Madigan Narrative Therapy Newsletter: Wide Spread Panic, Hope and Helplessness.

It is hardly possible to build anything if frustration, bitterness and a mood of helplessness prevail. Lech Walesa (labour activist who led Poland’s first independent Trade Union - Solidarity)


Hello Everyone: Happy New Year. Below you will find a personal reflection surrounding the helplessness critically under trained and underprepared Graduate students feel in not knowing what to do in the therapy room.


One of the reasons I want to share their stories is because they are so unlike my own Graduate MSW, MSc and PhD academic and therapy training experiences. I don’t have the answer to explain this divide but I would like to draw us closer on why this might be so.

What I can tell you is that a fair and growing number of students and new therapists I train through our Vancouver School for Narrative Therapy courses and my out of town training workshops are sounding more frantic about their lack of preparedness.


In many cases, student stories are sounding a bit more hard-edged, disheartened, resentful and frightened. Many report feeling an awkward sense of being left behind. Discarded. Embarrassed. Helpless.I’d like to make clear that I have no intention to level blame or question the moral character of today's Graduate School programs, Professors, dissertation/thesis advisors, practicum supervisors etc. The issues discussed are of course relational and situated within many financial, political and policy-related issues.

However, despite the burden of neo-liberal pressure and regulatory influence, there remains a number of first-rate Graduate School programs and practicum supervisors/placements etc., that, under these same deficit conditions, continue to prove themselves excellent in preparing students for the working world of counseling.


So my question is - how do we account for this difference that makes for this educational and training difference?


All I can insert into the puzzle rests in what you might take away from 2 personal stories of my rather fortunate Graduate School experiences. The stories I have chosen are written to highlight a marked difference to the stories students are telling. But first . . . I once sailed down the river Nile on a roughed up 12-foot felucca with bed sheet sails. One day I stopped at a riverbank miles from anywhere. After securing the anchor, four little boys on the shoreline began laughing as they threw newborn puppies into the water all around the boat. I didn’t understand their actions and felt helpless to do anything. The experience lingers.


A freshly Graduated counseling student recently said to me “I sit and hope and pray the clients cancel because I wouldn’t want my family and people I love to come to me for therapy”. They bowed their head, started to weep and whispered, “I feel so helpless”.


Experiencing a training therapist’s relationship with helplessness is not so uncommon. When proper supports are available the experience can be fleeting, educational and viewed as a rite of passage – a necessary step towards learning, growing confidence and knowing what one’s practice of therapy is capable of.

But if the experience of therapeutic helplessness settles in for the long run it can be devastating on many relational fronts.

A particularly tragic context of helplessness is epitomized when the dark veil of deficit Graduate education and training practicums intersect with clients who are desperate for help. Helplessness seems to relationally thrive when the under-trained therapist realizes they can’t offer clients the help they’d like to give them and they don’t quite know where to look for ways - to help.

Students (current and newly graduated) discuss therapeutic helplessness by twinning the problem alongside numerous disappointments such as: unfocused Graduate course learning, a Professor's lack of therapeutic experience, poor practicum experiences, and disengaged supervisors and supervision. Their stories could fill an auditorium with how stupefied and stumped they feel - wondering what on earth made it possible to end up where they are?

From my outside perch looking on, I can’t help but feel there is legitimacy to their panic. The student’s insider experience approaches me bold-faced and terrified. Asking questions about whether the experience of helplessness and panic is normal; was there something inherently wrong with their Graduate School program; is there something inherently wrong with them; and... wondering where the experience of helplessness will lead them in the future?

Heaped atop the anguish of the helplessly under-trained is the not so minor detail of owing tens of thousands of dollars in Graduate School tuition and the precarious debt load they now face. Leaving them to figure out exactly what the cost-benefit analysis of Graduate School experience is?

I hear students and training therapists reflecting on how a sister, lover or childhood friend graduated from programs that afforded them fair passage to work as lawyers, electricians, massage therapists, nurses, and IT specialists. They take notice when their pals, upon completion of their education and apprenticeship training, appear fully equipped with sets of skills that not only help them secure jobs but have prepared them to do the job properly and as required. From what I am hearing, this is not the case for more and more Graduate students studying to become therapists.

Part of this ever-growing problem (or perhaps this now warrants the term – crisis?) is the fact that common everyday historical mental health issues have not gone away.

Today’s therapy rooms are filled to the brim with mountains of complex gender violence, couple conflict, sexual abuse, bullying, racism, anorexia, grief, and suicide, etc. And it is within this therapeutic context the under-trained student is quite right to feel scared and helpless. Scared shitless and helpless. And let’s try not to forget the experience of the client seeking help within this helplessness ecology.


Another recently Graduated student I was teaching pointed out: “I felt a bit guilty and ashamed showing up at my graduation ceremony because I’d learned fuck all on how to do therapy”. Their lament continued with how embarrassed they felt having to admit this fact to their parents and friends – while their name rested on a Master’s degree.


I’d like to relay 2 personal stories that fall into stark contrast with the student experiences outlined above. They involve the security and trust I felt in my teachers and supervisors; the high expectations and possibilities that were customary after graduation; and the changing context of learning and training.


Ok story number One:

After graduating with my first Masters degree (an MSW) I found work as a family therapist on a well-respected agency team. I studied clinical Social Work under the guidance of Professor David Freeman who was also the cities most well-respected family therapist (he was also my thesis advisor). I was supervised in practicums by skilled family therapists who worked within the same model of therapy as many of my Professors. The logical extension was being hired by a family therapy agency. Students I studied with enjoyed similar experiences depending on what their interests were and where they wanted to end up.

My first post-graduate MSW job took place during an exciting period when the large majority of highly skilled therapists in Canada worked in the public sector. My agency colleagues were widely known as the most highly skilled therapists (and supervisors) in Vancouver.

The brief sketch below offers some insight as to why so many highly skilled public agency therapists (and hence practicum supervisors) in Canada are now (unfortunately) more prone to work in private practice – a practice that is well beyond the economic reach of many people seeking therapy and students seeking supervision.

PUBLIC SECTOR THERAPISTS

Odd as it may sound these days, the highly skilled and experienced therapists I trained and worked with wanted to work in the public sector. The pay was good, the client caseload was manageable, and the sliding scale at the agency allowed them to serve client families from all socioeconomic backgrounds. This has changed.


Public sector therapists at this time also worked within a culture of therapy, supervision, education, and training that afforded them a sense of freedom to work on new ideas that found agency-wide support. As a result, elevated levels of practice excellence surrounding the context of therapy became the agency norm. This was exciting. This too has changed.


This culture, structure, and context of therapy eventually changed due (in part) to aggressive government cutbacks in mental health services and the pervasive imposition of evidenced-based research in public sector agencies.


GRADUATE SCHOOL PRACTICUMS

As Graduate students, we were engaged within a therapeutic culture and context holding high-level standards and expectations from Professors, students, and practicum supervisors. And it was learning within this culture of high expectation we students soon came to realize that one day we too were going to be hired and held to these high-level standards and expectations.


The question of whether or not the graduating Masters level student had the relevant skills and practice knowledge in the therapy room was not in question!And this might be one of the reasons why.

Practicum supervisors and our Clinical Professors were on the same theoretical and practice page. They worked in tandem - a sensible likeminded recursion. And as for the practicum supervisor, their reputations were monitored, made, openly discussed, and held to high account in preparing Graduate students for the working world of therapy. Everyone knew who each of them was, how and what they practiced, and the responsibilities expected of them.


Your clinical Profs and practicum supervisors were counted on by the wider community to have properly trained you. This set up a sense of ‘family lineage’ regarding who had trained you as a student; what the supervisor/placement training and expectations were; the particular issues you trained in (violence, children and families, geriatrics, etc.), and the level of difficulty the client base you worked with involved. In all likelihood, your Masters thesis was intimately tied directly to your practicum. This was the norm.


When you eventually graduated, the family of Professors, therapists and social workers you ‘came from’ – the people who labored to teach and guide you through the maturing process - were excited when you gained admittance to the nightclub of the everyday working therapist. They were proud of you. You knew they were. They let you know.


When we graduated forward into the profession we also remained a member of this particular ‘learning clan’ and were, in no uncertain terms, expected to teach up and train the next generation of student therapists. And so we did. This was the norm.

Collectively, for the student, practicum supervisor and Graduate School Professor, preparedness and skill were matters of reputation, pride, accountability, and responsibility.

My Graduate School training (and outside study and family therapy workshops) had prepared me enough that 2 years into the new family therapy agency job the veteran team invited me to take on the role of senior therapist. I believe they gave me the position as a way to push me further in my therapeutic experience before entering doctoral school.

At the time, the colleague closest in age to me was eight years older. And I wasn’t yet thirty. Nine months after taking the senior therapist position I felt prepared enough to begin my MFT doctoral studies.Story Number Two:This story is another account of high-level expectations during my MFT PhD program at Nova Southeastern University. The story involves having to labor through a pre-dissertation qualifying paper before being allowed to write my dissertation on Narrative Therapy.

My Professor advising and marking my pre-dissertation paper was Dr. Douglas Flemons. At the time (and much to my utter delight!) he was fast becoming known as a family therapy scholar on the ideas of Gregory Bateson. And to us students he also had a reputation for his rigorous precision and high expectations in course learning and writing. In other words, he was viewed as a hard ass. He went on to write a few very good books on therapy and one specific to the topic of writing entitled: Writing Between the Lines: A Relational Approach to Composition in the Social Sciences.

Yeah, Douglas was brilliant and certainly knew the skills of writing and the level of writing it took to write a proper, well-organized and, intelligible dissertation. And I soon came to realize – I did not. Ha! What I hadn’t quite come to grips with was that having very good therapeutic skills did not equate to having very good academic writing skills. I soon found out.


I wrote my pre-dissertation qualifying paper entitled: The Application of Michel Foucault’s Philosophy In the Problem Externalizing Practice of Michael White. I felt quite chuffed with the 25-page paper since it required me reading Foucault on my own and unassisted. The paper’s ideas were fairly cool and the first of it’s kind in the program. I really thought I had something. Not!


Over the course of months, Douglas had me re-write that bloody paper SEVEN times. And I emphasize ‘seven bloody times’ to demonstrate how frustrated I became during the process and struggle of learning how to write a ‘real’ academic paper. The multiple redos felt peculiar and personal. Like he was trying to teach me a lesson I’d much rather not learn.

I do quite remember pouting and having a few private tantrums. Especially during the fifth re-write meeting when he spoke of sentence rhythm and iambic pentameter! Iambic pentameter refers to a type of rhythm and metric line used in traditional English poetry and verse drama And, to this day, I continue to ‘hum’ my sentences out to hear their rhythm and beat. Dadadada-dadadada. Ha!


As re-writes went by, I witnessed myself becoming a supercilious, pretentious and ridiculous. A young racehorse demanding release from the confines of the academic barn. And despite all my winging and protest, my Professor stuck to positions of academic accountability and high expectations of learning.


Douglas was completely correct to stay the course and painstakingly teach me what I didn’t know I didn’t know! In demanding a certain level of excellence and by setting the academic bar high he in his grace and wisdom (and patience! – have I mentioned patience!) taught me how to write a dissertation. Perhaps more importantly, he invited me towards holding higher expectations of myself. This was an invaluable lesson to learn.


Without a shred of doubt, Dr. Douglas Flemons remains the best academic teacher I ever had. He is that shining example of a Professor sticking to an ethos, value, and commitment to best help a bull-headed student like me learn things I did not know I needed to learn.In conclusion  . . . perhaps the best thing we can do is begin asking ourselves:

How do we as the mentoring and teaching generation of therapy - situated within the context and politic of today's world - begin to figure out ways to undo the ongoing complexity, helplessness, and confusion a large number of our students and new therapists are reporting?


How do we begin a conversation regarding what we have done, and what we continue to do - to best undo what it is we have done that supports their under-preparedness and helplessness?


Sláinte  . . . stephen HAPPY NEW YEAR

If you are up to the task, I encourage you to send this newsletter out to your students, colleagues, practicum supervisors, and supervisees to see what the conversation brings. And, as always, please feel free to write me directly at yft@telus.net

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