Category: Mindfulness Based Therapy

  • Johari Window- Nuances of Prejudices and Presumptions

    The Johari window tells about the open, hidden,blind, unknown aspects of self and is used by me to collaborate with clients to examine areas of communication, commitment and conflict.University of California psychologists Joseph Luft (1916–2014) and Harrington Ingham (1916–1995) helped conceptualize a model which helps see an individual’s position in and their relationships and interactions with others in a group (Spennemann, 2023).

      One exercise I encourage is to write a letter – to a loved one who has passed away- using the structure of the Johari Window and see how life changes, what things about oneself, relationships and society one can see after doing this exercise.

    Case Scenario: A client in his thirties came to me with feelings of unease after having ended a decade long marriage, gone into another relationship which he broke up, and is now in a live-in relationship with another person, but has intrusive thoughts about his previous relationships.

    Application– Through Transcript and Johari Window Exercises.

    Transcript of Session.


    Client  ( C) : I cannot put my finger on it, but I have been feeling a bit off

    Therapist (T-PB) : Is it a feeling of unease or tiredness or both

    C- Unease about some memories of the previous relationships

    T-PB: Is there a part of that joint energy which informs the present relationships.

    C- Yes. Though they should not be coming up, I have to admit that these offsetting memories are coming up.

    T-PB- Let us revisit our previous collaboration to examine the open and hidden shoulds which drive one’s thinking.

    C- What purpose does that serve

    T-PB- It is one of the tools one can use to deconstruct internal dialogue or interpersonal communications and create a safe space, structure and observer mind.


    Psychoeducation Point: Open or Hidden Shoulds can be a road to Cognitive distortions which can be emotionally exhausting (you can download worksheet below)

    Johari Window Exercises 

      The open self- what is known to both myself and others- can be truths which are undeniable over time, how they affected my relationships, especially with those I hurt, and what parts of me remained consistent and genuine. These can serve as a means to explore the personal and interpersonal dynamics, how they affect identity, isolation, meaning and freedom.

    For example

    C- We came together when we were in our teens. Despite her parents having warned her about me, she chose to be with me. However, around seven years after our marriage, we started drifting apart, staying together like hostel room members, avoiding any deeper discussion.

    T-PB: How would she write about this phase?

    This brings us to the blind self- what others can see, but I deny, or cannot see.

    C- she would probably tell that I was aloof, got too busy in my work, started spending more time with my friends and was irritable when her family came to visit.

    Th-PB- Did she try to mirror these aspects of your lived reality? 

    C-She did try to point out, but I was not open to these suggestions. At times I was very volatile, which made her shut down. Then we both got busy with our work, created our own separate friend circles and drifted apart.

    Th-PB- Knowing what you know now, can you look back and see how your body language, tone, omissions affected the relationship?

    C- It led to a feeling of loneliness, misunderstanding and feeling stifled. 

    T-PB: Did it lead to fear, confusion, entitlement 

    This leads one to the Hidden Self- What one knows but keeps hidden

    C- Yes, it led to confusion and led me astray from my commitment to this relationship. There was a sense of shame as she had supported me in my very difficult teenage years. There was a sense of rejection as we became aloof and I started seeking emotional nurturing from others.

    T-PB: What truths did you hide from yourself and others?

    C- I cloaked these outside relationships by deflecting questions of where I was spending my time and with whom. I also started developing a sense of entitlement by blaming my partner for these secrets.

    T-PB -Is there any pattern in your family of origin which you can see repeating?

    C-I never thought about it like this, but that could be an area of enquiry

    We agreed to journal about this and discuss as appropriate. This helped us to see the Unknown Self (not known to others and me, what I am only discovering now)

    In next sessions we discussed themes of communication, how feelings were discussed or avoided in family of origin and how these truths were handled. To assist this exercise we did the Family Dinner in Childhood Exercise (an adaptation of Family Sculpting Tool suggested by Alfred Adler- see worksheet below)

    C- A day in the life of the family, a dinner together led to some old wounds reopening.

    T-PB: Therapy can get uneasy and difficult before things get better. 

    C-(smiling): Yes, I understand that process, but I needed to look at some buried issues which have been coming up in the way I communicate my needs and feelings.

    T-PB: What cultural contexts did you revisit?

    C- That was a different time, my parents had freshly moved to Canada. The stress of shifting and still having ties, pulls from the parent culture were telling on their relationship. Being stuck in survival level manual labour jobs added to their burdens.

    T-PB: Can you now see the spaces which they had to navigate differently? What strengths are you building by going through this process?

    ..

    Comments: 

    Examining Dark Alleys- Using Tools like Johari Window

      I first came to know of the Johari window during a training session with my supervisor. She taught me to see things from different hats, and at times not put on any hat (my own prejudices and presumptions) and just walk along with the client, see the world as they see it. 

    This led me to sit in cafes near the community housing of Black Creek areas where living poor, working rough is common. I would visit a client weekly during my training, and help her navigate her reality, widowed in 2019 just before Covid19, institutionalized in 2022, having a teenage daughter back home in Ghana, separated from her pre-teen son in Toronto. The Johari window helped me see the relational dynamics and my own areas for growth.

    Psychotherapy is a form of caring which is different from psychiatry (which has become a titration of medicines) and will help see the forces, factors, DNA and development in a compassionate manner. As Carl Rogers said- “ The curious paradox is that when I accept myself just as I am, then I can change.” 

    Living Rough, Working Poor- Crossroads

    References

    Spennemann, D. H. (2023). The usefulness of the Johari Window for the Cultural Heritage Planning Process. Heritage, 6(1), 724-741.

  • Time to Remember, Time to Act

    by Prashant Bhatt

    August 31 is International Overdose Awareness Day (IOAD or Overdose Day), a global event observed on 31 August since 2001. Its purpose to raise awareness of overdoses 

    “Time to remember. Time to act” is the slogan used by campaigners.

    Key facts

    In 2023- 8,049  apparent opioid toxicity deaths (7% higher than the same period in 2022). In the period of Jan 2016 to December 2023 there were 44592 apparent opioid toxicity deaths, most in males (72%) with ages 30-39 being the most affected (29%). 

    Fentanyl was associated with 82% of these incidents in 2023, an increase by 44% since 2016. (Public Health Agency of Canada; June 2024)

    Stigma and Secrecy: Echoes of Silence

    As a primary school student, I came to know about overdose, after the death of one of the family members of a colleague of my father. This was in Pune, Western India in the 1970s. Over the decades, being in the medical profession, I have known many who have become dependent on prescription medications, recreational drugs and beyond. Every medical campus has such cases, though there is a lot of stigma, secrecy and no open discussion. 

    These silences in campuses, communities have left an echo, which can be heard in the lives of those affected by addiction.

    Resisting the Czar of the Heavens: The 12 step path to Recovery: 

    Why don’t you choose your own conception of God” 

                                            Ebby T to Bill W- the co-founder of Alcoholics Anonymous

                                             Page 12, Big Book of Alcoholics Anonymous

    Coming to the recovery movement from the Oxford group, Bill W tells of how the icy intellectual mountain resisted the Czar of the Heavens, whose creative intelligence and universal mind he had doubted for long. He tells of how Ebby T told him to be willing to believe in a power greater than himself. A loving fellowship can be a good place to start.

    Creating and such nurturing safe spaces where persons from different walks of life come and share their experience, strength and hope helps build a program of Recovery.

    One learns to learn from one’s resistance and be open to hear what has worked for others, and to develop a personalised program of recovery. For persons who are struggling with finances, family issues, faith, a fellowship where one can share without judgment is a key to recovery.

    Third Wave CBT: Acceptance and Commitment Therapy (Hayes, Barnes-Holmes & Roche, (2001). 

    Hayes and colleagues (2001) researched on the why change occurs using the relational frame theory, on how humans relate to time, each other and space and explained the why of how change occurs in cognitions, behaviour and systems. This was an evolution from 2nd wave CBT which emphasized on cognitions as developed by Aaron Beck and Albert Ellis(1960s, 1970s), and 1st Wave CBT – the Behaviourism of Skinner (1950s). CBT evolved from the Humanism of Carl Rogers (1950s) and the Psychodynamic empire of Freud (First half of 20th century)

    In his book, A Liberated Mind, Stephen Hayes talks about the cultural messaging -just snap out of it- as shown by the messages given by the character Peggy and her dialogues with Pete. He goes on to say how psychotherapy and counseling in the mid 20th century are partly responsible from such cultural messages- which just tell to “Snap out of It” . (Hayes, 2020)

    JUST SNAP OUT OF IT

     

    Hayes talks about the cultural messaging in Distraction, Avoidance, Indulgence which are not changing the basics. Acceptance and talking to the parts which one is avoiding has been a way forward to develop context rather than just trying to change the content of thought.

    The six core therapeutic processes of ACT are acceptance and willingness, cognitive defusion, present-moment awareness, self-as-context, values, and committed action. 

    Acceptance means gently holding whatever arises. This could be done by rating one’s presentation after filming as mentioned previously. Present-moment-awareness is a non-judgmental mindfulness exercise. Consider a client with social anxiety who overestimates criticism and has excessive self-focus. The techniques can be used to allow the individual to notice the behaviour of others by observing their verbal and non-verbal cues (Bennett-Levy et al.,2004; Kinnerley, Kirk & Westbrook, 2017; Stoddard & Afari, 2014).

    Summary of Themes 

    1- Overdose deaths are on the increase, they are shrouded in stigma and secrecy

    2- Loving someone in recovery can take a toll. Attachment theory, neuroscience, cutting edge 3rd wave CBT like ACT can help family members who are preoccupied with taking care of or controlling another person at the expense of one’s own needs.

    3- Different approaches to recovery can help evolve a personalized program

     

    Resources and Links

    Greening, T., & Kirschenbaum, H. (2013). THE DEFINITIVE BIBLIOGRAPHY ON PERSON-CENTERED PHILOSOPHY AND CARL ROGERS. On Becoming an Effective Teacher: Person-centered teaching, psychology, philosophy, and dialogues with Carl R. Rogers and Harold Lyon, 193.

    Hayes, S. C., Barnes-Holmes, D., & Roche, B. (2001). Relational frame theory: A précis. Relational frame theory: A post-Skinnerian account of human language and cognition, 141-154.

    Hayes, S. C. (2020). A liberated mind: How to pivot toward what matters. Penguin.

    Overdose Basics

    Overdose Basics – International Overdose Awareness Day (overdoseday.com)

    International Overdose Awareness Day – Wikipedia

    Opioid- and Stimulant-related Harms in Canada: Key findings — Canada.ca

    Public Health Agency of Canada; June 2024. Federal, provincial, 

    and territorial Special Advisory Committee on the Epidemic 

    of Opioid Overdoses. Opioid- and Stimulant-related Harms 

    in Canada. Ottawa

    https://health-infobase.canada.ca/substance-related-harms/opioids-stimulants/

    International Overdose Awareness Day: 31 August (overdoseday.com)

    If you would like to explore these areas in detail, we offer individual therapy based on mindfulness based practices. We also offer 3 hour workshops to groups if they are interested in getting an overview of the components of ACT therapy, and see whether it will work for them.

    Contact: Prashant Bhatt, 6478181385 (text with name please)
                      Candlestick Counseling Services-9055932287

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