Jackie Roberts
Biography:
“The unexamined life is not worth living” – Socrates
Research Question: Using creative writing in the form of psychotherapy
vignettes, to explore social justice themes of
intersectionality and inclusivity in student counselling at UAL.
Bibliography
References
- (No date) An existential perspective on anxiety – psyciencia. Available https://pavlov.psyciencia.com/2016/05/An-Existential-Perspective-On-Anxiety-1.pdf (Accessed: 01 January 2024).
- Agar, M. Speaking of Ethnography, Beverly Hills, Sage Publications, 1986.
- Atkinson, P., The ethnographic imagination: Textual constructions of reality, London: Routledge, 1990.
- Burgess, R.G. In the field: An introduction to field research, London: Allen and Unwin, 1984.
- Bloomsbury.com (no date) Vignette research, Bloomsbury. Available at: https://www.bloomsbury.com/uk/vignette-research-9781350299375/ (Accessed: 10 January 2024).
- Carona, C., Handford, C. and Fonseca, A. (2020) Socratic questioning put into clinical practice: Bjpsych advances, Cambridge Core. Available at: https://www.cambridge.org/core/journals/bjpsych-advances/article/socratic-questioning-put-into-clinical-7)
- Clifford, J. and Marcus, G.E. Writing Culture: The Poetics and Politics of Ethnography. Berkeley, CA: University of California Press, 1986.
- Clifford, J. The Predicament of Culture: Twentieth-Century Ethnography, Literature and Art. Cambridge, MA: Harvard University Press, 1988.
- Crenshaw, K. (1989). Demarginalizing the Intersection of Race and Sex: A Black Feminist Critique of Antidiscrimination Doctrine, Feminist Theory, and Antiracist Politics. University of Chicago Legal Forum, 1989(1), Article 8.
- (No date a) Disorientation as a learning objective: Applying … – sage journals. Available at: https://journals.sagepub.com/eprint/RFKSQGMDABG8NHGW3DDN/full (Accessed: 10 January 2024).
- Ethical guidelines for educational research, Fourth edition (2018) (no date) BERA. Available at: https://www.bera.ac.uk/publication/ethical-guidelines-for-educational-research-2018 (Accessed: 10 January 2024).
- Fetterman, D.M. Ethnography: Step by step, 2nd edition. Newbury Park, Sage Publications, 1998.
- Finch, Janet, 1987: “The Vignette Technique in Survey Research” in Sociology. Vol. 21, pp. 105-114.
- Fiscal Studies. Available at: https://ifs.org.uk/publications/which-university-degrees-are-best-intergenerational-mobility (Accessed: 09 January 2024).
- (2016) Fundamental facts about mental health 2016. Available at: https://www.mentalhealth.org.uk/sites/default/files/2022-06/The-Fundamental-facts-about-mental-health-2016.pdf (Accessed: 09 January 2024).
- Freud, S. (2005) The Unconscious. Penguin Publishing: London.
- George, T. (2023) What is action research?: Definition & examples, Scribbr. Available at: https://www.scribbr.co.uk/research-methods/action-research-cycle/ (Accessed: 09 January 2024).
- Grosz, Stephen (2013). The Examined Life: how we lose and find ourselves. New York: Norton. Eaves, W. (2014). The Absent Therapist. London: CB editions
- Hedrih, V. (2023) People with autistic traits tend to have higher intolerance of uncertainty, leading to dichotomous thinking, PsyPost. Available at: https://www.psypost.org/2023/10/people-with-autistic-traits-tend-to-have-higher-intolerance-of-uncertainty-leading-to-dichotomous-thinking-213903 (Accessed: 01 January 2024).
- Intersectionality (no date) Oxford Reference. Available at: https://www.oxfordreference.com/abstract/10.1093/acref/9780199599868.001.0001/acref-9780199599868-e-975 (Accessed: 01 January 2024).
- Kara, H 2015, Creative Research Methods in the Social Sciences: A Practical Guide, Policy Press, Bristol. Available from: ProQuest Ebook Central. [18 September 2023].
- Mark Bevir, 2006: “How Narratives explain” in: (ed. Dvora Yanow and Peregrine Schwartz-Shea) Interpretation and Method: Empirical Research Method and the Interpretive Turn, New York: M.E. Sharpe. PP. 281-290.
- Maxwell, Joseph A., 2004: “Using Qualitative Methods for Causal Explanation”, pp. 243-264 in: Field Methods, Vol 16, No. 3.
- Orbach, S. (2016). In Therapy. How conversations with psychotherapists really work. London: Profile Books ltd.
- practice/8C44C0BF33871FB55349695407700738vhttps://www.cambridge.org/core/journals/bjpsych-advances/article/socratic-questioning-put-into-clinical-practice/8C44C0BF33871FB55349695407700738 (Accessed: 01 January 2024).
- Rogers, C. (1967). On becoming a person. A therapist’s view of psychotherapy. 60th anniversary edition. London: Robinson.
- Sharon Martin, L. (2018) Why do we repeat the same dysfunctional relationship patterns over and over? Psych Central. Available at: https://psychcentral.com/blog/imperfect/2018/07/why-do-we-repeat-the-same-dysfunctional-relationship-patterns (Accessed: 02 January 2024).
- Thinkaheadsheffield (2019) The ethics of emotionally demanding research, Think Ahead Blog. Available at: https://thinkaheadsheffield.wordpress.com/2019/03/12/the-ethics-of-emotionally-demanding-research/ (Accessed: 10 January 2024).
- (No date a) The practice of innovating research methods – sage journals. Available at: https://journals.sagepub.com/doi/full/10.1177/1094428120935498 (Accessed: 09 January 2024).
- (No date a) The research vignette: Reflexive writing as interpretative … Available at: https://journals.sagepub.com/doi/10.1177/1077800416658066 (Accessed: 13 January 2024).
- (No date a) The sage encyclopedia of communication research methods. Available at: https://methods.sagepub.com/reference/the-sage-encyclopedia-of-communication-research-methods (Accessed: 10 January 2024).
- Yalom, I.D. (1989). Love’s Executioner and other tales of Psychotherapy. New York: Basic Books
- Yalom, I D. (2002). The gift of therapy. Reflections on becoming a therapist. London: Piatkus Books.
Presentation slides references including image references.
References
- Barter, Christine & Emma Renold, 1999: “The use of vignettes in qualitative research” in Social Research Update. Vol. 25.
- dew, chris (no date) August 13, 2023 15 Great Ethnography Examples., https://helpfulprofessor.com/ethnography-examples/.
- Finch, Janet, 1987: “The Vignette Technique in Survey Research” in Sociology. Vol. 21, pp. 105-114.
- O’Leary’s cycles of research (adapted from Koshy, Heather, & Valsa, 2010)
- Mark Bevir, 2006: “How Narratives explain” in: (ed. Dvora Yanow and Peregrine Schwartz-Shea) Interpretation and Method: Empirical Research Method and the Interpretive Turn, New York: M.E. Sharpe. PP. 281-290.
- Maxwell, Joseph A., 2004: “Using Qualitative Methods for Causal Explanation”, pp. 243-264 in: Field Methods, Vol 16, No. 3.
- Richardson, J.T.E., Mittelmeier, J. and Rienties, B. (1970) The role of gender, social class and ethnicity in participation and academic attainment in UK higher education: An update, Open Research Online. Available at: https://oro.open.ac.uk/68282/ (Accessed: 12 January 2024).
- Satchwell, C. et al. (2020) ‘Stories as findings in collaborative research: Making meaning through fictional writing with disadvantaged young people’, Qualitative Research, 20(6), pp. 874–891. doi:10.1177/1468794120904892.
- (No date a) The research vignette: Reflexive writing as interpretative … Available at: https://journals.sagepub.com/doi/10.1177/1077800416658066 (Accessed: 13 January 2024).
- Tyler, T (2000). “Social Justice: Outcome and Procedure,” International Journal of Psychology, 35(2), 117-125.
- UAL publishes ethnic representation index 2023 (no date) UAL Staff Careers. Available at: https://jobs.arts.ac.uk/story/ual-publishes-ethnic-representation-index-2023/ (Accessed: 13 January 2024).
Image references
- Roberts, J. (2023). LCF – Mare Street: London
- Roberts, J. (2023). A bridge between cultures: Musée du quai Branly – Jacques Chirac, – Paris.
- Roberts, J. (2016). Steps at the Wallace Collection, Marylebone. London
- Roberts, J. (2017). Private Practice: Marylebone, London
- Roberts, J (2016). Flower in Vase. Ongea Therapy: London.
- Roberts, J. (2017) Therapy Chair: Hackney, London
- Roberts, J. (2021). Photograph of artwork by Jennifer Packer, taken at the Serpentine Gallery: London
- Roberts, J. (2017). Private Practice, Duke Street, Marylebone: London
- Roberts, J. (2018) Winter sun, Shoreditch: London
- Roberts, J. (2016) Flowers in a vase. Ongea Therapy: London
Project Findings
Using creative writing in the form of psychotherapy
vignettes, to explore social justice themes of
intersectionality and inclusivity in student counselling at
UAL.
Introduction
Following on from the Inclusive Practices unit of the PgCert, I wanted to continue the theme of inclusivity for the Action Research Project (ARP) module. The aim is not only to enhance my own experience within the teaching and learning environment, at University of the Arts London (UAL), but also that of my team within Counselling, Health Advice and Chaplaincy (CHAC). With Social Justice in mind, I wanted to address the important topic of Inclusivity within our work as counsellors, and within CHAC as a whole. We know that there is a disparity in mental health between young people, and with marginalised groups being most affected by poor mental health (Fundamental facts about mental health 2016). It is important therefore, to move toward more equality in education, to think about the support that we are offering to make sure that it is inclusive and that we are reaching those who really need it.
The mental health of students/clients (for the purposes of this paper I will, from now on, use ‘student’ rather than ‘client’, unless I am referring to psychotherapy and counselling outside of the educational environment) effects their ability to learn and to create, and those with more intersectional issues have higher rates of non-attainment. (Which university degrees are best for intergenerational mobility? 2024). By using a Creative Inquiry approach for my research method, I was able to facilitate teaching and learning through creative writing, in the forms of psychotherapy and counselling vignettes, which also became a process for me to reflect on my work personally as a psychotherapist and counsellor, it became a form of ‘writing as process’.
Psychotherapy and Counselling vignettes have historically been used in both training institutes, and in popular fiction, as a way of communicating the very moving account of what happens in the therapy session, whilst attesting to ethics and respecting the anonymity and confidentiality of the client by making the account fictional and, for purposes of authenticity – based upon real case histories and client stories.
And so, a psychotherapy vignette will be an amalgamation of years of work with many clients, illustrated in one case example. Identifying features, such as names, dates, places will be anonymised and so what is left is a theme, or a ‘thread’ if you like, running through the vignettes, illustrating the rich and complex stories which unfold.
During my training in Existential Psychotherapy and Counselling, I read Loves Executioner, by Irvine Yalom (Yalom, I.D. 1989) for the first time. Yalom’s vignettes of therapy sessions with his clients really gave me an insight into to what happens in the consulting room, more than any theoretical text ever could. Although I found that reading about philosophers such as, Simone de Beauvoir, Jean-Paul Satre and Maruice Merleau-Ponty, and Psychiatrists and Psychotherapists such as, Viktor Frankl, Franz Fanon, and Rollo May, fascinating, what really drew me in was the fictional creative writing. Susie Orbach’s has also written widely in this form and her book ‘On Therapy’ (Orbach, S. 2016) has now been made into a channel 4 radio programme. It was within this style of writing that I found insights of what it must be like to be a psychotherapist and Counsellor in sessions with a client, and now years into my practice as a psychotherapist I can attest that the vignettes are very true to life!
For the purposes of the ARP, I chose five students who I was working with, who had intersecting (Crenshaw, K. 1989) issues in terms of marginalisation. For purposes of protecting the confidentiality and anonymity of the student, I anonymised the name, course, college, year of study, and other identifying details such as nationality, and sometimes gender of family members. I then wrote the vignettes, a page to two pages of A4 paper, about why they came for counselling, the intersecting issues they presented with, and how I worked with them as a counsellor and psychotherapist. The writing was based on the original story, and so there is an authentic thread running through each of the vignettes, but they are written as an overall amalgamation of all the students I have worked with over the past 8 years as a counsellor at UAL.
Firstly, I discussed my research proposal with my manager, who is a senior counsellor at UAL. She was incredibly supportive of my research and was excited by the idea of using the vignettes as a teaching and learning aid within our team to talk about inclusivity and to think about how we support students who come from marginalised groups. We discussed the ethical considerations of the research, with student confidentiality being paramount, and she was happy for me to go ahead with the research on the premise that students, a), gave their consent, and that b), they were explicitly made aware that they were under no obligation to consent to the research, and c), that our sessions together would not be affected regardless of whether they gave consent or not.
“You cannot rely on rules to help you to act ethically in research. Principles
such as ‘use research to do good’ and ‘guard against bias’ can be helpful. But
ultimately, to be an ethical researcher, you need to think ethically before,
during and after you make your research. Even this won’t protect you against
mistakes along the way and taking actions which, on later reflection, you
will realise were not the most ethical option. But if you’re making the best
decisions you can, on the basis of the information available to you at any
given time, then you’re doing all that anyone can ask.” (Kara, H 2015).
I also discussed the ethics of carrying out research into the emotionally demanding work that I do, for me and the students and it was helpful reading an online resource on this topic to remind myself about vicarious trauma and taking care of my emotional health during this time, as well as taking care of the students. For me I set some parameters around my schedule, I would try to do as much as I could on site at UAL and what I needed to do at home I would do early in the mornings, and I would aim to have evenings and weekends to recharge. (Thinkaheadsheffield, 2019). After getting the ethics form signed off by my PgCert supervisor, I emailed five students from marginalised groups in terms of: ethnicity, disability, gender, socio-economic background, and other intersectional issues such as, having caring responsibilities, growing up around addiction, and having mental health issues within the family, and asked if they were willing to give their consent for me to write about our work together in the form of psychotherapy vignettes, the vignettes being semi-fictional with all identifying features being anonymised, and for the writing to be used for teaching and learning purposes, on the theme of inclusivity, and will be used solely within the counselling, health, and chaplaincy team at UAL. I emphasised that our counselling sessions together will in no way be affected, whether they agreed to give consent or not.
Three students gave their consent, and I have named them, Isobelle, Sebastian, and Fleur. One student, who I will call Eman, said that she would prefer not to, and this was incredibly beneficial in our counselling sessions together, it is okay to say no! And one student, who I will call Kehinde did not respond at all, which I believe is indictive to the level of overwhelm she was facing, in part, because of intersecting issues, and so this is also relevant to the research.
The type of research I used would fall under both ethnographic research, and also creative inquiry. “Ethnography is a qualitative research method in which a researcher—an ethnographer—studies a particular social/cultural group with the aim to better understand it. Ethnography is both a process (e.g., one does ethnography) and a product (e.g., one writes an ethnography). In doing ethnography, an ethnographer actively participates in the group in order to gain an insider’s perspective of the group and to have experiences similar to the group members. In writing ethnography, an ethnographer creates an account of the group based on this participation, interviews with group members, and an analysis of group documents and artifacts. This entry offers an overview of ethnography and the ethnographic research process, including negotiating access, data collection, analysis, and writing.” (The sage encyclopaedia of communication research methods). My work as a psychotherapist and counsellor means that I am immersed in the world of my clients by the stories they tell and also, I am doing ethnography by writing an account of those stories.
Creative Inquiry is a… “personal or pedagogical process where individuals or learners engage in reflective, critical thinking though artistic, aesthetic, or creative modalities.” (What is creative inquiry. IGI Global).
Using a creative approach to research feels fitting when working with art students, additionally I very much see psychotherapy and counselling as a creative process in and of itself. When carrying out a literature review for my research I came across vignette research as a specific modality of research which fits perfectly with my chosen action research project! It is a phenomenological research methos which fits with Existential Psychotherapy.
Vignette research…… “is an innovative qualitative, narrative and phenomenological research methodology that has gained international recognition, sparking interest from a wide range of individuals and institutions in global contexts. Vignettes are concise narratives, which capture human experiences in real life settings. They reveal surprising or intriguing facets and intangible moments. The experiential narratives resonate with readers and reduce the distance between the researcher and the researched.” (Bloomsbury.com)
Initial ideas
Initially I did a lot of preliminary work around my initial idea of Inclusivity and the Imposter Syndrome workshop. I got the ethics form signed off, designed an information sheet and consent forms. Here is a preliminary action research cycle for looking at Inclusivity in the Imposter Syndrome workshop:
Below are the notes I made from the first two workshops. I have kept them in the blog as they helped to inform the design and process of the ARP.
ARP Day 1.
Reading for the session – McNiff, J. (1995) Action Research for Professional Development. One of: Alvesson (20212); Convers & Presser (2011); Ellis and Bochner (2006); Jones et al (2010); Irving et al (2012); Tjora (2006).
Aksel H. Tjora. Norwegian University of Science and Technology – the paper looks at taking field notes (or documenting observation) this is at the core of ethnographic research.. the article draws on the analysis of 247 short field notes taken in various situations by student observers.
ARP principles – creating an ethical space. Critical Friendship
Article – on documenting qualitative methods.
Article – Auto Ethnography
Fictional Methods to avoid disclosure (composite character)
Read Peter Cluff, Irvine Yalom, Suzy Orbach
BERA’s responsibilities – privacy, data retrieval, data storage, confidentiality, right to withdraw.
Learning Outcome 1 – critically analyse how a social justice issue within your academic practice context impacts student experience (knowledge)
- convincing others of your decision making
- arguing for the validity of your topic and approach
- why is it of interest to you? why it is of wider interest?
- which fields does it sit within/across?
- how do you define social justice?
Learning outcome 2 – define a feasible and detailed research design (enquiry)
Learning Outcome 3 – design implement and review research methods and instruments appropriate to your process (question)
- reading in to research methods
- documentation of reading on blog as an appendices for your presentation, i’e interview, data sketches etc
- havard referencing
Learning Outcome 4 – synthesize your findings and present your project in a coherent context-specific manner (communication)
Blog post – how/ways to make a start (individually) refine your process – why does it matter to me? Why does it matter to the world? Research question and keywords. Where are you up to? (taking stock). How am i feeling about it? (temperature check). What do i need to know more about? (knowledge formation/ concept mapping). What is the next thing i am going to do? (action plan/ tasks). note it all down on the blog – project refinement
Submit ethical enquiry form
Action research is about carrying out academic research in order to improve the student experience within the teaching and learning experience for higher education (H.E).
I will be required to carry out a social/climate/racial justice based action research project, which addresses an issue i have identified in my own teaching and learning practice.
Action research is philosophy, which i love, being an existential psychotherapist, and it is also a methodological approach. It is both action and enquiry and it allows creative methods.
I will first map my current understanding and experience of my chosen issue and i will work with peers to look at the feasibility of the project and then pose a research question.
I will plan, execute, document and reflect upon my research question, and an intervention whilst expanding my knowledge and referencing codes of practice for ethical research and consider the needs of my participants and the duty of care that i have towards them.
I will present my project to my cohort and receive feedback about where it might go in the future.
My tutor group will be an ‘action learning set’ of three or four colleagues supporting each other. the research project should be feasible to do within the ten week timeframe. at each stage of the project i will document relevant recourses that enable me to narrow my focus and refine the detail in my project.
I plan to experiment with different methods, observation, visualisation, journaling, narrative enquiry, enhanced interviews etc. i will use the ethical research form on moodle. I will approach the project as a ‘creative unsettling of my own practice’ (unit brief). i will look at my own positionality and embodiment in my practice as a researcher.
I will attend fortnightly sessions with my ARP group and action and learning set.
At the end of the unit i will present my project for summative assessment to my peers and tutors. The presentation will not exceed 10 minutes and should take a form appropriate to the project’s context and content and will include:
Original context / background
Rationale for selecting the topic
Reflection on research methods used
Summary of project findings
References to relevant literature (using havard referencing)
I will display my research journal and presentation materials on my blog and this will be checked by the assessor by 10am on the day of my presentation. this may include project documentation, visuals, notes, slides. my blog will be considered along with the presentation in the unit assessment.
Workshop 2 reading
Christina Templin writes about citation being a (cis white) male dominated world claiming that referencing in academia is not neutral and that academia in general underrepresents women and people of colour. she looks at some of the challenges that arise when trying to make research feminist and gender-sensitive.
The article looks at Sarah Ahmed’s book, “living a feminist life” (2017), as well as her blog, where she discusses what it means to be a feminist and the inherent challenges. She adheres to a strict citation method and reflects on how to we are influenced in our writing by the references we use. her work demonstrates that referencing is political and that there is an academic hierarchy. Templin goes one to link this work with women of Colour being excluded from knowledge production as citation and publication methods continue to contribute to sexism and institutional racism.
Templin goes on to reflect upon her own research within political science, questioning who she is citing and her intention for doing so before concluding on how contemporary research can help improve the challenges addressed, making citation more inclusive.
“living a feminist life” (2017) Templin states is a personal account of Ahmed, a woman of Colour with a PhD in critical theory who explores her journey to becoming a feminist in a patriarchal world. she is inspired by black and feminist of colour scholars and links everyday experience to feminist theory.
She says as researchers it is relevant where our ideas come from and what we put out into the world. it also guides our positionality and how we generate knowledge. she describes citations as “feminist bricks” as they help to build an inclusive world.
“In this book, I adopt a strict citation policy: I do not cite any white men. By white men I am referring to an institution, as i explain in chapter 6. Instead I cite those who have contributed to the intellectual genealogy of feminism and antiracism, including work that has been too quickly (in my view) cast aside or left behind, work that lays out other paths, paths we can call desire lines, created by not following the official paths laid out by disciplines” – Ahmed 2017, p15
This is to avoid what happens at large, that theorists cite other well established theorists keeping the hierarchy which is already in place and generally keeping to similar epistemological positions. this is a way of giving voices to those who have traditionally been excluded within epistemological research.
Templin goes on to comment that because academia is controlled by an elite of white men, their interests shape research and therefore their interpretation of the world is reinforced by those they cite or “citation chains” (Templin 2021).
The paper states that a way of validating marginalised voices by making space for the worldviews of which black women have sustained when living with intersectional oppressions. Patricia Hill Collins talks about “belief in connectedness and the use of dialogue” (p.260)
Due to this elitist method of using citations black feminist women are excluded from being visible a viable in research, as are their ideas and lived experience within community and alternative ways of being are not explored.
Templin asks, ‘why should we care’? After recognising that citational systems favor whiteness and leave out particular voices and people we have a responsibility to question power and systems in terms of working within the social sciences.
Citations can function as a “powerful corrective” (Baker 2019) and so we can all be more conscious of who we cite and why.
“Instead of understanding citation as a metric of influence and impact, we outline practical and conceptual ways to resist these neoliberal leanings by thinking conscientiously about citation as a form of engagement” (Mock/Cockayene 2017, p. 964).
Templin lists questions we can ask ourselves when using citations, taken from an Australian teacher –
- How does this list of references situate my work in the field? With what kind of scholarship am I aligning my work?
- From what nations, cultures and classes do my references come? To what extent do they represent Euro – or Anglo – centric ways of knowing and being?
- What is the gender mix of my reference list?
- Whose voices are silent? Whose scholarship have I ignored or excluded?
Templin concludes by stating that citational systems can uphold oppressive systems of sexism and racism in academia and that marginalised bodies and voices are excluded leading to only a narrow body of academic work that is deemed credible. It is therefore important that we reflect on our own citation practice and to think about how we can make it more inclusive.
Image: author’s own. Frieze Arts Fair table. ‘Giacometti’ 2023.
“Feminist thinking teaches us all, especially, how to love justice and freedom in ways that foster and affirm life.”
― Bell Hooks
These two images show the notes I had written after our final tutorial session when everything felt like it was (finally!) coming together! They are very messy but to me they contain everything I need to do before the final presentation.
Ethics
Ethical Enquiry Form
I initially decided to do my research into inclusivity in a workshop I deliver on imposter syndrome. However, for various reasons I chose to change the ARP question. Due to it being the end of term the uptake for the workshop was not great, in fact only three students signed up (there are usually at last 10), and no one showed up. This gave me the opportunity to re-think my research question and I decided to change it altogether.
I decided to use a creative inquiry approach in terms of semi-fictional writing to create psychotherapy vignettes of my client therapy work, with a theme of inclusivity in mind. This idea felt much more aligned and authentic with my work. One-to-one psychotherapy and counselling is the majority of what I do in my role at UAL. Attached above is the signed-off ethics form for the psychotherapy vignettes research.
Below I have added all of the ethics forms as they demonstrate the process of becoming clearer on the implications of my research and getting clearer on the ethics.
Participant Facing Documents:
Here I have added the participant consent form and the information sheet sent to five students.
Presentations
Research: psychotherapy vignettes – Isabelle, Sebastian, and Fleur.
Psychotherapy vignette – Isabelle.
Isabelle is the student’s “English name”, she is originally from China. It is common for students from China to take an English name to fit in. Isabelle’s mother is Chinese, and her father is English. Her mother moved to the UK from China to be closer to her parents, who had moved to the UK for work. She is a cleaner and this is physically demanding work, and on zero-hour contracts there is little security. Isabelles father has problems with addiction, he was unable to provide for the family and he was often violent towards her mother when drinking. He left when Isabelle was little, she can’t remember when exactly (it is not unusual for memory to be impaired when growing up around addiction and trauma).
Isabelle has a younger brother, 18 months younger than her, he has a diagnosis of ADHD and needs a lot of his mother’s attention, which means that Isabelle often must find a way to attend to her own emotions. This is in part why she is coming for counselling at UAL, to have someone to talk to about how she is feeling. She suffers from anxiety and depression and is currently finding being on the course, and life in general, overwhelming.
She has some friends at university but finds it difficult to open-up about her home life and how she feels on the inside. She feels different coming from a low-socioeconomic background with an immigrant parent, and a single parent household. She dreads the thought of someone asking about her father and having to explain that she doesn’t know where he is. These intersections she struggles with. Intersectionality can be defined as “the theory that various forms of discrimination centred on race, gender, class, disability, sexuality, and other forms of identity, do not work independently but interact to produce particularized forms of social oppression.” (Oxford Reference 2024).
She is studious and has sought refuge in education and learning – it being an escape from her home life. She works hard and a big part of her identity is centred around being bright and hardworking and gaining good grades. She is studying architecture at Central Saint Martin’s College, and this is a mentally challenging course. She is currently going through a depression, brought on by the breakdown of a relationship. It is my belief that the grief she is feeling is quite possibly not just about the sadness of the end of her first serious relationship, but also early loss from the early abandonment from when her father left, for which she has never grieved. She is unable to focus on her studies as well as she usually does, and this is causing anxiety as it is usually the place where she feels most in control.
She struggles with authenticity as she puts on a face to the world, and this in turn causes anxiety. There is inner conflict between who she is at home and who she portrays herself to be. What she desperately needs is to feel understood for who she is. There is a fear that if people knew who she really was, they would leave. This fear of abandonment is common in individuals who have an absent or absent parents, or where there are addiction issues in the home. Because the parent/s are pre-occupied with their own struggles with addiction they are unable to attend to the emotional needs of the child. And therefore, the child grows up believing that there is something wrong with them, that they are unlovable.
This pattern often repeats in adulthood. The individual unconsciously acts out strategies to try to avoid being abandoned such as people pleasing, perfectionism, or presenting a false self, in an attempt to be loved. However, it is these exact strategies which push people away as they create a barrier to real intimacy, closeness, and connection. This perpetuates the cycle of abandonment, which in turn, reinforces the feeling of being unlovable.
The human brain is adapted to always move towards what is familiar, rather than what is good for us. “When we recreate dysfunctional relationship patterns from our past, we’re unconsciously trying to re-do these experiences, so we can feel in control, so we can fix what we couldn’t fix as children. We think (again, this is mostly unconscious) that this time if we can be lovable or perfect, we won’t make the same mistakes and thus avoid the abuse or rejection that we suffered as children.” (Sharon Martin, 2018)
And so, it is the role of psychotherapy and counselling to bring these patterns into consciousness so that they can be worked through, as well as creating a safe space to allow the student to open up and to show their real self. By being vulnerable within therapy they learn that it is safe to do so and are then able to take steps to be more vulnerable with people outside the counselling room. They learn that being authentic and vulnerable creates more intimacy and greater connection and therefore a free to be their authentic self, which in turn, lessons anxiety.
Within the brief therapy setting at UAL, time is limited and so the first step is to acknowledge the intersectionality and to validate Isabells’s experience – to acknowledge the loss and the grief, as well as identity – wanting to fit in and yet feeling different, as well as commending her resilience and dedication. To show that by being vulnerable in the sessions and revealing her true self, I am still here, I will not abandon her. There is a solid framework of six sessions of fifty minutes, at the same time each week.
We address the ending from the initial session and talk about it in the sessions leading up to the final session. I acknowledge the sadness of the ending, and this is reparative, to be able to sit with the feelings of sadness and disappointment together. We look at themes around identity, what does it mean to her coming from mixed heritage? Around loss? How does she feel about her father not being around? About relationships, how she is scared to get close to someone for fear that they will leave. About money and having to work long shifts at a restaurant as well as studying full time. We look at what it means to be vulnerable and how it feels to start revealing herself. We look at what makes her unique, not despite where she has come from, but because of where she has come from, and in fact it is the things which she hides that are the things that people feel most connected to.
Existential psychotherapy is about using a phenomenological line of enquiry. Phenomenology is the study of what is, and so it is about staying with the clients’ experience, whilst bracketing our own assumptions as a therapist (and being aware of our unconscious bias). It is about avoiding making too many interpretations, but instead facilitating an unfolding of the clients’ experience, whilst gently pointing out paradoxes, which are inherent in the human condition. Therefore, using Freuds words, making the unconscious, conscious. When things become conscious, they can then be worked through, and this is often the starting point of therapy.
By carrying out a detailed history of the student in the initial assessment I was able to think on various levels about what would be helpful. I referred her to the disability team to advise on further support that she may be entitled to, as she had been suffering from anxiety and depression for some time, she may be entitled to an interim support agreement to assist with her studies. I also referred her to a student adviser regarding the hardship fund. Isabelle found it hard asking for help and coming for counselling was the first step for her to seek support. I also gave her some details of long-term psychotherapy organisations and encouraged her to self-refer directly after our initial session as there is likely to be a waiting time and by the time our six sessions come to an end, she would be closer to being accepted for longer-term therapy.
This left the remaining sessions free to offer her what she was looking for from counselling, a space to talk, away from friends and family, about how she is feeling, to try and make sense of it, and to move beyond it.
The six sessions gave Isabelle the space to grieve for the loss of her relationship, of the relationship with her father, to think about her identity and owning all of the parts of herself, including the parts she was hiding due to shame or feeling like she didn’t fit in, to embrace the parts of herself which have come about due to adversity and at the same time acknowledging the unfairness of how difficult it has been for her to get to where she is, despite the inequality she has faced.
I was able to offer a space to feel heard and feel validated and to embrace who she is and the beauty of her unique characteristics and her story. This gave her the strength to show more vulnerability to others. The counselling wasn’t perfect, I was only able to offer her six sessions when ideally, we would have worked together for much longer. But we explored the feelings of disappointment and sadness, that it is not perfect, but it is good enough, and that in fact she doesn’t have to be perfect, and that is okay.
Psychotherapy vignette – Sebastian
Sebastian came for counselling as he wanted to understand himself better. He was studying Fine Art at Chelsea College of Art and was in his first year. He was struggling with anxiety, and this was having an impact on his academic work and creative practice as he was unable to focus as he usually did. He was from New York, and on the face of it, a well to do family. His parents were corporate lawyers who divorced when he was 10 years old. His father died quite suddenly from a heart attack when Sebastian was completing the International Baccalaureate in Paris, before moving to London to go to university.
He described both parents as high-functioning alcoholics. He had an older sister, who had substance abuse issues and who was in and out of rehab and lived in the family home with their mother.
Sebastian was in a tumultuous relationship with his girlfriend, who he loved very much but who had self-diagnosed trust issues stemming from growing up in a chaotic abusive household. She was studying at university in Paris, and they were having some problems with the long distance.
Sebastian had never been diagnosed but questioned if he was autistic. He had trouble reading people and found that he did not know when to stop talking, he would overshare and afterwards would feel a great amount of anxiety and would go over the conversations in his head, questioning if he had said the right thing.
The questioning became a form of OCD, and he would ruminate on things that he had done or said and worry that he had caused offence or done the wrong thing. One of the main reasons for coming to counselling was to explore neurodiversity, he said that it would make sense to him if he was autistic, and that the diagnosis would account for the reason he thought and acted the way he did. He told me that a diagnosis would be a relief.
At school he was badly bullied for being different and it was only when he moved to Paris, to study the International Baccalaureate, did he make friends and it was here that he met his first girlfriend. He had made some friends at Chelsea College of Art, but they were mainly girls, and his girlfriend didn’t like it and so he distanced himself from them. He was becoming increasingly isolated and as his mother was busy with work and worrying about his sister, he didn’t have anyone to talk to and the only point of reference was his girlfriend, and he wasn’t sure if she was being unreasonable or not.
Sebastian is a white male from a financially secure family and so in many ways he comes from a privileged position. However, there are also intersectional issues in terms of neurodiversity and addiction.
During the initial assessment I took a full history and discussed with Sebastian the parameters of brief counselling, the counselling frame – that is the regular time and place we will be meeting as well as procedures around missing sessions and punctuality. I asked him what an autism diagnosis would mean to him and if this was something he wanted to pursue? He told me that it would help him to make sense of his life. With his permission I referred him to a mental health adviser to do a preliminary autism measure, which can indicate the likelihood of autism prior to a referral through the GP.
During our six sessions together, we explored themes such a guilt and anxiety, boundaries, and taking care of himself. As our sessions went on, it became apparent that the issue wasn’t as much his girlfriend not trusting him, but of him not trusting himself. He didn’t grow up with a secure attachment. His parents were busy working, and his sister, possibly self-medicating from her own mental health struggles, was taking drugs. He spent a lot of time alone in his room reading or playing video games. He didn’t have friends to talk to about how he was feeling, and he felt unsafe in the world.
What was clear from very early on in our sessions was that Sebastian had a very strong conscience, which is often the case with those suffering from OCD, and so he felt a sense of guilt about things that he didn’t need to feel guilty about. He knew right from wrong. He knew that he wouldn’t be unfaithful to his girlfriend, as he was in a committed relationship and yet he stopped being friends with girls on his course because his girlfriend didn’t trust him, or perhaps he didn’t trust himself. Life is not black or white, it is often a shade of grey and this is what caused him anxiety.
“Søren Kierkegaard said that “Anxiety is the dizziness of freedom…He who has learned to live with anxiety in the right way, has learned the ultimate.” (psyciencia).
Sebastian found it difficult tolerating uncertainty, and from an Existential perspective this was creating anxiety. He was pretty sure about important things but the element of uncertainty, which is part of the human condition, was causing him to doubt himself. It wasn’t helping that his girlfriend, because of her own difficulties with attachment was projecting her insecurities onto him.
The work that we did in the sessions together was to look at his childhood and adolescence and the loneliness and anxiety that came from growing up in a family with addictions, absent parents, being bullied at school, and how these intersecting issues created an anxious attachment style.
We also explored neurodiversity and one of the key components of autism being black and white thinking. Noi Suzuki and Masahiro Hirai looked to explore the potential link between autistic traits and dichotomous thinking in their research on “neurodiversity and in particular autism, with a key component being seeing things in a black and white or rigid way. “People with autistic traits tend to have higher intolerance of uncertainty, leading to dichotomous thinking” (Hedrih, 2023).
By making sense of the possible reasons why Sebastian questioned himself we were then able to explore why he felt so anxious and to look at his own agency and how he can use Socratic questioning when he starts to feel overwhelmed.
“The primary goal of Socratic questioning in psychotherapy is not to change the patient’s mind, but to guide them in discovering methods for improving their lives.” (Carona et al., 2020).
In Sebastian’s case this would mean looking at the possibility of the things he fears happening, happening, such as if he is friends with girls, he may be unfaithful. Socratic questioning would ask questions such as, have you been unfaithful before? If not, then what makes you think it will happen now? There is of course a possibility of it happening, as nothing is certain. And if the worst-case scenario did happen, which is not likely, you would have the capability of dealing with the situation, in this case talking to your girlfriend and deciding the next steps for your relationship. We also looked at core values and for Sebastian, a committed relationship is important to him.
We then explored what it would feel like for Sebastian to maintain his friendships and to work on establishing trust in the relationship. For Sebastian, the sessions helped him to explore where the anxiety and questioning of self comes from and to learn to trust himself, whilst having the tools to question his thinking in a logical way when he starts to feel overwhelmed.
When thinking about inclusivity in my counselling practice at UAL it is important to explore the impact neurodiversity, and growing up around addiction, can have on the students psychological and emotional health, which in turn can impact upon their academic and creative lives.
Psychotherapy vignette – Fleur
Fleur applied for counselling as she was feeling low and wanted to talk to someone. She had just started the first year of BA Womenswear at London College of Fashion and had originally planned to move to London with her best friend from where she grew in Brighton, but the friend decided to accept an offer at Glasgow at the last minute. Fleur felt let down by this, in the absence of a stable homelife she had relied on her best friend for emotional support.
Fleur was a mature student and at 25, although not at all old, she noticed her age and found that she couldn’t really relate to the 18- and 19-year-olds on her course and in the halls of residence where she lived in East London.
She had previously had therapy, through the local child and adolescent mental health services (CAMHS) in Brighton, and then cognitive behavioural therapy for anxiety and depression in her early twenties, and whilst it helped to a degree, she didn’t always feel validated or understood.
She had grown up with her mum, who was quite young when she had Fleur. Fleurs mother and father separated when she was still a baby. Fleurs father moved to Bristol and re-married and she didn’t see him much growing up. Fleurs mother suffered from bi-polar disorder, and Fleur often took on the parental role to take care of her mother and this meant that she grew up faster than she should have done. Fleurs mother would have depressive episodes where she couldn’t get out of bed for weeks at a time. She would also have manic episodes and would drink and go out a lot. This was unsettling for Fleur, she didn’t have an outlet for her emotions, and she would get depressed.
Fleur had lots of part-time jobs and helped financially and practically around the home. She delayed going to university as she felt that she needed to stay and take care of her mother.
It was important for Fleur to work and save enough money to go to university, she needed to feel secure as she didn’t have a secure base back home in Brighton to fall back on. She worked hard during a foundation course locally in Brighton and she got a place on the womenswear course at UAL. She worked hard but she felt undeserving of the place and felt like an imposter. It seemed that all the other students came from stable homelives and had the financial support of parents, and she did not.
The intersectionality of growing up in a single parent household, with a parent with a serious mental health condition, and a low socioeconomic status meant that she always felt that she didn’t belong at university.
After the initial counselling assessment, I signposted Fleur to student advice to see if there was any financial support through the hardship fund, and to the disability service to advise regarding additional support with studying due to a history of anxiety and depression, and I scheduled six weekly counselling sessions.
The psychotherapeutic frame of having the sessions at the same time each week, each session 50 minutes, and on the same day of the week, offered Fleur the consistency and security she craved. She had a space to breathe. She overworked, part due to necessity and part because this is where she found a sense of meaning and purpose, and this had become part of her identity. She overextended herself and felt comfortable in the role of being busy. We explored this together in the counselling sessions and looked at the pattern she was repeating from her adolescence and young adulthood, where she was the one to take care of her mother and the home. This was her chance to take care of herself, and if she didn’t do so, she was likely to burn out.
We explored the depression and made links to the betrayal of her friend not coming to London with her as planned, she was grieving the loss of this friendship and everything it represented. She was also grieving the loss of all that was familiar back home, and whilst it was a challenging home environment, it was also what she knew.
We looked at making room for the grief and to take the time to focus on herself and a new way of being in the world. Her focus for as long as she could remember had been on her mother, or on the house, or her work, and now it was time to focus on herself. The Counselling sessions became a brief opportunity of reparenting, with the safety, continuity and consistency of the sessions, and the space to start to heal. She was then able to start to reparent herself and to give to herself all of the nurturing she needed as a child.
Her depression started to lift, and she made some friends in the halls of residence and her confidence grew, she carved out a routine for herself of exercise and sleeping well and she focussed on her coursework. The counselling was focussed on staying with her experience, a phenomenological enquiry of where she is now in relation to what had gone before and where she wanted to be. This Existential approach suited Fleur as it gave her the space to explore what this new chapter of her life meant to her.
She started to feel more secure and realised that she was carving out a stable sustainable life for herself and had the potential to transcend her chaotic up-bringing. She had re-established contact with her father and was looking forward to seeing her mother in the easter holidays. We had worked on boundary setting and whilst she loves her mother dearly, it is not her job to take care of her. Her mother had started therapy also and she was getting the help she needed.
Conclusion
The intention of using creative methods, in the form of psychotherapy vignettes for the ARP was to carry the theme of inclusivity, from the inclusive practice unit, into the ARP and to use it as a teaching and learning aid for the wider team in which I work at UAL. What I hadn’t realised is that it would also end up being a method of deep reflective practice for me personally, as a way of processing and inseminating what I have learned in the PgCert and for my work as a psychotherapist and counsellor at UAL. “Processing includes problematizing, analyzing, and making attempts to solve social justice issues that emerge through reflective “processes such as journaling, reflection groups, community dialogues, walking, research, and observation.” (Disorientation as a learning objective: Applying … – sage journals)
Creative writing has given me a way of taking a step back and thinking about my work – it has become a form of reflective practice (Kara, H 2015). As a psychotherapist and Counsellor at UAL I have weekly supervision and clinical meetings where I can talk about my work and any issues that may arise, for the students and for myself, and this is crucial for the work I do. However, creative writing has become an additional resource for me to process and to reflect and for that I am deeply grateful. What next? The next step is to meet with my manager and think about how to best make use of the vignettes within the team. Some ideas that I have are to have a counsellors meeting dedicated to thinking about inclusivity as a team and how we best support our students. This would be an efficient use of time as many counsellors work part time, and everyone is already very busy and so to utilise a meeting that is already in place and which everyone attends, makes sense. And/or to use the vignettes within the wider multi-disciplinary team of mental health advisers and chaplains as an example of how we work as counsellors and for us to think about the theme of inclusivity and what support individual students may need from the multi-disciplinary team in terms of support. With either scenario I am sure that more questions/observations will arise, and this will be an opportunity to think about ideas for new research, thus continuing the action research cycle. (George, T. (2023)
Presentation – Here is the final 10 min presentation