Lego for Psychotherapists

The Reimagining Education in Psychotherapy (REP) Series, Part 4.

In the first series on Reimaginging Education in Psychotherapy (REP), Kindling the Flame I addressed the importance of kindling the learner’s spark early in the journey of higher education, as opposed to carrying on our default approach of a “banking model.”

In the second REP series, Teach the 3 Types of Knowledge and Not Just 1, given the evidence that formal education has not improved outcomes, I argued that we need to go beyond teaching content knowledge in higher education, and find a sweet spot to weave in process knowledge (how to relate in conversation) and conditional reasoning (“If A, then B”).

In the third REP series, Measure Growth, Not Competence, I highlighted the distinction of measuring growth matters, because an overemphasis on performance impedes us from learning.

Today, I’m going to use a classis toy many of us are familar with to make a case for experimentation, play… and mediocrity. 

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It is utterly false and cruelly arbitrary to put all the play and learning into childhood, all the work into middle age, and all the regrets into old age. ~ Margaret Mead

My daughter received a set of LEGO as a birthday gift from her classmate. It came in set pieces and clear instructions of what she can build. She was thrilled. 

Months later, I decided to give her another box of LEGO (actually, it was an old set that we kept away, and we re-hashed it like a new set of toys). It came with many more pieces, except that it was absent of any instructions of what she can or should build. It was pretty obvious she was less thrilled than before. 

Ok, as a parent, there’s some things to undo here.   

Turns out that there there is a key difference between teaching kids how to play with legos, versus telling them what to build.

The End of Creative Free Play?

Though this isn’t new, the renowned company started creating Lego single sets since 1964, giving a fixed set of legos that is pre-determined and furbished with instructions on what to build.[1] It became like Airfix models. Kids loved them. The instructions were clear, the single outcome is in sight (and alluring, especially when it is based on franchised movie characters like Star Wars and Harry Potter). In other words, a fixed set LEGO tells you what to build.[2]

Free play legos, on the other hand, is not only about open-ended building—messing around with ideas as you build—but an ongoing refinement and destruction. In other words, free play legos offers endless permutations and possibilities.  

When compared to a fixed set of legos, the initial tension of ambiguity of what to build can be disheartening. Granted, a fixed set of legos initially can help kick-off the kindling process.  

Take for example, the renowned architect Bjarke Ingel discussed how as a child, his grandfather’s christmas gift of a yellow castle LEGO sparked off a life-long love of design.
Here’s Ingel: “Of course, I instantly built the castle, as is.” As an education institution, we often stop at building a fixed set of legos perspective, and we rarely move into a free play mentality. Ingel knows this instinctively, as he adds, “… And eventually, all of that yellow LEGO made it into the ecosystem of (my) LEGO.”[3] 

The play of legos mirror the system in schools. In school, we are asked to complete fixed tasks. In real life, we need to figure out what task to work on, what problems that are worthy to solve. 

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Build Your Own

Let’s focus on teaching psychotherapists less on what to build, and more of how to build. We need to resist the urge to take the easier path of providing the learner what to think, and emphasise more on how to think about stuff.

Instead of saying that you need to learn this or that model of therapy, teach our trainees how to structure their work, and develop their own way of thinking, healing and being—while exposing the learner to a wide array of thinking in the models of therapy. Thinking is enhanced when we take an extra but important step to figure out first principles and not get stuck on methods . We need to think less algorithmically , and more on abstracting to a higher order of thinking. Teachers are responsible in the instruction process of abstracting examples into principles-based thinking, because transfer of learning from one situation to another, based purely on learning from examples, are notoriously weak.

The Improvisational Nature of Healing Conversations

Healing is made possible in the co-creation and improvisational nature of interaction between two or more people invested in the process, and using what the other party brings to the table, instead of an imposition of how things ought to be. So instead of saying, “we need to apply some CBT here for this problem,” we need to co-create differentiated approaches based on the what both healer and sufferer brings to the table of therapy. This doesn’t mean we need to create “a new therapy model” each time, but we need to abstract from various ways of seeing and thinking and bring it to the mix of the conversation, in farming for healing.

 When we are free to bring forth our true selfs into the therapeutic engagement, pulling from all sorts of models of thinking and lived experiences, the conversation is then given a chance to come fully alive. This requires a tolerance of ambiguity, uncertainty, and crucially, calculated risk-taking. Because this idea “might not work.” Given this, if we teach a way to be acutely adaptive, with the allowance for iteration—tearing down and rebuilding if needed—many more creative and powerful results might ensue. This is why a tight feedback loop of the use of outcome and engagement measures can help (see our article Beyond Measures and Monitoring, Miller Hubble, Chow, & Seidel, 2015). 

In the upcoming Reimagining Education in Psychotherapy (REP), I will dig a little further into this.

Deductive vs. Inductive Learning

The theorist can only build his theories about what the practitioner was doing yesterday. Tomorrow the practitioner will be doing something different because of these theories. ~ Gregory Bateson

Learning about how master therapists develop their theories is fraud with biases. Reading the giants in our field might lead us to think they took a deductive approach to developing their ideas, a “think before you act” process. The “top-down” deductive approach goes a bit like this: 

1. Develop a sound theory

2. Test the hunch

3. Confirmation of the theory

But in reality, most ideas ferment on messy grounds, and developed from a mix of deductive and inductive approach, an “act in order to think” process. The “bottom-up inductive approach goes a bit like this:

1. Experiment with ideas

2. Observe and study patterns after the fact

3. Make some tentative hypotheses

4. Develop a theory.

See this post for more: Is the Scientific Paper a Fraud?

As previously quoted in the Frontiers post, Is the Scientific Paper a Fraud? it is worth repeating what Australian academics Susan Hewitt and Anna Wilson say,

“Science is a social activity (emphasis mine) and we do students a disservice if we maintain that it is only about facts and objective truths… (we) need to learn that mistakes or false starts are not time wasted, but are an essential part of making progress.”

Fixed lego sets triggers a sort of deductive reasoning, whereas free play LEGO sets works a bit more like inductive reasoning.

Keys:

So what now?

1. Develop your own ideas. 

You don’t build what you know, but you get to know as you build. Instead of insisting trainees to do a particular treatment as a first line of treatment, while harnassing the wisdom of the pioneers in our field, teach students to be agile and co-construct their own ideas and approach to treatment via the road of principle-based thinking , as early as possible and not later in the journey of higher education.

2. Capture your learning process. 

For trainees/students, I would suggest that you get a journal or use a notetaking app, and write your learnings and your thinking process.

Here’s a simple framework to use: 

a. Content: “What are you learning?” 
b. Context: “How does this fit into the larger context of your previous learnings?” 
c. Process: “What are you discovering about you as you’re shaping theses ideas?”

Here’s why this simple 3-step structure is useful:

a. You collect the dots (content)
 b. Then you connect the dots (context)
 c. And then you reflect and articulate what the learning process says about you (process).

Connecting the dots is a crucial piece. Imagine your synaptical nerves are making these “click” connections, like one LEGO brick to another. Thereafter, becoming what our field likes to call a “reflective practitioner” makes perfect sense (See point c about). However, without the preceding steps of collecting and connecting the dots, reflection alone makes one go in circles and barren of another new knowledge to add to the fire.

3. Test your ideas

As you proceed in practicum or clinical practice, be systematic about tracking your outcome and engagement levels with every client at every session. Not just for the sake of evaluating your performance, but more for the sake of ongoing improvement, one-client-at-a-time. (More on this in upcoming REP post.)

When you have a feedback framework set up, test out your ideas. Seek to not just when you ideas are working, seek the opposite. Seek the counterfactuals. 
Be ready to “murder your darlings” and refine your ideas. This is a process of deliberate practice. 

4. Seek Coaching

Be sure that the clinical supervisors commenting on your work not only knows your work, but has analysed your sessions via recordings, and crucially, has information and is guided by your client outcomes. (See this article that appeared in psychotherapy.net, Analysing The Game). Here’s the danger: when we don’t “analyse the game” and are not informed by a systematic measure of client outcomes, we have a tendency to become “explainaholics” . Another form of going in circles.

Renowned surgeon and bestseller author Atul Gawande points out a key difference between a teaching model vs a coaching model for learning:

The pedagogical theory is you go to Julliard, you get your 10,000 hours of practice with the violin, and you then head out into the world and you’re responsible for the rest of your self-improvement along the way. That model is the primary one in professional life, most musicians, in medicine, in teaching, in business.  

The other model is mostly out of sports and that’s the coaching model, and that says, I don’t care if you’re Roger Federer, you will have blind spots when it comes to your own improvement and you need a coach. Over time I think what we’ve been learning is the coaching model beats the teaching model, and has significant advantages.

(Stay Tuned to a future REP post on Analysing Sessions)

5. Play

This is probably the most important point. Without a sense of playfulness, we constrict ourselves from deep learning.  This is why we should encourage less competition and specialisation in early age [5]. 
Even in higher education, we would do well to encourage and reward calculated risk-taking as learners experiment with their ideas based on sound principles (see points #1 to #3).

Leading researcher on play Stuart Brown says:

A lack of play should be treated like malnutrition: it’s a health risk to your body and mind.

6. Embrace Mediocrity…

All greatness goes through the road of mediocrity. If the metaphorical LEGO castle that you build doesn’t look anywhere near the one you saw in the showcase, fret not. We often see the results and not the process that leads to the results.  

Build. Refine. Get the feedback. Keep building.

In the part 3 of the REP series, I argue that especially in the formal training phase we need to measure growth, not competence. Education researcher Robject Bjork and his co-authors state, a person can be performing and not learning. On the other hand, a person can learn but not showing immediate results in the performance evaluation.

“Performance… is often an unreliable index of whether the relatively long-term changes that constitute learning have taken place…learning and performance can be at odds.” [6] 

Tolerance for mediocrity as part of the learning journey is helpful, especially when the aim is to strive for excellence.

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As a child soon discovers, building a towering LEGO building on wobbly wheels is probably not a good idea (unless the tv program Living Big in a Tiny House has inspired you to build a LEGO version of it).

In the next REP series, I will make the case of developing a firm foundation by developing a baseline performance to support the process of individualised learning and professional development.

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Footnotes: 
image by James Pond @JamesPondotco
[1] For more on Lego’s history, see https://www.bbc.com/news/uk-politics-29992974 

[2] Check out Chris Swan’s blogpost: http://blog.thestateofme.com/2013/01/01/the-perils-of-modern-lego/  

[3] Watch the Netflix documentary Lego House: Home of the Brick, and the other documentary that I really enjoyed, Abstract. Bjarke Ingel was featured in one of the episodes. If Ingel’s name rings a bell, he and his team were the architects involved in the design for 2 World Trade Center. Interestingly, Ingels couldn’t sign the paper becuase his license as an architect was not recognised in the US! https://therealdeal.com/2016/10/10/bjarke-ingels-will-build-you-the-tower-of-your-dreams-just-dont-ask-him-to-sign/

[4] From ‘Revisiting “Is the Scientific Paper a Fraud?”’ by Susan Hewitt and Anna Wilson https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4210093/

[5] Read Range by David Epstein, as he makes the case against early specialisation.  

[6] See p. 176 and p. 193 of Soderstrom, N. C., & Bjork, R. A. (2015). Learning Versus Performance: An Integrative Review. Perspectives on Psychological Science, 10(2), 176-199. doi:10.1177/1745691615569000