Preparing to design safe experiments

Early on in my main blog I included some ideas on how to design a safe experiment. Some people have realised the value of recording as part of the experiment, but they have asked me whether there is a systematic way of collecting information to prepare for all this. Well, as you might imagine, there are many alternatives and your researches may come up with a few. However, here is a simple set of questions to ask yourself before you get into planning:

  1. What do you want to change? this is the most general and, if needs be, most vague idea about your wishes for your future. The Road Map experiment, included in the early part of the main blog,  may well help here.
  2. How might you get want you want? This is a brain-storming exercise (meaning – just write everything and anything down on a bit of paper as it comes out of you head! Only when you’ve exhausted everything possible – however zany – you can then sift through the material to see if some particular things ring a bell).
  3. From all you now know: can you identify a problem that you’d like to solve about your current situation. Consider your life as thoroughly as possible – your physical health and well-being, your emotional health and well being, your present emotional state and the beliefs you possess about yourself and the world you live in. Body Scans, and all the exercises associated with them, can help here.
  4. In particular, identify negative thoughts that appear to be stopping you making changes. What things might be stopping you – in your work, home and your community; what limits do you appear to place on your self?. Beware of blaming others here as blame IS a major stopper. Remain aware of YOU – your body, your sensations, your emotions and beliefs. Be open to unpleasant feelings of shame, jealousy, fear and bitterness.
  5. For some people there may be critical incident(s) in their life that haunt or plague them. This is particularly likely where there has been some abuse or trauma in your personal history. Make a brief, factual note of any incident(s) noting, all the while, how easy it is to be drawn into them. This is one time, at this early stage, where avoidance is OK – on a temporary basis!
  6. From all this information, can you discern one or two specific opinions or beliefs that you  have developed about yourself – who you are. Can you record those thoughts briefly and to the point, e.g. I have failed in life; I am my own worst enemy etc.
  7. Does a single life message emerge from it all; e.g. life isn’t worthwhile, I don’t deserve to succeed.

Bear in are mind, as I have said a few times, these can be unsettling exercises. It would be wise to have available a back-up plan. Some-one to talk to and share with.

Once completed, you may find it possible to return to the main blog and revisit the section on AIMS AND OBJECTIVES. Do use your browser search facility to winkle it out.

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Relaxation techniques

There are many approaches to relaxation. Several are included in the major blog on www.your-nudge.com/how-to-give-yourself-a-nudge.

There are a number of CD’s and DVD’s available to enrich your experience of relaxation.

Would it help readers to know something about what was available – to purchase?

Another option is for me to place something on YouTube. I have not used this form of social media very much and I’d value the views of readers on what might help you.

Responses to: robintrewartha@tiscali.co.uk.

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When ‘doing’ isn’t enough.

My major blog places emphasis on action – getting something done.

So here’s a bit of heresy against myself!

Doing is not always a respectable word in therapy as action does not always ‘bring home the bacon’.  Action can be be a substitute for ‘real’ change in some situations – a handy disguise. We can pretend to be changing.

Ever heard of the French expression: “plus ça change, plus c’est la même chose“.  Roughly: the more it changes, the more it’s the same thing.

One reason why safe experiments may not work is that our cunning minds find actions-of-convenience that are, in truth, sneaky avoidances. In my blog, I have included a useful experiment to reduce that possibility – using Socratic Questions. Did you know that the first therapists were the ancient Greeks (oh, and probably even sages from even more ancient civilisations).

So what did Socrates do that seemed to help others? He used Ironic Modesty: once he was challenged by a claim that “No one is wiser than you.” Socrates, himself, that is. In his response, after trying the disclaim the award, Socrates concluded his wisdom  was greater than many simply because he possessed an  awareness of his own ignorance.He possessed a Questioning Habit in his conversations with others. He was argumentative and cross-examined others to improve our self-knowledge. He was said to be Devoted to the Truth so much so that he died rather than give up his philosophy and his home. He was obliged to poison himself when a jury of his peers convicted him of being too clever by half! He believed in the power of reason and, after his conviction, he was said to have continued to argue about his fate after death.

He saw the sneakiness of his fellows and appeared to test himself to the death.

To become more aware of our own sneakiness requires us to pay attention to our thoughts, beliefs, values and attitudes. In these areas, the experiments you may have to do are thought-experiments. Albert Einstein was the celebrity developer of thought-experiments and you can find out more about them at:

http://bigthink.com/paul-ratner/learn-how-to-think-like-einstein.

To work on inoculating yourself, try saying ‘hello’ to your own sneakiness and just notice the ways in which you are sneaky. Notice all the benefits of sneakiness to you and consider whether sneaky may help you from time to time and, if so, how.

When you find a way in which sneaky is getting in the way of your preferred change, go back to the main blog and get to designing a safe experiment once more and let Socrates keep whispering in your ear.

 

 

 

 

 

One of the principles I have mentioned in the blog is that no ‘safe experiment’ will always work for everybody or even work always for some people. The most sensible things to expect is that all experiments can work for some people, some of the time.

 

Sometimes it helps to think about things and to be aware of our thoughts, as well.

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Evidence-based therapy

As my major blog has been around for some time on –

https://your-nudge.com/how-to-give-yourself-a-nudge/

I have gathered some feedback as well as questions from readers and experimenters.

A regular question that arises is:  is there evidence for the effectiveness of  ‘safe experiments’? This question emerges from the modern preoccupation with ‘evidence-based practice’.

I’m going to say ‘yes’ and ‘no’, aren’t I!?

The ‘yes’ is that all the information recorded by blog users and clients over many decades constitutes ‘evidence’ in my book.  Also, cognitive behavioural therapy (CBT) – a key model for encouraging experiments (or homework, as some call it) – encourages substantial record keeping. Such records provide detailed information about the outcomes of all our efforts. Further, there is a large body of formal research seeking to organise evidence in books and PhD theses.

I am not an expert in this literature; it increases at an alarming rate and I do not see keeping it all at my finger tips as one of my professional strengths. If you have a specific question, I’d hope to point you in a sensible direction. You could start your own enquiries with a PDF document at:

https://www.nesta.org.uk/sites/default/files/using_research_evidence_for_success_-_a_practice_guide.pdf

What I’d really like to do in this short blog is to go back to that word – ‘evidence’ in inverted commas. What is meant by it and in what way does it help us to design experiments and promote the changes we want in our lives? There are some misunderstandings to identify and I’d like to clarify what is useful ‘evidence’ when exploring human experience and relationships (as compared to evidence obtained in, say, medical trials).

The dominance of medicine in ‘healing’ has meant there is pressure to define ‘evidence’ the same in both medicine and counselling or psycho-therapy. Fortunately, even at this very moment (2017), the British Association for Counselling and Psychotherapy (BACP) is taking steps to question this approach to the term, evidence.

Don’t get me wrong; medical bodies and regulators are quite right to place emphasis on obtaining very solid evidence before they let a new medicine loose on the general public. The Thalidomide scandal of the 1950’s and 60’s served to drive up standards in research. There have been moves to improve the independence of staff involved in research studies as well. That said, even today, the pharmaceutical industry funds a lot of research and this does not give the appearance of ‘independence’,  however sincere those companies may want to be.

The problem for measuring the effectiveness of therapy is that such tight control means that:

  • useful data and results are sometimes excluded from research studies. For example, the experiments I am offering, and you will design, may have no visible result on some occasion. You can neither confirm nor deny your progress toward the objective under scrutiny at that time. By all means throw out ineffective medicines – but effective therapeutic research needs to measure pathways that are good, bad and indifferent. What is bad one time, may be good or, at least, better another time.
  • methods applied to the test of a drug are very different from tests we should apply in therapy. You can objectify a drug and make it a ‘subject’ of study. You can control that subject as tightly as you want. Good therapists do not objectify their clients.  Effective researchers are ill-advised to offer a different approach.  The good therapist will negotiate a preferred outcome – one a client wants, and one a therapist is equipped to help on its way.  Then the therapist can help a client find a way towards that outcome.
  • Evidence-based researchers say they follow ethical guidelines and that is all well and proper. Those guidelines exist to see ‘subjects’ are not abused. Even so, the key focus of medical research will be: did what we do to our subjects – in applying a treatment in ethical fashion – make people better? In therapy, it is not enough to simply assist people to get better; the way therapists help people get better is central to the research. Ethics are more than a guideline to minimise the potential for abuse. How we behave towards one another is not an optional extra.
  • Research into therapy should assess what works to ensure clients are respected. Furthermore, research could identify what negotiating and communications styles engage clients. The way a tablet is given to a patient does not usually impact on outcomes (but, again, there may well be evidence to contradict this assertion!).
  • Research into therapy could study the validity and reliability of experiments but are the criteria to define these terms identical in the scientific and therapeutic environment. Now that is a BIG question
  • The recording systems used by client and therapist could be assessed. Some may be more efficient than others in illuminating outcomes. But even then, effective therapeutic research identifies how the parties got where they did. It follows the journey from the design of a safe experiment through to observing its outcome is key. Words explaining how the observations arose could miss the point. Research in medicine and science may ill-afford to study the journey; some people may die en route and that is not acceptable.
  • so the ‘danger’ to clients in therapy is of a different order to the risks involved in medicine. Some people do challenge this, say, in relation to reports of ‘false memory’ syndrome, but problems of that order say more about therapists pursuing their own ideas, rather than enabling ‘clients’ to make the move that is right for them.
  • Once we can recognise that ‘safe experimenting’ is not what some-one else does to you, then it becomes much easier to look for ‘evidence’ that fosters incremental and fluid outcomes.
  • Furthermore, taking small steps in the implementation of ‘safe experiments’ assumes that we can step back from the result and set off in a different direction. IT is perfectly reasonable to consider that successful journeys depend on mistakes – or at least, noticing them. Defining evidence in this situation means it is necessary to legitimise the ‘moving of the goal-posts’. That is a ‘no-no’ in strict research work and has been used to discredit some research in the past.
  • even when an experiment is a ‘small defeat’, things can be learned from the outcomes. As seen above, the strict assessment of evidence puts a negative value on ‘failure’ –  some people even turns their noses up at Placebo effects. That cuts off a very large chunk of helpful research into ‘what works for whom’.
  • Strict research looks askance at my assurance: if it works, don’t knock it. Therapeutic research needs systems to define what is meant by ‘works’ and it needs to consider identifying,  ‘works for whom’.

A useful example of the issues I am raising is encapsulated in the following quote from the web site listed above:

It [evidence based research] can also tell you what doesn’t work, and you can avoid repeating the failures of others.

I understand the web report is concerned about the apparent waste of resources when research appears to find out what does not work. However, in research into therapy, assessors will find that what works with one person, and at one time, will not necessarily work for some-one else or a different time. We can still learn from apparent ‘failure’.

I have a suspicion that some researchers like to follow strict rules of research to affirm the neat and tidy outcomes needed to generate confidence in a new pill or procedure they have designed!! The world of therapy is rarely that tidy and it will miss important things of it tries to copy the ‘medical model’ (not a good term, but it will have to do for now!).

If you want to apply your thinking to this subject, how about seeking out your own definition of evidence-based research. The one offered by the web site, listed above, is:
Evidence-based medicine is the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients. The practice of evidence-based medicine means integrating individual clinical expertise with the best available external clinical evidence from systematic research.
What IS “best”? Notice how the practitioner is included here but it is his/her “expertise“, that seems central. Do you wonder if the client is really included in the sentiment that “external clinical evidence” should be matched up with clinical expertise? Sounds research results are conclusions drawn from a conference of experts. Too rarely is a client understood to be expert in themselves.

 

Acceptance and Commitment Therapy

I have been asked about this approach to therapy. It is a relatively new arrival in the therapy world (1980’s onward).  ACT does contain elements that help readers design experiments for themselves. See –

Web site – https://www.actmindfully.com.au/acceptance_&_commitment_therapy

as this provides some insight into this model and a web search will disclose a lot more!

In general, Acceptance and Commitment Therapy (ACT) encourages you to accept what is out of your control and encourages you to commit yourself to action to improve your life.  It is an approach intending to maximise your potential.

Here is a diagram summarising the elements in the ACT approach.  I will need to explain myself a bit more, below, and this may help you research further.1017 ACT model

Contact with the present moment relates to the Mindfulness perspective.

Acceptance is related to the ability to decide between what you can be change and what IS.  ACT has useful things to say about our thought processes and how they can be harnessed to revise our behaviour.

Values: the model seeks to make explicit the values we possess and the ways in which our values help or hinder change.

Defusion is a specific technique rather similar to the experiment of “Just Noticing” or “Stepping Back”, included in my blog. Defusion assumes we can become over-focused on some aspect of our behaviour, particularly the language we use, and this restricts our ability to change that behaviour.

Committed Action: for me, this is ACT at its best as it is being very clear about doing something differently and noticing the outcome of your actions and being prepared to change once those outcomes become clear.

Self, as context: This element of the model is interesting. It places you and me at the centre of the process of change and respects our ability to notice and sustain changes we make. However, as with the Values element – see below – I am left uneasy about how this element works in actual practice.

The ACT model seems to help us to clarify what is important; it does inspire you to experiment. ACT helps by being action-oriented; it encourages you to find your own ways to change.  Change is achieved through teaching skills gleaned from, among others, the cognitive behavioural approach (CBT) and Mindfulness. It is the view that skills need to be taught that starts me asking questions. What are those skills and who defines them?

ACT has joined the ranks of those models that initiate training programmes. That tends to slide down the slippery slope towards ‘this-is-the-way-to-do-it’.  In my blog I have specified the way in which safe experiments can, even should, be designed. I hope I have made very clear who implements the experiment and who has to respond to the results generated.

There is an implicit assumption in the ACT model that it can define what is a ‘safe experiment’, and it places emphasis on having a guide to help you avoid a small defeat. It is possible to get it wrong. Personally, I dispute that inference.

The ACT view of Committed Action is troubling. The approach includes a commitment to values in its model. This includes a professed respect for education of the self, a view that one can be ‘trained’ toward some notion of personal growth. Sadly, that ‘education’ training perspective is not as closely focused on the individual’s path of learning as first appears. To be contentious, I’d suggest few training programmes are very focused on an individual learning about themselves, for themselves.

So, at this point, I become cautious and I look a little more closely at the model. When I do this, I find ACT seeks to be a coherent ‘whole’, when it is, in practice, a collection of approaches to safe experimenting.  You do not need to be trained in ACT to explore those other models. Also, why are a few approaches selected over the many hundred available? That is not clear to me. I have no great love of traditional psycho-analytic approaches to creating change in the human condition, but I would be reluctant to say they  have nothing to offer.

In short, the ACT perspective, when examined up-close, identifies a number of safe experiments already around from existing areas of psychology. For instance, Acceptance is an approach to ‘just noticing’ as touched on in my blog. Mindfulness, like Yoga, is one approach to experimenting that may help you, but you will not know that until you try it out. Also, it is a very large subject and you can go to Bangor University and do a post-graduate programme in Mindfulness practice!

ACT, in common with most models, is less explicit about the importance of you finding out what works for you, although it is willing to consider the possibility, see below.  Like other models, it rather implies it can tell you what will work for you. It seems to be saying that you can only make progress if you integrate your approach to experiments according to an ACT perspective.

Consider this view from – https://www.actmindfully.com.au/upimages/Dr_Russ_Harris_-_A_Non-technical_Overview_of_ACT.pdf

ACT assumes that the psychological processes of a normal human mind are often destructive and create psychological suffering. Symptom reduction is not a goal of ACT, based on the view that ongoing attempts to get rid of ‘symptoms’ can create clinical disorders in the first place.”

 

Apart from failing to respect the possibility of learning from symptom reduction and management, the final statement is an assertion. Where is the evidence for symptom reduction worsening or even creating clinical disorders?  The quotation sets up an almost neo-Freudian way of thinking: that effective therapy is full of unintended consequences that only a fully-trained expert can help you avoid. There is no respect for learning from our small defeats. This is combined with a Project Fear warning you off doing it yourself, lest you get it wrong.  The best you can do is to accept the hurt that comes with getting it wrong.

A real giveaway from Dr Russ Harris is the sentiment that:
ACT allows the therapist to create and individualise their own mindfulness techniques, or even to co-create them with clients.”
Note the way in which the role of therapist and client are defined. They can EVEN co-create techniques!!

My own blog encourages you to go your own way;  going on the scenic route. Getting things wrong is an important aspect of making progress. In practice, if you do safe experiments, you will learn from small defeats and small victories. If a series of small defeats encourage you to seek a professional consultant, then so be it – but only for the duration.