Interviews: In the political melee don't forget the green corner...!

individual
INTERPERSONAL : SCIENCES

humanistic ------------------------------------------- mechanistic

SOCIOLOGY : POLITICAL

group

Therapeutic alliance

"Sir Robin cited research conducted by two psychologists on interviews during the 1987 general election campaign. Dr Peter Bull and Kate Mayer found that Kinnock and Thatcher avoided more than half the questions put to them. They concluded the party leaders used 31 different forms of evasion, among them ignoring the question, acknowledging the question without answering, questioning the question, attacking the question, attacking the interviewer, declining to answer, giving an incomplete answer, repeating a previous answer and claiming already to have answered the question." FT Weekend. p.1

Source:
Katz, Ian, (2014) The death of the political interview. FT Weekend, Life & Arts, September 6-7th. p.1.

Disobedient Objects

individual
INTERPERSONAL : SCIENCES

humanistic ------------------------------------------- mechanistic

SOCIOLOGY : POLITICAL

group

personal ethics	objects
social justice

The Victoria and Albert Museum 26 July 2014 – 1 February 2015
Disobedient Objects:
From Suffragette teapots to protest robots, this exhibition is the first to examine the powerful role of objects in movements for social change. It demonstrates how political activism drives a wealth of design ingenuity and collective creativity that defy standard definitions of art and design.

Image source: Inflatable cobblestone, action of Eclectic Electric Collective in cooperation with Enmedio collective during the General Strike in Barcelona 2012.
© Oriana Eliçabe/Enmedio.info

Trade winds and time: The Clock of the South

S
INTERPERSONAL : SCIENCES

E --------------------------------------- W

SOCIOLOGY : POLITICAL

N
G7
G8
 ..

Alt	trade-winds
Socio- (political)	Clock of the South

individual
INTERPERSONAL : SCIENCES

humanistic ------------------------------------------- mechanistic

SOCIOLOGY : POLITICAL

group

C/o BBC: Bolivian Congress clock changed to turn anti-clockwise

The clock displayed on the Bolivian Congress building, located in the city of La Paz, has been re-set to run in reverse.

Its hands turn left and the numbers have been inverted to go from one to twelve to the left.

It's the latest measure taken by the government of President Evo Morales to promote the indigenous identity of the Andean country. ...

http://www.bbc.co.uk/news/world-latin-america-28040065

Additional link:
World Economic Forum

updated 26 August 2014
BBC Radio 4 20:00: Whatever Happened to Global Governance?
http://www.bbc.co.uk/programmes/b04f9rdr

Original image source:
http://bubblear.com/wp-content/uploads/2014/06/clock1-1110x400.jpg

Speaker's corner

INTERPERSONAL : SCIENCES
humanistic ------------------------------------------- mechanistic
SOCIOLOGY : POLITICAL

individual

canto do orador Le coin de l'auditeur, Rincón del oyente الزاوية المستمع 听者的角落, Canto do ouvinte, Listener's corner	音箱的边角 Le coin des haut-parleurs
الزاوية المتكلم esquina del orador	Speaker's corner

group - population

Image source: http://rebbls.dk/rebblog/speakers-corner/

TEDMED Great Challenges Google+ Hangout: Unraveling Dementia 31st Oct

Unraveling Dementia: The Race to Find Answers

Thursday, October 31st, 2PM EDT

Recent advances in research are describing more of what we need to know to prevent or treat Alzheimer's and dementia. Projects like the BRAIN Initiative, described at TEDMED 2013 by Dr. Rafael Yuste, and new medication discoveries, drive our opportunities to best understand dementia and imagine a future without it. Join our online conversation to talk about the latest breakthroughs in dementia, including research that has identified early lifestyle changes you can make to reduce your risk. 

 

Tweet questions and comments to #GreatChallenges and we’ll address them on air.  Join Us!

http://tedmed.com/greatchallenges?ref=live-events

Book review "Clinical Intuition in Psychotherapy: The Neurobiology of Embodied Response"

Clinical intuition is something that in formal learning terms is intangible, but in practice is earned and relied upon as a gift of experience. When I first received this book from the author Terry Marks-Tarlow, leafing through I thought the emphasis was on the neurobiology presaging a rather technical read. The references to brain structures, neocortex, brain waves ... seemed to suggest a reductive approach, remote from my conception of intuition in clinical practice. I need not have worried, the initial discussion on the brain and evolutionary development is not just a foundation for what follows but as the title suggests underpins and integrates the whole text. Despite the title and as the foreward advises you do not have to be a psychotherapist to read and appreciate this book. The stall is set from the outset in the introduction which explains that chapter one defines clinical intuition:

Clinical intuition is defined from a neurobiological perspective as a right-brain, fully embodied mode of perceiving, relating, and responding to the ongoing flows and changing dynamics of psychotherapy. (p.3)

The introductory material here is essential foundation reading for people starting a career in psychology and mental health related disciplines. The evolutionary development of the brain from reptile through to the mammalian brain is invaluable. Tying this to specific brain functions and circuits - care, fear, panic, play, lust, rage and seeking - helps integrate brain anatomy, perception, emotion, and behaviour. The advances in neurobiology to follow will no doubt demand that we all extend our understanding of this interdisciplinary fusion.

The book itself (hardback edition) is very well produced, the type face easy to read and the book well structured and with a well balanced mix of illustrations and photographs. The reference listing at the end runs over thirteen pages and is well grounded historically and in having regard to ongoing research. The index is comprehensive (fourteen pages) and a resource itself providing a look-up approach. The book's use of case studies, thirteen in total informs the text and provides some continuity through the book. Dialogue between therapist and client is easy to follow and illustrations are provided with ample explanation in situ. The references also utilize web-based resources.

I recall intuition coming up as a thread on several occasions on the psychiatric-nursing list especially between 1998 and 2004. Intuition is a central quality for all personnel working in health and social care. We must also recognise intuition as a human trait as when non-health professionals exercise the judgement that: "Wait a minute, we need a clinical opinion here." Self-care is also discussed. I had a Pythonesque moment - "Is this the right room for an argument?" - considering psychotherapy as a therapeutic modality within therapies as a whole. Here in the UK (and no doubt elsewhere) self, brief and solution based therapies rule economically. Even though the shortage of psychological intervention is recognised in the UK through IAPT improving access to psychological therapies, we need to ask: how does psychotherapy fare in the current (austerity) climate? To what extent can clinicians exercise intuition? Therapy relies on caseness, relationships and narrative, but to what extent can these be acknowledged and delivered within the economical time frames that frequently operate? 

Although there's no specific chapter on training for clinical intuition, Marks-Tarlow provides a list of how researchers have characterized clinical intuition (more recently in the 1980-1990s); five characteristics are proposed:

• Sudden recognition;
• Immediate knowledge;
• Emergent awareness;
• Non-verbal insight; and 
• Holistic integrative sensibilities. (pp.42-43).

 Of the first two sudden recognition and immediate knowledge, I thought of the intuitive sense that is applied upon receiving a referral. That is the assumptions (not always helpful) that arise from the information provided (and missing) and where this leads you? But of course, is this clinical intuition? Intuition as the author makes clear (p.3 and) throughout the book is in psychotherapy. Intuition here (and for me) depends on interpersonal - therapeutic - interaction. What precedes is something else (data integration, hypothesizing, reasoning...?). I can however still see explanatory avenues in the above that can help us travel from the conceptual (reduced) to a holistic whole. I did wonder about the role of intuition in suicidal ideation and risk management, but this is also a question of referral criteria and caseness.

I would very much like to write myself about information and complexity and these themes recur in the text, especially the latter. Several 'spaces' are discussed too: social, physical and spatial schemas. The work of Buzsáki on the hippocampus, navigation and maps - landmark navigation - is fascinating in chapter 7 Navigating the Seas. I have likened Hodges' model to a cognitive periplus - an ancient maritime map. Over the next few months I'll post some quotes from the book.

This is an excellent book that I heartily recommend. The discussion of what is implicit in the brain and so in therapy, what is embodied and wisdom in mentoring invites re-reading. Finally but vitally there is much humour and humanity here too.

Many thanks to Terry Marks-Tarlow for the review copy.

Computer-based 'avatar' therapy promising for persecutory auditory hallucinations

A study in the British Journal of Psychiatry has reported symptom reductions among patients hearing voices, who developed computerised 'avatars' of the voices and then engaged in dialogue with them. When compared with treatment as usual during a randomised trial, the therapy group showed mean reductions in scores for auditory hallucinations and for the omnipotence and malevolence of the voices. The researchers conclude: 'Patients who are able to sustain a dialogue with their persecutor feel much more in control.'
BJP June 2013, 202:428-433

Source:
http://www.mental-health-forum.co.uk/news-blog.html

In addition see and listen to:

UCL news:  Avatar therapy helps silence voices in schizophrenia

BBC Radio 4: http://www.bbc.co.uk/news/health-23141916

Individual - Group: Axes & Histories

What are the dimensions of the axes that make up the structure of Hodges' model?

Can the individual see the group - the global population - beyond the fresh air in their pocket?

In not seeing the individual, as the global corpus shouts about: "choice", "economic growth", "freedom", "human rights", "democracy", "justice" ... do they see the big picture amid the political smog, the corporate dust storm?

One form human society has so far not generally taken is global. There is still virtually no shared consciousness globally of common struggles or common achievements. Enormous groups - the poor in the Global South for instance - have no sense of forming a single community; in an earlier age, the experience of being subjected to European colonial force failed to create a common anti-colonial front. Even today's most urgent global issues tend to be tackled regionally or nationally: the history of global warming or organised crime is a history of multiple actors, as often as not talking at cross-purposes. p.8.

Prof. Mark Mazower, All together now, FT Weekend, March 9 - 10, 2013, p. 8. Reviewing The Undivided Past: History Beyond Our Differences, by David Cannadine, Allen Lane. 

http://www.ft.com/cms/s/2/edb5b2ea-84d3-11e2-891d-00144feabdc0.html#axzz2OXNCQ1xD
http://www.ft.com/cms/s/0/b1793262-8d6f-11e2-82d2-00144feabdc0.html#axzz2OXNCQ1xD

Update on new papers: 1. Case formulation & 2. Scope of Nursing

At present, with the support of a co-author, I am editing a paper on Hodges' model and the scope of nursing. The text some 6000 words was submitted to a journal last April and rejected, but as ever feedback is golden and the comments are being used to revise. The referees have set a challenge as amongst several points I tease out where the inherent theoretical perspectives lie in Hodges' model and how their identification within h2cm helps to define the scope of nursing.

Another paper in final draft - 4400 words - concerns the model and case formulation. At last I've arrived at this topic. Hodges' model is basically a simple drawing with care concepts superimposed. Cognitive behavioural therapy [CBT] and cognitive analytical therapy [CAT] make use of case formulation and CAT utilizes what are called sequential diagrammatic formulations.

The old website pages were written rather on the fly. They almost comprise a 'to-do-list' of thoughts and findings to revisit and check. Of two old pages one dealt with possible ideas and sources that might inform the structure of Hodges' model; the other page theory.

On the latter page I learned of SDRs - the sequential diagrammatic reformulations used in CAT and related this to the care domains of h2cm -

It feels good to be able to address this theme at long last.

In just over a week I'm looking f/w to a three day break in the Lakes. Weather permitting some  walking and a few runs, a bike ride, writing and Drupal - which I have put down of late...

H2CM: the 'title wall'

Museums and other organisations will often use a 'Title Wall' to present an exhibition. I read about this in the current IdN World and as I did thought about the Tate (London and Liverpool) and the visit to the National Gallery last February. The title wall will feature dedicated design, specific use of colour, typography and layout to communicate the promise that is the exhibition inside.

Perhaps Hodges' model is a Title Wall for health and social care?

Immediately, what title are we to use?

To begin with it is "Mrs Moore", until "Jessica - is fine."

The title wall is an invitation for a dialogue with an artist or artists. Hodges' model is an invitation to patient, carer, health professional and student to engage in a care dialogue.

The story still needs to be told whether by an artist or the patient. Listen to the wall. It should say nothing, despite the divide. Self. Other.

Words. Icons. Threaded in time. Often disjoint in mind.

What a job that combines the arts and the sciences - to collaborate in formulating THE BIG PICTURE of a person's health and social care situation.

A museum such as MOMA apparently has an in-house design team.

In-house ... this is our prize.

Can we provide the patient, carer and the general public with the level of health literacy for them to engage in self-care?

Care4grafitti anyone?

Image source: http://www.moma.org/explore/inside_out/tag/ann-temkin

Student placements and public engagement - over the years

Mentoring student nurses has always been and remains a non-trivial professional obligation. It is something that I have always enjoyed. I make a point of not wittering on and on about h2cm - well maybe a little :) . To save the student's patience and assure my time it is good to ensure a well-rounded placement.

Over the years I've engaged in community service and research projects so looking to the humanistic domains comes naturally. It's been quite interesting watching the various efforts the health sector has made to engage the public. There's no imperative, but I make a point of highlighting the possible learning to be had in contacting the local public involvement and engagement people. Students have found this to be quite enlightening. Encounters with the Community Health Council [CHC] especially so, although that seems a long time ago now.

The Health Service Journal (still catching up) reminded me of all this in the summer, c/o Calkin & West, 4 August 2011 pp. 4-5. This news item spanned my whole career outlining the history of such bodies:

• Community Health Councils: 1974 - 2003
• Patient and Public Involvement Forums 2003 - 2008
• Local Involvement Networks 2008 - 2012
• HealthWatch 2012 - ?

I even remember the demise of the CHC being reported. Actually no, correct that: I remember the report of the CHC's teeth being taken out before their end. As you look at the timeline represented above it seems to suggest either less stability, or less significance has set in; maybe both. The title of the above piece reads: Plans for engagement are 'insulting'.

Whether or not the CHC ever had sharp canines (with an extra full-moon glisten) and a bite force like a croc is something for the archaeologists to check. One thing for sure, it seems subsequent bodies have no need of dental check-ups, being sans teeth.

Working in the community it was heartening to see the CHC doing its work locally. I also read recently (HSJ I'm sure) how public involvement was finally enshrined in the The National Health Service Act 2006. So you see how progressive the CHC was. It is a great shame this momentum cannot be maintained - for reasons we'll return to in 2012.

For now, as students enter their third year I think it helps to bring life to the POLITICAL care domain. It matters. This ongoing issue is central to health services provision, planning, innovation and the commons ...