My mother, on a visit to our house and helping to put her young grandchildren to bed asked me how my psychoanalytic training was going. She couldn’t recall the name for it. Nor “that man” working in Vienna where she had been a medical student at the time, whom she believed had pioneered it. Learning my training was completed, her response “thank God for that” had absolutely nothing to do with my relief at no longer having to get up so early in the morning!
It reflected her time and her ways of managing herself over a lifetime of change in which contradictions (and silencing) abounded; fifty years after leaving Austria she still dreamt in German. Through her eyes I grew up seeing England in a rather un-English way; her own mother, who came to live with us, provided a kindly and non-judgmental presence in the background.
Because my family experience was also combined with being an identical twin, there was an early introduction to understanding the importance of non-shared family experience, not based upon assumptions but upon a continual need to make sense of experiences and the situations that contribute to these. That process was continued by marriage and bringing up children with a young woman brought up by parents of a very different English cultural background.
I was less than thrilled by my educational experience. Until schoolwork for entry to medical school entry was over and early undergraduate education completed, unlike my wife intellectual thought for me had been a rather tedious exercise. Associated with seemingly endless chores of studying or, more accurately, rote learning, or at best not goal-directed.
Encounters with patients transformed that, and began a lifetime of learning in a different way. A later two years at McMaster University in Canada (1976-1978) added sorely needed ‘baking powder’ to the mix. There medical students’ study was entirely by well-supported problem-based learning; it substantially influenced the model of family therapy developed there, which had been the sole reason I had gone there.
Even so, I remained unaware that twenty years before back in Europe, Martin Buber had written of how it was vital that professionals and patients encounter one-another as human beings and not let self-conscious professionalism get in the way (as it had daunted me as a medical student, and likewise throughout my early postgraduate years). However, his philosophy was embodied in how two of my family therapy supervisors worked: Val Gulens, an incisive and witty supervisor who had emigrated to Canada from Latvia as a young man and Dorothy Horne, a wonderful pint-size experienced and dynamic psychiatric social worker, as thoughtful and as good with words as she was kind, engaging, and optimistic.
One particular encounter stands out of the many cherished supervision sessions I had with Dorothy. Still in hospital after a major road accident, she had reviewed the video-recording of a particular family session I had made of a very stuck case. She proposed that she join me for the following session, which required wheeling her from her hospital bed – still encased in various plaster casts, her head in bandages – to the next family session. She had wondered whether the emotional stiffness and inhibited responses of the most cautious family member (presumably based upon undeclared fears from his childhood and as well as from current marriage) was central to under-powering family problem-solving.
She cemented a relationship with him soon after they were introduced: as we were settling into the session he had evidently noticed (although I hadn’t) the struggle she had to get out of her dressing-gown pocket the matches she needed to light the cigarette she had put in her mouth (remember, this was 1977!). He got up to help her, lit the cigarette for her, then returned to his seat. Dorothy listened and observed for a while, occasionally asking questions. She turned to him, gesturing with the cigarette-hand toward her plaster casts. “Len, I’m getting these casts off in six weeks, when are you going to take off yours?” It was the beginning of the turning point of the session, which in turn proved the most decisive meeting in the therapy, and constituted one of the most important waymarks of my journey as a therapist.
The years of detailed and high quality clinical supervision and training at McMaster helped me process head and heart together. Some of it was embedded within adult mental health, not just CAMHS, and the location of the department I worked in, on the campus of Chedoke, a physical rehabilitation hospital, helped placed systemic practice within mainstream clinical care. So the location of learning was another waymark.
Publications arising from the four years of quantitative research I had previously undertaken in the UK seemed of diminishing value. Their perceived value was not enhanced by the four years of psychoanalytical psychotherapy training I then began after returning to the UK. However, an unplanned intersection between the two traditions occurred, highlighting the importance of Bebe Speed’s Both/And. Firstly, analysing (by statistical methods) the findings of a three year-prospective quantitative study of postnatal depression, and secondly, the concluding years of my psychoanalytical psychotherapy training – because in each case the importance of attachment and of postnatal disruption by maternal depression emerged.
That was an important personal waymark, because it marks how I came to value again the diligence that quantitative research introduced me to. The experience initiated further research, which has since has invariably included qualitative research methodology. Finally, over the last ten years recent advances in neurosciences and neuropsychology have re-kindled my appreciation of these contributions to understanding the human condition, so thus another important waymark.
The rest – between 1985 and 2012 – is history, at least as Marian Gerry and I recently described it in Context. For example, another important waymark had occurred before leaving Canada for Edinburgh: some weeks in Philadelphia with Minuchin and colleagues, an intense learning experience because it re-introduced me to the value of pragmatic language (where in the words of Pope from 1711, “expression is the dress of thought”).
I had also heard there of the story of how Haley, Minuchin, Montavlo, and others had come together (literally too, shared car-journeys to work). I was reminded of that story by later reading some of the literature emerging from the Open University on the importance for development of learning in groups. It is apparent in the support new immigrants provide each other e.g. in early twentieth century New York only brought together for English language evening classes but then staying on together in the hours after each class stopped for the night to exchange experiences and advice. And it probably applies to most extra-mural postgraduate training, irrespective of the field of study, since it is likely that any one participant is under strong competing influences and commitments in their individual workplace, and in their personal lives.
Knowledge of this strongly influenced my decision to collaborate with others, without exception i.e. in every new professional venture considered and outline research project under development. In doing so, I have learnt that what others bring is far more than support and sharing the workload, since differences between us enrich whatever is developed, often in unexpected ways – just as an abrupt contact between two unalike materials can spark a flame, and then other material is required to keep that flame alight. In Scotland, by eschewing a mono-model of therapy, by establishing a ‘critical mass’ of trainers for systemic work, and in the design of training itself for trainees across Scotland. And most recently, in my decision to agree to Lisa’s proposal for a second edition of the book Dave Will and I had written.
Pope, Alexander (1711). An Essay on Criticism. Public Domain.