Locations of Site Visitors László Szögeczki's CE blog: December 2008

Wednesday 10 December 2008

Intruduction from basic

It is so strange that I need ( have) to write things like this when I try to introduce CE. The general medical public still has to be introduced, as I formulated in CE paradox, from a very basic. I thought to share some of my writings:

In research of rehabilitation, an increasing interest can be detected towards group community intervention programs in different rehabilitation areas having results feasible, acceptable, achieving provable improvements and enhance quality of life (Elsie, Lap, 2006) In practice and in some pilot studies we have been introduced, for instance, the efficacy of an outpatient cognitive behavioral group program for the rehabilitation of adult patients with chronic pain. Significant improvements in mood, coping skills, physical disability were found. (Skinner, Erskine, et al 1990). An other investigation proved the efficiency of aqua-aerobic programs in Multiple Sclerosis which are carried out in group situation for physically disabled (Pérez, et al, 2007). However, less emphasis has been laid specifically on the relationship between social, emotional and physical dimensions of the development within group setting but some scholars have already expressed that the motivational aspect provides evidence for the use of groups in physical rehabilitation. (Lawson, Sonja Kristi, 2006).

The successful management of physical disabilities is critical to successful healthcare delivery. The development of practice and approaches are the most important factors in this field. Contributions from a range of experienced researchers and practitioners associated with the rehabilitation and treatment of people with a range of physical disabilities are mostly based on the traditional point of view of delivery; carried out person to person, in the way of individualized therapy. In relation to recent researches, however, the greater significance of development of practice and approaches of physical disabilities is when emotional, social aspects are also involved and psychological management takes great place. (Kennedy & Paul 2007).
“The assets of the person must receive considerable attention in the rehabilitation effort. A person’s healthy physical and mental attributes can become a basis for alleviating as well as providing a source of gratification and enhancement of life. The active participation of a client in the planning and execution of the rehabilitation program is to be sought as fully as possible.” (Beatrice Wright, 2005) In this respect, and critique of traditional point of view of delivery, the predictive quality of practice alternatively could be increased by changing contribution from person to person to group setting in certain areas (such as Parkinson disease, Head injury, Stroke - Aphasia, Ataxia, MS, CP, Ageing).
The implication of emotional, social aspects in the management of physical disabilities shed light upon the links between health science, social psychology, pedagogy, sport science and it seems to be drawing a more holistic contribution. The link between rehabilitation and education, the adult education point of view shell introduce accordingly a ‘new’ possible way of rehabilitation of motor-disabled, the group setting, and the possibility of community intervention programs. (Szogeczki L 2008) “Human beings are group beings” (R. Brown, 2000) “physical disabled are humans, so physical disabled, should be group beings, too and everything what was studied and discovered on group approach for healthy people or people with behavioral, emotional and social difficulties should related to group of people with physical difficulties as well. Group processes is deepen our understanding of relationships within and between groups of motor-disabled and should conduct the successful healthcare delivery.” (Szogeczki L 2008) From generous educational point of view there is no question about the possibility and the success of group setting. Conceptions of adult transformative learning of Mezirow and the most recent alternative perspectives in contrast to Mezirow’s psycho-critical perspective lead us to the psychoanalytic, psycho-developmental and social-emancipatory views of transformative learning. The mentioned teaching approaches could be considered to work in the process of tackling the problems of the adult physical disabled. A forth perspective however, seems to be of crucial importance: the neurobiological perspective of transformative learning (Janik 2005).
This “brain-based” theory was discovered by clinicians using medical imaging techniques to study brain functions of patient who were recovering from psychological trauma. What these researchers determined was that a neurobiological transformation seen as invoking “the parasympathetic branch of the autonomic nervous system, and the hypothalamic-pituitary pitocin secreting endocrine system to alter learning during periods of search and discovery.”(Janik, 2007, p.12) In simpler terms the findings suggest that the brain structure actually changes during the learning process. These findings turn bring into question of traditional models of learning…and instead offer a distinctive neurobiological, physically based pathway to transformative learning. (Taylor, 2008, p.8)

Psychotherapy is an interpersonal, relational intervention to aid clients in problems of living. This includes increasing individual sense of well-being and reducing subjective discomforting experience. Psychotherapists employ a range of techniques based on experiential relationship building, dialogue, communication and behavior change and that are designed to improve the mental health of a client or patient, or to improve group relationships (such as in a family). Gestalt therapy is an existential and experiential psychotherapy that focuses on the individual's experience, the environmental and social contexts in which these things take place, and the self-regulating adjustments people make as a result of the overall situation. It emphasizes personal responsibility. (Masquelier, 2006).
Meaningful living however, is a central focus of several humanistic theories as well. The rationale for the use of logotherapy is introduced. Somov and Pavel G. review group applications of logotheraphy and offer a clinical curriculum for a group application. They provide a discussion of the specifics of the group format and role induction to the "Meaning of Life" group (Journal for Specialists in Group Work, Oct. 2007).

As I promised...

As I promised, herewith I let you know about the references of the topic of the body:

Clarkson P (1989) Gestalt Counselling in Action Sage, London
Crossley N (1995) Merleau-Ponty, the Elusive Body and Carnal Society
Body and Society 1 (1) 43-46
Leder D (1990) The Absent Body The University of Chicago Press, Chicago
Merleau-Ponty m (1962) The Phenomenology of Perception Routledge and Kegan Paul, London
Rock I and Palmer S (1990) The Legacy of Gestalt Psychology
Scientific American 263(6) 48-61
Sharma U (1996) Bringing the Body Back into the (Social) Action: Techniques of the Body and the (Cultural) Imagination
The Journal of the European Association of Social Anthropologists 4(3) 251-263
Shaw R (1996a) Towards an Understanding of the Psychodynamic
Process of the Body Psychodynamic Counselling 2 (2) 230-246
Shilling c (1993) The Body and Social Theory sage, London
Straus EW (1966) Phenomenological Psychology Tavistock, London
Tolman CW (1994) Psychology, Society and Subjectivity Routledge, London

Sunday 7 December 2008

Body V.

The Body in psychotherapy

There is a need to justify the inclusion of psychotherapy into this discussion of the body. Psychotherapy which focuses on individuals and acknowledges societal influences as external, is at odds with the sociological perspective which tends to look away from the individual. There is, thus, a dualistic problem of how individual subjectivity can be located within a sociological framework and conversely, how sociological influences are contained within psychotherapy. As Tolman (1994) suggests, “the end result is that the human subject is either totally subjectified or totally objectified, becoming abstracted and isolated in either case.” Psychotherapy does though offer some important insights into how we may come to experience our bodies.

One particular aspect of interest is the notion of preverbal communication; that is the mode of communication employed prior to cognitive process of verbalisation. This preverbal communication is predominantly body-orientated and therefore becomes a means of being able to understand the world via our bodies. It is primarily transmitted via the body, be it as screams, posture, movement, or the contraction of muscle. We feel the world via our body, and then begin to understand and adjust to the environment. There is a link with the phenomenology of perception and preverbal communication since it is the body which is first able to perceive the world and initially the communication with the word is preverbal. Various branches of psychotherapy acknowledge the importance of preverbal communication; those that do include Reichian vegetotherapy and gestalt.
It is these therapies which advocate the use of touch within therapy. This is a major issue within psychotherapy and the prevailing ideology is to avoid physical contact. Touch is considered to evoke sexual feelings and questions arise as to whether the touch involved is the need of the therapist or that of the client. As a consequence, there is a fear of physical contact within the therapy world. However, the controversial debate on touch and its appropriate place in therapy also demonstrates that the body is an important part of the world. The touch taboo is the means of excluding the body, but at the same time, an implicit acknowledgement of its existence.
Psychotherapy acknowledges body process but tends to stand back from a deeper understanding, almost in fear of the repercussions that such work engenders.
The significance of addressing psychotherapy is the somatic process which may be being expressed as preverbal communication. It is well known and observed that psychotherapy clients frequently exhibit somatic symptoms. However, within psychotherapy it is the verbalisation of feelings which is paramount.

Thursday 4 December 2008

Comment II

Tunde Rozsahegyi could not put her comment through the blog's comments so she mailed this:
Laci,
I absolutely agree with the thoughts in this thread of postings and since your original entry I keep thinking of the issue you highlighted.Yes, we live in a world in the 21 century when anecdotal evidence is not sufficient enough to move CE forward. If we want to strengthen CE by identifying, proving and making the strength and uniqueness of CE more widely acceptable we have to do two things: firstly disseminate our values, experiences and expertise in an academic manner; secondly identifying the weaknesses too.Over the last 30-40 years in English language so many people have said their thought and perspectives on conductive education: therapists, psychologists, educators but unfortunately less heard from conductors themselves. Would a professional body be helpful to change this? Would it be influential enough first of all to have members? I seem to remember that in the last 20 years there were sooooooo many attempts to establish a professional body! Sorry for being pessimistic but I see the role of a professional body something different.I think the advancement of CE and the establishment of a proper academic discourse is emerging, perhaps not in a pace as it is anticipated by those who just passively wait for its outcomes.Working for and 'doing' proper research, seeking and writing about evidence based practice seem to be something alien for the majority of conductors, but this perception needs to be changed and opportunities and support have to be given to those who feel confident and interested to be involved. Hard to believe this can take place without the support from CE organisations, managers and others in a decision-making position.Andrew writes a lot about the economic depression and I do not want to reiterate any of his thoughts accept that in recessions education always do well because people see a way of getting out from the situation by gaining new knowledge and experiences. Perhaps for those involved in the strategic level of managing CE services it would be a time now to rethink what would be useful as a long-term investment; how could they support their conductors to cope with this ever-changing world. To do this it needs long term vision, understanding and commitment to CE and belief in its values.A very final thought if conductors do not articulate CE, will not look into how it should be developed further it is hard to envisage that it will survive in a long term. Others will not do instead of us.
Best wishes,
Tunde

Comment

I think it is very important to share Judit’s comment here because she thought forward the issue of CE paradox and pointed out some serious truths where from we must move…..

“I really enjoyed reading your post. I read it again, and again, and again. You raised a very important question. ‘So we are here, but what next?’The directions of CE will be determent on the clarity and focus we are prepared to invest in creating its future. Clarity is power. We know this from our work when we facilitate in a conductive way. Just when we look at how CE works at its best, what do we need for that? Amongst many other things we need a unified team who believes in, manifests and carries the same highest level of standards, with a clear outcome in mind. Wishing and hoping will not take us there. Do we want it badly enough to make us move and create such a team? Do we really want to have a professional body, which is prepared to publish the basic core values, standards and structures that would truly represent Conductive Education?We need more brave, talented and diligent people in the here and now to deal with this paradox and to help all of those who are trying to work with CE in different settings. If we really wanted to be taken seriously I think it is about time that we created something valuable for all of us and for the future generation to come.Once hearts and minds meet it will be done.”

First, it is not enough merely to discuss about the difficulties but some actions should be taken. The professional body must be efficient and directed by the real needs. Most importantly, CE professionals individually should reach a certain interest level and develop their own quality requirement for themselves. To sign a code of practice is not automatically means that we are living so….

Next to my everyday practice I work nowadays a lot towards science which makes me a bit capable to recognise some part of why we are still in a professional infancy, it makes me to be a critical viewer of everything what happens around CE. The acceptance of anything (a new medical method, pedagogical approach, philosophy, etc.) comes through science in the modern world. We live in an age where sciences are testable, and the results of careful studies are both replicable and generalizable. I sadly have to recognise that what we completely missed is the scientific appearance in the sixties, seventies, eighties and nineties about CE. This fact also caused that we pretty often turned to be so variable and so different in opposite part of Europe or the World. Everybody runs conductive education as she thinks CE is. That is a simple result of lack of scientific introduction and acceptance.
So, because the scientific method is so widely accepted, conductive education practices that are grounded in science will be easier to “sell” to the still sceptical public or potential clients, and especially to organizations that want reassurances that the service will be effective. My prediction is that conductors who can honestly claim to work from a foundation of the latest scientific research and theory will have a tremendous market advantage over their peers. Not only will prospective employers look favourably on them, they will enjoy the comfort of knowing that their interventions are effective (not only in front of them but widely) and obviously appropriate to their unique client base. The importance of science to our field was recently noted and hopefully will help to find the ground for a new start and identify our strengths better than in the past. Have a good day….

Tuesday 2 December 2008

CE paradox

The work of the brave, talented, diligent people who pioneered the field of CE has started to pay off a bit: CE is more widely known - mostly in the private sector of rehabilitation of physical disabled - in some cases getting accepted, different kind of conductor training programs are existing. Even, some Universities take notice of our profession. I should say we are effective.
Beneath this veneer of effectiveness however, there is an irony in the profession that I think of as CE paradox: For a profession that systematically helps people aspire to and reach their innate and function potential, CE has not yet reached its own potential. In fact, although CE is a 60 years old profession, it is still in its relative professional infancy.
CE lacks a coherent, widely agreed on definition, conductor training varies in content and its interventions differ sometimes greatly. In short, CE is still a broadly defined endeavour in need of refining. I would not suggest to look for ‘mistakers’ but we should definitely learn from our mistakes of past and start to be more constructive for the future.
So, we are here, but what next? In which directions CE might move how our interventions and services might evolve in the near future. Where do we, as profession, go from here? CE has long been a powerful force for transformation in people’s lives. Whether contributed in school situations, in blocks, summer camp ways, private, etc., CE is about harnessing the best in people and inspiring them to live out their potential. CE should be a wake-up call, challenging habilitation, rehabilitation, challenging folks to tap their inner abundance. The profession of conductive pedagogy is fortunate to have many skilled and imaginative people working toward a great end.
I hope we can get there one day….