles of positions) Applicable to psychotherapy transcripts 11

12 An example of PM (Lisa) Understanding/ Forgiving Resentful Helplessness Dialogical self and psychotherapy Clinical problems and processes of change 12

13 Models of psychotherapy and the dialogical self Dialogically-inspired models of psychotherapy Dialogical Sequence Analysis (Leiman) Open Dialogue Approach (Seikkula) Metacognitive Interpersonal Therapy (Dimaggio) Clinical useful methods: Self-Confrontation Method (Hermans) Personal Position Repertoire (Hermans) Dialogical change processes of the self as transtheoretical, applicable to any therapeutic approach Clinical problems and the dialogical self-structure Clinical problems as the result of conflicts between selfpositions or voices Dominance of problematic positions (Hermans) Lack of assimilation of painful voices (Stiles) Fragmentation of the self (Lysaker & Lysaker) Interpersonal rigid patterns (Dimaggio) Problematic cycles of positioning (Salgado & Cunha) These types of structures create dysfunctional relational patterns regarding particular objects or themes 13

14 1. Dominance Hermans (2006): clinical complaints originated by ineffective or problematic positions that prevent the person of achieving one s goals. Narrative related perspective: problematic self-narratives (Gonçalves & Ribeiro, 2011), problem-saturated stories (White, 2004) or monological (Lysaker & Lysaker, 2002) Overdominant, rigid positions: firmly established, hard to change, easily activated or even ever-present ineffective actions, as well as lack of flexibility and difficulties in the articulation and dialogue with other self-positions. Clinical case study by Hermans (2006): client dominated by a pessimistic self-position, resulting in impaired performance in daily situations. Extreme psychotic cases: Barren self-narratives (Lysaker & Lysaker, 2002) 2. Fragmentation, inconsistency or incoherence Lysaker and Lysaker Schizophrenia: lack of coordination between different positions à cacophonic self-organization, = disorganization of thought. Hermans (2006):. extended this problematic type of self-organization to less severe forms of psychopathology, arguing that difficulties in articulating the diversity of self-positions tend to originate incoherence, which is common in clinical problems of different sorts (see also Neimeyer, Herrero, & Botella, 2006). 14

15 3. The lack of assimilation Clinical problems: the result of disconnection between parts or voices of the self (Stiles et al., 1990) Facing a disruptive or incoherent experience, the person is pressed to differentiate a difficult perspective or voiceà rejected by the established community of voices à non-assimilated, leaving painful experiences unvoiced or unconnected with the usual ego-syntonic voices of the person. A related view While we describe therapeutic conversations as dialogues, we have to keep in mind that they are not readymade stories or narratives, but rather broken stories. Clients are speaking about particularly sensitive and emotional issues, and while some of what the clients say can be understood as narratives about their lives, in many respects, their narratives may be incomplete, multivoiced, and contradictory (Gergen, 2009). Clients do not have exact words or phrases to utter their most sensitive experiences and their most pressing concerns. (Seikkula, Laitila, & Rober, 2012, p. 2) 15

16 4. Positions as interpersonal patterns (G. Dimaggio) Problematic voices or positions are part not only of intrapersonal dialogues between different selfpositions, but also as part of the ongoing real dialogues with others. Therefore, self-positions are thought to be also modes of interpersonal action, which tend to create specific results and expectations, creating interpersonal cycles that can be perpetuated throughout time 5. A dynamic view By using Positioning Microanalysis in a series of intensive case studies, we proposed the notion of 16

17 5. Toward a dynamic view of clinical problems: Problematic Cycles Based on intensive cases analysis, we have been proposing the notion of cycles of positions to describe self-dynamics (Salgado & Cunha, 2012; see also Leiman, for a related proposal) Cycles of positions = sequential patterns of positions with observable stability across time Problematic cycles versus Alternative cycles n Problematic Cycles: Cycles associated with clinical problems; Recurrent; Dynamic stability Example of one Problematic Cycle Distressed Determined Changed Submissive Cautious Confused 17

18 Processes of clinical change under a dialogical perspective Change in the dialogical self-structure and dynamics, both in self-self and self-others relationships. What changes? Processes of clinical change: 1. New positions Emergence of new and healthier positions (more agentic; more empathic) (Hermans; Leiman & Stiles; Leiman) E.g. A confident position in a system previously dominated by self-doubt and criticism 18

19 Processes of clinical change: 2. Available positions Change in the availability of self-positions (Hermans) E.g. the confident self-position that was highly available in the past but apparently hard to emerge in the middle of a specific period of life can again become available Processes of clinical change: 3. Coalitions between positions Coalitions between positions, counteracting the previously dominant positions (Hermans) Hard-working and playful position create a coalition to counteract the pessimistic position 19

20 Processes of clinical change: 4. Assimilation of avoided positions Change in the dialogical articulation between selfpositions, promoting the integration of previously avoided or rejected voices (Stiles) Processes of clinical change: 5. Emergence of a metaposition Emergence of new form of self-observation: healthier metaposition (Leiman; Hermans) More empathic forms of self-understanding 20

21 Processes of clinical change: 6. A dynamic view on change Positioning Micronalysis and the Alternative Cycles: Cycles associated with clinical change Increasing instability followed by a stable pattern An example of an Alternative Cycle Distressed Determined Valued Confused Distant Peacefu l New positions and Higher diversity Problematic positionsl ess available New forms of self-appraisal Higher integration between negative and positive em Coalitions of positions More dominant cycle 21

22 Overall Process Therapy Problematic cycle Alternative cycle Poorly differentiated and unconnected field (Scarcity of self-positions and interactions between them) Dominance of problematic cycle Differentiated, connected and recursive field Dominance of Alternative cycle Final remarks Next big challenges To connect more clearly the processes of self-change with therapeutic events (how self-change is promoted) To explore the dialogical forms of self-self and selfother relating and their role on clinical change 22

23 Kiitos!! 23

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