Medium 9781782202011

Creativity in Times of Constraint

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Contemporary practices in mental health (and social care) are increasingly characterized by approaches that overly simplify social, political, and psychological concerns. The persistence and ubiquity of models designated to tackle diagnoses through focused technologies serve to minimize the human encounter in all its relational and systemic complexity. Practice becomes a technological activity instead of one concerned with the unique creative potential in meeting with others in therapy.With the growth of privatized mental health services, many practitioners are facing a plethora of "Must Do's" that focus on measurable outcomes, with clear goals and cost effective treatments. Yet, in practice, such apparent clarity of purpose often leads to bureaucratic clutter and risk aversion instead of clearing the decks for creativity.The focus of this book is how the practitioner or therapist can navigate around current practices in order to avoid falling into the rapids of quick fix solutions, whilst staying afloat to find realistic outcomes to human dilemmas that are brought to us. Therapy is only worthwhile if the practice is not dictated by a "manual" and instead guided by a "humanual" that does not eschew theories or protocols but places the human encounter first and foremost as the locus of attention.

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Chapter One: Systemic Humanism and the Ethics of Practice

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Systemic humanism and the ethics of practice

The term systemic humanism was coined by me to combine key concepts from systemic family therapy with inspiration drawn from the work of Paulo Freire to shape practice more distinctly as a process of humanisation (Wilson, 2015). “Radical humanism” within systemic practice struck me as a necessary emphasis to counteract dehumanising traits that thwart both practitioner and client in the search for creative possibilities to enrich practice.

Systemic humanism emphasises that a practice be both cognisant of, and actively involved in, opposing oppressive practice. It is rooted in ways of enabling our clients and ourselves to become more active, powerful, and creative within the helping process. It explores ways that practitioners, from whichever profession, can remain curious, creative, and alive to possibilities. This involves a consideration of the values that we enact in the jobs we try to do. Practical applications of systemic practice are enriched by reference to Freire's concept of radical humanism in his philosophy of education, which I have found invaluable in my work as a family therapist.

 

Chapter Two: Hope, and Doing What is Possible

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Hope, and doing what is possible

The inspirational quote by El Saadawi in the Introduction emphasised that it is possible for creativity to grow despite opposition and oppression. Becoming aware that something is not right can spur one to challenge, to resist, and to ask the question, “Why is this so?” She was more than intellectually curious; her question was a provocation to herself and others not to become organised by a fear of offending the status quo. Creativity for El Saadawi includes acts of dissidence. At the same time, her provocation poses a quandary because we encounter situations with which we disagree and must decide whether to introduce a challenge to practices and policies that we consider counterproductive or detrimental to our clients. We live with frustrations when we see that more is needed to maintain humanising practices, and to connect more effectively with the clients of our services. For example, I feel angry at the over prescription of drug treatments for young children when their social and relational circumstances are the main reason for their distress. Anger is legitimate and appropriate when expressed against injustice, exploitation, and violence, yet many practitioners are required to work within systems that constrain our expressions of dissidence in the face of the restrictions on service provision. How we position ourselves, as well as how we are positioned by others, influences what might be possible (see, for example, Campbell & Groenbaek, 2006). The question is deciding how, where, and when I can act effectively, speak up, not lose heart, yet avoid false hope. Such are the expressed concerns of many colleagues I meet in social care and mental health services. So, how might we consider creative possibilities in practice without capitulation to the processes that each of us wishes to dispute and change for the better?

 

Chapter Three: Exploring Creativity in Context

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Exploring creativity in context

There is a story told by the late John Weakland, from the Brief Therapy Centre (Fisch et al., 1982; Watzlawick et al., 1974), who was inspired by a client's distinction between a difficulty and a problem in life. According to Weakland, the client defined the distinction thus: “A difficulty is just one damn thing after another…A problem is the same damn thing time and time again!”

When we are caught up in repetitive and unproductive processes in our work, it is easy to see how we can become disillusioned and resigned to follow the increasing demands on our energy and willingness to continue to do a good job. This chapter invites your exploration of what can, and does, provide us with inspiration by looking at dimensions of practice that open possibilities for continued development and inspiration. This is a way of setting aside some time to reflect on what matters to us as practitioners. It is a breathing space. It is also a chance to consider your unique ways of developing your creativity, yet avoiding the illusion of thinking that one's creativity comes only from within, as if by magic. A systemic humanising perspective places creativity as a psychosocial process, aided or restricted by our living relations with others, and our historical precedents.

 

Chapter Four: Listening and Responding: Ethical Practices and Constraints

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Listening and responding: ethical practices and constraints

A central belief of systemic humanism is the creative potential of every human being to overcome oppressive contexts in their lives: in therapeutic and social practices, this entails challenging features that fail to try to transform human distress into human achievement. The practitioner actively contributes towards this goal, and, in so doing, both client and practitioner become participants in a process of mutual humanisation. The practitioner, like the client, is encouraged to challenge those ideas and ways of acting that constrain options for becoming other than they appear (Holzman, 2009). To do this, the practitioner looks towards therapeutic possibilities in direct work with the clients, as well as to a critique of organisational features and social–political forces that shape organisational procedures and policies. It is, wherever possible, a co-operative endeavour, but one that allows for debate and disagreement as well as consensus.

 

Chapter Five: Co-Creative Supervision and Practice: Experiment, Improvise, and Perform

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Co-creative supervision and practice: experiment, improvise, and perform

How might practice be enhanced by creating opportunities for greater experimentation? The examples set out here are drawn from my experience of working in the National Health Services in the UK, and had to be negotiated within the strictures of limited time availability and waiting list demands. However, creating space and time to experiment paid dividends in keeping up our morale, mutuality of respect between team colleagues, and energy in trying to “recognise ourselves in the jobs we do”. There is no short-cut to creativity in practice. I hope you find the examples useful in both supervision and in direct practice with your clients/patients. I also hope that you will see this chapter as a further expression of building practice upon the foundational ideas of systemic humanism and creativity discussed earlier. Here, we can explore together how our practice can push beyond the constraints we typically work under, while keeping an eye on doing what is possible.

 

Chapter Six: Forces that Push us from Behind

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The morning begins with coffee and a chat with some of my colleagues, who are already seated at their computers by 8.15 a.m. A new habit of entering the exact time of arrival and departure has emerged in recent weeks, and a new form of “presentism” has appeared. There is a joke about who gets the prize for being first at their desk each morning. Behind the humour is a feeling of being scrutinised. To “wake up and smell the coffee” has never had such relevance. The temptation is to go straight into the email correspondence, and attend to a never-ending stream of requirements in the “must dos” of administration.

This sets the scene for an increasing number of dedicated practitioners in social care and mental health. The forces that push us from behind is a metaphor for the pressures created by distal processes that have an influence on how we think and function in our jobs and, more generally, in our lives. Fromm sees our awareness of such forces as the first step in altering our circumstances. It is a belief

 

Chapter Seven: How do we Keep on Keeping on?

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In my career to date, I have worked in local authority social work, the voluntary sector, independent private service provision, and in the National Health Service. Therefore, I have had the opportunity to see from the inside of organisations and their functioning from the perspective of a practitioner as well as from the outside, as visiting consultant trainer, or supervisor. These various positions provide different possibilities to contribute, to challenge, and/or feel the power to comply with, the status quo. As a consultant or visiting lecturer, I can try to contribute from the sidelines, so to speak, as adviser, educator, facilitator, and so on, and to encourage exploratory conversations about matters of ethical importance and creativity. These special settings promote reflection and an opportunity to stand back from the daily pressures and demands of practice.

As a practitioner within an organisation, I am an employee and, therefore, bound by contractual agreement that includes paying me a salary. The organisation calls the tune. I am placed in a relationship to others in my immediate work context who influence, and are influenced by, me. These ongoing social relations in the immediate workplace inform how we conduct our affairs and are shaped by perceived power relations and hierarchical arrangements. I can speak up if I am a consultant more easily than as a practitioner on a short-term contract. If I disagree with an idea a colleague has, I cannot simply walk away as one might do as a visiting trainer. We are caught in the mix of ongoing social relations in a more professionally intimate way. As a visiting lecturer or consultant, I still walk away at the end of the day. So, when we discuss what keeps us going and striving to improve our creativity in practice, my views always need tempering with what is possible in any given context.

 

Epilogue: The Journey Home

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From the top of Shooters Hill I can see the Shard shafting the sky above London. It has been a good day. Most of the families and young people turned up for their appointments. My notes are more or less up to date. I am tired but I have been totally absorbed in the work of the last nine hours. The bus arrives and I sit beside a young colleague who has a two-hour commute home.

“Busy day…as usual?” I enquire.

She nods enthusiastically.

I am glad to be part of a profession that has such committed, good-hearted people in its midst. We talk about the latest goal-setting regulation shortly to be introduced. I sigh, “More of the same.”

She says, “Yeah, that's the way it goes. How is the book coming along?”

“Oh, not bad”, I say. “Thought I might start with a journey into work…”

Later, I am listening on my iPod to John Martyn singing,

May you never lay your head down without a hand to hold.

May you never make your bed out in the cold…

We all need companions…

 

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