{"id":1472,"date":"2017-11-10T04:46:34","date_gmt":"2017-11-09T20:46:34","guid":{"rendered":"http:\/\/darylchow.com\/frontiers\/?p=1472"},"modified":"2020-02-17T15:41:13","modified_gmt":"2020-02-17T07:41:13","slug":"first-principles-5-steps","status":"publish","type":"post","link":"https:\/\/darylchow.com\/frontiers\/first-principles-5-steps\/","title":{"rendered":"First Principles: The 5-Step Process for Deep and Accelerated Learning in Therapy"},"content":{"rendered":"

In a previous post, I\u2019ve talked about the importance of <\/span>Developing First Principles Before Methods<\/span><\/a>. <\/span><\/p>\n

I\u2019ve also talked about the ways you can develop first principles from challenging situations, therapeutic mistakes, and guidance from a mentor (see the <\/span>previous post<\/span><\/a>), <\/span><\/p>\n

But what is the process required for learning from and developing first principles? Why is this important? <\/span><\/p>\n

In this post, I\u2019d spell out a 5-step approach (see Figure 1) to improve the rate of learning from your work, so that you can reap the rewards from your experience + reflection, and generalise the first principles to other related contexts: <\/span><\/p>\n

<\/p>\n

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

Figure 1: The 5-Step Process for Deep and Accelerated Learning [1]<\/strong><\/p>\n

Step 1. Therapeutic Attempts: <\/span><\/h2>\n

At this stage, your focus is to perform to the best of your ability. Do what you do. It\u2019s important to remind ourselves that if we can fully embrace what we have at a given point in time, it is enough. (Until you get to Step 5).<\/span><\/p>\n

Step 2. Challenging Situations\/Mistakes:<\/span><\/h2>\n

Catalog the various types of challenging situations that you\u2019ve faced and the types of mistakes that you\u2019ve made in the therapy hour. Name them, and make it a conscious attempt to revisit them. (See the previous <\/span>post<\/span><\/a> on points #1 & #2, Challenging Situations and Mistakes, respectively). Don\u2019t leave this to chance. Block out some time in your calendar to do this.<\/span><\/p>\n

It is important to remember, \u201cIt\u2019s better to fail well than to succeed badly.\u201d[2] This is not the most pleasurable activity to be doing, but just know that when you get through the five steps, it is very rewarding!<\/span><\/p>\n

Step 3. First Principles: <\/span><\/h3>\n

Create space for deep reflection on the specifics. Distill the elements. Ask yourself, \u201cwhat can you learn from this challenge\/mistake?\u201d Don\u2019t get caught up in the technique or worry if you didn\u2019t adhere well enough to a particular treatment protocol. Work backward (see <\/span>Figure 2 of previous blog<\/span><\/a>), and reflect on what was the underpinning idea that was guiding you in that situation. Turn that around, and ask yourself, \u201cWhat might be a useful guiding first principle to adopt in this situation instead?\u201d <\/span><\/p>\n

Sometimes we come up with nothing at this stage. Read materials to spark off some ideas. Seek the help of a mentor\/consultant\/clinical supervisor to get some objectivity. We often miss the forest for the trees.<\/span><\/p>\n

One time I was stuck with a case that just wasn\u2019t going anywhere. In our group supervision, my supervisor noticed a certain pressure I was experiencing for driving the change in my client\u2019s life who was steeped in depression. She offered me an idea that stuck with me for more than a decade on. Here\u2019s what I\u2019ve grafted from my supervisor\u2019s suggestion and turned it into a first principle: \u201cWhen a client is reluctant to commit to taking action, Raise the Possibility of Change vs No Change [3]<\/span><\/p>\n

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

Figure 2: This is the post-it note that I\u2019ve kept for many years to remind me of the lesson I\u2019ve learned not to pressure for change, but to Raise the Possibility of Change vs No-Change.<\/strong><\/p>\n

Without establishing the roots of first principles, you are left to deal with challenging situations or mistakes in a haphazard fashion. Without first principles, you deal with each challenging situation or a genuine mistake as if you are experiencing it for the first time. Maybe that is one of the reasons we do not get better with experience.<\/span><\/i><\/p><\/blockquote>\n

Step 4. Refinement: <\/span><\/h2>\n

Guided by your first principles, this is the part when you repeat the scenario in your mind, or better yet, review the specific segment of the session recording, and try to improve on your attempts in that particular therapeutic engagement (see Step 1). Once again, this revised attempt must be guided by your newly developed first principle. <\/span><\/p>\n

Here\u2019s  a clinical example to highlight the refinement process. Recently, I was working with a man in his 30\u2019s who wanted to address his anger issues. Initially, I was guided by a first principle of figuring out the Client\u2019s View of the Problem, given that it must be hard to acknowledge anger as a problem. But as we delved further about his \u201canger\u201d issues, I soon realised that I wasn\u2019t hitting the mark. I knew this because there wasn\u2019t any resonance or vitality. The session was stale. It felt like each statement I made about his anger issues, my client  was implicitly saying, \u201cYes, but\u2026\u201d<\/span><\/p>\n

I thought about this before the next session. And it dawned on me I should go further and deepen on the issue he had with anger. I developed another first principle: Re-define the Problem. This idea meant that I should pursue what\u2019s underlying the outburst anger towards his wife. So once we\u2019ve established the focus at the start of the next session, I said the following to my client, based on the newly re-fined first principle: \u201cYou know, we talked about the issues with anger the last round. I want to hear what you think, but from what you\u2019ve said, I don\u2019t think that anger is the issue; feelingunappreciated is.\u201d<\/span><\/p>\n

Watching my client\u2019s visceral reaction and listening to his response to that, he agreed with this. We came to a consensus that to be appreciated is an important theme to address in therapy. We found a way to acknowledge this issue with compassion, given that \u201cun-appreciation\u201dtriggered a host of memories with his ex-wife. He was able to turn this around and found a way to have a conversation with his wife about to share about what happened in the past, and made a sincere apology to her for his recent outburst.<\/span><\/p>\n

The reason for this clinical example is to stress the importance of the learning process, not the outcome of the session. I\u2019m now able to extrapolate the newly minted first principle and use this concept in other situations. At first, I was guided by Client\u2019s View of the Problem. In the process of Refinement, I revisited Step 3. First Principles, and re-framed it as Re-Define The Problem, which led to an emotional deepening and resonance for the client, and ultimately, meaning change in his relationship with his wife.<\/span><\/p>\n

Step 5: Generalise:<\/span><\/h2>\n

This is the litmus test if your first principles are of any use. Use the first principle established in Step 3 & Step 4 and see if it helps you in other similar contexts. Be prepared to continuously refine and recalibrate. This tight feedback loop helps to accelerate your learning tremendously.  <\/span><\/p>\n

\"\"<\/span>
\nImagine this feedback loop repeats itself in an iterative process, get better at each step of the way, cycle by cycle.<\/strong> <\/span><\/p>\n

Talking about the concept of first principles is difficult. It is easily misunderstood as a rule, or even misconstrued as a new method. This is not my intention. It\u2019s also not my intention to say that the first principles I\u2019ve mentioned in the examples are the \u201ccorrect\u201d first principles to have. <\/span><\/p>\n

Develop your own first principles. The purpose of developing your first principles is so that you can learn. Carl Rogers said, \u201cThe only person who is educated is the one who has learned to learn and change.\u201d <\/span><\/p>\n

At the heart of this 5-step Process for Deep and Accelerated Learning in Therapy, is to learn from our experience. Meaning experience is not what happened to you, but what you do with what has happened to you.<\/span><\/p>\n

Remember the following: <\/span><\/p>\n

\n

LEARNING = THE ABILITY TO TRANSFER KNOWLEDGE INTO ANOTHER SITUATION.<\/span><\/i><\/p>\n<\/blockquote>\n

I love to hear your thoughts around this 5-step process and the types first principles you\u2019ve developed that guided you in your clinical practice. It might <\/span>help<\/span> to revisit the previous post on <\/span>Developing First Principles Before Methods<\/span><\/a>.<\/span> Please leave your comments below and I will respond to you. <\/span><\/p>\n

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

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

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

[1]  My colleagues and I have been running the Difficult Conversations in Therapy (DCT) project that my colleagues over the last few years. Working with many therapists across several repetitions has allowed me to learn and develop this idea. We are now at a stage of near completion of an RCT, so more on this in the future posts. The idea for this diagram was adapted from one of the most important books I\u2019ve seen this year, Principles, by Ray Dalio, founder of Investment company, Bridgewater. <\/span><\/em><\/span><\/p>\n

[2] The original quote is from Cistercian monk, Thomas Merton: \u201cA man who fails well is greater than one who succeeds badly.\u201d No Man is an Island, p.127<\/span><\/em><\/span><\/p>\n

[3] Some of you might think that this is a technique used in motivational interviewing. Maybe it is, but the idea is not to make it a technique, but rather to use it as a guiding first principle. <\/span><\/em><\/span><\/p>\n","protected":false},"excerpt":{"rendered":"

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