International Training Workshop for Psychotherapy (ITWP)
Basics of Psychodynamic Understanding
On 11th-12th March 2006, the first workshop was held in Hawaii. Here, we have a second report of results from the workshop.
I would like to thank various people for their contributions to this workshop. First, gratitude is extended to the Advisory Board consisting of members from all over the world for their firm organizational support. Second, appreciation is extended to the secretaries, university officers, and especially the young instructors and assistants for their efforts in preparing for this international program. Third, I would like to acknowledge faculty colleagues for their skilled and efficient management of our workshop sessions. Last, but certainly not least, thanks are extended to the younger generation of psychotherapists who are preparing themselves enthusiastically to meet the challenges and opportunities facing psychotherapy in the years to come.
As we are called as human beings to explore the vastness of the cosmos, so we are called to explore that vast, internal and still mysterious universe of the human mind. Psychotherapy might be compared to a space ship specially designed to explore this inner universe. These young and enthusiastic psychotherapists who have chosen to engage in an internationally-oriented training program show us the possibilities inherent in such an enterprise. Different cultural viewpoints may bring us new angles to help us understand better the unknown inner world. Psychotherapy is often regarded as being very much related to the patient’s background culture. Sometimes too much emphasis may be placed on this. It might be good for trainers as well as trainees to get away from their home culture and language when they reexamine the psychodynamics of a given patient, especially when the focus of interest is the investigation of universal dynamics.
This report presents what we have tried to in the international training workshop for young psychotherapists, the methods and techniques we employed, what the participants experienced in the workshop, and the rationale for holding this workshop. It is our hope that our efforts will lead to new perspectives of psychotherapy, especially training perspectives, and will encourage the creativity of those future leaders in the field of psychotherapy who can and will work in the international field.
Training is not easy, but this is especially true for psychotherapy. As I look back over this ITWP and the feedback, what comes to mind is my training experience. There were good and not so good aspects; however, I was grateful that there was an enthusiastic trainer who talked to me and my seniors, juniors and peers on equal terms, based on the sense of mutual respect. The importance of respect towards clients cannot be emphasized enough, but it seems that the training brought out the importance of supportive relationships, which cannot be taught through usual educational methods.
The situation of “developed nations” where evidence-based psychotherapy is called for and progress of compiling it in a manual is taking place could eliminate the chaos, complexity, and power that human beings have and the most revealing part of psychotherapy by the economic principle and so-called science. At least, what the author would like to tell trainees is that an attitude which protects, understands, and fosters the absolute space of the human mind cannot be taught directly. Therefore it is necessary to use other methods such as self-experience, case understanding, and case guidance.
ITWP was a project which contained plenty of these opportunities, in a short period of time. It included a self-experience group and case seminar, and divided participants into multiple small and large groups in multicultural settings. Considering feedback from the trainees, the objectives of the training - which was to evaluate ones own experience and involve different cultures, to examine cases based on these differences and to verbalize various associations and fantasies as they came to mind – were generally achieved.
Feedback from the trainees related to issues such as promoting self-understanding and clarifying self –task in both the small and large groups. It is interesting that ‘hiding’ in the large group worked as a field to where trainees could contain things which they couldn’t deal with in the small groups enough while hiding themselves. Moreover, through the self-understanding participants not only realized the importance of verbalization and exploration - which are the central work of psychotherapy, but also contributed to learning the core concepts of psychodynamics, such as transference and object-relations. In fact, there is no way to learn but through these experiences. Such groups had the effect of activating self-experience and becoming sensitive to learn about the cases and increase interest in clients. Also, the structure of discussions within the small and large groups provided the axis of both depth and spatiality. Having a variety of trainers also served as a stimulus. Although there are not many psychotherapy training methods in Japan which utilize self-experience, its importance was again recognized.
In addition, these experiences were very stimulating for the training staff. Having a common ground of psychodynamic psychotherapy, meeting various individuals who work in many different places, provided the opportunity for staff to broaden their range of experience and notice the individuality of trainees, which would normally be overlooked in a chance or routine meeting, and made a refreshing difference. Of course, a broad project like this cannot be done successfully without trust among staff members and basic techniques to conduct group training. It cannot be overlooked that the variety of cases presented and the level of the presenters closely matched the learning goals. Such points will guarantee the success and effectiveness of similar training workshops in the future.
At the same time, future trainers need to fully grasp the meaning of this systematic workshop and promote functional learning. For example, a common understanding of the links between the small and large groups and the aims of the self-experience group among the staff will be necessary. Furthermore, this time the workshops were developed as a large container, and it contributed to increasing the freedom of trainees; however, there were few chances/opportunities to question trainees on individual tasks and training goals. The degree of freedom and the individual tasks are opposite/different problems, which need to be discussed further. Finally, what is very important is to assist trainees who are dropping struggling in intercultural situation.
I think that the theme of this 2006 workshop, “Basics of Psychodynamic Understanding” had meaning not only for “beginners”, but was also valuable for experienced members to repeat and deepen their understanding. In other words, it was fundamental, rather than basic. I believe this produced/generated enthusiasm among the entire staff and provided a valuable opportunity for beginners to experience the “essentials”. Looking back, it seems that this group was sincerely committed towards teaching and I would be delighted if it promoted the growth and development of the trainees.
Outcomes and Future Tasks –In the Ring of the Pacific Ocean
When you look on a map, Hawaii is located almost in the middle of the vast Pacific Ocean. As the East and West Center of Hawaii is set up, it is an island where north, south, east and west meet. A land like this is an appropriate place for holding a truly “International” training workshop.
Although the workshop lasted for only two days, - a very short period of time, - it incorporated a self-experience group and case seminars, conducted in both large and small groups. The project seemed ambitious, because it aimed to achieve two goals in a short time. However, if you consider it carefully, these two topics are deeply related in nature, and in fact they generated synergistic effects. For example, if you were to attend a usual case seminar and try to objectify the cases, and assess the scene in a detached manner, you may gain some knowledge, but not much usable, practical experience. In order to grasp as much experiential knowledge as possible, you must participate and be engaged in the scene, so you start to imagine how you would handle the case if you were the case therapist, or understand how the client would feel. You may gain more if you express your impressions or thoughts about the scene and actively participate. In this workshop, the self-experience group prepared members psychologically for participating in the case seminar. In this way, the case seminar became a field for trying out in practice what was gained experimentally in the self-experience group, deepening the self-experience.
In addition to the structural rule (i.e. retain group confidentiality,) additional workshop ground rules were: “To express whatever popped into your mind” and “To respond with whatever thoughts floated into your mind while listening to other people’s remarks”. As suggested by the subtitle of this workshop, “Basics of Psychodynamic Understanding”, members were encouraged to be free-associative. At the same time, in the first large group, there was an explanation regarding opening and closing one’s boundaries. For the participants, this concept of “opening and closing the boundary” was meaningful. They were effectively given a shield to protect their mind, and being free to open and close it made it possible to interact with the people around them. In short, it became possible to interact in groups while maintaining one’s sense of safety. This meant that, instead of behaving synchronously with other members in the group, they could participate in the group expressing feelings from deep within their mind.
The relationship of individuals within the small group was similar to that of a small child and mother. That is to say, the basic feeling of trust that the world is safe is challenged in one’s condition. It again could be a chance to modify one’s basic trust. If the small group represented the maternal or familial relationship, then the large group could be likened to a broader world, such as a school or society. It means that with the experience gained in the small group, one could go out into society, i.e. the large group, and test these changes. Each individual attending this workshop attempted an experiment like this.
What is self-experience? The meaning may vary from individual to individual/person to person; however, it seems that the direction to aim for is affirmed. This could involve being more faithful to oneself and experiencing ones internal self.
Regarding future tasks, I would say we need to constantly prepare the field for people to meet other people, to feel their inner feelings, and have self-experience. A person’s change and growth requires the presence of other people. A group is a magical thing. In the group, anyone can help another person to grow, while also promoting their own growth and development.
A key word of this ITWP is “diversity”. Faculty and participants came from various regions and countries. Faculty participants included clinical psychologists, psychiatrists, and psychiatric nurses. Participants varied in their professional degrees and fields. Some were M.A. students or Ph.D. students while others were professional counselors and psychotherapists. A second key word is “experiential” while “individual and group” constitutes a third key phrase. We placed “psychodynamics” as the core axis and wove the workshop matrix with these different elements incorporating all participants, including trainers, on the basis of “Psychoanalytic Systems Theory”.
As seen in the feedback questionnaire, participants’ involvement was very high. This seemed to relate to the systems structure of the workshop. We began with a self-experience group with two trainers. This gave participants a good chance to analyze themselves and also enhanced their active involvement in the training. We used combined small group and whole group discussion strategies in two case seminars. This was also very helpful in encouraging participants to become involved in the case seminars. I believe this was a strong element that played an important role in making the workshop a great success. The diversity of participants also served to facilitate participants’ involvement. Those of us serving as trainers emphasized individual differences and appealed to individual experience and expression in every session. The Group Psychotherapy technique of “group free association” facilitated experiential aspects of the training and interactive dynamics between individuals and groups. Experiential understanding is crucial for learning psychodynamics correctly. Many kinds of psychodynamics were explored through experiential discussion. The combined small and large group discussion systems raised a lot of psychodynamics here and now in the various sessions. The experiential aspect enhanced participants’ interest in psychodynamics very much.
As an organizer, I reconfirmed the universal effectiveness of training techniques and methods in terms of Psychodynamic Systems Theory beyond cultural boundaries. This was a major benefit. It was our important discovery that the diversity of participants, including cultural differences and different clinical orientations, could be overcome for effective and creative psychodynamic training.
We grasped, I believe, our future of psychotherapy training in an international context. We can work together and enlarge our potentials in interactive training beyond cultures and theoretical orientations. Psychotherapy theory and practice should be developed further according to rapid global changes of skills and value systems in human life. Young scholars and clinicians are our hope. We should convey to them not only our knowledge and skills developed in theory and techniques but also ways of learning by themselves and from each other. The unknown inner universe of man is infinitely wide and deep and is awaiting our exploration. The only difficult problems are financial in nature. However, enthusiasm and dedication can often overcome political and financial problems. We shall continue to persevere, overcoming any difficulties, so that our metaphorical psychotherapy spaceship will continue to explore the uncharted vastness of that hidden, inner universe we call the human mind.