Therapy Today

Co-creating
therapeutic
conversations
Reflexivity in therapeutic
practice
Fran Hedges
Palgrave Macmillan 2010,
£21.99
ISBN 978-0230553088
Reviewed by Richard House
Few, if any, specifically
counselling/psychotherapy
books have been written on
reflexivity per se. Several
books have been published
on reflective practice, and
on therapists’ use of self;
however, the distinction
between ‘reflexive’ and
‘reflective’ might be one that
needs more attention. In the
introduction we’re usefully
told that ‘reflexive’ is defined
as ‘capable of turning or
bending back… directed
back upon the mind itself’
[my italics] (p2).
Writing a book on
reflexivity is by no means
straightforward, and Hedges’
approach is perhaps as good
as any. Following Vernon
Cronen’s lengthy
contextualising foreword,
chapter one explores the
ways in which our own
biographical stories influence
our therapeutic conversations.
Thus, ‘when we meet a client...
our identities intermingle...
we are literally entangled in
stories at the interpersonal
level... and we... influence
each other’s self-descriptions,
developing... “we-identities”’
(p15). The author’s socialconstructionist,
postmodern
predilections (which I largely
share) are clearly apparent
throughout. Chapter two
looks at the central role of the
emotions in reflexivity, and
chapter three looks at how
language (a favourite theme
in postmodern thinking)
influences our assumptions
and prejudices. Chapter four
looks, interestingly, at how
stories of time influence
conversations, and chapter
five explores transparency
and self-disclosure. Chapter
six considers bodily responses,
and chapters seven and eight
look, respectively, at further
ideas/resources for practice
and supervision.
The book has an engagingly
non-mystifying readability
that never lapses into
theoretical obscurantism or
superficiality. Hedges renders
challenging postmodern
ideas in a comprehensible
way, weaving in case study
material that is always
stimulating and thoughtful.
I do, however, have several
concerns. The term ‘made
me feel’ recurs throughout
the book. This is a problematic
notion, suggesting a kind of
determinism that most
therapy modalities would
reject; and it surely has no
place in a reflexive discourse
that privileges co-creation.
There are also points in the
practice examples with which
some therapeutic modalities
would take issue: for example,
extensive self-disclosure,
inviting the relatives of clients
to come to therapy sessions,
etc. But these practices do
serve the goal of encouraging
readers to look again at the
often taken-for-granted
therapeutic ‘regimes of truth’
within which we work, and to
question their assumptions.
This is an excellent book
for any student/trainee
wanting a readable and
engaging introduction to
systemically informed,
postmodern approaches
to co-creating effective
therapeutic conversations.
Richard House is Senior
Lecturer in Psychotherapy
and Counselling at Roehampton
University and the author of
Therapy Beyond Modernity
and Against and for CBT
The impact of
domestic abuse
Rebuilding lives after
domestic violence:
understanding long-term
outcomes
Hilary Abrahams
Jessica Kingsley 2010, £18.99
ISBN 978-1843109617
Reviewed by Cath Fuller
This is a longitudinal study
of the effects of domestic
violence and abuse on the
lives of 12 women. They were
interviewed first when they
were in refuges, then six
months later, then a few years
after that. This is the book’s
unique selling point, as most
studies cover a much shorter
timescale. Working with the
women over this extended
timescale, Abrahams was able
to gain their trust, and they
report they found the research
process a validating and
positive experience in itself.
The author’s respectful,
acceptant and honest approach
models the guiding principles
of working with women whose
self-esteem and sense of
safety have been shattered by
domestic violence and abuse.
It is the author’s aim to assist
today’s policy makers
and service-providers in
developing appropriate,
targeted and cost-effective
services.
This is a really useful
resource for inexperienced
and trainee counsellors. It
is written in clear and direct
language and is well
structured, with bulletpointed
summaries at the
end of each chapter and
a useful list of organisations
and their websites in an
appendix. Counsellors who
are more experienced in this
field may not be surprised
by the book’s conclusions,
but they are likely to gain
a richer and deeper
understanding of the
problems and impact of
domestic violence from
these women’s stories.
With evidence that 30
per cent of a larger group
of women surveyed either
started or returned to abusive
relationships after leaving
the refuge, emotional
loneliness is identified here
as one of the major hurdles
to be negotiated. The reader
learns that the gradual
process of leaving and
returning to an abuser ‘may
ultimately increase a woman’s
confidence in her ability to
manage alone, or… to
recognise that she is repeating
old and outworn patterns of
behaviour and eventually gain
the strength to take a stand
against the abuse’.
It can feel frustrating and
overwhelming to counsel
these clients. The closing
chapters of the book – in
which the women look
forward to brighter futures
– powerfully validate the
work of services which do
not give up on those who live
with domestic violence and
abuse, difficult and draining
as the work may be.
Cath Fuller is a psychotherapist
November 2010/www.therapytoday.net/Therapy Today 39