{"id":1399,"date":"2017-10-27T23:52:17","date_gmt":"2017-10-27T15:52:17","guid":{"rendered":"http:\/\/darylchow.com\/Daryl_Chow\/Blog\/wordpress\/?p=1399"},"modified":"2018-12-18T22:33:53","modified_gmt":"2018-12-18T14:33:53","slug":"develop-first-principles-before-the-methods","status":"publish","type":"post","link":"https:\/\/darylchow.com\/frontiers\/develop-first-principles-before-the-methods\/","title":{"rendered":"Develop First Principles Before The Methods"},"content":{"rendered":"

As a field, we were obsessed with methods, approaches, tools, theoretical orientations, and schools of thought. Money poured into establishing treatment efficacy differences have not yield much fruit; therapists investment in time, effort and money to train in specific models have not demonstrated improvement in our results.<\/span><\/p>\n

I suspect that one of our key mistakes is a failure to learn first principles, instead of methods.<\/span><\/p>\n


\n\"Develop<\/span><\/p>\n

\n

As to methods, there may be a million and then some, but\u00a0principles are few. The man who grasps principles can successfully select his own methods. The man who tries methods, ignoring principles, is sure to have trouble.<\/span><\/i><\/strong><\/span><\/p>\n

\u00a0<\/i>~ Ralph Waldo Emerson, Essayist and Poet<\/i><\/span><\/strong><\/span><\/p>\n<\/blockquote>\n

\"First<\/a><\/span><\/p>\n

<\/span><\/p>\n

First principles is about deconstructing\u00a0to the fundamental truths or origins. Aristotle calls this \u201cthe first basis from which a thing is known.\u201d (\u2018origins\u2019; archai).[1]<\/span><\/p>\n

For instance, no amount of cooking is going to\u00a0make a dish with bad ingredients taste good. One the first\u00a0principles of good cooking is using fresh ingredients. No amount of embellishment to a song is going to\u00a0make a tune stand\u00a0out if it does not have a strong melody. One of the\u00a0first principles of good songwriting is a strong melody.\u00a0<\/span><\/p>\n

At this point of my thinking, I view first principles as a set of mental short cuts (i.e., heuristics, or what Nassim Taleb calls \u201crules of thumb\u201d[2]) that organises the way I think, and subsequently, guide the way I approach a situation (often, a challenging or difficult situation) in therapy.\u00a0<\/span><\/p>\n

In a previous post, I talked about the the three types of knowledge<\/a><\/span>\u00a0that we can immerse our appetite for learning.\u00a0<\/span><\/p>\n

\"3<\/a><\/p>\n

 <\/p>\n

To recap, content knowledge relates to the clinical theoretical understanding that you have of a client\u2019s presenting concerns (e.g., depression, obsessive compulsive disorder, schizophrenia).<\/span><\/p>\n

Process knowledge relates to the the moment-by-moment interaction between client and therapist (i.e., what you will say).<\/span><\/p>\n

Finally, conditional knowledge relates to how you would work differently with someone who is depressed due to bereavement, compared to someone who is also depressed but has a history of domestic violence.<\/span><\/p>\n

Depending on the phase of our professional development<\/a>,<\/span> we would have different levels of focus in these three types of knowledge.<\/span><\/p>\n

Applying First Principles Thinking<\/strong><\/span><\/p>\n

Pulling together the content, process, and conditional knowledge, here is a concrete example of what I mean by first principles on an applied level:<\/span><\/p>\n

1. When a conflict arises between you and your client and your client gets angry at you<\/em>:<\/span><\/p>\n

– First Principle = Disarm by Agreement<\/b>: Instead of defending your point, disarm the situation by not becoming defensive, or even trying to clarify your point.\u00a0 Rather, take the position of your client\u2019s inner world, and speak from there.<\/span><\/p>\n

– e.g., \u201cYou know, as I think about what you just said, I can\u2019t believe how insensitive I\u2019ve been. You are right<\/i>. I haven\u2019t been here for you when you needed me most… not wonder you are angry at me\u201d<\/span><\/p>\n

2. When a conflict between you and your client arises and your client gets angry at herself<\/i>:<\/span><\/p>\n

– First Principle = Target of Emotion: <\/b>Instead of pondering on her self-blame, help your client face the angry she has towards you which she has negated.<\/span><\/p>\n

– e.g., \u201cDo you notice that when we were facing the issue earlier, you went straight to getting anger at yourself? What if we face the emotion together? Can we invite this into our conversation? What is your feelings towards me<\/i> when I wasn\u2019t there for you when you needed me most?\u201d<\/span><\/p>\n

Why do We Need First Principles?<\/b><\/span><\/p>\n

\n

First principles are GROUNDING IDEAS, not GROUND RULES.<\/b><\/span><\/p>\n<\/blockquote>\n

First principles organises us with a form, not a formula. A form gives you a rough guide on how to operate; a formula tells you a fixed rule on how you must operate.\u00a0<\/span><\/p>\n

First principles are not meant to be formulaic, and it\u2019s not about having stock answers to pull out from your toolkit. First principles provide you mental representations of how to handle a situation, roughly. First principles are about having a compass<\/b> to guide you on an uncharted terrain with your client; it\u2019s not a detailed roadmap.<\/span><\/p>\n

Without clear first principles, even though we say we are intentionally taking a\u00a0\u201cnot knowing\u201d position, we behave like we don’t know what to do in every new situation. We say, “we will response to the client’s presentation at that time,” or we say, “It depends.” The truth is, most of the time we\u00a0do not have a mental model of how to approach especially a challenging situation.\u00a0<\/span><\/p>\n

Renowned basketball coach John Wooden says this,\u00a0<\/span><\/p>\n

“You win by becoming a better player of the game at large, not by adapting your technique to every new team you face. Your opponent will always be changing; it’s a losing race. But if you master the game, you will have skills and knowledge you need to defeat whoever you face.\u201d<\/i>[3]<\/span><\/p>\n

First Principles is a first step at mastering the conversational craft of psychotherapy.<\/span><\/p>\n

What is NOT a First Principle?<\/b><\/span><\/p>\n

– <\/span>Case\u00a0<\/b><\/span>conceptualisation<\/b><\/span>: \u00a0Case\u00a0conceptualisation or formulation are not first principles. A first principle will give you not only\u00a0a rough guide of how to think, but also roughly how to handle a situation (recall content + process + conditional knowledge);<\/span><\/p>\n

– Algorithm:<\/b> A first principle is not algorithm. An algorithm provides a list of clearly defined steps on how to approach and solve a situation. Whereas a Principle is a rough mental model to guide you in a somewhat uncharted terrain;\u00a0<\/span><\/p>\n

– Rule:<\/b> A first principle is a\u00a0grounding idea, not a ground rule. There are rough mental\u00a0“rules of thumb”;<\/span><\/p>\n

– Theory<\/b>: A first principle is not a theory. Theories may be governed by principles, but theories are less of a \u201cgood guide\u201d on how to therapeutically engage\u00a0with a given client.\u00a0Saying that one of your principles is to be empathic is not a principle. It’s a theoretical idea. A first principle must provide the estimates of HOW to explicate empathy in particular situations.<\/span><\/p>\n

Before we develop tools and methods, let\u2019s develop first principles. It\u2019s important to note that even though I\u2019ve talked extensively about the implications of deliberate practice in our field, deliberate practice is a methodology, not a goal. Let’s not get caught up with any methods. Once we are able to go\u00a0to the base\u00a0of the semantic tree and articulate the first principles, we will have at our disposal an array of\u00a0different and expansive methods and approaches, far beyond those articulated in psychotherapy schools of thought.<\/span><\/p>\n

The truth is, first principles thinking is annoying, because unlike a set of clear instructions, or an algorithm, first principles do not spell out what to do each step of the way. Once again, it’s\u00a0not a detailed map, but a guiding\u00a0compass. Besides, a map is useless if you don’t know where north is!<\/span><\/p>\n

Treat first principles as signposts for the journey.\u00a0<\/span><\/p>\n

What If I don’t Have Clear Principles?<\/b><\/span><\/p>\n

Most likely, you already have some. It’s probably not been deliberated and explicated consciously.\u00a0<\/span><\/p>\n

In any case, it’s time to start developing them. Write them down!\u00a0(see previous post<\/a> <\/span>on the difference between note-taking and note creation<\/a><\/span>)<\/span><\/p>\n

Stay tuned for\u00a0the next blog post on Three Ways to Develop First Principles in Your Clinical Practice<\/span><\/strong><\/a><\/span>. In the mean time, I would love to hear what you think about the distinction between first principles and methods, and how you apply this idea into your practice.<\/span><\/p>\n

Best,<\/em><\/span><\/p>\n

Daryl<\/em><\/span><\/p>\n

 <\/p>\n

Footnotes:<\/b><\/span><\/em><\/p>\n

[1] See Terence Irwin\u2019s book, Aristotle\u2019s First Principles<\/span><\/em><\/p>\n

[2] See Nassim Taleb\u2019s book, Antifragile.<\/span><\/em><\/p>\n

[3] John Wooden, A Game Plan for Life, 2009, p.41<\/span><\/em><\/p>\n","protected":false},"excerpt":{"rendered":"

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