For as I see it, dialogue is not a method; it is a way of life. We learn it as one of the first things in our lives, which explains why dialogue can be such a powerful happening. Because it is the basic ruling factor of life, it is in fact very simple. It is its very simplicity that seems to be the paradoxical difficulty. It is so simple that we cannot believe that the healing element of any practice is simply to be heard, to have response, and that when the response is given and received, our therapeutic work is fulfilled (Seikkula & Trimble, 2005). Our clients have regained agency in their lives by having the capability for dialogue.
How does this happen? For therapists the main challenge becomes being present in the moment, as comprehensive embodied living persons, and responding to every utterance, and thus living in the ‘once-occurring participation in being’ (Bakhtin, 1993, p. 2).
In dialogue an intersubjective consciousness emerges. Our social identity is constructed by adapting our actions to those of others; and even more, knowing me myself as such is only possible by me seeing myself through the eyes of the other (Bakhtin, 1990). Living persons emerge in real contact with each other and adapt to each other, as in a continuous dance in which automatic movements occur, without controlling and deliberating on their behavior in words.
The intersubjective quality of our consciousness is shown in the mother–baby communication studies conducted by Trevarthen (1990; 2007). Trevarthen’s careful observations of parents and infants demonstrate that the original human experience of dialogue emerges in the first days of life, as parent and child engage in an exquisite dance of mutual emotional attunement by means of facial expressions, hand gestures and tones of vocalisation. This is truly a dialogue: the child’s actions influ- ence the emotional states of the adult, and the adult, by engaging, stimulating and soothing, influences the emotional states of the child.
Bråten (1992, 2007) describes the Virtual Other as an innate part of the baby’s mind that, in a way, waits for a dialogue with the Actual Other. If the Actual Other is not present, the dialogue emerges with the Virtual Other. Near relations take place in the mode of felt immediacy, in feelings that are felt in a pre-linguistic form (Seikkula & Trimble, 2005).
Too bad they could not share an actual session with a patient. — Cavacava
Bråten (1992, 2007) describes the Virtual Other as an innate part of the baby’s mind that, in a way, waits for a dialogue with the Actual Other. If the Actual Other is not present, the dialogue emerges with the Virtual Other. Near relations take place in the mode of felt immediacy, in feelings that are felt in a pre-linguistic form (Seikkula & Trimble, 2005).
The only issue I can see here is that of the American doctor telling a patient that they have a defect that some drug can address, based on some neurological understanding of the etymology of a disease and the stark contrast with the doctors in the film to soothe and calm the patient into accepting and understanding their condition. — Posty McPostface
Of course if the notion of a shared inter-subjectivity implies the co creation of new shared reality (a third kind), as integral, then unconsciously our relationships must also develop a third kind, perhaps as our automatic, unconsidered reactions in our relationship with others. — Cavacava
According to this "stronger" meaning, intersubjectivity is truly a process of cocreativity, where relationship is ontologieally primary. All individuated subjects co-emerge, or co-arise, as a result of a holistic "field" of relationships. The being of anyone subject is thoroughly dependent on the being of all other subjects, with which it is in relationship. Here, intersubjectivity precedes subjectivity (in the second, Cartesian, sense, but subjectivity in the first sense, of experienced interiority, is implicit throughout). The fact, not just the form, of subjectivity (in the second, Cartesian sense) is a consequence of intersubjectivity. Here, the "inter" in intersubjectivity refers to an interpenetrating cocreation of loci of subjectivity-a thoroughly holistic and organismic mutuality. — Quincey
Since I rarely if ever talk to anyone, that's my general mode of being. — Wosret
The sorts of things no one will talk about, or can talk about. — Wosret
The relationship one has with one's parents is quite a different thing. — Wosret
With antisocial children, I've read that they seem to be done by four. If they aren't properly socialized, so that they're too mean, violent, or prone to withdrawal at four, so that their peers reject them, then they're pretty well done. Arguably all of the most important parenting takes place just up until they can talk. — Wosret
So the restraint of the therapists is the vital factor; not to impose a theory, a diagnosis, a course of treatment, but to allow the opening of negotiations, perhaps for the very first time. — unenlightened
Yet, the theory is the foundation upon which the therapist stands in relation to the patient. I've never head of psychosis without BPD or SZ, and bipolar disorder or schizophrenia are quite devastating diseases that need to be treated with something more than talk therapy. Perhaps, I am wrong, but... — Posty McPostface
So, are you, in saying this, the patient? — unenlightened
But this is not me treating anyone for anything, but trying to learn philosophically, from this therapeutic practice that has been reported. — unenlightened
In open dialogue meetings the focus is strengthening the adult side of the
patient and normalising the situation instead of focusing on regressive behavior
(Alanen et al., 1991). The starting point for treatment is the language of the family
in describing the patient’s problem. Problems are seen as socially constructed and
are reformulated in every conversation (Bakhtin, 1984; Gergen, 2009; Shotter,
1993; Shotter & Lannamann, 2002). All persons present are encouraged to speak in
their own unique voice
Open dialogues has been systematically studied in Western Lapland with first
episode psychotic patients (Seikkula et al., 2006; Seikkula et al., 2011; Aaltonen et
al., 2011). These studies have shown favourable outcomes in psychosis. At 5-year
follow-up 85 % of patients did not have any remaining psychotic symptoms and
85% had returned to full employment. Only one third used antipsychotic medication.
There is also some evidence that in Western Lapland the incidence of schizophrenia
has declined during the 25 years of the open dialogue practice.
But my particular interest in this thread is to explore the notion of intersubjective consciousness, if anyone is up for it. And the particular thing that I want to keep to the fore, that I take from all the above, is the way in which the manner and tone as well as the content of our contributions actively shapes what I have elsewhere indicated as our morale, but here will call the intersubjective consciousness we are and will be constructing. — unenlightened
I'm considering starting a new topic, but I'll let it stew in here.
Isn't this therapy essentially against psychiatry? Everything psychiatry is built on is rejected in this form of therapy. There is a divide between psychiatry and psychology that seems to be brought out hereabouts. Is anyone else seeing it? — Posty McPostface
There is a way to think of this as a narrative process starting with the initial narrative we tell our selves, the difference between "I"(Author) and "me"(Narrative). This initial differentiation gets the ball rolling. — Cavacava
This is a really hard question. It seem absolutely vital, and central to the whole approach - of discussing the patient in the presence of the patient. But then I hear Cava asking 'what is the truth of a narrative?' Here's a story:Where does honesty lie in this approach? — Metaphysician Undercover
The patient comes in an tells the therapist that I have a disorder.
Therapist replies, 'says who?' — Posty McPostface
I don't understand. Are you attempting to reject, or downplay the notion that parents are authority figures? That adults in general are to a less extent, and even elders are to adults? It definitely isn't like a logical necessity or anything, and they definitely aren't authorities on every single thing, but this is still clearly the case. — Wosret
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