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Early Identification of Resistance “In fact, this seems to be the rule, that every single time I want to do good it is something evil that comes to hand. In my inmost self I dearly love God’s law, but I can see that my body follows a different law that battles against the law which my reason dictates. This is what makes me a prisoner of that law which lives inside my body.” Paul, Rom 7:21-23
Resistance in Clinical Supervision ACPE Webinar Series 10:00 AM - August 16, 2012 Gordon J. Hilsman
Objectives • Appreciate resistance as a key perspective on learning • Recognize resistance phenomenologically • Ponder the use of creativity to overcome resistance
Outline • Resistance: A Useful Concept? • Individual Educational Resistance • Forms of Resistance • Strategies for overcoming resistance • Group Resistance
Pastoral Supervision – a Practical Definition • Partnering between a learner and a mentor agreeing to process the thoughts, feelings, words, actions and memories of the learner regarding that learner’s ministry relationships
Resistance – A Practical Definition • Patterned behavior, initially subconscious, that inhibits the open processing of students’ ministry relationships
Identifying Resistances • What keeps this student from becoming intimate (authentic, open, vulnerable, self-disclosing) with patients, peers, and the supervisor? • What habits or characteristics tend to take the place of talking openly about ministry relationships? • What are the observable, troubling patterns of communication of this student? • What coping devices have become barriers to this student’s open relating?
Six Kinds of Resistance: “Why not offer feedback to your peers?”“What happens during your actual ministry efforts?” • Verbal • Intellectual • Affective • Attitudinal • Behavioral • Spiritual/Religious
Verbal Resistance • Debate, hyper-verbalizing, loquaciousness, super-extroversion • Minimally verbal - Inhibition, reluctance to describe, • Patterned – repetitive phrases • ____________________
Intellectual • Intellectualizing • Rationalizing • Minimizing • Justifying • Unsophisticated (excessive cluelessness) • ____________
Affective • Don’t get angry • Don’t get serious about yourself • Don’t hurt anybody directly • Don’t get hurt, (get even, get ready) • Don't feel • Don't belong • Don't be important • Don't be close • Don't be well
Behavioral • Please me/others! • Be perfect! • Be Strong! • Try Hard! • Hurry Up! • Passive • Passive Aggressive • Acting-out • ___________
Attitudinal or Moody • Hyper-Cheery • Edgy, snarly, sullen, cynical • Victim-hooded, self-pitying • Timid • Depressive • Self shaming
Meeting Resistance • How can the supervisor address the resistance to help the learner begin (again) to openly share clinical material about pastoral relationships? • Every resistance is unique. Here are three tiers of suggested strategies in plying the art of dealing with resistance, i.e., doing supervision.
“The more you focus on personal issues the more students will resist; the more you focus on pastoral care the more personally open they become.” • Bernie Pennington
Strategies - Tier One • Listen - Raise your level of attentiveness: body, mind, words, feelings, events • Wait – give it some time, • Intuit – Let yourself know what you know about what is inhibiting radical honesty in this person’s self disclosure • Think – Conceptualize, theorize, “psychologize” • Strategize – Internally ponder how to word an intervention
Strategies – Tier Two • Interpret - raise the student’s level of awareness • Invite/Request/Structure - creatively transition to the processing work • Confront - challenge the student to relate with authenticity • Utilize the group–facilitate group encounter re: patterns of communication and relating • Behavioral assignment - • Provoke - exaggerate to upset the balance of coping/anxiety • Consult – open yourself to assistance in dealing with your supervisory role in the “stuckness”
Interpretation Commenting on the behavior • “I notice that your comments about your peers’ ministry have been quite thin.” • “I’ve been noticing how quiet you are during verbatim sessions when critique is being offered.” • “Well we’ve talked for fifty minutes now and I notice we didn’t talk about any patient conversations you’ve had.”
Invitation/Request/Structuring Suggesting the openness about patient contacts; requesting the behavior; seeking agreement for part of individual supervisory sessions to include ministry material • I believe you’d benefit from talking about your ministry events in these sessions • I’d like to hear more about your conversations with patients • I’d like us to spend at least half of our time together talking about your conversations with patients
Confrontation Calling attention to discrepancies among a student’s observed behavior, speaking, owned thinking, and/or apparent emotions - I remember you wrote one of your goals about …. (e.g., ministry to people when hospitalized) and I don’t hear you talking much about patients.”
Prescriptive Group Facilitation Selecting a timely opportunity to focus the group’s attention on the student’s behavior in that arena “How much would you say you know about (Jim’s ministry) or (what Jim thinks about you or your ministry”?) “Would you be willing to share the first impression you had of (Janice) when the group started in June?”
Provocation Challenging the student with irony, hyperbole, or good natured humor “Do you really want to be cushioning everything you say?” “We’ve got to find a way to keep Jim quiet in these sessions.” “Don’t be letting on that you feel anything when you visit patients.”
Behavioral Assignment • Suggesting a specific behavior to address a named resistance “Would you be willing to not say anything in the group until you can say it in ten words or less?” “Would you be willing to try something for a day or two? --not speak in here until you can include first how you are feeling about something?”
Consultation Opening up data with a trusted colleague about the student’s troubling resistance, in hopes of improved perspective, creative suggestions, and awareness of your own part in the continued resistive behavior
Strategies - Tier Three • Consider theological perspectives- a classic way out of a supervisory impasse • Accept Mediocrity – allow natural limitations • Refer - facilitate the acceptance of professional assessment or therapy • Expel – while attempting to motivate for therapeutic help
Theology Request a shift to process theological thinking about the behavior “How do you think theologically about something like critiquing your peers?” “What would be your theology about sometimes causing hurt in a colleague in order to possibly do her some good?” “What do you think God would be saying about your ministry with patients so far?”
Acceptance of Limitations • Resignation that the promise of excellence developing in this student at this time is minimal • Continuing to validate what you see as positive about this student’s ministry and peer relationships - Continuing to draw attention to ministry issues directly, realizing it is likely that little access will be gained to the inner processes of this student • Continuing to create language to describe this frustrating process in a final written evaluation. • Keep observing
Referral Using the student’s conveyed emotions and your own observations and assessment to motivate acceptance of a therapeutic relationship to address the behavior in the best interest of the student and the ministry world. “Jim it seems to me that open conversation about the personal aspects of ministry is very difficult for you, as your peers and I have observed. It seems frustrating for you to describe yourself and your feelings in relationships. Have you considered (further) therapy to increase your self reflection in order to improve your ministry relationships? It actually seems your needs right now are more therapeutic than educational?”
Referral -2 • Referral is generally for assessment. Refrain from diagnosing about what is not your professional role to decide. • On the other hand, crisp questions may slip through the fog of denial and brief instruction may offer insight leading to the best kind of treatment.
Expelling Removing the student from the program. “Jim your efforts in this program are simply not fruitful enough for you to continue here. This will be your last day today. Get together whatever things you have here and I’ll be walking out with you immediately after today’s group session (about 11 AM) (in a few minutes) (this afternoon). You’ll have a chance to say a final goodbye to the group if you want to”.
Group Resistance • Individual resistance in a group setting • Group member collusion in obstructing the group work
The Group Work • Partnering among members of a peer supervisory group, all agreeing to process together the thoughts, feelings, words, actions and memories of the group members regarding their ministry relationships
(Perls) Individual Resistance in Group • Chicken Shit - Cowering in avoidance, stubborn silences, people pleasing, …. • Bullshit – Subverting with the disingenuous • Elephant Shit – Intellectualizing, monologues, explaining, over-interpreting
Collusion in Group Resistance Collude = Latin com (together) + ludere (to play)
Recognizing Group Resistance “When the group needs to address something important (and usually obvious), it won’t do anything else significant until it does what it most needs to do.” Bernie Pennington
A Few Forms of Group Resistance • Silence – (temporary) refusal to verbally process • Silliness – superficial humorous antics • Acting out (tardiness, absence, unpreparedness) • Sub-group Collusion – reinforcing one another’s obstructive behavior • Expelling the supervisor – inevitable initial efforts • Debate – energetic cognitive arguments
Group Strategies • Waiting • Interpretation – commenting on the behavior • Re-iterating the group purpose/work • Querying – “Where did you all go?”“Why do you suppose the group has become so often tardy?” • RE-structuring or re-establishing the agreed upon group contract • Directive insisting on compliance (Use authority, while also avoiding power struggles)
Best Wishes Having engaged this material with riveting attention, I hope you have benefitted in some small way and can now glide slickly into your supervisory work with greater cleverness, confidence short of arrogance, and more vibrant skills that lead to exceptional job and life satisfaction as a CPE Supervisor.
