The Metatherapeutic Current in Pluralism
Nicola Blunden, BSc Person-Centred Pluralistic Counselling, Metanoia Institute, London
Terry Eagleton, one of my favourite philosophers, has written that, ‘For much of the time, our intellectual and other activities bowl along fairly serenely, and in this situation no great expenditure of theoretical energy is usually necessary. But there may come a point when these taken-for-granted activities begin to falter, log-jam, come unstuck, run into trouble, and it is at these points that theory proves necessary.’
When our team at Metanoia Institute decided to turn our person-centred undergraduate therapy training into a person-centred pluralistic therapy training, we experienced a log-jam: a pressure that squeezed us time and again when we tried to explain the practical and philosophical basis of the course. At the time, there were two main ways of understanding pluralism: as a pragmatic framework for integrative practice; and as a broad philosophical stance (implicitly for single-modality therapists). Our training does not really fit either of these descriptions. We are not an integrative training, unless you count the many and varied ways of being person-centred. But we do not just hold a philosophical, or abstract position either. We are engaged in something that is distinctively both pluralistic and person-centred, and deeply rooted in practice.
Trainers, supervisors, and students ask us, ‘How can you be both a single-modality training, and pluralistic?’ Our answer is that the pluralistic way of being has something unique to offer therapists of many orientations, and of one orientation: that is the co-creative, reflexive metatherapeutic current.
Alongside the therapy space, pluralism establishes and maintains a continuous current of reflective activity. We form it in the first session, when we ask clients about their preferences and aspirations for the therapy. But it is not a discussion that only happens at assessment, or at periodic review. It sits constantly alongside the therapy, like a flowing stream, always available to both persons. I experience it as another space, not the therapy space. It’s a parallel current, a metatherapeutic current, in which we work together as a team. It is a creative, ongoing discussion, in which we fine-tune our approach, and generate a new, unique, and innovative way of working, that suits the particular needs of the relationship, and the moment.
Either the client or the therapist can step out of the therapy space and step into the reflexive stream. In this illustrative, anonymised example, the therapist (Shay) initiates a move to this metatherapeutic current. The client (Sam) has been talking about how difficult it is to access his feelings in the moment.
Sam: I know I’m supposed to be feeling stuff in here, but I just can’t. I feel kind of numb. It’s frustrating.
Shay: Hmm. Yes, I feel the stuck feeling with you. Can we pause here for a minute, and think about how we are working together? Maybe there is something we can do differently. Or maybe there is something I’m doing that’s not helpful.
Sam: I don’t know if you’re doing anything wrong… I think I’m trying too hard?
Shay: Well, maybe we’ve both assumed something here about what you ‘should’ be doing, as a client.
Sam: …I feel like I’m supposed to be crying and feeling all these feelings. I know I am grieving, underneath. I just can’t get to it.
Shay: I’m not expecting you to cry. I think my job is to be here alongside you, whatever you’re feeling. I also think it’s important not to try and force your feelings. Perhaps it will come when it’s ready.
Sam: But I do want to try and get at the feelings. I haven’t cried in years. I think it would help me to let it out. I just don’t know how.
Shay: Okay. Well, maybe the way we are approaching it isn’t working for you. Do you have a sense of what might help?
Sam: I don’t know… I was thinking, maybe we could do something different? Like, when I try to speak, that’s when it shuts down. Is there anything we can do that isn’t about speaking? That sounds stupid.
Shay: That doesn’t sound stupid at all to me. Um, there are a few things we could try instead of talking. We could do something creative – sometimes it helps to describe the feelings in colour, or with music. I have lots of creative stuff here we could use. Or we could try connecting more to the body. Your emotions might not have many words attached to them, but we could approach the feelings as sensations. That’s a technique you can learn and use outside of the room as well.
Shay: What are you feeling or thinking about those ideas?
Sam: I like the idea of using music. I do use music when I’m feeling crap. I do feel things then, sometimes, in the car.
Shay: That feels like something we could work with, and try out?
Sam: There’s this song that always makes me think of my mother. It came on the other day, while I was driving…
At this point, the client moves naturally back into the therapy space. Sam and Shay go on to weave songs and then poetry into their work, as a way of symbolising Sam’s feelings, without the pressure of having to vocalise them. This helps Sam to contact his feelings of grief and pain, in a way that feels comfortable.
It’s important to note that at the beginning of the above extract, Shay could have stayed in the therapy space, sitting with Sam’s feeling of pressure and frustration. But she sensed that they might be able to adapt their approach, or re-orient it somehow, to support Sam in his feeling of stuckness. An integrative or single-modality practitioner who hasn’t established this metatherapeutic current would not have had this choice.
This metatherapeutic current is a space that keeps developing, empowering the client to be proactive in co-creating the therapeutic approach. In the next example, from a few sessions later, it is Sam who initiates a move into the metatherapeutic stream, right at the beginning of the session:
Sam: I was thinking we might do something different today.
Shay: Sure. What are you thinking?
Sam: You might think this sounds weird, but I’d like us to swap seats.
Shay: Oh, you sit here, and me there?
Sam: Yes. Obviously not if you don’t want to.
Shay: I am happy for you to sit where you like. What are you guessing will happen when we do?
Sam: Okay, it does sound weird, but I want to know what it feels like to sit where you are. I want to… see myself through your eyes?
Shay: You know, I never really find your ideas weird. They are always interesting to try out. Let’s swap now?
[They swap seats]
Shay: I’m very interested to know how it feels over there.
Sam: [laughs] Yes that’s how I felt when I sat there! Very interested in how you were feeling! I feel… more powerful somehow. I feel kind of warm about you, over there, in the client seat. You seem a bit more vulnerable, but… I like it.
Again, Sam moves back into the therapy space. Having negotiated a new method in the therapy, Sam begins to process his feelings about their relationship, where the power ‘sits’, and perhaps how Shay feels about him. This subsequent discussion is full of immediacy (the therapeutic skill in which two people talk about their direct experience of themselves and each other in relationship), but is now firmly back in the therapy stream, with the intention of having direct therapeutic benefits for the client.
So, there is a difference between the metatherapeutic current (which is concerned with the negotiation and co-creation of the processes of therapy), and immediacy (which is therapeutic discussion in the here-and-now of the therapy as it happens). Both are a form of metacommunication, but they have different purposes. Metatherapeutic conversation is intended to support the therapy but it is not intended to be therapeutic, per se. Metatherapeutic communication is a distinctive feature of pluralistic approaches—whether integrative or single modality.
In summary, the metatherapeutic current is a collaborative, creative, and joint relationship that sits alongside the therapy space, like a stream. It supports and upholds the therapy space in at least five important ways:
- It enlists the client as an explicit co-creator of the therapeutic approach, leading to innovation, diversity of practice, and personalisation.
- It demystifies the therapist’s intentions and knowledge for the client, enabling the client to make use of the therapist’s knowledge in explicit and client-led ways.
- It demystifies the client’s intentions and knowledge for the therapist, enabling the therapist to tailor the approach more sensitively, and make use of client feedback about their way of working.
- It horizontalizes the therapy, sharing power and responsibility for the therapeutic approach, taking seriously and acting on the client’s style, aspirations, ideas, evaluations, and preferences.
- Because it is continuous and concurrent, it creates a deepening coherence and consistency in the work, centred in the unique, unfolding relationship.
How do you experience and facilitate this metatherapeutic space with your clients? I’d be very interested to hear your comments!
5 thoughts on “The Metatherapeutic Current in Pluralism”
This fits well with my understanding of the person-centred approach, and doesn’t feel like it would be particularly alien to many of the key figures in the modality over the years. This “stepping aside” feels like an ordinary part of practice, wherein either I or the client or both of us can initiate a conversation about what is happening and perhaps see even already familiar facets of our relationship but from different perspectives.
I love this blog Nicola. So helpful. It stimulated me to try and put together some clarifications of terms, just really reiterating what you are saying in some different words.
Metacommunication is an umbrella term for when the therapist and client talk about what is going on in the therapy. This can involve both immediacy and metatherapeutic communication.
Immediacy is when the therapist (and client) talk about the here-and-now experiencing of the relationship as a specific therapeutic intervention: designed to develop insight or other therapeutic outcomes such as the enhancement of congruence. For instance, instance, a therapist might say that they feel uncomfortable with the client’s level of anger being expressed towards them, or that they feel a deep sense of care towards the client.
Metatherapeutic communication, or ‘Channel 2’ communication, is where the therapist and client talk about how the therapeutic process will function, per se. It is ‘outside’ of the therapeutic work, in that it is not intended, per se, to have a therapeutic effect on the client, but is a medium through which the client and therapist can decide on how the therapeutic work will progress. MTC is synonymous with shared decision making. MTC may have a therapeutic effect (for instance, the client might develop their feelings of empowerment or ability to communicate with other assertively) but this is not its principal aim, per se. MTC is an adult-to-adult conversation, akin to contracting. It is not something that gets reduced to a therapeutic process: for instance, the therapist interpreting why the client might like more direction. Certainly, MTC can involve dialogue about the client’s preferences, and the therapist may propose an adapted or alternative way of working. But MTC is a second channel of communication and irreducible to therapeutic work, per se.
CHANNEL 2 COMMUNICATION
This is another term for MTC. The therapeutic process can be likened to a large, flowing river: client and therapist work with each other, they use various methods to help the client develop insight, practice new skills, grow etc. Alongside this river runs a second, smaller channel. The channel flow continuously alongside the river, and both client and therapist know that it is there—something that they can step into—but for much of the time it runs silently alongside. This is the channel in which the therapist and client can talk about the therapeutic work and how it should best be developed and delivered. For instance, here, the therapist might ask the client whether they want more direction, or the client might say that the two-chair techniques are not working for them. This second channel is distinct from the main one, in that it is a form of conversation that is not reduced to therapeutic processes. It remains a different kind of conversation, albeit one that segues in to the main therapeutic work.
METATHERAPEUTIC COMMUNICATION VS IMMEDIACY
Both MTC and immediacy can be of great value for therapy, but they are not the same thing. Immediacy is within the flow of the therapeutic process; MTC involves a standing out from it to decide on the flow itself. In immediacy, the aim is to engage with the client in ways that are therapeutic. In MTC, the aim is to work with the client to decide on what would be considered therapeutic. Immediacy is present in many forms of therapy, particularly humanistic (as, for instance, congruence) and psychodynamic (as, for instance, transference and counter-transference work). MTC is also present in many forms of therapy, albeit often in an implicit way. MTC is at the core of pluralistic therapy, in that it strives to work with the client to collaboratively agree how the work should develop. This may then involve immediacy work. But MTC is a standing back from any particular form of practice, including immediacy, congruence, and counter-transferential work to make some shared decisions about the kind of therapy that might be best for a client. In this respect, it is at a more meta-level: the client and therapist deciding together, for instance, that they would like to focus on what goes on between them in the relationship. Here, MTC is a ‘stepping out’ into a different kind of conversation. This may just be brief. But, as a second channel, it is always available alongside the therapeutic work for the client, or therapist, to dip in to.
Blog above. ‘Admin’, from Mick Cooper
My therapist sometimes steps into psychological education, always asking my permission first: eg talking about brain evolution or sympathetic/parasympathetic systems, or about therapeutic models as in family systems therapy. Sometimes it’s a way of giving me space when I’m becoming overwhelmed; sometimes that’s not relevant, but he thinks (usually rightly) that it’ll give me another way of seeing what’s going on. How does that kind of ‘stepping aside’ link to the meta therapeutic communication you’re discussing? [He’s core systems trained, but has a lot of affinities to person-centred.]
if I might offer a couple of observations. Taking Nicola’s illustrative examples, it seems to me important that in both cases it is Sam who proposes the actual alternative way of working. In the first example, Shay makes the suggestion of thinking about another approach and it is Sam who proposes what that might be albeit from Shay’s options, so there is some initial direction being offered and perhaps the key for P-CC is how this is taken forward collaboratively. In the second example, Sam perhaps inadvertently (or perhaps advertently) suggests a fairly well known technique of swapping places to try and look through a different set of spectacles; we might see this as Shay offering herself to Sam as a proxy for Sam – Sam is looking back at “himself” from a different vantage point. Sam leads and Shay goes along, so far, so person-centred. But if Shay made the suggestion of swapping places as a log-jam breaker, this would feel overtly directional. So there does seem a need for some form of bounding on entering an MTC together.
Secondly, the analogy of the stream alongside the river feels strong, although if the stream and river run in parallel, it conjures up Kipling’s first line in The Ballad of East and West that “Never the twain shall meet”. Intuitively, this alone is not what is meant and indeed the full first verse of The Ballad as a whole would seem more apposite, recognising similarity or interconnectedness as more important than difference.
Mick talks about the MTC being a different conversation but segueing into the main therapeutic work and I wonder if an interconnected analogy would be quantum entanglement, where something happening in one place (MTC or stream) alters something at a distance or distinct place (therapeutic space or river). Put another way, what happens in the separate MTC momentarily affects the therapy, that somehow they are connected by communication but are different conversations. Maybe we think of what happens in the separate channel as absolving, in the sense of freeing or liberating, the mainstream therapeutics process or at least having that as its sole intent, provided, of course, that it involves, and is beneficial to, the client.