Wednesday, May 22, 2013

Education and psychoanalysis.

The school year is coming to an end here. Not only will I move some of the child patients I see to an earlier time in the day but I am reminded of ways education research informs what I do in the consulting room. For example, in 1964, Robert Rosenthal experimented with what would happen if teachers believed that certain students as reflected on their testing were poised to have a dramatic rise in their IQ. Even though these students had been randomly chosen, and no such test actually predicted who would have a rise in IQ, it turned out that teachers treated these supposed identified students so differently, with the expectation that these students were smart, that, lo and behold, IQs for these differently treated students rose! Teachers’ expectations of these kids really did affect their students’ performance. How was this possible?

We psychoanalysts might think of implicit relational knowing. It turns out that the teachers’ moment to moment interactions with these students changed. They gave these students who were expected to succeed more attention with smiles, nods, and touches, and gave them more time (to answer questions), feedback and approval. So how get teachers to change their expectations? Robert Pianta at the Curry School of Education (UVA) found teachers’ beliefs about students and about what is effective teaching were more likely to change if— through coaching and videotaping of their teaching –teachers changed their behavior rather than if teachers took a course on how to change expectations.
All this got me to thinking about how we behave with patients. Do we have the expectation that they can make a richer life for themselves or do we share too much of their hopelessness? Do we implicitly, and sometimes explicitly, communicate our hope, or despair? And, if so, do we reflect on how we implicitly communicate— through gesture, tone, facial expression— our expectations? Pianta’s work does not make me think that CBT is the way for me of working with patients. Instead it confirms the power of experience and procedural learning that we offer when we do long term treatment with patients. Both studies confirm for me the power of right brain experience over left brain cognition or insight. They say to me that living the experience in the deep immersion of a psychoanalytic relationship changes brain networks.

In addition, one of my favorite contributions from education, and elsewhere, is the idea of constructionism. It recognizes that people construct their own understanding and knowledge of the world, and their place in the world, through the very things we utilize in psychoanalysis: experience and reflection upon experience. Through assimilation and/or accommodation (Piaget) we reconfigure or create our own knowledge. Like teachers in the classrooms, therapists encourage patients to reflect on and talk about what they do and about what they understand about their experiences. While the teacher might have the answer, or the therapist an idea, both encourage the student, or patient, respectively, to find their own answers, encouraged sometimes by the way we formulate our questions or musings, particularly in helping to question the self and the self’s strategies to learn or grow. Rather than a passive recipient of knowledge, we encourage students/patients to actively engage in curiosity and in negotiation and co-creation of reality and emotional truth. 

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