THE FOCUSING TECHNIQUE WITH CHILDREN AND ADOLESCENTS
Focusing , is a new way of therapeutically living with a child or adolescent in a play therapy setting or, for that matter, at school or in the home. Only recently has focusing been adapted to children. For about 15 years, following research findings from psychotherapy that clarified the self-referential process that distinguish successful adult clients from unsuccessful ones, focusing has been a welcome new addition to the armamentarium of therapeutic procedures.
Despite its effectiveness with adults, this experiential therapeutic procedure has been untried with children and adolescents. Can the steps involved in focusing be adapted to children? At what age levels? Can children be taught to focus? Is the crucial determent for successful therapy with children the same as with adults? Literature, and its use of focusing in play therapy is limited, and it is too soon to answer these questions. However, this article is intended to fill this void and, it is hoped, stimulate others to explore the possibilities of using focusing in working with children.
The growing significance of focusing with children is reflected in the reports by educators in Austria, Japan and Canada; they are included in this chapter. Also included is the description of a mother who has been using focusing with her three children for the past three years. It needs to be emphasized that focusing is not just another new therapeutic modality; it is, rather, a skill that can be ,taught in the context of any modality used or that the therapist is trained in. A fundamental assertion of focusing theory, which has its historical roots in the work of Carl Rogers and his colleagues, is that genuine personality change does not occur unless the special internal processing called focusing takes place. Another way of putting it is that no changes takes place unless the client engages in a series of experienced, definable, self-referential steps. The fact that successful therapy outcomes have been reported from varying modalities means that the steps described in the focusing procedure have occurred. That these steps, or movements can be taught to persons who do not possess this skill naturally is a unique and valuable contribution.
This article will describe research from which focusing theory and procedures evolve. It will provide a compressive overview of focusing work done with children and adolescents and will give case illustrations to demonstrate how children are brought to live their problems differently, and then to separate themselves from whatever troubles them.
FOCUSING-RESEARCH, THERORY AND PROCEDURES
The focusing theory and procedures were developed by Eugene T. Gendlin (1985a) at the University of Chicago. For many years, Gendlin was a close associate of Carl Rogers and played an important part in the continued development of client-centered therapy. However, his interest in the experiencing process that goes on below the level of awareness, and the way symbolization carries the person’s experiencing forward/ led eventually to his development of experimental psychology. This was catalyzed by his research with Carl Rogers using client-centered therapy with psychotic patients in Wisconsin. It was also based on a sequence of studies van der Veen & Stoler, 1965; Tomlinson & Hart, 1962;Rogers, et al., 1967;Gendlin, et al., 1968) with adult patients from whom Gendlin and his colleagues at the University of Chicago discovered what successful patients do and what unsuccessful patients do not do. They discovered that patients who frequently refer, or attend to their bodily feeling process, the holistic quality of their organismic experiencing which prompts new images and fresh words to surface), have a different self-reference process than unsuccessful patients. People who link concept-to-concept-to-concept and do not take time to refer to their whole bodily sensing of what they are saying usually intellectualize or engage in what a gestalt therapist would call about-ism or, simply, emoting.
The successful patient (client and patient are used interchangeably in this article) makes room for the felt sense. The patient states the problem and then becomes a good listener to what it all feels like inside, the whole quality of it. The patient links concept-to-bodily process, and so on. It is a nonlinear, non-logical process, but the interaction between the implicit bodily felt sense and the symbolic processing that occurs is crucial to change-steps.
Central to focusing is its emphasis on bodily experiencing, what Gendlin has termed a felt sense. Felt sense does not refer to mere physical sensations, nor does it refer to emotions, such as sadness, anger, fear, and so on. It is less vivid, not as intense, and usually unclear. One of the distinctive aspects of focusing is that it cherishes those moments of experiencing that are confusing, unfamiliar, marginally there, and fuzzy. It is an assumption of focusing theory that change does not happen if a person stays only with reactions that are known and familiar. Perhaps the reader has experienced using a self-developing film. At first there is no image at all on the film. Very shortly, there is a murky quality to the film and it seems as if nothing is going to appear. However, allowing the time for the chemicals to interact produces a sense, still indefinite, of an image. Finally the person’s attention to the film is rewarded with a meaningful image. Now one interacts with a complete picture rather than with something unformed. Suppose the picture were thrown away while still unformed and murky. This would be analogous to being too anxious to attend to any uncomfortable, confused, unformed place within order to stay with the safety of familiar words and reactions; too impatient to allow the time and attention for something new and different to develop.
Thus, the quality of bodily sensing and knowing is basic in focusing and is or primary concern. A major effort of the therapist is to help clients attend to how they are being with their problematic situations, not just what they are addressing. The view of people is that they are bodily interactions, with others and with their environment. This bodily sense of the complexity of our situations and interactions can be expressed in more than one way. For instance, when hunger is experienced, the words “I am hungry” do not reflect all that being hungry implies (e.g. the extent hunger is experienced, the implicit actions one must take to satisfy one’s hunger, etc.). It has already been mentioned that the felt sense is unclear at first (i.e., preverbal, preconceptual). When one receives an image or word that seems to adequately reflect what: the feeling-intricacy is communicating, there is an experiential effect. Gendlin has termed this movement a carrying forward, to signify a further bodily living. Most of us have had the experience of sensing that we know a name cannot be recalled. Our body experiences-felt-sense-this knowing. We also know those names that don’t fit our bodily sense of what is right. Finally, great relief occurs as the correct symbol is remembered. Our living, goes forward in a, released, unblocked way. One must constantly refer to the bodily feeling as the energizing source to new words, responses, and images. (Gendlin, 1981a; 1984).
It may be useful to contrast the way focusing is done with children as illustrated in this chapter with the six steps taught to adults. Adults can learn to do focusing alone or with someone else. It is important that the adult be comfortable and relaxed to the point of sleepiness. When first reaching focusing to adults as a skill, the procedure may take longer and appear more mechanical than a naturally flowing process until it is learned. In actuality, the steps may not follow sequentially inwardly; there is nothing mechanical about this approach; in fact, it is sometimes exquisitely subtle. The sense of how the person is experiencing a problem is more important than what the problem is. The experience must feel good to the client or it is not being done right.
THE SIX STEPS WITH CHILDREN
In doing the six steps with children it is important: to underscore that the relationship is more significant than the technique. This also means that the therapist should readily allow the child to break from the game. The goal is to reach the inner felt sense and the strategies used to archive this must not come to dominate the process. As Schaefer (l976) has shown, there are many different avenues leading to change in play therapy; this technique is not at all that occurs during the hour. The following examples of the ways children have been engaged in focusing assume that sufficient rapport has been established and that the child’s needs to do something else do not complete.
The therapist might say, “Let’s play complaint department: You tell me all the things you don’t like, that make you mad, things that bother you. Each time you come, if you would like, we’ll tape your complaints.” After the client exhausts all his complaints, the tapes are played back to him. The pause button is used after each complaint as the child is gently encouraged to refer inward, “See how that feels.” No other comments or interpretation are given. The goal here is two-folded (1) To reach children to allow space for listening to their feelings, and (2) To gradually teach children not to be afraid of their feelings and to value them. One educator in Japan has children put each problem in a separate box that they have drawn. Another has the child draw a picture of how each problem feels. A mother who has been doing focusing with her children introduced this step through a storytelling technique. With an older child, an adolescent, the therapist might say, “Pretend you are emptying your pockets of all the problems, just as if they were things or objects. Put anything that stands in the way of your feeling great on my desk.”
Step 2 is completed by asking the child to pick the complaint that is most bothersome. The important point is that it is a here-and-now sensing. Alternatively, the therapist could list all the complaints, read them back, and have the child make clay balls or cut out paper circles that are placed next to each problem to indicate the size of that complaint. How the relationship is, the age of the child, and the type of child determines the way these steps are presented. Obviously flexibility and considerable ingenuity are required.
In step 3 the therapist might ask directly, “How does all that (the complaint that feels worst) feel inside you?” or, “How does your body feel inside when you think of that?” (Focusing questions are usually open-ended.) A variation would be to invite the child to draw or paint a picture of how he feels inside when he thinks of that complaint. Sometimes painting both a picture of the problem and a picture of how the problem makes him feel helps the child gain some distance. It also implicitly gives the child a measure of control of the problem. In addition the child can be asked, “Does the picture match how you feel inside right now?” If the child says, “Not exactly,” he is asked how he needs to change it so that it will match. If there is no need for changing the picture, encourage the child to use the words to describe the feelings represented in the picture. (If the child is very young, he may be encouraged to tell a story about: the picture and encouraged to tell how he feels about it. Then may be encouraged to tell a story.
In step 4 the child conveys the way he experiences the problem. For example, the child says he feels “a lot of wavy, ver wavy” inside. The therapist invites the child to sit quietly and say to himself, “a lot of wavy,” or the therapist might just quietly repeat the words. The child might be asked just to sit and draw what “a lot of wavy” means to him and then to tell about it. If the words match the feeling, then movement to Step 5 occurs.
The child is asked what it is that makes it feel wavy. This step, like the others, cannot be hurried. The child is encouraged to listen to the “lots of wavy” inside as if he were at a play and “a lot of wavy” was on the stage performing and he was in the audience. This creates a sense of how it all feels. The child, in fact, may be encouraged to see what comes with “a lot of wavy” on the stage, how that makes him feel, and so on.
Finally, the child is encouraged to continue being with the performance. He might asked how it would feel to let himself enjoy the performance. After a while the therapist may ask the child if he would feel like closing the curtain or if there’s still something going on with “a lot of wavy." Perhaps, following up on the example where the child drew paper circles or made clay balls, the therapist may ask the child how far away he can put the paper circles cutouts or clay balls representing the problem. The writer urges children to be literal about this and to move the circles or bal1s as far across the room as possible.
The sixth step with the child, as with the adult, is a new bio-integrative way of living with the problem. The child is not caught by it but can close the curtain on it. He has the problem but he learns he is not synonymous with the problem. He gains a sense of separateness from it while still relating to it until he can let go of it.
It must be reemphasized that: the above steps are not mechanically done, and that they vary according, to the ages and personalities of the children as well as the therapist's relation with them. The introduction to focusing as a skill with younger children is not formally done, as it might be with an adolescent or an adult. (One might say, for example, to a teenager, “I know you've tried many ways of looking, at and solving these problems, but I wonder if I could interest you in a different way of going at it?” and then proceed with the steps.) In the writer’s practice, the child leads the way and focusing is not imposed: therefore, the above steps may not happen sequentially. The steps are a useful criterion whenever the opportunities arise to help the client be more helpful to himself. The therapist does much listening and reflecting, especially when the child's behavior, verbal or other wise, is clearly symbolic of important experiential biomeanings inside.
As the reader will set from the literature described below on focusing with children and from the case illustrations, there are many ways of approaching children with the focusing steps.
LITERATURE ON FOCUING WITH CHILDREN AND ADOLESCENTS
The research described and the method of experiential focusing developed by Gendlin have been applied in widely varying contexts: school, business, creative writing, religion, work with cancer patients, and dream work, as well as psychotherapy. All of these efforts, however, involved working with adults, and the 1iterature reflects this. Literature reporting work with children and adolescents is very limited. Child therapists who are using focusing have not written much. Levant and Shlien (1984) lamented that so few child therapists have taken the time to write; Virginia Axline is one of the notable exceptions.
The first article in this country on focusing and play therapy appeared in the Association For Play Therapy Newsletter in March. 1986, and was reprinted later that year in the Focusing Folio published by The Focusing Institute (Neagu, 1986). The first article on the use of focusing with borderline adolescents was published in 1984 in this country, a reprint of an article from Holland (Santen, 1984). This was followed by another study using focusing with a teenage firesetter (Barba, 1985). Exciting projects still on the way have been reported teaching focusing to entire school districts in Schruns, Austria (Rudisser; 1986) and in Fukuoka Japan (Murayama, 1986).
In addition, two Catholic priests, use Reverend Peter A. Campbell and the Reverend Edwin A. McMahon both of whom hold Ph.D., teach focusing to promote spiritual growth. Their organization, The Institute for Research in Spirituality, trains people in focusing and has published pamphlets of the way a California mother, Marianne Thompson, has taught her own children to use focusing in their development (McMahon & Campbell, 1985).
FOCUSING IN SCHOOLS AND AT HOME
Dr. Shoji Murayama, a professor of education at Kyushu University in Fukuoka, Japan, and editor of the Japanese Journal of Humanistic Psychology, has been working with a group of schoolteachers in Fukuoka, Japan, developing a research project on teaching clearing-a-space, the first focusing step, to elementary school students in the classroom (Murayama, 1986). The students are taught focusing in the classroom for one year, three to four days per week, 5 to 20 minutes per day.
His project is built on two years of preliminary work that indicates that second and third grade students can do clearing-a-space very well after three months' training of only a few minutes each day. He reported that the students show a marked improvement in their personal integration and achievement, as well as improvement in the class. Atmosphere.
He first teaches focusing individually to the elementary school teachers, 10 sessions each. Then the teachers are taught to use focusing instructions that he and his colleagues developed for the children. They asked the students to imagine boxes, or they hand out a sheet on which six open boxes are shown. When the students practice clearing-a-space, they put their felt problems into the boxes in imagery, or write each problem or situation into a box. Follow-up sessions are conducted with the teachers. The goal in their research is to determine whether learning focusing, especially clearing-a-space, has a significant effect on elementary school students' personal integration, achievement, and class atmosphere.
Mary McGuire (1986) of the Focusing Institute in Chicago described how she helped children clear-a-space in a pilot project in a school in Ontario, Canada. She chose to work with two grades. Grade one consisted of 32 children, aged 6 years, and grade six consisted of 28 children, ages 10 to 11 years (McGuire, personal correspondence).
McGuire reported that the first graders were able to directly sense their feelings, including positive feelings like loving, through the use of their favorite stuffed animals. The sixth graders were able to clear a space, most of them using vivid imagery. It is clear from McGuire's observations and follow-up work that children can experience a shift in the way they release themselves from problems similar to the shift adults experience.
Frans Rudisser, is a director of an elementary school in Schruns, Austria, where he has been teaching focusing in his school system. His emphasis is on focusing as it has been done in the context of a helpful, trustworthy, facilitative relationship, and he provides moving examples of the imagery children’s produce during group focusing sessions (Rudisser, 1986).
For example, nine-year-old Svetlana was often rejected by other children. She had only attended school in Schruns for six years and would return to Yugoslavia in another year. In order to ingratiate herself with other children, she exaggerated her importance in order to impress them; this, of course, defeated her purpose. After group focusing, she explained:
I arrived on a meadow. Because I was tired I laid down and fell asleep. Then I heard a lot of other children. I didn’t know them but they came to me and they played cat and mouse together. When we were done they took their backpacks and left. Then I was alone-no, totally alone-but just a little. I was sad. Then I left in a different direction than the others. It was summer and a large, large sun was in the sky. She smiles. Svetlana is sad and smiles. (Rudisser, 1986, p.3; author’s translation)
All the quality of her felt sense of the relationships with her peers, her sadness in leaving, and in letting go of the problem at the end of her imagery were reflected clearly.
Rudisser observes that children do not: need interpretation as much as they need people who will take them seriously and listen to them. He admits that educational systems are designed poorly in regard to having enough flexibility to allow children to relate to their feelings. For him, liking children and the quality of the relationship with them each day as facilitator and helper is extremely important and enhances the focusing he does with children. He does not find it helpful to plan a time each day for a set period of time in school to do focusing; he prefers to do focusing in the context of daily relationships as opportunities or needs occur. He stresses individuation. He laments the pressure lessons plans place upon teachers to insure that children know more; he believes such plans de not insure that children understand more.
Much of this procedure relates to the first step, which is to help children learn to clear-a-space. After the person or group focuses, he has them draw a picture of how their imagery made them feel: this continues the processing of feelings.
FOCUSING IN THE HOME
Marianne Thompson is a trained focusing facilitator and a mother of three children, ages six, eight, and ten. She is an active member of the California based Institute for Research in Spirituality and assists at focusing and at spirituality workshops. When her children were ages three, five, and seven, she began to introduce them to focusing. Although her work did not take place in a play therapy setting, her approach is instructive to play therapists as she outlines how she did each focusing step.
Because they were so young, she talked to them about stories and how they felt when they were totally involved with a story. She found without formally mentioning focusing to her children, that the whole idea of stories behind all their feelings was fascinating to the children. She found that the movement of an ongoing story captured and held their attention. As she puts it:
Stories seem to be important even to adults that I have worked with: it’s the more behind what they already know about a situation that unfolds and surprises. And it’s the surprise of something happening that they don’t plan for that intrigues children (personal communication).
She gradually went further with her children as she sensed in them a certain uncomfortableness around a situation, or noticed some negative behavior that stood out. She found that her children created a space step one of Gendlin’s procedure quite naturally and that their number one issue, or most troubling problem, is very clear. She believes that in doing focusing with a child it is very important to stay with the problem that s of most immediate concern, that it helps to ground a child in what is real now.
The second and third steps are moved into simultaneously as they learn to “just be quiet with how it feels inside”. Thompson does not do Gendlin’s fourth step, which is resonating a handle. She believes it is very important to check with the child to ensure that it is agreeable to be with whatever feeling is there. She shows her respect for the child by always “asking them to check inside to see if it’s okay to be with this feeling” (or sad feeling, etc.). Thompson stresses that it is importance to the whole process that children learn to respect how they feel inside and to know that sometimes it may be too frightening to be with what are feelings therefor, the way she puts it to the child, is important also. If it is scary to the child, she asks, “Would it be okay to stay with how scary it feels?” This often gives the needed distance in order for them to continue, and teaches them that there is never anything too frightening that cannot be sat with in this way. (To this writer, who also works with ambulatory schizophrenic adults who are chronically ill, this point is of immense relevance as many of the patients seen cannot support the inner person and seem so fragmented as to lack an inner core that can be trusted by them. Had they learned to bear their scary feelings in childhood, they may not have had to suffer so much later in their lives.)
For the letting go step, Gendlin sixth step, Thompson finds that the key element that helps all three of her children is when she asks them if they can be friendly with their hurting place. She nearly sees a visible release in them as they relax, take a deep breath, and go deeper into themselves. Before they stop , she calls their attention to the difference between how their bodies felt when first began and how they feel now. She allows a considerable amount: of time for this step so that the children can assimilate the difference in how it feels. She stresses to them the importance of appreciating any steps taken in focusing, even if they appear to be very small ones. Thompson’s observations and conclusions after three years of implementing focusing with her own children are: (1) She did not find any of the steps to be impossible in teaching focusing to children, although she does not do the fourth step with them. (2) She found it was for them to let go when they were very young. As they have gotten older it has become a less spontaneous movement. She states that how it takes a longer, “more gentle, friendly presence within themselves” to accomplish this step. (3) She notes with satisfaction that trust has deepened in them, which she finds exciting. It is becoming more and more natural for them to quietly go inside and wait when they are uneasy or have problems. (4) The oldest child, age 12, is less prone to snare details in the initial stage of a focusing situation, although Thompson assures him that she does not need to know any of the details for her to be with him while he is focusing. She has found that the what (the details) loses its importance whenever how he carries an issue changes. (5) Finally, the most visible change she has noticed in them after focusing is a difference in their behavior. There seems to be an inner strength that appears in the way in which they manage themselves. She states:
A freedom comes to them as they become more confident in themselves and their ability to handle difficult situations. There is an ease with which they go inside themselves for answers, so as to become more inner directed rather than always looking to me outside of themselves for answers (Thompson, personal correspondence).
In a case illustration from Japan presented previously in the Focusing Folio, (Vol. VII, Issue I, 1988), Yuper & Murayama, described now drawing was used sensitively and creatively as part of the focusing procedure during play therapy with a 12 year-old girl. They showed how drawing can be used in helping a child with clearing a space, the first step in focusing.
Other illustrations of the use of focusing with children and adolescents are presented below.
FOCUSING WITH A FIVE-YEAR-OLD
Jonathan was five years old. He was extremely bright and already possessed a good vocabulary. His parents had been divorced a couple of months prior to his being brought to the mental health center, where I became his play therapist.
Jonathan was an only child. Jonathan and his mother lived with his maternal grandmother, who babysat him during the day while his mom worked. The grandmother was a very indulgent, permissive person according to the mother. When he visited his father one day each week, he received firm limits however, Jonathan was being encouraged by the father to live with him. The effect to this, according to the mother, was to upset Jonathan when he returned home and leave him with confusion and angry feelings. The mother felt she could not complete materially with what the father had to offer and was concerned about the lack of an adult male role model in his life.
She brought him for therapy because she was aware that he was conflicted and she wanted the child to have an opportunity to work out some of his mixed feelings in therapy to prevent what she felt could result in greater difficulties later in his development.
There were 15 sessions in all, only excerpts are presented to highlight some of the focusing steps with a very young child. We had had one preliminary interview with both Jonathan and the mother, who had been having therapy sessions with another therapist. I also had had a brief encounter with Jonathan in the waiting room. It was suggested to the mother that Jonathan may want to bring one of his favorite toys or stuffed figures with him to the first session.
When he entered the playroom at the first session, holding his stuffed figure (which he called Timmy), he ignored the family of doll figures in the dollhouse by the door and close to play with the animal figures next to the dollhouse on the table. He chose the lion figure and used it to frighten and knock the other animal figures off the table. He did this several times. The therapist followed his play closely as Jonathan was seriously involved. He did not engage with the therapist directly at first; he seemed very intense. Therapist comments were extremely limited and literally based: “You pushed them all away”; “You pushed them off the table”; “You don’t want them close to you.”
He ignored the therapist’s comments and. After the fourth time knocking all the animal figures off, he paused briefly. Then he ran to an adjacent room and took all of the figures off a shelf and set them up carefully on a low table; he then knocked them off onto the floor. He quickly looked at the therapist, then took a ball and threw it at the wall. He was very forceful in his manner.
He ran to the first room and picked up a pair of boxing gloves and addressed the therapist for the first time directly, “What are these for?” The therapist informed him that they were for hitting the wall or punching at something. Surprisingly, he put them down immediately and asked the therapist his name. He then asked for the therapist’s assistance in the use of the water-colors. He worked on one picture carefully and asked if he could give it to his mother. Then he explored the use of the finer paints, but soon pushed the jars aside.
******************** Ik heb nog ca.5 A4tjes te gaan *****************************
He pointed to Timmy and said, “Timmy was afraid.” Since the child was talking about Timmy, the therapist also talked about Timmy. “how does Timmy feel now?” Jonathan responded, “Timmy is still afraid, but not a lot; not like he was.” The therapist asked Jonathan to point to where Timmy felt scared. He pointed to Timmy’s midsection. The therapist suggested, “Jonathan, would it be okay with you if you held Timmy while he’s afraid?” Jonathan held Timmy for a while patting him a little. (He is not the intense, forceful child he was.) The therapist suggested again, “Can you make a clay ball to show how scared Timmy is now?” Jonathan set Timmy aside and made a clay ball. The therapist encouraged Jonathean to check with Timmy, to sit with Timmy to see if he was still scared. Jonathansat quietly for a moment with the clay ball in hand: "“eah, he'’ still just a little scared."” "“onathan, is it alright with you to pretend you are holding Timmy’s scary felling in your hand, that the scary feeling is in the clay ball?” the therapist asked. He answered, “Yeah,” The therepist asked, “Does that feel better to Timmy, to know that you have this scary feeling in your hand?” “Yeah,” he responded. The therapist saked, “How far away do you think you can put Timmy’s scary feeling in the room? Use the clay ball to show me.” Jonathan thought for a brief time. “I know,” he said. He walked to the door leading to the small toilet room that divided it from the adjacent playroom. He turned to the therapist and smiled quickly and disapeared into the adjacent room. The therapist decided not to follow him . Within a short time he returned. “Do you know how far away I put it?” he asked. “Nope.” The therapist replied. “Come on,” he said, “I’ll show you.” He led the therapist into the next room and pointed to the corner of the room. The clay ball was there. Th therapist asked him to check with Timmy to see Timmy felt now. Jonathan airily stated, “Oh, he’s okay. He’s not scared anymore.” The therapist asked Jonathan to see whether Timmy felt good or whether something else might be bothering him, not feeling okay. "“kay," he said. They both walked into the main playroom and he sta by Timmy. Jonathan suddenly asked, “what time is it?” The therapist told him the time and also mentioned it was almost time for him to leave the playroom to join his mother. He asked, “Will I be able to come back?” The therapist responded, “How do you feel about coming back?” Jonathan answered, “Ilike it here.”
The above excerpt illustrates the introduction of focusing to a very young child as well as a point that is extremely valuable and perhaps unique to focusing. Peolple often become/accustomed to dealing with difficult, hard, confused, painful feelings by deflecting or avoiding them in some way. Focusing encourages a person to be gentle and friendly to these difficult feelings. The reverends Campbell and McMahon (1985) relate focusing to spiritual growth, and describe this as a vital element in the focusing process. They relate the process of being gentle and friendly to unplesant feelings while focusing is crucial to spiritual as well psychological development.
Transactional analysis theory is based upon the notion that an individual has, as one of his ego states, a child-state. (The other states are adult and parent). It is as if a person who is emotionally hurting or troubled has a hurting child within who needs someone to sit with him. The person who is troubled may not find a solution to the problem, but being with the troubled child within a friendly caring way is at least not neglecting or abandoning him.
The experience of being with a scarde or sad place without any compulsion to control, attack, or eliminate those uncomfortable, unpleasant feelings, is not a frequent one. In the above session, the therapist introduced focusing to the child deep into the session when some of his intensive had already diminished and when Jonathan had begun to engage the therapist directly. He was asked to sit with his favorite stuffed figure much as an older brother or parent might sit with a frightened child. In addition, he was asked to concretize the scary feelings by making a clay ball. The very act of holding this symbol of his inner frightened place in his hand provided a different relation to his discomfort and possibility some measure of assurance that he was in control. It is also important to note that the therapist had checked again with Jonathan after the clay ball was formed to see how Timmy felt. The reason for this was to help Jonathan stay with his felt sense and not get distacted by the activity of making clay balls for ist own sake. The crux of focusing, no matter what the age, is the felt sense, not the technique.
In the third and fourth sessions, Jonathan began playing with the people figures in the dollhouse. He arranged the top floor, especially the bedroom, with just the mother figure and the child figure in it. On the bottom floor was the figure of an adult male that was ignored. Most of the sessions were conducted on a client-centered baseline following the child and reflecting the child’s meanings and feelings, using the child’s own main symbols.
In the fourth session, Jonathan turned to the adult male figure for the first time and, with an angry look, threw him down and disarranged all the furniture in the dollhouse room. Then he stepped on the figure and abruptly began to work with clay. He made a long, rounded shape, and then broke it up. Then he picked up the male figure off the floor and placed it in bed with the female figure; the little boy figure was placed in the other room in the dollhouse. Jonathan appeared calm and the angry look was gone.
What is significant in the above sessions was that the child had strong, angry feelings that appeared to be related to anxieties he was attempting to manage related to his family situation. The child needed the space to conduct and control his own therapy. He needed neither interpretations nor the intrusion of a technique; he made his own change-steps.
In the sixth session, Jonathan stated that he felt sick inside, like he wanted to throw up. He had awakened during the night and had seen his mother and a strange man naked outside his room in the hallway. He was frightened but there was more to his nausea than fear, there seemed to be a twisted feeling there - like an emotional knot - not easy definable. He seemed to want to verbalize about it, but couldn’t put it into words. He seemed stuck and frustrated. A doing activity (i.e., physically doing) did not seem like an option for him; he needed to be with what was bothering him but to unbottle his feelings also.
‘Jonathan, what part of you feels the strongest?’ the therapist asked. Jonathan said, ‘My fists.’ The therapist asked Jonathan to make a fist, and let himself feel the fist. The therapist asked, ‘Can you feel what you feel when you make a fist anywhere else in your body, Jonathan?’ He said, ‘In my shoulders.’ The therapist urged him to check how strong he felt in his shoulders. The therapist then asked, ‘How about anywhere else?’ He answered, ‘In my legs.’ ‘So you feel strong in your legs, too. Stop and feel your legs being strong,’ the therapist said. After 15 seconds of waiting, the therapist said, ‘Jonathan, let your fists, your shoulders, your legs, and all the parts of you that feel strong be with your sick stomach; pretend it is like they are visiting a sick friend; can you do that?’ The therapist continued, ‘Would your sick stomach welcome someone strong and friendly to be with it?’ Jonathan said; ‘Yeah.’ He even managed a little smile. There was a silence. ‘How do you feel now?’ the therapist asked.
‘I thought the man was going to hurt my mummy!’ blurred Jonathan.
In the remainder of the session Jonathan was able to verbalize some of his feelings of being afraid, of the way his world was jarred without having concepts that could help him explain what was happening. He used finger paints to express his feelings later in the session as he unbottled his emotions. At the end of the session he was sufficiently free or released from his problem that he could invite the therapist to show him how to make paper airplanes out of some of the fingerpaintings.
The excerpt illustrates a subtle existential as well as a therapeutic point. The person is always more than his behavior or any thing he can say about himself. A planet can be viewed through a telescope, but there is a vast cosmos surrounding it. The leaf implies a tree, and feelings imply situations, happenings. There is always an implicit sense of a situation, of another person, and so on. The feeling remains encapsulated, stuck, unless the feeling sense once again - and in a fresh way - joins what it is a sense of.
Jonathan was stuck, but he sensed so much more than he could express at the moment. He was in his fear and whatever else he was experiencing. It was as if the situation owned him, rather than he owning the situation. He felt overwhelmed and helpless. The therapist felt centered in Jonathan’s need and was directive. He literally helped Jonathan to get in touch with some of his own strength, in effect, reminding him in an experiential way that he was more than the helplessness that filled him. Once Jonathan began to sort out his own feelings the therapist returned to his client-centered baseline.
Several months after the termination of therapy sessions with Jonathan, his mother requested an appointment with the therapist. She came to share her observations of changes in him and to express her appreciation.
She noted that he laughed more, was more fun for her to be with, and seemed much more stable and content whenever he returned from visiting with his father. She stated that he asked her, occasionally, whether he could visit the playroom. The therapist met Jonathan and his mother in an unplanned way a year later. Jonathan was very excited to see the therapist, and his mother stated that he had begun school and was making a good adjustment.
FOCUSING WITH ADOLESCENTS.
The following case is presented in an oversimplified manner in order to illustrate the way focusing assisted an adolescent, referred by the Probation Department, to get in touch with and to clarify vague bodily experiencing and sensations prior to acting-out behaviors.
James was a 14-year old who was one of ten children. His mother was a passive, compliant woman who was very dominated by her husband. James’s father was subject to explosive outbursts, blackouts, and so on. He was compulsive and perfectionistic, especially as related to the family image in the community. He was very concerned about the way the family dressed, how they behaved in public, and so forth. He saw no dichotomy between his own open affairs with women in his neighborhood and his strict behavioral expectations of his family.
James had done well in school academically until a year before when his grades had begun to slip. He was liked by teachers and other students. He had been apprehended previously for shoplifting, but he admitted in therapy that he had shoplifted several times, always alone.
In the first session, he appeared more self-assured than the therapist expected based on the intake report, although he respectfully looked at the therapist waiting for him to take the lead. The therapist met his gaze, and gently instructed, ‘Just take your time, and scan to see where you want to begin.’ A minute can seem like a long time in this kind of silence. He seemed to look up for help. In this situation the therapist decided to use a focusing opener that he has found useful, ‘James, I want you to say to yourself, ‘Gee, I feel great, ‘and then put on the desk, - just like you would put groceries out of a grocery bag, or newspapers out of a heavy bag - all the things that bother you, that stand in the way of your feeling good.’
He put out two problems: (1) he expressed concern that he keeps stealing even though he had no intention of doing so and it makes him sad (tears welled into his eyes); and (2) he felt unwanted by his father. Asked which was the problem that was the hardest for him right now, he answered, ‘The stealing.’ He continued, ‘If I could straighten up, dad would not be so mad at me.’
In this last statement, the first sign of the critic was manifested. It is not helpful to allow the critic to take over one’s inner space, for several reasons: (1) it does not solve the problem; (2) it makes an already difficult situation harder, (3) it is seldom that, if all the pieces that bring you where you are psychologically could be known, one would be found to be totally responsible for what came to be. James went on to blame himself for making his father angry with him and not want him. He strayed somewhat from how he felt about this shoplifting ad began to get held back from further processing by his critic.
The therapist invited him to return to his feelings about his shoplifting. James said, “I don’t know why I do it. I don’t need the stuff I take; most times I give it away.” He was a puzzle to himself. He often looked down sadly with his chin on his chest.
The therapist asked him to listen to his feelings just like he would listen to his Walkman with his earphones on. He urged James to imagine himself and how he felt prior to entering the store and then as he entered the store, but especially before he entered the store. James looked downward with his eyes half closed. After a while he said, “Cranky, I feel cranky inside, like something crankin' me!” This was different than being cranky and he wanted the therapist to hear the difference.
The above shows how a person can sense something undefined yet to know what it is not. Obviously, in such instances, the person is matching what his feels against an unclear experience base that informs and directs one’s processing.
“James, just be with that feeling of being cracked for a while. Be with it in a friendly way. If something bubbles up from there like a picture or a word or a person, let me know when it happens,” the therapist gently directed. After about a half-minute, tears welled up in James’ eyes, overflowing onto his cheeks, as he sat with his head downward. He said, “It’s my dad. Yeah... I was mad at my dad.” The teas came more freely. “I want him to do things with me and he never does. I want to go fishing and he won’t go. I want to go to games with him and he won’t go. He doesn’t want me!”
James had made an important bioconnection between the hunger he had for his dad’s closeness and approval and his shoplifting. His acting out was no longer to be a puzzle to himself. As the sessions continued there were many ups and downs in James life. Eight sessions later he reported that he was doing very well in his relationship with his father. His father was playing basketball with him and it had been a “long time since I’ve thought of stealing.”
In the 11th session the client reported that he was given a free sample (later verified) from a nutrition store. When he got home his father would not believe he had not stolen the sample, and he withdrew all privileges. He was also worried that when he would begin high school he would get into fights and the teachers would not like him. His confidence was beginning to unravel again.
In the next session James reported that he was hit in the face by his father for ironing without permission. He wanted to find an alternative living situation. The Probation Officer was assisting him in this matter. James was very oppressed.
Fortunately, the father did care and entered treatment himself with another therapist. In the next few sessions James began to be optimistic again about his relationship with his father. His father allowed him to structure his own discipline when he left home without permission; he got off to a good start at school; he was taking up basketball and swimming (an activity he was afraid of). He was in the process of terminating; three sessions prior to terminating he came to the session, greeted the therapist and sat quietly.
The therapist and client sat in silence a long time, possibly 15 minutes. It was a comfortable, even enjoyable, silence. It felt like sharing but the therapist did not know where this quality came from. Because such a long period has passed without anything being sad, the therapist said, “James, I feel comfortable and even enjoy this quiet time with you but I have a need to check with you as to how it feels to you. Is your inside as relaxed as your outside looks?” James nodded, and smiled. The entire session was wordless with only one more gentle check made by the therapist to make sure this way of using his session really fit where James was psychologically.
The therapist can only speculate about what this silent session meant to James. Coming from a home where there were so many in the family, perhaps, for once in his life he could share a quiet space, a time when he could just be without any expectations on him or anyone pushing him to do something. Perhaps it was a relief from instability or chaos that could erupt at any time at home.
Whatever was occurring, it seemed to be enjoyed. It was very important that James was able to share a totally at-ease situation with an adult. Without words, this was a powerful and friendly silence. For James it may have been too good to be true, having been either depressed, angry, or frightened of an adult most of his life.
Three sessions later, James terminated therapy although the therapist felt he might return at a later date due to his uncertain relationship with his father. Two years later the therapist learned that he was in jail for stealing after a good adjustment in school and home, and he was going to be sent to a boy’s school. According to school officials, who liked James and thought he had an outstanding basketball career ahead of him, his relationship with his father had worsened again.
FOCUSING AND GRADUATION ANXIETY
Every year in a comphrensive community mental health center, as graduation approaches, one can expect a certain number of self-referrals who are suffering from graduation anxiety. These are usually short-term cases. Typically, the adolescent is frightened or panicked at suddenly being faced with job and career responsibilities, leaving home, and the separation from friends. Complicating this situation is that he cannot be open with his concerns with his parents or relatives as they are so proud of his accomplishment and seem to have no doubts that he will succeed. Th youth does not want to disappoint their joyous moment and their sense of success as parents, especially. Those nearest and dearest to him may not have the faintest hint that he is scared.
The following are excerpts from a therapy session with a young person who referred himself. He stated that he was having some mild suicidal ideation.
The curious feature of his own very expensive automobile, so he had demonstrated both his ability to take care of himself and his sense of responsibility. The following example shows how important it is for the therapist to be open for surprising turns as the client takes his own direction from processing his feelings. Also, it will re-emphasize that focusing is introduced gradually in the context of the therapy session by taking advantage of interactional opportunities to sensitize the client to relative to haw he feels about a problem. Focusing must fit easily and naturally within these interactional opportunities. If in any way it does not, the therapist returns to the client-centered baseline that is a precondition of therapy.
The client's presenting problem was that he had some mild suicidal ideation. He was so anxious about graduating and going through the ceremony that he had thought about overdosing on pills his mother had in the home. (His father had died when he was in his first year of high school>) He had not shared this problem with his mother.
A major conflict for him was that he would soon be separating from friends he had known since childhood. He detailed their planes. One was joining the Navy, a few were going to the same college, and so forth. He was remaining home to work. As he said, “I knew it was coming someday but now that it’s here, it’s awful! I can’t stand the idea of not seeing them at school or going over to their homes or just calling them up.”
The therapist responded in a client-centered way except that he did take advantage of a couple of pauses to ask the client gently, “Can you make friendly place for that in front of you?”
After a while, the client’s intensity diminished, and suddenly he began to weep quietly. (The therapist did not know what was going on.) The client said, “If my father were alive, I know I’d be able to go away to school! Why did he have to die?” Very gently, as he continued to weep, the therapist asked him if he could make a special friendly place for all the hurt and anger he felt for his father not being there to help him, right there in front of him. He cried more freely, as if his body was releasing all the pent up anger and hurt it had held in while he manfully took up the slack in his household. And when he stopped crying, he very softly, without any intensity, stated, “I miss him very much. I worked so hard at not missing him for such a long time. He was a good father and he would be proud of me. It’s hard for me to go through this ceremony without him out there!” He cried again. The therapist watched the body closely as well as being sensitive to other dimensions of what was being expressed. When the client stopped crying again, his facial expression was relaxed, his breathing fuller; generally, he seemed untwisted and whole, that is, at peace with himself.
At the end of the session (the remainder of the session was spent in reflecting in a client-centered way) he had resolved that he would go through the graduation ceremony. He was surprised at how much better he felt, and he stated he would like to leave the option open for returning for a session and would telephone if he needed it. The therapist was not called for an appointment, but he did get a graduation invitation.
In the above excerpts, the therapist did not depart much from being client-centered in his reflections. However, he did seize interactional opportunities a few long pauses to urge the client to: (1) Make a large, friendly place for all that was involved in his conflict, and (2) To put it all in front of him, out there, where he could see it all.
That he could be friendly to feelings that troubled him, that cause him distress, that makes his life difficult may come as a surprise and a relief. In the above example, it certainly helped to open the way for underlying feelings that were difficult for the client, feelings he had avoided facing for along period of time. When he could finally admit these feelings, he no longer felt incomplete; he felt more wholly human.
OBSERVATIONS IN FOCUSING WITH ADOLSCENTS
Although the writer has done therapy with many self-referred teenagers, very often in a comprehensive community mental health center adolescents are referred against their will by parents, Probation Departments, schools, and others. In a few instances, it has been helpful to the client for the therapist to maintain a stance as a technical companion in a phased exercise. This has the effect of maintaining an initial distance while still working on the problem with the focusing procedure. It has proven to be very reassuring in those instances, as there also appears to be a safe psychological environment created by the structured exercise. At the same time, the steps can be done while the youth closes his eves; this also contributes to having some control in the unwanted situation. There is no clear criteria for this as yet, except the therapist’s intuitive sense of the person. Generally, the writer has proceeded much as he would with an adult in the therapy hour. The exception would be those younger adolescents who use the therapy hour in the playroom and/ or in the office.
Focusing consists of specific steps of instruction to enable someone to attend to the bodily sense of a problem; to get a word, phrase, or image that helps hold onto that bodily sense; and, through further specific steps, to process the problem experientially. The experiencing body is central to focusing, and each interaction of the focuser is aimed at helping the person become aware of how he experiences his problem, and not just the details of the problem. This approach can be used to make any method or modality more effective, including play therapy and working with adolescents. The focusing technique applied to children and adolescents are relatively new, and the literature regarding it is scant. However, the few published reports, and the personal communications to the writer, suggest very strongly that focusing can be used to benefit children as young as 3 years of age as well as adolescents.
With younger children, there appears to more interest by focusers in helping children to clear a space (Step 1) and getting a felt sense (Sense 2) as well as receiving (Step 6). All steps are valuable although these seem to be most useful at lower age levels.
There are three cautionary notes that need to be observed. First, the relationship is more important than the technique, and the child may discontinue a focusing step whenever he chooses to do so. Second, the goal is to reach the inner felt sense of the problem in a bodily way and the strategies used to archive this, such as the clay balls, picture, and so on, must mot come to dominate the process.
Focusing with children and adolescents is a new important method for catalyzing changes. Much more exploration with this approach needs to be done.
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