Chile y las cuotas electorales de género

This integrates with ‘Shaping the on-going work’ as a consideration of how the therapist uses information highlighted by the genogram to decide the treatment direction. It refers to their

103 approach in the overall context of the work rather than working in the moment as described earlier in this section.

If the circumstances of the therapy permit, many therapists like to be open to where the process leads. Therapist F likes to be “free-ranging and imaginative”, sometimes “having rather wild ideas about whatever it was that happened and looking at them”, as this can bring revelations. This allows the therapist and client to gain a wider perspective, which may change their idea of the presenting issue. Therapist C states:

“you would try to get an understanding of um, what they think is the presenting problem....then getting into the genogram, a broader perspective will emerge.”

However, it can lead to information over-load where they feel over-whelmed and struggle to know how to utilise what emerges, so the therapist’s approach and ability to manage is crucial. Therapist I highlights that:

“you can get into quite complicated situations sometimes if the genogram is so complicated... it's almost like it can be over-whelming.... so you have to prepare yourself if you're going to use a genogram...to use the skills as a therapist and to remember that you are a therapist doing a genogram.”

In this way, it is also important to trust the process; Therapist I adds that she is:

“quite comfortable with holding a lot of information and letting the picture slowly emerge without really knowing what's going to happen, so that doesn't bother me with being flooded with information”.

Therapist B takes what might be seen as a more transpersonal perspective by believing in something guiding the process:

104 “I'm not a shaman trained person....but I think it's the same sort of feel, that whatever's going on can be tapped for a healing and beneficial outcome, and we don't always know what that is”.

Others are more pragmatic, drawing upon their training, experience, intuition and curiosity to judge what is important to focus on. After years of practice, Therapist G purposely listens to the client’s language, paying attention to what is said and avoided as a way to guide her explorations. She comments that:

“the advantage of having worked for 40 years.... is that you've got so many ideas in your head you have a great advantage over somebody who's just practised, so you can hear all the different things and you think, ahh right, let's look at this bit, paying attention to what's being said, or what's being avoided.”

Therapist C says that she uses genograms to focus on particular themes with her palliative care clients: “I use them in two ways, one for assessment and one as a focus for particular issues so, say secrets or who cares for whom in the family”. When Therapist H has felt over- whelmed using a genogram, she has used her feelings as a way to re-prioritise the work, breaking it down so it becomes manageable each session. She says: “you can use it to focus as well, if it feels over-whelming, ok well what can we focus on?”.

In this way, the therapist might be more directive, depending on their reasons for introducing the genogram and the length of sessions available. In short-term work, the therapist will keep in mind the presenting issue and ensure that the genogram focuses on areas relevant to the goal of the work. Therapist E says that “it's always about how is this in the service of the task? What are we here to do?”. Even in long-term work, therapists will refer back to the presenting issue at key intervals when reviewing the work against the original contract: “often, I keep bringing it back, you know” (Therapist F).

In other cases, the direction of the work will arise naturally from joint discussions around what has emerged in the genogram. For example, Therapist C said that “being curious at

105 every step” with her aforementioned palliative care client who had a fear of dying allowed them to follow a particular line of enquiry that presented itself in the genogram. She adds that: “seeing it visually and working up through the family together....I think for her using a genogram, it prompted a particular line of enquiry”.

Therapist A believes it becomes apparent from the conversation between her and her client, so she may even use the genogram to uncover or test a hypothesis further. She says:

“the dialogue between me and the client tends to present....the focus really, um... I suppose if I've got an inkling that, that or I can begin to see a pattern, and I, then I might try and you know, work out or test my hypothesis I suppose with a genogram, you know, is this pattern really real, is what I'm picking up really real”.

This shows that therapists work in different ways with each client and according to the clinical situation. Within my data, I get a sense of the tension between the therapist choosing to follow or direct the process, both in the moment and within the overall direction of the work, which I see as an overall theme in therapeutic work more generally.

3.8 Closing remarks

In this third section of my thesis, I have demonstrated that “genograms and process of therapy are interlinked” (Therapist E). Using quotes and rich examples from my data, I have shown that how genograms are integrated into the on-going work affects their impact and that both of these are influenced by the therapist’s approach and interventions. I have highlighted many themes and issues about the meaning and consequences of my findings that merit further deliberation in my Discussion.

106 4 Discussion: Considering the meaning and impact of my findings

“My ancestors’ souls are sustained by the atmosphere....since I answer for them the questions that their lives once left behind” (Jung, 1967)

4.1 Overview of this section

As I sit here preparing to write the first words of my Discussion, I am aware of both a sense of slight over-whelm and loss. My work on my thesis thus far has sparked so many thoughts and ideas that part of me feels baffled about how to bring them together into a coherent argument. I know that not everything can be included, so there is a loss in going from an open, exploratory period to a more fixed narrative. The possible parallel between this and what I have learnt about using genograms from my findings does not escape my notice; this leaves me reflecting again on the power of what comes up with this topic area and the need to maintain a clear focus.

I am also aware of how I am constructing what is included in my Discussion just as much as at any other point in the research process. Therefore, I am naming at the outset that my intention has been to highlight and deliberate what I see as the key themes from my findings that are relevant for the theory and clinical practice in integrative psychotherapy and counselling psychology. Other readers will have different interpretations, which I welcome as part of a creative and constructive debate about this topic area that I hope will be ignited by my project.

Returning to my quote at the beginning of my literature review, Rigazio-DiGilio et al. (2005; p.140) continue by saying, that:

“while context matters, it is very often difficult to bring into the therapy setting...it can be overwhelming, emotionally and informationally... it is often discussed, then discounted, and removed to the background, being superseded by preferred therapeutic methods”.

107 The aim of this research has been to sincerely engage in the process of investigating how therapists use genograms to bring context fully and actively into work with individuals in one- to-one therapy. I can vouch for Rigazio-DiGilio et al.’s insinuation about the intensity of this inclusion, in terms of my participant’s voiced experiences and my own in the parallel process of conducting this research.

I have found that the key variables in using genograms are how they are integrated into therapeutic work, how they create impact and change, and how the therapist’s actions and enablers interrelate with both of these processes. In this section, I shall discuss the main outcomes from my findings in the context of relevant literature and research, bearing in mind that there has not been any previous research into the use of genograms with individuals, and propose a model which helps me understand these. I shall then consider any professional implications and issues around personal and professional reflexivity.