Therapeutic Autoethnography is founded on Autoethnography, an emergent field in qualitative research. Therapeutic Autoethnography engages the practitioner as a researcher in the field of the psychotherapy situation. It is a practice-based, practice-driven, practice-informed qualitative research method. It provides an in-depth understanding of what goes on in the diverse naturalistic setting of psychotherapy practice. In Therapeutic Autoethnography, the field being investigated is the therapy situation, which encompasses the individuals attending the session, the therapeutic alliance, and its environment. In the role of researcher, the therapist creates aesthetic accounts of their experiences in the field with their client(s). The writing process is deliberately reflexive and integral to the method. This act of creative writing is a heuristic process where new insights emerge for the researcher. This thesis demonstrates how Autoethnography can be applied as a practical methodology for psychotherapy case study research, especially for explicating the implicit nuances in therapy.
Keywords: Autoethnography, Therapeutic Autoethnography, psychotherapy research, case study research
Understanding Salomo Friedlaender’s Creative Indifference: A Psychotherapy Case-Study.
Abstract
Salomo Friedlaender’s Creative Indifference, or Schöpferische Indifferenz, first published in 1918, is a founding philosophy of Gestalt therapy that has invaluable implications in the process of psychopathology in the psychotherapeutic process. This article features a psychotherapy case study of a client who has been diagnosed with Major Depression and Atypical Anorexia Nervosa. The case story is written by the therapist using Therapeutic Autoethnography, a method of inquiry into the psychotherapeutic process. Writing this case study in an evocative aesthetic form, the understanding of Creative Indifference is fleshed out and enriched. Story and theory are interwoven reflexively to illuminate how aspects and meanings of Friedlaender’s philosophy of Creative Indifference, the centering in the here-and-now, the fertile void and zero point, apply to the real-life, naturalistic situation of psychotherapy practice. Though the case study details but a portion of the client’s work, one can grasp the atmosphere from which the client’s pathos is made visible. Creative Indifference facilitates this process of psychopathology in a powerful way, expanding our understanding of suffering beyond the traditional attitude of clinical diagnosis.
Keywords: autoethnography, psychotherapy case studies, psychotherapy process research, gestalt therapy, aesthetic inquiry
Excerpt from the Case Study: “Stuck”
The leather armchair seems massive as she slumps into it. Min looks almost childlike, dangling her chunky Dr. Martens covered feet. “I just feel hopeless and devastated,” she says. “It’s my birthday today, and I thought I bought myself a gift.” That “gift” , she explains is the “gift of therapy”. I would have mistaken her for another cosplay preteen, wearing a head of neon green dreadlocks, had she not revealed that today she turns 29.
“What do you do here in Vienna?”
“I work at a Konditorei.”
“Are you studying here as well?”
“Not any more. I actually moved to Vienna for study at a university. The exams were too hard and I got stuck.” Min explains that she’s been living in Vienna for three years, shares an apartment with 3 Russian-speaking housemates and has few friends here.
This is our first moments together and I find myself mesmerized by the girl looking back at me. The small body, the square shaped face, the big head that tilts to the left as she smiles reminds me of someone familiar. Very familiar.
I ask her if there is anything that she needs to know about therapy at this point.
“Uh. This is my very first time doing therapy, and I don’t know what I want.”
“How did you choose to contact me?”
“Oh… I saw in your profile that you are social, with group therapy and all… and that you were doing something cultural.”
[…]
“I had to think for myself,” she says, “but now, as an adult, I feel dependent.”
A psychotherapist’s lived experience in-session with an asylum seeker and translator: An autoethnographic case study
Abstract
Featured in this article is a psychotherapy case study recounted from the lived experience of the psychotherapist working with an asylum seeker from Afghanistan, with the help of a translator. The method applied is an aesthetic inquiry adapted from Autoethnography which engages the practitioner as the researcher who enters the ‘field’ of the therapy situation. The reflexive writing of the case story, which is integral to the method, sets off a heuristic process, integrating research and practice. Reading this case study, one may grasp the nuances and the atmosphere of an otherwise linguistically challenging therapeutic situation. The story and Gestalt therapy theory are weaved together, which makes palpable, intangible aspects of the therapeutic process.
Keywords: autoethnography, psychotherapy case studies, psychotherapy process research, gestalt therapy, aesthetic inquiry
“I want to be confident, but something in my past is stopping me,” Zaya translates.
I give Ali a nod to acknowledge what I am hearing. He smiles back at me. His jacket hangs on a clothes rack by the door. This is the start of our second session.
Ali’s opening sentence this morning feels like an invitation. Ali stands by a threshold between the future and the past. He points us in the direction of the past. I see him shudder. I shudder, though I do not know what it is I am seeing. I am interested, in earnest. I am also wary. I lean back.
***
I ask Ali what he meant by the past stopping him from being confident.
“Uncle.” Ali explains that uncle is the younger brother of his father. Ali was put in the care of uncle and his wife when he was 9 years old. Till he turned 18, Ali lived with the couple and their daughter, who’s a little younger than Ali. “I always hear uncle say, ‘you will come to nothing. Nothing’.”
“What would you say to him right now, if he is sitting here?” I ask.
Zaya translates.
Ali clenches a fist, then promptly holds it down with the other hand. “I have no words, nothing.”
“Yes.” I say. I give space to the young man’s rage. Zaya reaches gingerly for a filled paper cup and takes a sip. Ali and I follow suit.
I ask him how he got to be put in the care of uncle.
“After school I play football. The playground is near my house. One day, I was playing football, then the bomb of the Taliban exploded on our house.” Zaya translates this, ice cold. They were all home when it happened; Ali’s father Zabi, his mother, Fatemeh and his baby sister Khatere. Ali’s voice cracks as he mentions the name of his baby sister. He stares, glassy-eyed, blank.
The skin on the back of my neck tingles. I glance towards the radiator by the window, as if to check if it was turned on properly. No, the air in the room is not cold. I am being touched by phantoms who have now descended amongst us. I search my bag for paper, only to find a dog-eared stack of neon coloured post-its. I write, “Zabi”, “Fatemeh”, “Khatere”, on three little sheets, careful to get the spelling right. I lay the post-its on the coffee table. I feel tears well up in my eyes. The space between us is saturated.
***
“How… are… you?” Ali asks me in English, then giggles.
“Thank you, Ali,” I say. “I slept well, so this morning you have my fullest attention.”
Zaya translates.
“How about you, Zaya,” I ask.
I catch a slight blush in her cheeks, as she giggles, “very well.”
“Ali says that he doesn’t sleep well. For example last night he had a bad dream. A nightmare.” Zaya translates.
“There is the mafia,” Ali says, “who is raiding the castle. Me and my friends are hiding in it. The mafia shoots me. I’m almost dying and my friends save me. My father is there. Oh. But that is only for a short time. I fall out of the window and run away.”
We share a round of chuckling. I offer Ali and Zaya a suggestion to do a chair work. Zaya’s eyes lights up. I’m aware that she had read much about the Gestalt therapy method of working with dreams. “I’m not sure if you’d like to try this exercise.” I say to Ali, who is probably sensing Zaya’s interest.
“Yes. Yes,” is his reply.
“Well, if at any time either of you are feeling unwell doing this dreamwork, say stop.” I tell them.
“Yes. Yes,” he says.
Zaya translates, “What do I do?”
So we set the stage with empty chairs around us. I am thankful for having booked this larger room again this morning. Ali puts a chair for “the mafia” a distant right from his. He then says that the rows of chairs stacked up along the wall of the room are where his friends sit. He takes the last chair and places it close behind him slightly to his left; there Ali seats his father.
***
Conference Presentation
Reference
Chew-Helbig, N. (2022). A psychotherapist’s lived experience in-session with an asylum seeker and translator: An autoethnographic case study. European Journal of Psychotherapy & Counselling, 1-16.
Find this Journal here: https://www.tandfonline.com/doi/abs/10.1080/13642537.2022.2156138
Writing evocative case studies: applying autoethnography as a research methodology for the psychotherapist.
Abstract
This is an introduction to the application of autoethnography, a qualitative research method, an aesthetic inquiry into the psychotherapy process. The method engages the practitioner as researcher-autoethnographer who enters a field, which is their client’s therapy process. The aim is to derive insights and deepen the understanding of process, theory and diagnostics from psychotherapy sessions in practice. The therapist creates a reflexive account of their experiences, recording this in their session notes, which are also the field notes and the data. As an autoethnographer, the therapist begins therefrom a process of creative writing. The writing process is reflexive, and aesthetic. Integral to the research method, the act of writing forms a hermeneutic circle where new insights into the phenomenon of therapy happen for the researcher. The writing is created as an art form, usually a story or poetry. The result of this method is a written, evocative, aesthetic representation of the therapy process, based on the phenomenological experience of the practitioner. Demonstrating this method, a single case study of an online Gestalt therapy session of a male client diagnosed with depression and borderline personality disorder is featured in this article. The outcome of this form of aesthetic inquiry is the embodiment of psychotherapy theory through the aesthetic sensibility of the therapist-researcher.
Keywords: autoethnography, psychotherapy case studies, psychotherapy process research, gestalt therapy, aesthetic inquiry
Excerpt
In Gestalt therapy practice, aesthetic sensibility to the atmosphere is instrumental to the therapist, in order that they can attune to the movement of the phenomenological field (Francesetti, 2015). This is where this research methodology aligns with Gestalt therapy practice. Theory of the phenomenological field is central to Gestalt therapy (Parlett, 1991; Staemmler, 2006; Francesetti, 2019; Philippson, 2009; Robine, 2006; Spagnuolo Lobb, 2013) as it is in psychology (Lewin, 1951). Attunement to the aesthetics of the phenomenological field allows therapists to move beyond the mono-personal, third-person attitude of diagnosing the client’s psychopathology using manuals like the DSM (American Psychiatric Association, 2013) and evaluating clients using psychometrics. It goes even beyond the bi-personal, relational attitude of inquiry into the therapeutic alliance (Greenberg, 1986; Clarkson, 2003; Jacobs & Hycner, 2009; BCPSG, 2010). Aesthetic attunement brings the psychotherapeutic process beyond therapist and client, into the atmospheric realm of the phenomenological field of the here-and-now.
Reference
Chew-Helbig, N. (2022a). Writing evocative case studies: applying autoethnography as a research methodology for the psychotherapist. The British Gestalt Journal, 31(1), 35-42.
Find this Journal here: https://www.britishgestaltjournal.com/shop/british-gestalt-journal-311 or request a copy from me.
Dialogue analysis of a filmed Gestalt therapy session: an introduction to a method
Abstract
Psychotherapy process research takes us beyond answering the question, ‘does psychotherapy work?’ This area of research aims to study the hows and whats that happen within the psychotherapeutic session that potentiate change. The psychotherapeutic dialogue is an important source of data for psychotherapy process research. Micro-analyses of dialogical turns within the therapeutic session support the understanding of the therapeutic method. This paper introduces the Helbig Method of Dialogue Analysis. This method is founded upon four pillars: 1) that dialogue is implicit action between persons that is supported by explicit verbally uttered content; 2) that the individual’s mode of interaction within the dialogical dyad reflects the person’s relationship patterns; 3) that dialogue is an intersubjective process that leads to the development of new intersubjective configurations; and 4) that the observer-researcher’s phenomenological involvement plays a part in the analytical process. In this study, Bob Resnick’s video-recorded Gestalt therapy session entitled ‘A Rose on the Grave of my Family’ was selected. The transcription of the session was coded using the instrument, the Core Conflictual Relationship Theme – Leipzig/Ulm. Results obtained from this study are quantified graphical representations of the developing relationship between therapist and client. Simple to operate, scalable and practical, this method is designed for use by therapists and researchers who are interested in tracking, comparing and/or contrasting the developing psychotherapeutic alliance in a single or in multiple psychotherapy sessions.
Keywords: psychotherapy process research, dialogue analysis, psychotherapeutic alliance, Gestalt therapy.
How can we visualize the evolving psychotherapeutic alliance in dialogue? The psychotherapeutic dialogue is an important source of data for psychotherapy outcome and process research. Micro-analyses of dialogical turns within the therapeutic session support the understanding of the therapeutic method. This paper introduces the Helbig Method of Dialogue Analysis. This method is founded upon 4 pillars: 1) that dialogue is implicit action between persons that is supported by explicit verbally uttered content, 2) that the individual’s mode of inter-action within the dialogical dyad reflects the person’s relationship theme or pattern which plays out in the here-and-now, 3) that dialogue is an intersubjective process that leads to the development of new intersubjective configurations, and 4) that the observer-researcher’s phenomenological involvement plays a part in the analytical process. In this study, a 28-minute video-recorded gestalt therapy session is selected. The transcription of the session is coded using the instrument, the Core Conflictual Relationship Theme Leipzig/Ulm. Results obtained from this study are quantified graphical representations of the developing relationship between therapist and client. Simple to operate, scalable and practical, this method is designed for use by therapists and researchers who are interested in tracking, comparing and/or contrasting the developing psychotherapeutic alliance in a single or in multiple psychotherapy sessions.
This thesis addresses the complicated nature of the psychotherapeutic alliance, by attempting to deconstruct what is already in practice. In piecing out the different aspects of the relationship between psychotherapist and client, and referring back to relevant literature, one can understand better the dynamics that exist within the therapeutic encounter. In the process, one can also see how the different principles of different psychotherapy schools fit into what we understand today as the profession of psychotherapy. Considered a profession, psychotherapy is bound to ethics, within which is the question of competence and accountability. The importance of understanding what really happens in a client-therapist meeting that is unique to psychotherapy, and that which leads to therapeutic change, is emphasized in this paper, with case studies from classical texts and referred back to modern day change-process research.
