“The secret for harvesting from existence the greatest fruitfulness and greatest enjoyment is—to live dangerously.”
The Tavistock framework
We have inherited a generative framework from our Tavistock predecessors for understanding the psychology of work. Thinking within this framework we can say that any work worth its salt—which means it entails significant risk—stimulates anxiety. For example, when a person works alone, the anxiety may be a prod to good performance. Consider, for example, the stage fright a person feels before she is about to address a large audience. This feeling can induce a state of high arousal, enabling her to be attentive to all the signals in her surroundings. If, however, at the moment she begins her talk, she remains anxious, her performance may be impaired—for example, she will forget her opening lines. But there is a third alternative. She may feel sufficiently anxious days before she is supposed to speak and, if unable to contain her anxiety, may rehearse carelessly by ignoring the difficult spots in her speech. In this last case, we say that she has developed a defence against the anticipatory anxiety. The defence takes the form of a detrimental practice: ignoring difficult spots.
While psychoanalytic writing has turned its attention many times to Shakespeare's plays, the history plays do not feature very obviously in the bibliographies of books, articles, and papers on characters and themes in the plays. The exceptions are Henry IV and the two Richards (II and III), although even in these instances the references are few. Perhaps that is because the history plays at first appear more a series tracing the dynastic struggles leading up to the Tudor monarchs.
The same relative paucity of interest applies also to the plays in performance. There are from time to time performances of the histories in sequence, and at one time Henry V attracted patriotic attention. But one of the more popular of the history plays remains Henry IV Part 1, perhaps for two reasons. The first is the inclusion in the cast of characters of Sir John Falstaff—a figure almost larger than life. Yet Sir John also appears in Henry IV Part 2, and in half the scenes. Nevertheless, Part 2 is performed less frequently and appears to have had less success even when it was written. The other ingredient that turns Part 1's dramatic history into a historical drama is the theme that runs through it of pretence, or of role-playing, even what the latest editor of the Arden edition calls “counterfeiting”. This is a reference in part to the motif of coinage that is a constant feature of the language of the play; but, even more so, counterfeiting refers to the fact that Henry IV has usurped the throne, that his son Prince Hal appears to deliberately associate with low life in order to appear all the grander when he becomes King and rises above it, as well as the pretence of Falstaff at the concluding battle of Shrewsbury.
In this final chapter we draw together some of the key lessons of the book and the issues they raise for professional training. The perspective we attempt to describe is capable, we believe, of useful application in many contexts.
It is, of course, possible for a systemic approach to be generalized after specialized training in family therapy or consultation. But our aim in this chapter is to pay attention to how we can address more generic training courses in order to enrich and widen the theory and practice of many of the professionals involved directly in work with families and schools, including psychologists, social workers, learning support staff and the teachers themselves.
Since supervision is the core of much professional training we consider these issues of particular importance for supervisors, since they have an opportunity to provide a model of an interactional perspective and of the use of feedback. A section of the chapter therefore looks at some of the opportunities and issues supervision raises.
This chapter, and the one following, provide a basic, generic overview of assessment and case formulation in cognitive-behavioural hypnotherapy. The inclusion of hypnosis only entails slight modifications to common CBT approaches, which are well-documented elsewhere (Grant, Townend, Mills & Cockx, 2008; Persons, 2008). However, some counsellors and therapists who use hypnosis will be less familiar with structured approaches to assessment and cognitive-behavioural case conceptualisation. As this area is not well described in many books on hypnotherapy, and because there are some minor adjustments worth including, I have chosen to include a chapter discussing assessment and conceptualisation sufficiently to provide a very basic introduction. However, I would suggest that readers consult the texts referenced for more detailed information and guidance.
Many practitioners using hypnotherapy assess clients primarily in the initial session, which typically lasts around fifty minutes. Other practitioners employ longer sessions, or more of them, to complete the initial assessment and conceptualisation process (Westbrook, Kennerley & Kirk, 2007, p. 54). For example, Chapman provides an example of clinical hypnosis in CBT where two sessions are dedicated to preparation for treatment (Chapman, 2006, p. 76). This is bound to vary depending on the therapist and their circumstances, for example, whether the client has already been thoroughly assessed commencing treatment. Although hypnotherapists will probably tend toward simpler and more concise approaches to both assessment and conceptualisation, and briefer treatment plans, things should not be abbreviated at the expense of “essentials” such as the assessment of risk factors and contra-indications, etc.