youngsters stop self-harming through using strengths and solutions-oriented conversations combined with using the WRAP (Wellness Recovery Action Planning) and the ACT (Acceptance & Commitment Therapy) hexaflex. I met Gemma, a South Asian young woman who was cutting herself intensively. I used my usual approach but was surprised to discover that her ceasing cutting following our initial sessions was short- lived. After five months of weekly sessions, we reviewed the ‘progress’ (cutting has been supplemented with overdosing) she is making in individual sessions with me and in family sessions with my supervisor. Gemma told me, “Without our sessions I would be dead by now”. I ‘mistakenly’ took this as a sign of improvement so I was shocked when she took another overdose a week or so later. When I visited her on the children’s ward with her parents, her father accused me, and also CAMHS, of not helping her. Perhaps I was ‘mistaken’ to ally myself with this appraisal but I left the ward determined to ‘do something different’ when she was discharged. On the morning of her discharge assessment visit, she told me she had been wandering around the ward the previous evening trying to find something sharp with which to cut herself. From this, I ‘mistakenly’ sensed that her cutting was compulsive like a drug addiction and I carried this thought with me when, following her discharge, we met the next day. Gemma had promised that she would no longer take overdoses but had said that she would continue cutting. I ‘mistakenly’ suggested a ‘crazy idea’ that involved: 1) changing the pattern of Gemma’s self-harming (for example, see Cade & O’Hanlon, 1993, p. 11); 2) baselining her cutting to regular days and times each week rather than cutting when distressed and 3) of going to mum for care afterwards rather than keeping the wounds hidden and untreated. I had in mind a possibility of a paradoxical effect in gaining a sense of control and of ceasing cutting, similar perhaps to the local adult psychiatric ward’s harm reduction strategy of providing a ‘ safe cutting’ pack on demand. Both Gemma and mum readily agreed to give my ‘crazy’ idea a try. When I returned to work the following week, I was challenged by my family therapy supervisor about my intervention and discovered that all my appointments had been cancelled, except for attending a


14


looked after child review. The reviewing officer praised my work with this young woman, who had ceased self-harming and who was looking forward to initiating family work facilitated by me with her mother. The following morning, my line manager suspended me and, for the next eleven months, I was suspended on full pay until the final disciplinary hearing that I won. Subsequently, I was ‘struck off’ the social work register – nearly two years after I had started collecting my state pension. Some people have asked me about


ending my career in this way, perhaps suspecting that I might have a sense of shame about these ‘mistakes’. On the contrary, I think that my career ended on a ‘high’. To explain this, I refer to Fernand Deligny, a French educator and social- care practitioner who inspired the radical psychiatrist Felix Guattari. Deligney writes (2015), “The random chances of existence have


led me to live within a network rather than otherwise, by which I mean in another mode. A network is a mode of being...I sometimes reach the point of telling myself that a network is waiting for me at every turn...I was predestined for my work; from my earliest years I have always had some network to weave.” Unlike Deligny, whose sense of network


arose randomly but seemed predestined, my sense of network seems fateful, inevitable even. My sense of con-/joining therefore is more about moving into and out of social networks rather than moving into and out of relationships, mostly due to circumstances I had little sense of at the time and even less control over. As Deligny writes, “…there are events that grow…and there are networks that spin and weave themselves…” So, to reframe Deligny in an Alan Watts way (‘Do you do it or does it do you?’) I ask, “Who is doing the joining and conjoining or is the joining and conjoining doing us?” When considering a sense of network, then it seems necessary to consider our place within system(s). Do we do our practice/ therapy within networks/systems of our choosing or have the networks/systems of which we are a part chosen us? R.D. Laing once described


psychotherapy as “an obstinate attempt of two people to recover the wholeness of being human through the relationship between them” (1967, p. 53). This idea may


be based on a creation/fall/redemption archetype that may not be healthy or useful. Against the Biblical Genesis story as interpreted by Augustine, there is the interpretation of Iranaeus that may be supported by systems thinking in general (for example, chaos, emergence, and complexity theories, etc.). Iranaeus taught that humanity is evolving and maturing (ever so slowly!) toward a divine moral standard. So perhaps networks and systems are the scaffoldings that frame humanity’s evolutionary ascent. Ecological, cultural and organisational scaffoldings can be considered in terms of how they help or hinder our maturation. Humanity was provided with a


‘Garden of Eden’ where we could exist in equilibrium with nature. However, Greta Thunberg has recently drawn our attention to the way that our planet appears as being exploited to human extinction by the end of this century, if not before. Cultures have provided humanity with experiences and beliefs that create meaningful lives. Cultures have also provided us with systems that oppress like language, something understood by Deligny when citing Lacan: “How is it that we don’t notice that the words we depend on are imposed on us? Rather, the question is why a normal man, a man said to be normal, doesn’t notice that speech is a parasite, that speech is a veneer, that speech is a form of cancer that afflicts the human being?” Organisations have provided human groups with collective purpose but they have also provided us with, for example, the imposed ‘rule of law’ dictating obedience to elites and their statutory policies and procedures that can undermine professional discretion. We cannot separate ourselves from the


networks and systems within which we have our being and doing. Joining and conjoining may be an illusion based on a lack of understanding of how our lives are lived for us by networks and systems over which we may have no or little control – see W. Edwards Deming’s much quoted aphorism: Put a good person in a bad system and the bad system wins, no contest. So joining and conjoining may not be the linear process that we may assume it to be. Can we be sure that we can identify and separate the person from their context? What if joining and conjoining are or became circular processes, what


Context 169, June 2020


The tactics of mistake – on being pushed and pulled


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