"Honest criticism is hard to take, particularly from a relative, a friend, an acquaintance, or a stranger."   Franklin P. Jones

I'm a member of a "therapists' group".  We currently get together for a three hour meeting once a month.  I wrote about this initiative last year in the post "Setting up a therapists support group" where I said "The therapeutic relationships we establish with our clients are so central to our work. Being together, ‘encountering' a group of other experienced therapists in the here-and-now, gives us an opportunity to explore our ‘in-tuness', our flexibility, the issues that support, or get in the way of being present, empathic, caring, authentic with our clients ... we can be ... fellow travelers using our evolving interactions in the group to challenge & care for & inspire each other to help our clients more fully and deeply."

We had a meeting at the weekend and I and another group member "clashed" a bit.  I think we both, at times, found each other's interpersonal style somewhat difficult.  My memory is that he specifically mentioned an unease he had with how he perceived me sometimes when I was expressing caring or concern for others in the group.  I think that for him I, at times, came across as a bit forced or artificial or speaking in a way he was uncomfortable with.  These kinds of clashes in groups are a real opportunity for learning and I said something like "I guess it's pretty much inevitable that at times during this group some of us will have a bit of difficulty with others.  My sense is that potentially this can be very helpful ... a chance for everyone involved to get feedback, gain insight and maybe learn important & useful things about ourselves."  It didn't seem to me that the other person involved was very keen to step forward for feedback, but I was certainly open to it.  Several people spoke.  Someone talked about "a polished bedside manner" and someone else commented that he felt I came across at times as "in facilitator mode".  A third person said something like "I'm a bit hesitant about saying this but sometimes you come across to me as a bit seductive".   Very tricky to square that one with the "polished bedside manner"!

I joke about it, but it's painful to hear this kind of thing.  At least I find it painful.  Now a couple of days later, sitting before breakfast writing, it's a bit like feeling with my tongue for a sore place in my gum.  It's not that I have been thinking about it very much but, when I do, I ache.  There's so much that I could write about that's relevant to the experience of receiving challenging feedback.  For now I'd like to say something about feedback in interpersonal groupwork, something about responding to challenging information more generally in life, one or two thoughts about "goodwill practice" & mindfulness, and then come back full circle to the value of feedback.

So first feedback in interpersonal groupwork.  It's potentially very valuable.  In his classic book "The theory and practice of group psychotherapy", Irvin Yalom describes a dozen therapeutic mechanisms that research has identified as important in this kind of process group.  Usually interpersonal factors, catharsis and group cohesiveness are rated particularly highly.  There is considerable variation though - with the type of group studied, with how long the group has been meeting for, and with the participant's level of functioning and personality style.  Of twenty particularly endorsed statements about group value, several relate to receiving feedback including "Other members honestly telling me what they think of me", "Group members pointing out some of my habits or mannerisms that annoy others" and "The group's teaching me about the type of impression I make on others".  Interestingly the other side of the equation is also highlighted with particularly valued aspects including "Expressing negative and/or positive feelings towards another group member", "Learning how to express my feelings" and "Being able to say what was bothering me instead of holding it in".  Obviously this can be difficult territory.  I've been in groups as a participant where interpersonal "mud-slinging" was emphasised and encouraged.  Not helpful.  It's likely to be best to include this potentially "strong taste" in the group "cooking" with a good deal of care - see for example slides on process groups & constructive facilitator style.   

And how about the feedback I received a couple of days ago?  What can I do to make it more likely the "cooking" is nourishing for me rather than producing acute indigestion!?  This overlaps into the second point I wanted to touch on about responding to challenging information more generally in life.  It's easy to "defend" against it.  Sometimes it's important to defend against it, but quite often challenging information has great potential value.  Carol Dweck's work is relevant here and its emphasis on an "incremental", learning & mastery mindset rather than an "entity", success or failure mindset - see for example her paper "Defensiveness versus remediation: self-theories and modes of self-esteem maintenance" which is available in full text from her website.  Acceptance & reappraisal responses are likely to be helpful too.  I've been talking about acceptance and "turning towards difficulties" in a recent post on mindfulness and I'm a great fan of reappraisal and the space & perspective it often brings.  Fascinatingly, and to me surprisingly, these two coping responses - mindful acceptance & cognitive reappraisal - seem more entwined than I would have expected.  So rather than just bat away the challenging feedback I received in the group, I can let it in, be with it, literally feel its effects in my body ... and also step back to put it in perspective ... perspective about how the group is functioning and the ways others are participating, and perspective from gentle appreciative feedback I have received over the years from family, good friends, patients & others. 

This issue about maintaining one's sense of worth while still being open to new learning has been explored extensively as well in self-affirmation theory.  This is good territory.  The relevant Wikipedia article comments "People tend to interpret relatively uncomfortable information in a way consistent with their existing beliefs ... The need to protect a valued identity is a major source of biased processing.  Fortunately, people identify with multiple values. Researchers discovered that providing people with affirmation opportunities on alternative sources of self-integrity lead to a less biased evaluation to threatening information.  Self-affirmation increases the openness of people to ideas that are difficult to accept ... For example, when encountering threatening health information, people often try to resist the information and persist with their unhealthy habits.  In this case, self-affirmation can be used to help them be aware of potential risks and they may be more willing to consider the information, leading to higher motivation to engage in corrective reactions."  Knowing about self-affirmation theory makes good sense, particularly for health professionals & psychotherapists.  I've written about this in a past blog post and looked at its implications for creative forms of therapeutic writing as well.  So reminding myself of the appreciation of loving family & friends makes it much easier for me to look with clear eyes at what was said to me in the group feedback.  And there are many other ways that one could self-affirm to encourage this ability to stand firm and tall and open when faced with difficult information.  Being able to be loving is probably my central value, but courage rates highly for me as well and so does looking for what's true.  I can certainly self-affirm on these qualities when "threatened" over my sense of self as a loving, warm-hearted being.  I can walk around the experience and look at it from many different viewpoints ... how about, for example, if when I started to participate in this group I'd been told "You may well get feedback that could help you be more constructively loving and helpful for others".  "Wow" I would have said "Count me in. That sounds very worthwhile."  Well maybe that 's exactly the opportunity I now have! 

I'll look at this "opportunity" more in tomorrow's post.