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‘Arts in psychotherapy journal’ march 2010 PERSONAL DEVELOPMENT GROUPS IN POST GRADUATE DANCE MOVEMENT PSYCHOTHERAPY TRAINING: A STUDY EXAMINING THEIR CONTRIBUTION TO PRACTICE Helen Payne ABSTRACT There has been little research into the value of personal development (PD) groups in arts therapies/counselling/psychotherapy training, particularly in relation to trainees developing practice, despite a number of studies evaluating personal outcomes for trainees. Programmes assume trainees will benefit, however, how (or indeed if) the experience contributes to their actual practice has yet to be explored. This paper highlights findings from an analysis of the follow up data six months after the end of a weekly, 1.5 hour, DMT PD group for DMT trainees with reference to their reflections of the experience in relation to post-qualifying practice. The study was over three years, an intensive single cohort study which used qualitative methodology within a collaborative framework. Semi-structured interviews were undertaken (N=38) with trainees on a nationally validated, post graduate programme in dance movement therapy (DMT - now termed dance movement psychotherapy/DMP in the UK) in higher education. The aim is to stimulate debate and research on this aspect of training in body psychotherapy, arts therapies and counselling/psychotherapy, all of which appear to use groupwork for self awareness/personal development. Key Words : Personal Development Groups; Dance Movement Therapy; Trainee Therapists; Practice; Higher Education.
INTRODUCTION
This paper documents themes from the third phase of a qualitative, phenomenological, research study. It describes the analysis of findings from the seventh, final, follow-up interviews for each co-researcher (trainee) six months after ending their DMT group experience as trainees on a UK validated post graduate programme. In total 38 interviews were conducted during the two year group experience. These findings are hoped to be of assistance to those designing training programmes for arts therapies, counselling and body-oriented psychotherapies, in particular dance movement psycho/therapy. A critical literature review and methodology related to this study can be found in Payne (1999) and Payne (2004) respectively. Other major findings from this study concerned the ‘question of safety’ (Payne 2001); ‘ferocious polar bears’ as symbolic of destructive group forces (Payne 2002); ‘becoming a practitioner-client’ (Payne 2003) and ‘the DMT approach, including loss and physical contact’ (Payne 2006). The analysis of a global survey of PD groups in therapy training, including DMT, as a backdrop to the study can be found in Payne (2001a). Studies in the arts therapies have yet to be undertaken in this highly significant area to training, but in the related field of counselling they are also fairly limited (Lieberman, 1981; Fairhurst & Merry, 1999; Anderson & Price 2001; Donati & Watts 2000 ; Lennie 2000, 2005 , 2007; Robson & Robson 2008). In addition, to date the author has found no studies exploring the relationship between PD groups and trainees’ placement or eventual practice. This was the question this research study engaged with from the perception of
evaluations which show trust, empathy and genuineness were felt of a nature never before experienced, compared with those who disliked the PD group, commenting on its dysfunctional character (Lennie, 2000). Mirroring this polarity are the analytic theories of groups, ranging from Foulkes’ (1964) notion of the group as providing a source of growth, believing it to be an all-embracing, benign mother, to Bion’s (1959) more gloomy focus on regressive, primitive fantasies and archaic patterns of relating to others. Nitsun (1996), on the other hand, argues that the hopeful conceptualisation of groups comes from our belief in the need for cohesion within a group. Nitsun claims destructive forces are essential if the group’s creative potential is to be fulfilled, his theory uniting the polarity. METHODOLOGY A detailed outline of the methodology is well documented in Payne (2001b), but a brief overview is offered here. The main data collection tool was the recorded, individual, semi-structured interview which was conducted by a trained counsellor with interviewing skills. The recordings were transcribed by a transcriber and returned to co-researchers for their comments before being analyzed by the researcher. The interview schedule was designed by the researcher using material from the literature for the first and thenceforth the findings from the previous analysis. Trainees from year one were invited to participate in the study through informed consent prior to accepting their place on the programme. Full ethics approval was given for the study. All seven trainees volunteered, all female, between the ages of 30 and 45 years and white. Two were from continental Europe. After a year, one withdrew from the training and the research^1.
De-briefing meetings were held regularly with the research group to reflect on the process and consider ideas for changes in methods and so on. The approach was only collaborative to the extent that one co researcher analyzed her own data as well as the researcher. The confidential nature of the PD group, alongside the constraints of researching live participants in a group environment results in difficulties methodologically. To overcome some of these it was arranged that the researcher, interviewer, transcriber, PD group facilitator and her supervisor were uninvolved in the training/assessment process. Only the researcher was involved in the study. Neither the interviewer nor the transcriber was aware of the identity of the participants. Apart from the researcher no one else was involved in the data 2 analysis. This study followed the experience of each co-researcher/trainee in the DMT PD group as studied through in-depth, semi structured interviews at each third of the way through the PD group journey (two years), and at six months follow up. It sought to encourage reflections on links made between their experiences in the PD group and their practice. This final, follow up interview presented here brought forward all previously analyzed themes as a guide to elicit further reflections concerning the trainee’s previous placements and their current practice as qualified practitioners. The focus was on how, if at all, the DMT group influenced, or facilitated, their developing practice (as currently aware of) in terms of skills, capabilities, attitude, reflexivity and so on. Responses to questions analyzed for common and contrasting themes were built upon over time in a naturalistic, thematic analysis (Denzin and Lincoln 1994).
in ending the DMT group this participant went on to say she had ensured that her clients were aware of the reasons for their group ending and gave them space to say goodbye. If, for some reason, the ending/goodbyes had not been undertaken she said she felt ‘at a loss…the consequences of not saying goodbye seem more for the therapist’s needs than the client’s, to relieve her guilt feelings’. There was also awareness of endings highlighting loss. ‘Comprehension of reasons for an ending gave meaning to loss, but did not necessarily alleviate the feelings’, commented another co-researcher. It was important that’ loss made rationale sense’ claimed another: ‘To just disappear would give them a greater sense of loss. If no reason is given [for the ending] clients can loose trust. There needs to be a certain amount of trust left intact in endings, and in building trust and security in beginnings when setting up new groups this is important to remember’. Every ending can, potentially, be the foundation for a more secure beginning according to psychodynamic thinking. In every beginning the end is acknowledged in the way that beginning happens. Endings stimulate feelings of loss not only of the group, its members and facilitator but also of past or current life losses. One co-researcher recognised her feelings of loss would be powerfully re-stimulated in the beginning and letting go stages of a new DMT practice group. She felt it too problematic to set up a group to run at this phase of her life (she had lost both parents and her partner during the lifetime of the DMT group). ‘I decided not to run a DMT group, post qualifying, to give me time to get over the losses. I couldn’t give it the safety, contain anything, or differentiate my stuff from theirs. I am always tired, in a giving-up mood, a sort of passivity, the lethargy. I’ve recognized there is always interference as a constant interruption but I am not capable now of looking into these at different levels. In my gut there’s still too much pain down there’.
She tells us she recognizes the interface between the personal and the professional. Another group means another loss to her, just too painful to experience as yet. In deciding to give herself more time to heal, she respects her client’s needs for her to be there for them as a primary objective, and she simply cannot do that for the time being. Although she understands there will always be interferences from her personal life in her work she cannot process her losses on the many levels required if she facilitated a clinical DMT group. She admits the pain, located in her gut, is too great. Perhaps there is a belief in operation here that in order to work as a therapist she requires the pre-requisite of a lack of pain at the psycho-physiological level. Her comment poses the question as to whether the therapist has a responsibility to consider if, as a result of these interferences, she is fit to work and the possible yardstick for this self-assessment. This co-researcher wanted to work with groups focusing on loss and bereavement issues after she felt more healed herself. She thought going through her own losses in the context of the DMT group had prepared her well for the grief etc in running such groups in the future though. Another co-researcher spoke of the facilitator sharing her feelings of loss in the final session of the DMT group which had helped her to learn about endings in her own practice: ‘It was very moving to see her openly share her grief of loosing the DMT group - us- and that was important to witness. I realize it was brave for the therapist to talk like that to the group. When I’m ending groups I tend to block a bit, sort of cover up and put on more of a professional front, as a way of not really getting in touch with my own pain about the group ending. Seeing that happen in the DMT group and the effect it had on me I realize the value of being honest with your feelings, and sharing your pain openly to the group when ending, rather than showing a false front. It showed me it was really OK to be there really present at the ending, and not to be one jump ahead or behind. It’s a way of giving the group permission to release feelings, a role model. If that stuff doesn’t come out in the group where is it going to go? It’s going to be taken and spattered all over the place. The
ending – because we all knew we would salvage something – there would still be a connection. I do think about what it would have been like if it had been ending, curtains!’ Perhaps they felt cheated of a real ending due to the research because all but the facilitator would be meeting up again for a de-briefing of the research and final individual interviews, albeit with a different purpose, context and with the primary researcher - a stranger to the DMT group. On the other hand, on-going contact with each other, the researcher and the reflection process was very much appreciated: ‘we reflected on the study of the inquiry into the DMT group!’ One co-researcher pointed out that although the life of her practice DMT group might end these participants still had on-going relationships with one another as they lived in the same place, unlike the participants in the DMT group. However, it was linked to the on- going contact the co-researchers had with one another because of the research project following the DMT group. She went on to say that in this situation she felt, as a therapist, that she held far more of the feelings of ending (grief in particular) in her practice group than in the DMT group. She wondered if the DMT group facilitator was openly sad in that last session because she knew the trainees would continue to meet together for the research fieldwork, post-DMT group ending. Another co-researcher noted her difficulties with being on the ‘inside/outside’ of the DMT group and how, in her practice, it was hard not to feel, as the therapist, that she was on the ‘outside’. She was sad at not having taken the opportunity to process these ‘insider/outsider’ feelings more in the DMT group, as they were now arising in her practice. Processing them might have enabled a greater sense of belonging to both the DMT group during training, and to her practice group, to understand and empathise with
inclusion – exclusion feelings as they arose for her clients. In her current practice she mentioned feelings of exclusion towards her, as a therapist, together with feelings of rejection and abandonment by the client group. How the therapist deals with these powerful themes is crucial to the therapeutic process, and her relationship with the organisation as a context for that work. For example, if the therapist feels on the outside, as a sessional worker (one who is paid by the session/hour rather than on the permanent staff) to a hospital or school, any action by the organisation towards her or her group may be interpreted as a threat to her or rejecting of her/the group, for instance. If this is not processed by the therapist in supervision then it may get acted out (by her or the group) in a reaction towards the organisation or in her facilitation of the group - by becoming angry with them or needy of them, for example. Rivalry, envy and jealousy: A co-researcher said it was ‘too frightening to work with rivalry and jealousy in the DMT group’. It did get addressed in certain exercises though, she admitted, such as in intensive weeks and skills workshops. Here she discusses the matter of jealousy from fellow professionals in her practice setting when she was a sessional therapist, going in weekly. ‘There is no model for how to cope with jealousy as a therapist. I learned about myself in the DMT group and about the role of the therapist – when she stepped in – and when she did not. As a therapist I would try to encourage the group to deal with rivalry and jealousy. To be honest it’s never such a disaster as you think it’s going to be. Usually people grow from situations such as those. People end up in therapy through a lack of honesty in their lives so in leading a group I would go for it. As a sessional therapist the OTs, and others who are with the clients every day, are envious because I only go in once a week, for two hours. There is novelty about my group, and my presence because I do a different sort of activity. It can be felt by someone who is a bit jaded in their work that the visiting therapist has all the star quality, which you have not’. The same co-researcher continues to reflect on the issue of envy in her practice:
‘that there was a feeling of jealousy towards me in the group – a relief to me to hear this but quite shocking. It was less dangerous if talked about, but rarely was this the case in the group’. This experience helped her to understand the importance of addressing jealous and rivalrous feelings in her clinical groups. For example, in her hospital DMT group clients held onto old, jealous feelings in the group, perhaps due to a lack of safety. Consequently, they appeared to prefer to act them out on the ward rather than address them in the group. Own needs being met: Trainees’ own needs for self exploration in an ‘as if client’ role, identified in the pre- DMT group questionnaire analysis were met in a primary way (Payne 2004), but the influences of this exploration on practice was also evident as a tracing into the final interviews. For example: ‘The DMT group enabled me to explore myself as a person and within the group. It has certainly enabled me to carry on. Discovering a kind of inner strength, having gone through a lot of loss, I needed to know I had a kind of reserve. If I got through all the pain that the bottom line was I was OK, strong enough’. The implication here is the need to develop an inner strength and that stages have to be worked through to appreciate that she was fundamentally ‘OK’. She was aware in her practice individuals may never reach such a place, particularly when most of her groups were short-term unlike the DMT group, which she saw as a limitation on growth. She enlarged on the concept of ‘ego strength’ (Freud 1960) as being needed in order to ‘individuate’ (Jung 1989), to break away from the personality of the group, which she acknowledged, may not be possible for most of her clients. Overall comments evaluated the DMT group as providing a stronger sense of self - a classic aim of psychotherapy. For example: ‘Expanding on all levels, becoming more of
who I am’. However, some participants revealed a reluctance to explore specific private aspects of themselves. Reasons included not yet being ready to be open and preferring an individual setting or self help groups for such disclosures. One co-researcher made a connection with her practice DMT group on this issue: ‘I’m always aware that anyone I’m working with, especially women and young girls, in special needs settings who are pre or non-verbal are quite vulnerable. They may well have been exposed to levels of abuse whether it be sexual or physical. I always hold that in mind and I don’t think I was aware of this before, I mean I used to read about it, but now it is more specific’. In relation to practice, lower grades for assignments mattered less to trainees than ‘doing it [practicing DMT] their own way’. This connects with another aspect whereby the DMT group model during training was explored in students’ own practice, but found to be inappropriate for many of their clients (Payne 2006). Therefore, they concluded, they were required to formulate their own model of practice of DMT in relation to those client populations with which they were now working. In other words, their own development of both ‘being’ and ‘doing’ was seen as crucial to practice. In addition, co-researchers were able to point out how an awareness of their own needs and motivations linked to their practice. For example, they were conscious of the fact that in selecting a particular client population or issue they were unconsciously responding to their own needs. One participant was able to reflexively consider her motivation for being in training and working with a particular population: ‘It [the DMT group] has made me realize this incredible link that makes it very important to constantly watch out and see why you are doing a group. Or what makes you pick a topic. Why does one become a therapist? And why with this particular population?’ As she continued it became clear she believed in the task of the therapist as ‘helper’ and in the importance of the therapist’s experience of her own personality and history being
group since there were absences and even members leaving. One co-researcher described how a particular technique used by the facilitator in the DMT group which she experienced as confronting at the time actually enabled her own practice at a later date: ‘The autistic lad spent the first two sessions hiding. I acknowledged his hiding. He was building a box out of cushions and hiding inside, looking through a gap. I poked my head through the gap and left him to work his own way out. He may have felt gently confronted. He managed to get though. I learnt that gentle confrontation techniques which give the client the space to think about it, be angry perhaps but then to work through that anger with them’. Another commented: ‘I learned anger can come about if there is resistance in the environment.’ And another said: ‘I was so frightened of anger until it was shared in the DMT group situation’. Sexuality: ‘In schools I get passing comments in the staff room like; well if you could stop him masturbating it would be fine… So it is about taking the movement, masturbating rhythms and finding a different way for him to be able to release rather than physically. I did not have a problem with the children masturbating in my groups’. This was one student’s comment concerning the theme of sexuality. She does not appear phased by the subject matter communicated to her. Instead she reflects on how she might use the rhythms inherent in the child’s masturbation, which appears to be of concern to staff at the school, to help the child to express himself and release tension in a more appropriate manner. However, nearly all trainees found the issue of sexuality difficult to work with in the DMT group. Comments indicate some were working with the issue of their own sexuality consistently throughout the DMT group, but in a private way rather than overtly, or in terms of how it affected the group. It was admitted that the all-female gender group could have blocked the development of the group in certain directions. To have had a man in
the group might have introduced other issues around sexuality/gender. They felt the issue was ‘conveniently skipped over’. Some felt it was surprising not to have been consciously raised as two members were lesbian in sexual orientation. The belief here seems to be that if the group were heterosexual, sexuality would not have been an issue. The lack of overt processing of it left at least one co-researcher at a loss when dealing with it in her practice groups. However, it appears from some trainees that they believed that if the group was all-women there would be no issue around gender/sexuality. One acknowledges she needs to process aspects of her own sexuality for it to be addressed in groups. The fact that most of her groups were female apparently results in it not arising at all, and even with a man in the group it remained hidden (albeit not from her it seems). ‘It is something I would have to work through myself if I wanted to run a group. Most of my groups are all-female. One group had a male in it and it did come up there but under the surface, never addressed’. Another co-researcher connected her inability to have children with homosexuality: ‘It links with homosexuality because she is young and (silence…) I won’t have any children [due to her age].She won’t either as she is a lesbian and…um…so it would have been something I would have liked to work through in the DMT group’. This comment implies some anger or envy towards the younger member. Perhaps some of the expressed anger in the DMT group was a result of such underlying feelings being repressed, rather than being expressed and processed. This raises some anxiety as to whether the issue of gender, sexuality and sexual orientation could ever be raised in participant’s clinical practice groups.
The self limiting therapist/client: Co-researchers, on reflection, thought they could have done much more with some issues/feelings in the DMT group. Now, in their practice, the clients who were unable to ‘break through’ and move into/out of feelings were more easily recognized, they felt, as a result of their own experiences in the group. They could empathise with these clients in their practice groups more easily now, they said. However, they thought there was less known to them about how to practically help such clients. This stickiness with current clients appeared to be directly related to how stuck they felt at times in the DMT group. At this point they claimed they felt no encouragement or guidance from either the group, or the facilitator, on how to process their feelings in a deeper way, that is beyond their self limits i.e. those limitations they imposed upon themselves about how deeply to explore. Criteria for going ‘freelance’: On a more pragmatic note, co-researchers were able to feel confident enough, following their training, to become self employed in their work. One discovered she was ‘OK’ and gained confidence and a belief in herself and what she was doing as a result of the DMT group experience. She was able to decide to take the plunge and ‘go it alone’ as a practitioner. She felt able to sell DMT to other professionals in hospital and school settings due to the recognition that it ‘seemed to work for her’. This recognition seemed to reinforce to her that it would therefore be ‘OK’ for others to experience too. Armed, in addition, with an understanding, at a bodily, cognitive and affective level, that the ‘as if’ therapy group gave opportunities to process issues: ‘the process part of a therapy group provides experience of issues concerned with the totality of what the person or group experience is at the time’. This participant went out into the wider world to persuade others to employ her to run DMT groups on a sessional basis.
The experience of being a client: This was still seen as a valuable aspect of the DMT group on follow up (Payne 2004). The group provided them with a strong sense that DMT was the right path for them, professionally, but also that DMT had an intrinsic value, which had been experienced personally, a foundation on which to build their professional practice. ‘I believe in DMT and its value because I have personally been through it. It would feel like I still lacked something if I said ‘I can set up a DMT group’ and that ‘I know about DMT because I’ve read all the books’. But I’d really not know what it might be like to be a client in a DMT group. You have to have that if going to practice DMT. I can guarantee it is going to be hard work for clients. I have experienced the pros and cons. Not that my clients will have the same experience as me. It can be very valuable though, knowing it from inside of a person, rather than from [a theoretician’s name], so it must be so’ Another co-researcher summed up this internalisation of being a DMT client: ‘The best was that it activated a journey, which I will be on for the rest of my life – wanting to enable other people, to facilitate some process for them. Not a week goes by without me being transported back to the DMT group. I feel I carry the group with me’. Short term versus long term groups: One co-researcher considered these structures in her practice. Most participants groups were short term and closed. However, she felt these groups never got to the stage where they were strong enough for the individuation of participants, as she had experienced in the long term DMT PD group: ‘The DMT group gave us the space to explore ourselves as a group and actually form a group, and be aware we were working as a group to become more individual in that group. I wonder how long they (her client group) need as a group to be strong enough to do this, given the nature of these groups? Due to limitations of funding we cannot always have open-ended groups though’. This comment indicates the model provided in the PD group during training (closed and long term) was unsuitable to be adopted wholesale to the populations being worked with following training and connects to trainees need to develop their own models for practice (see above ‘own needs being met’ and findings in Payne, 2006).
