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The jazz trio metaphor: reworking the core conditions, relational depth, compassion & two kinds of empathy (1st post)

Working as a psychotherapist or counsellor, practising as a doctor, participating in interpersonal groupwork, and at the heart of relating deeply with another human being - I have internal reminders, charts, ways of helping myself be present in as constructive a way as I can.  One inner chart or internal reminder is the jazz trio metaphor.  A bit like a musician revisiting and making fresh again their playing of a well known classical work, the jazz trio metaphor takes another look at the key, so often explored territory of the therapeutic relationship - which overlaps to a huge extent with the more universal territory of how to be profoundly present in any deep relationship with another human being. 

Carl Rogers' core conditions are empathy, authenticity & "unconditional positive regard".  I talk sometimes of these qualities as a three-legged stool that we want to keep in balance.  Mick Cooper has reworked these conditions into a dynamic dyadic model for meeting at "relational depth":
meeting at relational depth And as Tim Anderson has shown in his research on "Facilitative interpersonal skills", this ability to navigate deeper connection with a client (especially when the going gets bumpy) is at the heart of what it takes to be a really helpful psychotherapist and, I believe, at the heart of what it takes to be a really helpful human being when relating at depth with others.

So in the powerful flow of a strong interaction with another person, what is the jazz trio metaphor and how is it useful?  The trio is made up of head, heart & gut - observation/knowledge, warmth/compassion & emotion/authenticity.  To do this well is like being a fine musician ... or a fine jazz trio!  It can be fantastically challenging and a deeply rewarding flow activity.  At the centre is the heart.  It's a dedication, a vocation.  I'm not formally religious, but pretty much every working day I will internally "pray" for the clients that I'm going to be seeing.  Pray?  Well, channel them goodwill ... think of who I'm due to be seeing and internally, deeply wish them well.  This isn't just some empty ritual.  Research shows that this kind of practice can help to orientate and open us ... like a warm-up exercise before playing sport!  And returning physically, internally to a sense of my heart area and a physical feeling of connection with the other person ... maybe using the breath to help this ... maybe relaxing, releasing into a sense of letting the other person in, of connecting with them.  These are "cookery tips", ways of working that aren't typically discussed in psychotherapy training, but they can be so at the centre of one's work. 

And at the same time there's the paying attention.  What is this person saying?  How are they saying it?  How do they look?  How do they sit?  How does the problem they're bringing relate to the huge amount of research and knowledge that is relevant to their situation.  After decades of work, reading thousands of research studies, having worked with such huge numbers of clients, how can I access information that's truly useful to this unique person in front of me.  How can I link with truly helpful information while honouring this particular person's never-before-seen history & characteristics?  There's a joy in knowing, in understanding ways that this suffering human being can ease the pain they're experiencing.  It's one of the most rewarding things I can experience.  A deep pleasure.  "As we explore this together, can we come up with a different way of understanding what you're struggling with.  What you're experiencing makes huge sense and it's possible, very possible to move forward from where you currently feel so trapped.  Here is a way that so many others in your situation have been able to free themselves."  A guide in a mountain landscape.  Knowing, from so many years of experience, how it may help to move forward while being aware as well that this person is a once-off.  Listening, monitoring, getting feedback, checking.  Is this right for them?  Is it helping them get to where they want to be? 

Teaching medical students to try to see things from their patients' point of view certainly seems to increase patient satisfaction - see "Does perspective-taking increase patient satisfaction in medical encounters?" I get a little nervous though that this cool cognitive stance can become manipulative. So in their paper "Why it pays to get inside the head of your opponent: the differential effects of perspective taking and empathy in negotiations", Galinksy & colleagues wrote "The current research explored whether two related yet distinct social competencies - perspective taking (the cognitive capacity to consider the world from another individual's viewpoint) and empathy (the ability to connect emotionally with another individual) - have differential effects in negotiations. Across three studies, using both individual difference measures and experimental manipulations, we found that perspective taking increased individuals' ability to discover hidden agreements and to both create and claim resources at the bargaining table. However, empathy did not prove nearly as advantageous and at times was detrimental to discovering a possible deal and achieving individual profit. These results held regardless of whether the interaction was a negotiation in which a prima facie solution was not possible or a multiple-issue negotiation that required discovering mutually beneficial trade-offs. Although empathy is an essential tool in many aspects of social life, perspective taking appears to be a particularly critical ability in negotiations."

See tomorrow's post for an extension of this discussion of head (observation/knowledge), heart (warmth/compassion) & gut (emotion/authenticity).

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