Formulation in Clinical and Counselling Psychology

Foundation Socio-Political Formulation Questions Family History Transgenerational history. Why the child. Why then. Whose desire. Stories and scripts around the baby when in the womb. Identifications spotted. Transference Countertransference Formulation in Clinical and Counselling Psychology Positions of: Gender Race Age Ability Class Education Ethnicity Sexuality Material reality and power A short narrative to hypothesise what is happening for the direction of treatment. Constantly being revised by its usefulness. Revised by lots of clues such as level of rapport, and level of material produced (if we take the unconscious seriously). Dr Jay Watts Shrink at Large Early early experiences Breastfeeding Weaning Reaction to early separations Relation to triad Relation to siblings Separation-individuation Is this just another type of diagnosis? Is the level of rapport between shrink and patient the best way to measure utility? How we can intervene at a socio-political level whilst recognising the real of money and power? Would we want our own shrinks to be formulating us? Schemas What ways or modes we tend to use. The angry child The bitter husband etc and the recriprocal roles they link with From a relational perspective: Who we are for the patient at that moment Our reactions to the patient Process Comments Curiosity about what is going on in the relationship Using any live material Using voice, prosody, silences, facial expressions, etc as objects of curiosity Moments of Rupture and Repair, connection and mourning. The Therapeutic Relationship Work on your self is crucial here. The biggies are: - to have enough experience of a personal therapy to know its tough, imperfect and deeply specific to the two people in the room. - to be able to tolerate lots of anxiety so you don't colonize the room with your own stuff Current Difficulties What is the problem Why is the client coming now Why has the suffering changed Whose problem is it Is this really a psychological therapy form of suffering What keeps the problem going What protects the client Formulations have a number of levels: 1.The Individual 2. The Relational 3.The Socio-Political You want to develop a loose relationship to your formulations. They are a tool for thinking, exploring, and knowing where you might focus. Beware of looking for the 'right' formulation. You want something 'useful, which you can juggle loosely, distractedly (whilst the relationship does all the healing work - ssh!). But how will I hold this all in mind? How do I do this? You might loosely bring in some difference between you and your client. For example, that you are a young caucasian woman working with an older asian male. The key is to show you are primed to hear difference and think about it (eg a slight reference to slavery) without infliclicting your political correctness on the space..