Clinical PCT Training? (was: Thought...blah)

[From Chris Cherpas (981118.1812 PT)]

Bill Powers (981118.1156 MST)--

The method of levels...on the last day of a three-day
seminar...[e]ven better would be to make it the subject of
a full week's workshop for people who know something about PCT
-- practice is needed, plus critiques based on actual sessions.

Could MOL be bundled with other "Clinical PCT" topics?
- PCT interpretions of traditional diagnoses, therapies;
- introspection/meditation a la PCT;
- others?

A long weekend workshop would be of interest to me,
and, I imagine, to my wife, who's a psychiatrist.

I'm considering offering such a workshop here in Durango
if there's enough interest. Just to get the ball rolling.

Offer it in SF Bay! But then, I'd never get to see Durango.

I think we need to train people who can then go on to
develop skill with this method and teach it to others.

The beginnings of a certification program?

Best regards,
cc

[From Bill Powers (981121.1025 MST)]

Chris Cherpas (981118.1812 PT)--

Could MOL be bundled with other "Clinical PCT" topics?
- PCT interpretions of traditional diagnoses, therapies;
- introspection/meditation a la PCT;
- others?

A long weekend workshop would be of interest to me,
and, I imagine, to my wife, who's a psychiatrist.

I'm of two minds. Of course you and your wife would be very welcome to
attend (see my post to Tim Carey) under any circumstances. But the Method
of Levels is still in the experimental stages, and I don't know if it would
be wise to start mixing it with anything else at this early date.
Naturally, we could talk about its relationship to other approaches --
there should be plenty of time for that -- but I'm really the most
interested in teaching others to do it so we can start getting some
real-world information about how it works. I envision the pre-CSG meeting
as a real workshop, in which teaching the method is combined with applying
it (to each other) and looking for bugs in the program. By the third day,
anyone who is willing to suspend belief in other methods ought to be able
to conduct an MOL session with reasonable success. After that, they can do
anything they like. Your wife, being a psychiatrist, might have problems
with this; on the other hand, with her clinical experience she might find
the whole thing completely familiar and take to it right away.

We have to remember that the whole thing might fizzle out -- maybe the MOL
gives nice feelings during sessions and then everything reverts to the way
it was before. But we can't know that without learning to do it and giving
it a good try.

Best,

Bill P.

[From Tim Carey (981122.0530)]

[From Bill Powers (981121.1025 MST)]

We have to remember that the whole thing might fizzle out -- maybe the

MOL

gives nice feelings during sessions and then everything reverts to the

way

it was before. But we can't know that without learning to do it and

giving

it a good try.

Even in my bumbling, clumsy attempts at MOL Bill I think I have some
preliminary evidence that the MOL does more than give nice feelings. In
fact at times I think it does precisely the opposite in some sessions. I
can recall people becoming a bit annoyed at themselves when they've
considered two completely opposing ideas they had on a particular subject
(mind you, their annoyance then just becomes the focus of the conersation).

Perhaps one of the most frustrating things for a fresh egotistical
therapist who wants to change the world is that a lot of the "work" in MOL
seems to happen outside therapy. Just a fortnight ago one of my clients
(the woman with significant anger problems who ended up separating from the
man she had been living with for the past 4 years) described how her
ex-partner was still pulling her strings. She described how attached she
felt to him and how she thought he was still controlling her. We chatted
about this idea, I concentrated on having her explain this situation to me
in as much detaill as possible (Bill's suggestion to play dumb and get lots
of information out on the table is really helpful) and tried to move the
conversation in an up direction. The next week this woman came in and said
that she had realised the _she_ was the one who was pulling the strings and
she began to explain to me about all the options she had.

Although I'm still working with some of my clients, a summary of my
semester's inernship would be:

Client 1: An 8 year old boy whose parents requested a psychological
assessment. I took some classroom observations and conducted a WISC-III and
a WRAT 3 (two measures of cognitive functioning ... supposedly). (No MOL)

Client 2: An 11 year old boy diagnosed with Tourette's Disorder and
Attention Deficit Disorder who was having problems at school. The teacher
was very traditional and just wanted "some strategies to deal with this
kid". I used a version of Ed's RTP material (No MOL).

Client 3: A 33 year old woman who wanted strategies to deal with her 3
year old twins. She had a range of problems herserlf and a chaotic
lifestyle (verbal and physical abuse in her marriage, bipolar disorder,
panic disorder, and phobias). I attempted MOL with this woman but she
dropped out after 5 sessions because she was accepted into a parenting
program.

Client 4: A 15 year old boy diagnosed with Intermittent Explosive Disorder
and Dysthymic Disorder. He had been excluded from school for punching a
teacher. At the first session he scored 19 on the Beck Depression Inventory
(BDI; 19-29 moderate-severe depression) and at the 4th session he scored
23. Also at the first session he was above the 85th percentile on the
State-Trait Anger Expression Inventory (STAXI) for the intensity of angry
feelings experienced and on the RADS (an assessment item looking at various
feelings people have e.g., I feel happy; I feel upset, etc) he had a raw
score of 80 (77 is considered the cut off for clinical depression) which
placed him in the 97th percentile. At the tenth session this boys BDI score
had dropped to 7 (0-9 none or mild depression). At the 14th session his
score on the STAXI for the intensity of angry feelings experienced had
dropped to the 35th percentile and his score on the RADS had dropped to 69.
I'm seeing him for one more session. The only thing I've used with this boy
is MOL.

Client 5: A 46 year old woman with a history of anger problems. Has never
been out of a violent relationship since the age of 15 and has lost
countless jobs because of her anger. I have two more sessions left with
her. I don't have any measures to report yet (I'll pass these on when I get
them) but she has bought her own house and is living independently for the
first time in 36 years, she has received promotions in her current
workplace and she reports that she is living her life more the way she
wants to. The only thing I've used with this woman is MOL.

Client 6: A 20 year old man who has seen a variety of psychiatrists and
psychologists since the age of 14 for various things: school refusal;
depression; social anxiety; and obsessive compulsive disorder. Again, I
have two sessions left with this man and I don't have any measures yet with
him. He reports, however, that his life is much better. He has reduced his
thought problems, is managing his time better and has started exploring
romantic relationships. The only thing I've used with this man is MOL.

I'm not trying to paint a rosy picture here, I just want to portray my
understanding of my internship experience. My experience with MOL is that
it is much more difficult with clinical populations than when you're trying
it out with friends. It was also very sobering to watch videos of my
sessions and to realise how dreadful I am at this process. I think there
were too many times where I missed opportunities to go up a level and I
also think therapy went too long for most of my clients. I've seen all of
them in excess of 10 sessions and my goal would be to discover how much I
can reduce this number by. I think I had an unrealistic idea of how clients
were supposed to be before therapy ended. I sort of had the idea that they
had to be completely unconflicted or something. Despite all this, my
clients did seem to make some gains in therapy and I am really excited
about the possiblities that might be realised once I become more "elegant"
with this process.

Cheers,

Tim

[From Bruce Gregory (981122.1640 EDT)]

Tim Carey (981122.0530)

What would you say are the greatest differences between MOL and Freud's
method free association? From what I have been reading, I am unable to
identify the distinctive elements of MOL. (I am also unable to discern the
relationship between MOL and PCT, but this is a separate question.)

Bruce Gregory

[From Rick Marken (981123.0840)]

Bruce Gregory (981122.1640 EDT) to Tim Carey (981122.0530) --

What would you say are the greatest differences between MOL
and Freud's method free association? From what I have been
reading, I am unable to identify the distinctive elements
of MOL.

Maybe it would help if you explained what you think these
methods have in common. Then we might be able to help you
see what (if anything) distinguishes them from each other.

(I am also unable to discern the relationship between MOL and
PCT, but this is a separate question.)

The relationship is between MOL and HPCT; it's the idea that
behavior is the control of a _hierarchy_ of different _types_
of perceptual variables that links PCT to MOL.

Best

Rick

···

--
Richard S. Marken Phone or Fax: 310 474-0313
Life Learning Associates e-mail: rmarken@earthlink.net
http://home.earthlink.net/~rmarken

[From Bruce Gregory (981123.1315 EDT)]

Rick Marken (981123.0840)

> Maybe it would help if you explained what you think these
> methods have in common. Then we might be able to help you
> see what (if anything) distinguishes them from each other.

In the conventional Freudian approach, the client is invited to
describe anything he or she happens to be thinking of without
censoring his or her thoughts. The therapist asks questions
designed to encourage the client to speak further on topics the
therapist feels may be open to further exploration. The therapist
does not express a judgement about what the client says or offer
interpretations as to the significance of what the client says.
The process is designed to make the client aware of relationships
that the client has not noticed before. How does this approach differ from
the approach taken in MOL?

The relationship is between MOL and HPCT; it's the idea that
behavior is the control of a _hierarchy_ of different _types_
of perceptual variables that links PCT to MOL.

Exactly how? Is the therapist concerned with control of
perceptions at the level of configuration or sequence or program?
How is this concern expressed to the client? How are the insights
of a hierarchical control of perception used in MOL and made
accessible to the client? Does it help or hinder if the client
knows something about PCT? Why?

Bruce Gregory

[From Rick Marken (981123.1250)]

Bruce Gregory (981123.1315 EDT)--

In the conventional Freudian approach, the client is invited to
describe anything he or she happens to be thinking of without
censoring his or her thoughts. The therapist asks questions
designed to encourage the client to speak further on topics the
therapist feels may be open to further exploration...How does
this approach differ from the approach taken in MOL?

The MOL therapist's questions are aimed at getting a person
to go "up a level"; they are not aimed at learning more about
"topics the therapist feels may be open to further exploration".

The difference can be illustrated in terms of the famous "What
are you doing?" question from RTP (I hope Ed plans to copywrite
this question; imagine the income RTP would get from the licensing
agreements alone;-)). The "therapist" asks this question when a
kid is doing something like making fun of another kid. In
order to answer this question, the kid must "go up a level"
and look at his behavior from a perspective that allows him to
talk about it (assuming he wants to answert the question).

"What are you doing?" is the kind of question an MOL therapist
would ask. The MOL therapist would not be interested in the
making fun behavior per se, for example. Rather, the MOL therapist
is interested in getting the client to see the behavior from a
new conscious point of view. The Freudian therapist would, as you
say, be more inclined to ask questions in order to find out about
the topic at hand; so the Freudian therapist might ask questions
like "And why do you say that Johnny is a wimp?" or "Are there
any other disparaging things you would like to say about Johnny?",
or "Where is all this hatred coming from?" etc. All these questions
can be answered from the point of view of the abusive control
systems themselves; the kid can say "Because Johnny's a jerk"
or "He's a wimp and a jerk" or "I don't like jerks or wimps",
etc. I think people do go "up a level" occasionally in Freudian
therapy; MOL is just a more economical way to get there.

Is the therapist concerned with control of perceptions at the
level of configuration or sequence or program?

Not specificially. The MOL therapist is just interested in
seeing talk that indicates a change of conscious point of
view (a change of levels).

How is this concern expressed to the client?

I don't believe the MOL therapist would be inclined to express
concern to the client.

How are the insights of a hierarchical control of perception
used in MOL and made accessible to the client?

The only thing the MOL therapist does is help a person go
up a level; when a client does go up level then it's likely
that the client will have the insight.

Does it help or hinder if the client knows something about
PCT? Why?

I think it might help a little; it might make it easier for
the client to catch on to what's involved in "going up a level".
I think going up a level is a learnable skill. A client who has
learned how to do it may be able to therapize themselves in
the future.

Best

Rick

···

--
Richard S. Marken Phone or Fax: 310 474-0313
Life Learning Associates e-mail: rmarken@earthlink.net
http://home.earthlink.net/~rmarken

[From Bill Powers (981123 MST)]

Bruce Gregory (981122.1640 EDT)--

What would you say are the greatest differences between MOL and Freud's
method free association? From what I have been reading, I am unable to
identify the distinctive elements of MOL. (I am also unable to discern the
relationship between MOL and PCT, but this is a separate question.)

I don't know what the "greatest differences" are, or even if there are any
differences. I suppose that to answer your question, one would have to
consult experts who have used both methods. I know only about the method of
levels, in the roles of guide and explorer.

The MOL began in the 1950s as mere curiosity about a phenomenon: the
observation that one can, at the same time, attend to and discuss a
foreground topic and also have background thoughts, feelings, or attitudes
_about_ what one is saying or thinking. Kirk Sattley and I were discussing
this, and one of us wondered how many times in a row one could detect a
background thought, move it to the foreground for discussion, detect
another background thought, move it to the foreground, and so on. Would
this process peter out after a step or two? Would it go in circles? Would
it just wander on and on forever like free association?

We found that it doesn't just "peter out," nor does it go in circles or
wander on forever. It's a finite process that leads one into an interesting
(in restrospect) quiet state of mind which has a resemblance to what others
have described with words like meditation, insight, nirvana, and other such
terms. It's possible to do alone, but much more effective when there is
another person to remind one repeatedly to look for or recognize the
background thought.

Perhaps what is unique about the MOL is the emphasis on levels: the idea
that one thought does not just remind one of something else, but that the
foreground thought is subordinate to the background thought in some way.
The background thought is _about_ the discussion itself, the discussion of
the foreground topic. Thus if I'm describing a conversation with someone, I
might introject something like "I'm not telling this very well -- you had
to be there." So that's a background comment about the very action of
describing the conversation. In this case, it's as if there is some
superordinate watcher who is perceiving and trying to control what is going
on in terms of how well one is conveying an experience in words. In
psychiatry, I think it's called "dissociation." In PCT we just call it a
higher-level system.

An experienced person acting as guide would recognize such a statement as
originating at a level above the level of the foreground narration, and
would call attention to it by asking about it: "Are you making a judgment
about how well you're telling this story?" or something like that. The
person doing the exploration, after a little experience with this method,
would recognize the question as a request to turn attention onto the act of
judging how well the communication is going, and to say more about that
(new) subject. That discussion would go on until some new background
thought manifested itself: "I always seem to be wondering if I'm doing
things right," for example. That would be a signal to the guide to direct
attention to that topic.

And so on, as many times as possible. In the pure MOL, the guide's only
objective is to keep this process going as long as possible. The session
ends when there is resistance, or when the explorer indicates that it's
finished. The guide does not try to steer attention toward "significant"
topics, or to have insights for the explorer, or to give advice.

Rules of thumb like these have come mainly from experience. When the guide
starts getting too interested or involved in the subject matter, he or she
fails to recognize "up-a-level" comments, and the process bogs down. When
the guide gives advice the process stops dead. When the guide starts
arguing with the explorer, or suggesting topics that seem important, or in
any way tries to help the explorer attain insight, the process stops
working. It's almost as though the guide can't even care whether this
process helps or not (at least during a session).

The relation of this method to HPCT (as Rick points out today) is through
the concept of levels of organization, with higher levels being concerned
with variables that are functions of (and thus "about") sets of lower-level
variables. I strongly advise people learning to use this method to ignore
the 11 levels I have tentatively defined, and think strictly in terms of
_relative_ levels. When we have transcripts of 10,000 hours of people going
through the MOL, we can start trying to see if there are any discernible
levels that people have in common. It could be that the levels we address
in the MOL are subsets of just a few of the higher levels in the HPCT
model. It could be that they are different in each individual.

The other main theoretical topic here is the role of awareness in the
operation of the brain. It's well-known that awareness can become
associated with the operation of different parts of the brain, creating the
phenomena we know as consciousness or attention. In the MOL, awareness is
associated first with one level, then with a higher level, and so on -- or
that's one interpretation. The apparent rule is that awareness can take on
the point of view of any of several existing levels (maybe any at all), but
while it is associated with one level, the person is conscious only of
lower levels of perception: not the level the person is aware from, or any
higher level. The procedure of transferring attention to the background
thought can thus be interpreted as moving the locus of awareness up a level
in the perceptual control hierarchy. My conjecture is that this also moves
the locus of reorganization up a level, which is how this random process
gets directed at least to the levels where it can resolve problems, and
perhaps to the specific systems that are having control difficulties.

Perhaps Freud had some similar mental model of what went on during free
association. I know that in his book on the interpretation of dreams, he
describes a hierarchical model of perception, in which each level is
thought of as a camera focused on the viewscreen of a camera below it, in
turn providing an image for a higher-level camera to see. While he went in
more for hydraulic engineering than cybernetics (understandably), we can
assume he was trying to model the same organization we are trying to model,
and that he noticed many of the same phenomena.

Best,

Bill P.

[From Bruce Gregory (981123.1645 EDT)]

Rick Marken (981123.1250)

"What are you doing?" is the kind of question an MOL therapist
would ask. The MOL therapist would not be interested in the
making fun behavior per se, for example. Rather, the MOL therapist
is interested in getting the client to see the behavior from a
new conscious point of view. The Freudian therapist would, as you
say, be more inclined to ask questions in order to find out about
the topic at hand; so the Freudian therapist might ask questions
like "And why do you say that Johnny is a wimp?" or "Are there
any other disparaging things you would like to say about Johnny?",
or "Where is all this hatred coming from?" etc.

None of these questions are characteristic of any Freudian approach I am
familiar with. You must have some other school of therapy in mind. How does
MOL differ from Rogerian therapy? Or do you believe that Rogers would ask
similar questions?

All these questions
can be answered from the point of view of the abusive control
systems themselves; the kid can say "Because Johnny's a jerk"
or "He's a wimp and a jerk" or "I don't like jerks or wimps",
etc. I think people do go "up a level" occasionally in Freudian
therapy; MOL is just a more economical way to get there.

Wouldn't it be even more economical to ask, "What were trying to accomplish
by doing that?" This immediately forces the person to "go up a level".

Not specifically. The MOL therapist is just interested in
seeing talk that indicates a change of conscious point of
view (a change of levels).

I don't understand why it is not possible to change point of view without
changing levels. Describing a conflict from the other person's point of view
is a change in viewpoint, but does not entail a change of levels as far as I
can tell.

The only thing the MOL therapist does is help a person go
up a level; when a client does go up level then it's likely
that the client will have the insight.

How would you describe "an insight" in HPCT terms?

> Does it help or hinder if the client knows something about
> PCT? Why?

I think it might help a little; it might make it easier for
the client to catch on to what's involved in "going up a level".
I think going up a level is a learnable skill. A client who has
learned how to do it may be able to therapize themselves in
the future.

There is nothing that I am aware of in HPCT that suggests that the level at
which awareness operates plays _any_ role in the functioning of the
hierarchy. So if it is a learnable skill, it is not obvious what benefits it
confers. If awareness somehow "encourages" reorganization, the outcome of
MOL is just as likely to be negative as positive. Is the idea to keep
"encouraging" reorganization until error is reduced? What if battering your
spouse reduces _your_ system error? Is this a satisfactory outcome of MOL?

Bruce Gregory

[From Bruce Gregory (981123.1740 EDT)]

Bill Powers (981123 MST)

An experienced person acting as guide would recognize such a statement as
originating at a level above the level of the foreground narration, and
would call attention to it by asking about it: "Are you making a judgment
about how well you're telling this story?" or something like that. The
person doing the exploration, after a little experience with this method,
would recognize the question as a request to turn attention onto
the act of
judging how well the communication is going, and to say more about that
(new) subject. That discussion would go on until some new background
thought manifested itself: "I always seem to be wondering if I'm doing
things right," for example. That would be a signal to the guide to direct
attention to that topic.

So in MOL, a "meta-comment", one that is about the conversation taking
place, is the hallmark of a higher-level. The interviewer is looking for
such meta-comments and uses them to change the direction of the
conversation. This certainly seems unique to MOL.

And so on, as many times as possible. In the pure MOL, the guide's only
objective is to keep this process going as long as possible. The session
ends when there is resistance, or when the explorer indicates that it's
finished. The guide does not try to steer attention toward "significant"
topics, or to have insights for the explorer, or to give advice.

But a meta-comment _is_ significant as far as the guide is concerned. So
steering is going on. The process is directive, in this sense at least.

It's almost as though the guide can't even care whether this
process helps or not (at least during a session).

Yes, I can see this must be so.

My conjecture is that this also moves
the locus of reorganization up a level, which is how this random process
gets directed at least to the levels where it can resolve problems, and
perhaps to the specific systems that are having control difficulties.

O.K.

Perhaps Freud had some similar mental model of what went on during free
association. I know that in his book on the interpretation of dreams, he
describes a hierarchical model of perception, in which each level is
thought of as a camera focused on the viewscreen of a camera below it, in
turn providing an image for a higher-level camera to see. While he went in
more for hydraulic engineering than cybernetics (understandably), we can
assume he was trying to model the same organization we are trying
to model,
and that he noticed many of the same phenomena.

Thanks. I understand the process a lot better now.

Bruce Gregory

[From Bill Powers (981124.0532 MST)]

Bruce Gregory (981123.1740 EDT)--

So in MOL, a "meta-comment", one that is about the conversation taking
place, is the hallmark of a higher-level. The interviewer is looking for
such meta-comments and uses them to change the direction of the
conversation. This certainly seems unique to MOL.

I think so, although one of my contentions is that the MOL is embedded in
all successful psychotherapies. It's the part that makes them successful;
the differences are the parts that are irrelevant.

The guide does not try to steer attention toward "significant"
topics, or to have insights for the explorer, or to give advice.

But a meta-comment _is_ significant as far as the guide is concerned. So
steering is going on. The process is directive, in this sense at least.

Yes it is, but the direction is only to point the person up a level. No
particular _topic_ is preferred. As much as possible, the guide or
interviewer (not a bad term) follows the lead of the explorer.

Best,

Bill P.

[From Tim Carey (981126.1800)]

[From Bruce Gregory (981122.1640 EDT)]

What would you say are the greatest differences between MOL and Freud's
method free association? From what I have been reading, I am unable to
identify the distinctive elements of MOL. (I am also unable to discern the
relationship between MOL and PCT, but this is a separate question.)

These were good questions Bruce. Unfortunately I see that Rick and Bill have
already done a great job of answering them. We had an electrical storm here
a couple of days ago which fried my modem so I've been out of action for a
while.

Cheers,

Tim