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Engaging Reflection in Practice - A Narrative Approach

by by Christopher Johns

listed in psychotherapy

[Image: Engaging Reflection in Practice - A Narrative Approach]

I feared this would be the most difficult book review I’d ever written. I was plagued by negative feelings about the book. I decided to use Christopher Johns’ narrative approach to reflect on my difficulty, as if the book were a person with whom I was having a troubling experience. Johns writes that “guided reflection is a journey of self-inquiry and transformation for practitioners… to realise desirable practice as a lived reality.” The journey is a written one involving six levels of dialogue.

1.    Dialogue with self
I write my disquiet with the book, without censoring my thoughts or feelings. Here are a few excerpts:

I’m irritated – he’s self-righteous, arrogant – blowing his own trumpet – who does he think he is, doing this special work with the dying, being a special healer, such a good Buddhist – what’s he trying to prove? His self-exposure makes me want to cringe. He’s smug. If I were a good Buddhist like him I’d be able to breathe out my irritation – I feel petty, spiteful;

2.    Dialogue with my story to create a coherent text
I use MSR (Model for Structured Reflection), a list of questions to stimulate reflection by identifying significant elements, emotional reactions, old patterns, lessons to be learned and future responses.

I identify separate elements in my negative response. I’m critical of the author’s seemingly fearless ability to self disclose and see how this triggers my fears about exposure. It takes a lot of courage to be as open as this author. The other significant element is envy, professional and spiritual. On reflection, behind my scornful ‘who does he think he is?’ lurks my desire to  be a powerful healer too, and  a regret that my spiritual beliefs don’t  inform my work as intimately and consistently;

3.    Dialogue between the text and sources of theoretical knowledge to widen understanding
From a psychotherapeutic perspective, my encounter with the book is full of polarities: life and death, good and bad, light and dark, humility and arrogance. My emotional response demonstrates the phenomena known as splitting. It was as if the book were entirely ‘good’ and I was the one holding all the ‘bad’. The book is full of light, the light of a man of integrity and compassion and spirituality writing quietly about the work he does in a hospice using complementary therapy with the dying and their families. His lack of ego aroused huge ego reactions in me! Or, to use a Jungian concept,  I got caught in the shadow of the book;

4.    Dialogue with guides
Talking with colleagues or a supervisor takes the experience deeper and provides further insight;

5. & 6.    Further dialogue with the text and potential readers.
To create a coherent text that could be of use to others.

I found the process of self-reflection to explore my negativity toward the book an en-lightening experience, in that owning my darkness allowed me to reconnect to my own light, and to be able to write about the book from a fresh perspective.  I was impressed by both the permissive and challenging aspects of the process and can see the role it could play in developing and maintaining self awareness as a practitioner, as an adjunct or alternative to supervision. My reservation is the time and commitment. It took my spare time for the best part of a week to work through the process.

Christopher Johns is a nurse, an academic and a complementary therapist working in a hospice. His first four chapters are theoretical and academic, exploring the essence of reflective practice, reflective models in clinical practice and the process of self reflection that I have described above. The aspects of theory located in nursing tradition may have little direct relevance to CAM practitioners, but the second part of the book, called The Heron and the Tree, can be read separately for its wisdom, gentle descriptions of many individual patients, their meetings with death and Christopher Johns’ reflective narrative.

This is a multi-faceted book. It’s about the use of Therapeutic Touch, Aromatherapy and Reflexology with the dying. It’s about palliative care and describes many of the issues faced by those working in this area, including the notion of the ‘good death’ and how that can be oppressive,  how the prevailing culture of niceness in hospices makes confrontation hard, and how complementary therapy can be  sidelined by medical staff. It’s a book about self-refection as part of good practice; in the professional sense, working ethically, within clear boundaries, skilfully, to the limits of competence and so on. But it’s also about good practice in the sense of spiritual practice as something that informs every moment of working life. It’s a good book.

This book can be ordered from the Positive Health bookstore. Please click the Bookshop image at the top of the column to your right, then click on Psychotherapy.

Su Fox
Blackwell Publishing Ltd
ISBN: 1-4051-4973-6

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