Keynote presentation at Using Research in Practice Education Conference Southbank University 3 July 2015 By: Claudia Megele Senior Lecturer & CPD/PQ Programmes Leader & Digital Lead    Sawa bona Sikhona Unless we exist in the eyes of others we may come to doubt our own existence. Being is a social and psychological construct; it is something that is made not given. (Myerhoff, 2007, p.31 cited in Megele, 2015, p.149) © Claudia Megele Emotional Labour, Mentalising, Empathy & Mindfulness 2    Highlights intrinsic human need for validation, recognition, reassurance, acceptance and belonging. And our need for feeling understood and to understand. What is required to meet these needs? © Claudia Megele Emotional Labour, Mentalising, Empathy & Mindfulness 3   © Claudia Megele Emotional labour is defined as the expenditure of intellectual, physical and emotional resources, time, effort and energy to identify/understand and fulfil one s own and other s emotional needs. Megele, 5 Emotional labour is embedded in all human interactions and relationships. Emotional Labour, Mentalising, Empathy & Mindfulness 4  Personal Level  Cultural Level  Professional level  Organisational level  Political Level © Claudia Megele Emotional Labour, Mentalising, Empathy & Mindfulness 5    Emotions are deep level signals about information that demands attention. The rapid appraisal of such signals conveys the meaning of the situation and is often a trigger for action. The main difference between feelings and emotions is that feelings are conscious while emotions can be unconscious (for example anxiety or anger). Externalising versus internalising. © Claudia Megele Emotional Labour, Mentalising, Empathy & Mindfulness 6    But sometimes we hear: Think objectively and put your emotions aside We create meaning through a combination of emotions and cognitions In that sense emotions colour (i.e. add shades and hues) human experience © Claudia Megele Emotional Labour, Mentalising, Empathy & Mindfulness 7   Brenner s (2001) research and analysis of critical incident interviews with experienced nurses indicates that in acute medical or care situations, the successful expert nurse had a level of anticipatory, observational, analytical and inter-personal patient care skills that were both care enhancing and frequently life-saving. This was achieved by a combination of timely intervention during medical crises and by making powerful emotional contact with the patient during such crises that motivated the patient s self healing determination. © Claudia Megele Emotional Labour, Mentalising, Empathy & Mindfulness 8  )magine what your world would be like if you were aware of physical things but were blind to the existence of mental things. I mean, of course, blind to things like thoughts, beliefs, knowledge, desires, and intentions, which for most of us self-evidently underlie behaviour. Stretch your imagination to consider what sense you could make of human action ... Baron-Cohen, S. (1995) © Claudia Megele Emotional Labour, Mentalising, Empathy & Mindfulness 9  Mind-blindness Mentalisation  Mind – reading © Claudia Megele Emotional Labour, Mentalising, Empathy & Mindfulness 10   The mental process by which an individual… interprets the actions of herself and others as meaningful on the basis of intentional mental states such as personal desires, needs, feelings, beliefs, and reasons a form of imaginative mental activity Source: Bateman, A and Fonagy, P (2006) Mentalization Based Treatment – a practical guide OUP: Oxford © Claudia Megele Emotional Labour, Mentalising, Empathy & Mindfulness 11 Baron-Cohen et. al., 2001 © Claudia Megele Emotional Labour, Mentalising, Empathy & Mindfulness 12 Baron-Cohen et. al., 2001 © Claudia Megele Emotional Labour, Mentalising, Empathy & Mindfulness 13 Baron-Cohen et. al., 2001 © Claudia Megele Emotional Labour, Mentalising, Empathy & Mindfulness 14 Baron-Cohen et. al., 2001 © Claudia Megele Emotional Labour, Mentalising, Empathy & Mindfulness 15  Exploring every day examples…  What mental state prompted the action (tears)?   What happened on the inside to make these outside external aspects visible (the crying, the turning away)? You re mentalising when you ponder: Why did ) do that? or wonder, Did ) hurt her feelings when ) said that? © Claudia Megele Emotional Labour, Mentalising, Empathy & Mindfulness 16  Strong emotions:  Defensiveness:      Fear – generates self & safety focus Anger – results in blame and fault finding Shame – results in withdrawal/lack of engagement Strong positive or negative bias  Not wanting to know what another person thinks of us  Not wanting to know what we think and feel  Indifference Congruency of memory (happy people remember happy things/experiences/memories) © Claudia Megele Emotional Labour, Mentalising, Empathy & Mindfulness 17    Depression: interferes with creative thinking and breeds negativity Anxiety: narrows thinking to focus on threat Substance misuse: influences cognitive and affective capacities and reflective ability © Claudia Megele Emotional Labour, Mentalising, Empathy & Mindfulness 18   Why do you think your parents behaved as they did during your childhood? Because I think maybe my mother found it difficult to cope with three small children. It’s not that we were naughty instead she just found it difficult to provide us with the attention and care we needed. Looking back I think she experienced a lot of anxiety. She also found it difficult to control her anger so she felt that she needed to chastise us. That’s what her mother did to her and what she did to us. I don’t think she thought about a different way of doing things. © Claudia Megele Emotional Labour, Mentalising, Empathy & Mindfulness 19   Why do you think your parents behaved as they did during your childhood? I don’t know? Ask them! You’re the social worker! They’ve always been horrible people and even worse parents © Claudia Megele Emotional Labour, Mentalising, Empathy & Mindfulness 20    Psychic equivalence –mental reality = outer reality Telelogical mode – mental realities are considered only if physically manifested Pretend mode – mental events disconnected from external reality; thoughts decoupled from feelings Source: Bateman, A and Fonagy, P (2006) Mentalization Based Treatment – a practical guide OUP: Oxford © Claudia Megele Emotional Labour, Mentalising, Empathy & Mindfulness 21  Developmental research shows that we learn about our own mind from the outside in: it is through the mind of another person— ideally a secure attachment figure—that we become fully aware of our own mental states. Source: Allen, J. (2013) © Claudia Megele Emotional Labour, Mentalising, Empathy & Mindfulness 22  Building / keeping relationships  Stabilising sense of self and identity   Regulating emotions (deeper look; e.g. shame/guilt under that anger?) Self destructive behaviour Source: Megele (2015) Psychosocial and Relationship – based practice © Claudia Megele Emotional Labour, Mentalising, Empathy & Mindfulness 23 Psychological representation of selfstate with internalisation of caregiver’s mirroring Mirroring display of metabolised emotion Expression Symbolic organisation of internal state Reflection Physical self in state of emotional arousal Non verbal expression of emotion Caregiver Infant © Claudia Megele Resonance Source: Fonagy et. al, (2002) 24  Social work is about relationships and accurate mentalising is essential for relationships and relationship based practice  Understanding self and others  Influences assessments, appraisals and decision making   Enhances understanding, minimises resistance and encourages users of services to open up Provides better support and empowers and motivates users of services to initiate and sustain positive change Source: Megele (2015) Psychosocial and Relationship – based practice © Claudia Megele Emotional Labour, Mentalising, Empathy & Mindfulness 25   Reflective rather than reactive approach to what is going on. It enables us to think and ask how did we get here? How can we change this? What is it that you are feeling or thinking or that I am feeling or thinking that we need to consider or reflect upon in order to avoid having this difference and/or conflict? © Claudia Megele Emotional Labour, Mentalising, Empathy & Mindfulness 26    Empathy is a choice – connecting with a part of myself that knows that feeling Sympathy is feeling alongside rather than with people Response versus connection: )t s connection that makes things better. Response with no connection has limited impact. © Claudia Megele Emotional Labour, Mentalising, Empathy & Mindfulness 27     Perspective Taking: ability to take in someone s perspective, recognise their perspective and their truth /experience Staying out of judgement Recognising emotion in other people and communicating it Communicating emotion with people (feeling with people). Source: Theresa Wiseman 8 A concept analysis of empathy Journal of Advanced Nursing Journal. Vol. 23. No. 6 pp. 1162-1167 © Claudia Megele Emotional Labour, Mentalising, Empathy & Mindfulness 28 Source: Forrester, et al. (2008) © Claudia Megele Emotional Labour, Mentalising, Empathy & Mindfulness 29    Mentalisation is attending to what is in our own and other people s minds i.e. our own as well as others mental states) Empathy is concerned with the other person s mental state Psychological Mindedness is about introspection and personal insight  Self refection can be thought of as self mentalising  Mindfulness is about attentiveness and being mindful © Claudia Megele Emotional Labour, Mentalising, Empathy & Mindfulness 30    Close your eyes and think about …. Letting go of the assumptions… sometimes we think we know but we don t… sometimes we think we have seen and observed but we haven t actually seen. Becoming more mindful…. © Claudia Megele Emotional Labour, Mentalising, Empathy & Mindfulness 31   A process of bringing increased intention in your life Anything that can be done mindlessly can be done mindfully  Being fully aware and present in the moment  To just notice and observe  Broadening and focusing awareness © Claudia Megele Emotional Labour, Mentalising, Empathy & Mindfulness 32     We can get so caught up in activity, that we can get busy DOING and forget who is DOING the DOING. Kabat-Zinn (2013) Life can become a long to do list of tasks when connection, meaning and BEING are lost . Feelings of repetition can mean that we aren t making space for BEING. Feelings of emptiness can be evoked when we don t allow for or forget about the importance of BEING and meaning. © Claudia Megele Emotional Labour, Mentalising, Empathy & Mindfulness 33  Take a step back to appreciate the uniqueness of practice…  How do you use your skills in a unique way with every client?  What is the unique experience and interactions with each client?  What did you learn or appreciate about that encounter?  Appreciating the uniqueness of each moment… there is no moment like any other moment… © Claudia Megele Emotional Labour, Mentalising, Empathy & Mindfulness 34     Policy and focus on benchmarking often ignore the emotional labour involved in practice. Procedure driven practice focuses students and practitioners on DOING social work with the BEING removed. The currency of DOING over BEING is a significant challenge for social work and its values. Psychosocial & Relationship Based Practice offers us a powerful anti-dote to deprofessionalisation and deskilling of social work and social workers. Psychosocial & Relationship based Practice enables us to reconnect with our users of services in powerful and life transforming ways, and to make a deep and genuine positive impact in other people s lives. © Claudia Megele Emotional Labour, Mentalising, Empathy & Mindfulness 35  )n the beginner s mind there are many possibilities in the experts there are few. Zen teacher Shunryu Suzuki    Embrace the power of possibility and beauty of the beginner s mind Open the mind to not-knowing. Let go of ) already know how this is going to turn out . Accepting not knowing … © Claudia Megele Emotional Labour, Mentalising, Empathy & Mindfulness 36    Users of services/ clients sometimes say: ) know this is not going to work... nothing is going to work for me. It could be that the user of services/client is speaking to the deep fear and sadness about not having those things work in the past. (elp clients understand that we cannot know… and open clients mind to the not knowingness. © Claudia Megele Emotional Labour, Mentalising, Empathy & Mindfulness 37  Claudia Megele  Twitter: @ClaudiaMegele   Academia.edu: http://mdx.academia.edu/ClaudiaMegele Psychosocial & Relationship Based Practice is available from:  Books etc.  Amazon.co.uk  CriticalPublishing.com © Claudia Megele Emotional Labour, Mentalising, Empathy & Mindfulness 38 Allen, J. Bleiberg, E. & Haslam-Hopwood, T. (2013) Understanding Mentalising. The Menninger Clinic Bateman, A. & Fonagy, P. (2006) Mentalization Based Treatment – a practical guide. OUP: Oxford. Baron-Cohen, S. (1997) Mindblindness: Essay on Autism and the Theory of Mind. MIT Press. Forrester, D. et al (2008) Communication skills in child protection: how do social workers talk to parents? Journal of Child & Family Social Work. 13 (1): 41 – 51. Kabat-Zinn, J. (2013) The Mind's Own Physician. New Harbinger Publications. Megele, C. (2015) Psychosocial and Relationship – based practice. Critical Publishing. Wiseman, T. 8 A concept analysis of empathy Journal of Advanced Nursing Journal. Vol. 23. No. 6 pp. 1162-1167. © Claudia Megele Emotional Labour, Mentalising, Empathy & Mindfulness 39