No-teacher no-healer no-doctor no-therapist: bringing it all back home.

Abstract: A committed Heart-Centered therapist bears witness to the experience of bringing Wellness Institute training into an established psychotherapy practice. Four transitional domains are described. A distinction is drawn between Hypnotherapy and Hypnocounseling. Notions of homeostasis of risk and clinical imperialism are discussed. No-Mind Therapy, an intuitive/permissive stratagem for the Heart-Centered modality, is presented as a conscious alternative to the medical model. An annotated narrative example of Invitational Hypnotic Therapeutics is presented. Implications for the Heart-Centered movement are discussed.

Dedication

This article is dedicated to my son Isaac Joseph Sussman, who has taught me that the human need for openhearted exchange outlives my personal capacity to provide it.

Introduction

I am a committed Heart-Centered therapist (Zimberoff & Hartman, 1998). My intent in writing this paper is to detail strategies, experiences, criticisms, questions and comments, and insights arising out of my journey bringing Heart-Centered Therapies into an established private clinical practice in psychology. I offer it for publication in the hope that it will stimulate discussion of what I believe is a number of important issues related to and affecting the Heart-Centered therapy movement. I hope that some of the suggestions and observations prove useful to Heart-Centered therapists.

By definition, training materials which appear to function in the home clinic the same way they do when demonstrated during training produce a linear transition in the function of the home clinic. My experience has been that returning to the home clinic with materials and practices from training at the Wellness Institute (WI) initiates a distinctly non-linear transition. Some material works as it did during training, some material works quite differently, and my clients almost always find some ways of responding to interventions that fit nowhere in the expectations honestly developed in response to the suggested scripts and/or the demonstration and practice sessions with fellow trainees. In considering reasons why this might be so, it seems logically irrefutable that some of the non-linearity stems from the fact that, unlike WI trainees, most of my clients are not licensed health care professionals with graduate training. It seems equally clear that not all of the non-linearity can be accounted for in this way. The hypothesis that some of the differences encountered here reflect the fact that clients here have not been trained at the WI is not easily or readily discarded: It is clearly possible that some aspect of the WI training experience affects trainees' responses to clinical applications of the Heart-Centered modality.

The six years since undertaking training with the Wellness Institute has seen a remarkable and overall positive transformation in this one private psychological practice. Transformation has occurred in at least three domains. First, there has been a transformation in the methods used: I was a more traditional (if eclectic) therapist before WI training, and now use a variation of the formal Heart-Centered approach involving Altered State (AS) work (Tart, 1972) about half the time. Having taken certification in Heart-Centered Breathwork, of course one challenge in this private practice has been to integrate the breathwork into the hypnotic strategies. Observations made and strategies developed in the process of doing so have proven useful, and are worth sharing.

A second and more challenging change in this private practice relates to working with a different type of client now. We have always specialized in seeing those people who call on the phone and make appointments. That has not changed. The shift in client characteristics means that different people seek therapy here now. Much more of the present work relates to personal growth than to symptomatic complaint. While welcoming this trend, the shift has necessitated that both the initial interview and the focus of the first hypnotic session be re-construed. What is right action when there is no diagnosis to make and no symptom to eliminate, but the client wants to continue his/her work, or to commence working in the first place?

A third transitional domain has to do with my own personal growth and development. The kind of intensive personal challenges uttered by WI teachers during the course of training evokes profound consequences, either in the form of resistances or personal changes. I am referring here to changes in myself which are separate from any alterations in the methods I have come to use in working with clients.

Perhaps it is also fair to speak of a fourth transitional domain, concerning the ongoing growth and development of the Heart-Centered movement. This domain provides the global context within which the three local transitional domains fit. The nature of the local transitions has implications for the global movement, and vice-versa. Admittedly, the trademarked name belongs to the WI. However, there exists a growing number of therapists who use this term to describe what we do and who we are. Perhaps we who make up this group would do well to engage in deeper reflection upon (and more effective communication about) what precisely is meant (or ought to be meant) by the term "Heart-Centered" as it applies to us. Other questions we might reflect upon include: What kind of "alternative" to the medical model does Heart-Centered therapeutics in fact represent; or, wish to represent? Indeed, is the Heart-Centered model a clear alternative to the medical model at all? The following discussion includes materials intended more to contribute to processes of reflection and communication upon these matters than to provide final answers.

Wellness Institute Training: Impact in Four Transitional Domains

1. Personal Transition

Possible sources of a sense of isolation

Probably the only possible healthy response to WI training for a therapist is to enter a state of personal transition. In my experience, most of that has been fruitful; but some of that has been difficult. I believe that I am not a casualty today at least in part because I have long acted on my belief that therapists ought to be in therapy for as long as they practice. So, I have always had my own therapist to whom to turn. As a result, despite having issues related to a personal history of abandonment and parental unavailability, I have been able to maintain and have maintained proportionate perceptions of and responses to a sense of isolation stemming from at least three sources in the here-now.

Real sources

In dealing with much of the sense of isolation and distance emerging during and after WI training, I find that I can only account for part of it by probing around inside myself. I am convinced that some important share of it is coming from the outside in the here-now. Using esoteric therapies in my private practice has always been associated with some sense of isolation. This simply reflects real characteristics of the situation: My spouse aside, I live far from anyone who practices Heart-Centered techniques. I don't really have anyone else with whom to share about what it is I do. I know that my colleague psychologists know something of what I do. I get referrals for cases traditional psychologists are uncomfortable treating (Satanic Ritual Abuse and the like). But up here in the Canadian "Bible belt", unless circumstances demand it, nobody really wants to talk about the implications of even mildly esoteric methods and nontraditional models of psychological status. For example, I was saddened to hear the reason a University of Alberta Psychology graduate student was intrigued and anxious about wanting to attend the meditation circle at my private clinical practice: Sadly despite the availability of academic resources (e.g. Tart, 2001) she knew of nobody at the university who was teaching how to guide meditation circles.

Growth-related sources

It strikes me as somewhat ironic that, at the time I came to the WI for instruction, I rather enjoyed playing the lone wolf among my colleagues, who perceived me as a rebellious but affable curmudgeon (when they liked me) or a dangerous threat to professional psychology in Alberta (when they did not). I know of no other psychologist who has been both professionally disciplined (1983) and formally honored with an award for outstanding contributions to professional psychology in Alberta (1994). Through the WI process I have come to prefer playing no-role, and also to prefer participating in closer professional relationships. At the same time, common misperceptions of the nature of the very practices and pursuits that taught me to seek greater closeness with others now apparently serves somewhat to isolate me further from my colleagues.

Procedural sources

Some additional sense of personal isolation occasionally appears in response the WI training and group process itself. During WI training some criticism from my fellow interns was forthrightly directed at my personal characteristics: my male gender, my intellectualism, my appreciation of and background in the practice of empiricism, my use of computers, and my daring to doubt. I've been criticized on much the same grounds before; however, I generally expect it to be associated more with religious than clinical contexts. I have the unmistakable (and troubling) sense that the process of WI training may be operating under a tacit double standard: In pointing to the importance of the intuitive side of our being, we may devalue the uses of the intellect. Out of an abundance of concern that trainees find in the WI an environment where woundedness may safely be expressed and resolved, inadvertently an environment that increases the risk of producing casualties may be created.

Homeostasis of risk and the potential genesis of casualties

That such an environment may participate in the genesis of casualties can be understood through the concept of a homeostasis of risk. A mechanical example may serve here: Making automobiles seem safer could have the paradoxical impact of causing people to drive less safely, as they mentally hold constant the perceived risks of driving. Providing air bags and seat belts make driving appear safer, and perhaps as a direct result, people take more risks, driving faster and closer together.

The WI training environment is consistent with the core teachings that psychopathologies arise from our keeping silent about our experience, especially during childhood; and that we kept silent then as speaking up was too risky because it broke the family rules. During WI training, interns accept a set of guidelines and procedures to govern social exchanges. These are engineered to render it safer for us to break the rules of our families of origin. Paradoxically, the perception that it is safer to break the silence may trigger a veritable counter-phobic zeal, especially among trainees who see themselves as especially sensitive and/or vulnerable to victimization. In my experience, occasions when it has precisely that impact are common. It is incumbent upon people who facilitate clearings to ensure that the environment is as safe for the person being singled out for clearing as it is for the person who initiates the process.

People do well to value and to balance both the intellectual and intuitive aspects of being human. People also do well to remember that many who have done us no harm indeed share personal characteristics (such as gender) with our abusers. Perhaps those who initiate clearings should expect to de-role at the end of every clearing procedure.

The impact of charisma on attention to ideas

I perceive a subtle class structure in our dealings, especially but not exclusively at conferences of the Heart-Centered Therapies Association. It seems that, more than is consistent with careful reflective thought we embrace ideas on the basis of the charisma of their proponent(s). Regardless of how daunting the task of changing this ultimately proves, its cause may be relatively simple. It is this: The voices of those experienced in the right application of the medical and/or empirical models often sound a little more sober, a little less charismatic, and (possibly as a direct result of sounding the way they do) may go unheard (Butler, 1998). They may go unheard when they say that videotapes documenting the work of a skilled practitioner represent highly selected anecdotal data about what can but may not happen when Heart-Centered methods are applied clinically. They may go unheard when they say that working with professional caregivers who self-select for desire to participate in energy release workshops is different from providing professional services to working class stiffs whose needs to heal are certainly as valid as those of the healers who work with them. I have heard them shamed into silence through argumentum ad hominum judgements such as "you're in your victim place" or "you're coming from your head, not your heart" (as if it were possible to consistently come from just one of one's chakras). Shamed into silence by believers who believe whatever they hear from sources to which on some (probably subjective) basis they assign credibility ... perhaps because what they hear is the truth, but also perhaps simply because they want to believe something. Compelling by definition, charisma catches their attention.

Nothing is permanent. I recall with great warmth being in a 300-voice choir during high school. Whenever I hear good tight harmonies sung, I find myself wishing for those times. Occasionally I imagine a turn of events that causes us to get together and sing just once more. But, who would populate the audience? Many of our parents now are dead; certainly most of our grandparents are. Our elders made up the appreciative crowds who came to hear us sing back then. Who would come today? No matter how well we prepared ourselves, few would come. From one point of view, this is only appropriate. It is we who should be going to hear our children and grandchildren singing now. However, what if we had something important to demonstrate by our singing? No matter how well we performed, social expectations regarding just who should be listening to who would seriously limit the power of our demonstration. A similar kind of social expectation seems to limit attendance at conference demonstrations given by persons who have not been granted the status of "teacher" within WI circles. Some rooms overflow, while in others the emptiness is near deafening. In my experience, some of the most creative, courageous, and challenging offerings come from people who are not recognized as teachers. To be fair, I think sensitivity to presenter status affects audience attentiveness in many (if not all) scientific circles. Its impact upon communication is negative, however, and Heart-Centered therapists especially are philosophically mandated to rise above it.

I remember well the position repeatedly articulated by my late mentor and noted biologist Dr. T.W. Betz (a position many "recognized" scientists often reacted to with irritation). He proposed that research monies should be assigned by lottery, and then only to novice researchers who had achieved no status. He held that once scientists achieve recognition for their work, they come to have a vested interest in reaching and reporting only data consistent with previous findings for which they are noted and to which they trace their status as established scientists. Thus, they come to lack objectivity, and to be less likely than novices are to report findings inconsistent with foregone conclusions. He also argued that the history of science is rife with demonstrations of the fact that it is impossible to forecast from a research project proposal the quality of science that will result once it is completed. Many "accidental" and "incidental" scientific discoveries (such as penicillin) can be given as examples of research projects from which completely unexpected products have arisen, and that to the huge benefit of humanity at large. Greater scientific progress for research monies spent would accrue from a system where only unknown, novice scientists without any status or expectations to bind them would receive funding. Perhaps we would do well to award our attention preferentially to those with no-status.

Shakyamuni Buddha noted 2500 years ago that "all truths (dharmas) are empty" (David-Neel & Yongden, 1967; Hanh, 1998; Rahula, 1959). As he addressed his students for the last time before he died, he asked them if they had any questions or doubts. He encouraged them to question, telling them not to rely solely upon faith or belief. That any process through which the questioning voices of precise empiricism are silenced can weave itself into our training in my opinion represents a real threat to any lasting positive impact Heart-Centered therapists could have on their clients, and on society at large. Any tendency to embrace ideas on the basis of the charisma of the one articulating them represents exactly that kind of a process. I am convinced enough of the real basis of my observations that I risk making them public as part of my description of the personal transition of which they are certainly a part.

2. Professional Transition

In addition to bringing a deeply personal transition to my life, WI training is also evoking a professional one. Coming from a more open place of course provokes a transition in the client pool one attracts. Many clients were quick to notice the outward manifestations of the changes in me. A number of them left ... quickly. A far greater number of them called their friends and suggested that they finally found a therapist who wasn't stuck in his views. To this day, this form of "advertising" accounts for the lion's share of new clients. On the whole, this private practice has grown.

Client needs for orientation

Client responses to the introduction of Heart-Centered therapeutics here can be described as falling into at least two basic types: First, there are people who have been working on their own for a while. The proportion of such people in my caseload steadily increases. They are familiar with self-help and spiritual materials, and generally consider themselves ready to jump in with both feet. Some of them are so into self-help technology as to present significant problems when resistances are encountered. They acknowledge having encountered important limitations of the self-help techniques they once found useful; however, they are reluctant to move beyond them in the professionally facilitated process. For example, they may positively be fulminating with releasable energies related to an issue they claim to have resolved because they "did a Step 4 and 5 on it" (or otherwise "dealt with it" earlier). Their belief that they "got rid of that garbage" reduces their willingness to revisit the issue in therapy Therapists do well to leave their client's important schemata intact, and learn to work within any limitations they present (Bar-Levav, 1984).

By far the most difficult challenge I find in working with this group is that they may experience a desire for a facilitated growth process in the absence of any apparent or reported difficulty in functioning or subjective distress. So, there appears to be no symptom to "fix." For example, where does one start with clients who appear already asking what it is about them that repeatedly has attracted persecutors into their lives? Wherever that is, it is going to be different from the place one starts with someone presently living in the middle of an abusive relationship and who has not yet identified the abuse, or persists in blaming the abuser. In many ways, this more accomplished group presents the greater therapeutic challenge, in my opinion.

It is easier to reach the point of arranging an appointment with callers who have been working on their own for a while and seek professionally facilitated growth than it is with callers who seek symptom reduction. Paradoxically however, there are ways in which their prior work counter-prepares them for AS work. As previously mentioned, clients who seek a facilitated growth process are generally less able to come into a session with a specific issue identified than are clients who seek symptom reduction. They often need to be guided through a process of identifying an issue for treatment. Usually this takes at least one preliminary session of one hour. It is not uncommon for it to take two or three such sessions, especially where physical manifestations prevail. In addition, their intellect needs to be satisfied about various aspects of AS work. As a result, it is quite uncommon for us to jump into AS work on the first session. When that happens, it usually doesn't work out very well. I have seen Diane Zimberoff (gifted founder of the Wellness Institute) do it on video; but it just doesn't typically work out that well when I try it.

A second type of caller seems to be looking for something that will work on them -- almost a medical model thing. They often say that they have "tried" other therapists, and have hopes that the methods I have become known for practicing will "work" for them. The passivity of this stance is usually unmistakable. Client passivity can easily stymie the most skillful psychotherapeutic intervention, and frequently all a psychotherapist can do when stubborn client passivity is encountered is bear witness to it. That can be powerful (Glassman, 1998). However gratifying it may be for me to believe that I can live up to the expressed hopes these clients have of me, I do well to remember that I am just another therapist.

For example, I still am unsure of how one most effectively handles people who call for help with hypnosis to quit smoking. I kind of dread the calls. They want free consultations; they want guarantees. I handle these by telling them over the telephone that they can get pure suggestive hypnosis for less money elsewhere. I am a therapist. I was a therapist before I studied the Heart-Centered modality. I insist upon looking for the reasons why clients wishing to quit smoking started the habit in the first place. Only when the reasons it was possible for them to commence smoking are addressed and released will client vulnerability towards resuming smoking vanish. My experience is that this goal cannot usually be achieved in the first session, and (however astute the authority or pointed the suggestion may be) it cannot come through pure authoritative hypnotic suggestion at all.

Another kind of "work on me" effect some clients seek from therapy is a method for instantaneously vaulting over emotional issues into something they view as being a more appropriate place for them to start. People who seek this sometimes ask to be hypnotized so that they can forget someone forever (usually but certainly not always a former partner to an intimate relationship). They are usually fond of repeating "I just want to get on with the rest of my life." People who repeat this phrase see themselves as stuck, and indeed, clinically they appear to be stuck. Standing at some Point A, they imagine their life course correctly starting at some Point B; and, doggone it, therapy ought to transport them from A to B effectively. To heck with this emotional release stuff, just tell me how to get to Point B.

For good or for ill, all effective psychotherapies work to clarify exactly what Point A is. Point A is the same as here-now. The rest of one's life starts from here-now. If one is to get on with the rest of one's life, one has to find a way to do so from here-now. Anything that clarifies the nature of here-now is thus apt to be therapeutic. Anything that clarifies how it is that one managed to wind up at here-now is apt to be therapeutic. In the process of clarifying how one wound up at here-now and where exactly here-now happens to be, here-now moves toward Point B all by itself.

Here-now is the end result of history. Ipso facto history is important. Unless a client is near completely non-reflective, they've probably used their conscious intellect to review their history to some significant degree prior to coming to therapy. That review has not availed enough to eliminate their felt need for therapy, or they wouldn't show up asking for it. The point every altered state method, from the absolutely free association Breathwork evokes (Hendricks, 1995; Zimberoff & Hartman, 1999) to the saltatory, emotion-driven age regressions used in Hypno-Behavioral Therapy (Zimberoff & Hartman, 1998), is to facilitate an exploration of history in a manner that reveals patterns so far unrecognized by the conscious intellect. The point of all energy release methods, from Gestalt chair talk (Wheeler, 1991) to Primal Scream, is to empower clients to take ownership of their entire history. Only ownership of the entire history brings them completely into the here-now. Being completely in the here-now is the only position from which it is possible to get on with the rest of their life.

In my experience, the reduction of symptomatic complaints is achieved by changing direction. The symptoms arise out of causes in the there-then, and persist because of conditions in the here-now. When the direction is changed, here-now changes. When here-now changes, the former conditions no longer apply. The historic causes of the symptoms become like seeds falling on inhospitable soil in bad weather: symptoms cannot grow from them.

So, the telephone rings and the voice at the other end asks "Do you guys do hypnosis?" in a tone which is nearly impossible to describe but clearly predicts that this is going to be one of those calls where someone who needs effective therapy to get unstuck is asking for a Band-Aid instead. The voice's owner wants verbal psychosurgery; to be "put under" while the problem is removed for her/him, so that he/she can get on with the rest of her/his life. Never mind Point A. Never mind all this talk about finding a way to be fully in the here-now. Just get me to Point B, and be quick about it. And leave me with money left over for smokes. This kind of request is a clear invitation to the victim trap. I have struggled with the question of how or whether it is possible in the few minutes' time this person is willing to give me (or, to be honest, that I am willing to spend) to explain the approach of the Heart-Centered Therapies to treating the kinds of symptoms that bring people into therapy.

Hypnocounseling and hypnotherapy

The quickest and most effective way I know to help callers differentiate authoritative approaches from exploratory approaches is to differentiate between what may be called "hypnocounseling" and hypnotherapy. I point out that I have heard only a few therapists speak of this distinction, and that I am the only one I have ever heard use the term "hypnocounseling." I believe I may have coined the term. Hypnocounseling makes no attempt to identify the primal cause(s) of treated conditions in the distant past. Instead, hypnocounseling utilizes pure authoritative hypnotic suggestion(s) to reduce symptoms. In contrast, hypnotherapy adds to this a concerted effort to explore history for unresolved issues that form the basis of the complaint(s) which bring the client into therapy.

Although distinguishing between hypnocounseling and hypnotherapy works better than any other approach tried to date, many people still remain stuck. Forthrightly stuck in the medical model. Stuck in the notion that they can rely upon authoritative professional intervention to place them at Point B without referring to Point A, the here-now. Having given my best telephone explanation of the Heart-Centered approach and the difference between hypnocounseling and hypnotherapy, I encourage callers who remain stuck in this view to go see someone else. Of course, it is going to be impossible to completely explain this over the telephone prior to a caller coming in for an appointment. However, I find it preferable to tell people enough that they fail to come in rather than risk becoming an element in a pathogenic triangle. To the fellow who calls and asks "Can you make me stop drinking?" or "Can you make me remember what happened?" I always respond emphatically "No." The methods I am willing to employ cannot possibly be used to make anyone do anything. If I believe in what they wish to do, I can help people do what they want. In fact, I can be pretty effective at that. Heart-Centered methods work.

Others among this type of caller are non-psychologically-minded people who pick my name out of the `phone book. Some recall having seen me in the media (I do a lot of media work), or just recognize my name. But, they don't typically come from a pool of people who work as healers themselves. Neither have they experienced WI training. These clients are more comfortable with the direct suggestions involved in the scripted Hypno-Behavioral Therapy process than those who are more psychologically-minded and personal-growth-oriented, and therefore seem to need less orientation. They might well be content with my taking a pure authoritative approach, despite the clear indications in their presentation that only temporary benefits would accrue were one used. They seem to need an orientation where emphasis is placed on delineating the difference between counseling and therapy, and on explaining the need to examine historical issues in facilitating personal growth and making permanent changes.

Trying to vault over the orientation period clients need (or using the wrong kind of orientation for a client) can evoke resistances so profound as to stymie therapeutic progress and (occasionally) even create therapeutic casualties (Butler, 1992). Instead, I have come to employ a (sometimes much) longer orientation period than WI training taught me was needed, and have modified inductive narratives toward the less directive, especially with brighter, psychologically-minded clients.

Some risks of therapist expectations of clients

What I initially found to be most perplexing about applying the clinical methods of the Heart-Centered modality in some ways remains difficult to articulate. As previously indicated, an increasing share of my clients just don't come in with the kinds of clear presentations I viewed on the demonstration tapes. When they have symptoms they wish to reduce, they don't self-diagnose with any accuracy at all. They have no idea what is wrong; or, if they do have an idea about what the matter is, they're typically wrong about it. Either the description is unclear, or the problem as described doesn't easily lead to a recent time or situation we can "go back to." There have been occasions when I have felt guilty about not being able to plug my client into the directive Heart-Centered approach to hypnotic induction. Worse yet, on occasion it can seem as if there is something wrong with my client, because he/she does not fit the mold (Butler, 1992). On those occasions, I believe that unless I keep a firm grasp on my purpose in being a therapist and practicing therapy, I am at risk for shaming my client for not living up to my expectations. On those occasions, therapy can harm rather than heal.

Certainly clients are entitled to have and develop their own ideas about what exactly wellness is. Factors commonly associated with client heterogeneity (inter alia culture, race, gender, religious denomination, socioeconomic status) are associated with different views of proper therapy and its right goals. Therapists who develop too strong a commitment to any one notion of wellness (or the therapeutic pathway that leads to it) risk engaging in clinical imperialism. It simply is not the manifest destiny of any single modality to impose its ideas of wellness on everyone. Clients here commonly achieve results satisfactory to themselves despite utter refusal to engage in one or another Heart-Centered strategy. At some point I disclose my model of wellness to them. However, as long as I can see a possible path toward the goal they stipulate through the process they are willing to engage, I fail to press the point.

Some expectations of the therapeutic process

Clients here seem to experience memories of sexual abuse less frequently than I expected would be the case on the basis of my WI training. Even where the client's clinical presentation creates a in a therapist the conviction that a history of sexual abuse is likely, he/she does well to be scrupulous about avoiding making any suggestions of abuse (Yapko, 1994), and to respond impartially and compassionately to any memories the client may describe. Over an 18 month series of sessions, one client here gave detailed descriptions of Satanic Ritual Abuse, and engaged in absolutely rafter-shaking energy release. On a subsequent session, and apparently coming from a centered place, she indicated that she doubted whether these memories were accurate. She indicated a belief that she needed these images to evoke the emotional energies she had clearly released. She came to believe that the emotions were real, but the memory images were metaphoric. My professional opinion is that memory is either metaphoric or real, and (for the purposes of energy release) it matters not one jot which one it is. I naturally responded just as warmly to both of her interpretations of her hypnotic experiences.

From viewing tapes of the founder of the WI, Diane Zimberoff working, one can get the sense (as I did) that one ought to be able to use AS interventions the first session, and fully resolve issues in a 90 minute stroke. Experience has taught that for most of the clients who attend here nothing could be farther from the case. Clients here need to get to know me first. That takes at least one session. When clients insist upon diving right in at the first session, they certainly can be accommodated. However, these clients seem never to continue for more than two or three sessions. They discontinue with their issues apparently unresolved. Especially when working with clients whose defensiveness takes the form of compliance, Heart-Centered practitioners do well to avoid creating the impression that Heart-Centered therapeutics produce instantaneous effects. The effects are rapid and powerful, but not instantaneous. And a 90 minute AS session is positively a squeeze.

Introducing nontraditional approaches to clients

When introducing the idea of nontraditional therapeutics, I provide a set of questions and answers about AS work as information (this is a modification and extension of the set provided by the WI to its trainees. It includes items on false memory syndrome and specific fears of hypnosis expressed by clients here). I tell the client that AS work has both the drawback of requiring a longer session and the advantage of progressing much more quickly. I tell them that there will come a day when they will need to commit to the length of session at the time they book it. However, for their first session, I ask only that they agree to come at a time when we have the longer session available, and to read the information I gave them. Then, decide on whether to do traditional psychotherapy or AS work as they walk in the door. If they wish to do traditional therapy, I'll find a way to use the other half-hour. This arrangement at once softens the edge of the financial choice they must make if they are to do AS work, and honors any need they have to reflect before deciding.

When they decide that they want to go ahead with the AS work (which they generally do), I immediately suggest to them that we take a "playful attitude" for the first session. I tell them that we can afford to do so because we are going to make a great deal of progress through doing AS work. In fact, I guarantee that we can reach one of two sets of goals, either of which would take about six to twelve months using traditional therapeutics. The first and preferred set of goals includes achieving two methods of relaxation that they do not presently have, plus an audio tape recording for rehearsing them. It also includes introducing and using the technique most commonly used for exploring the COEX of linked trauma in hypnotherapy (Groff, 1988). We may even reach resolution of some issues. The second set of goals precludes the first, and is achieved by clients who test their control of the process through resisting all invitations and suggestions. They fail to close their eyes, say they have no favorite, most relaxing place, take excessively long times to respond to the simplest of interventions, won't touch a teddy bear, etc. These clients will ultimately realize that they are indeed in control, that control cannot be usurped by the therapist, and that hypnosis cannot be used to change the fact of their proprietorship over their own process. I tell them I much prefer the first set of goals; however, I warmly affirm the validity of any need they may feel to achieve the second set of goals instead.

Heart-Centered Therapies and the medical model

I think that, had the Nazis won World War II, even the most liberal amongst us would think more like a Nazi than is presently the case. Well, the medical modelers won the war. Even the most Heart-Centered of us is more deeply committed to disease (persecutor) - patient (victim) -- diagnose/treat/cure (rescuer) model than we would have been had the medical modelers not won the war. The Ph.D. has a thousand year history. The medical doctorate was created about three hundred years ago for would-be Ph.D. students who could master chemistry and anatomy and physiology, but could not grasp philosophy. Today, some argue that doctors of philosophy ought not to use the title "Doctor" because people might mistake them for physicians and overestimate their worth. Obviously, the medical modelers won the war. Equally obviously, we can and do wind up in the medical model without using traditional medical techniques and/or terminology. We can and do engage in many activities without being aware of what we are doing at all (Tart, 1995; Wolinsky, 1991). It may be important to consider some indicators that we have inadvertently lost our alternative point of view:

In my opinion, whenever we therapists speak of what we did to help a client (i.e., "I used the basic induction, induced hypnosis, and took M. Smith to his/her favorite, most relaxing place") rather than speaking of what our client accomplished (i.e. "M. Smith says that he/she achieved a deep state of hypnosis and felt tearful when experiencing the favorite, most relaxing place) it is likely that we have wandered into the medical model.

Even when it's an effective treatment, taking a pill for what ails you has the strong potential to bring us back into the Victim Trap. Of course, the less a phenomenon fits the medical model, the greater the risk. Most so-called mental "illnesses" are phenomena consisting of a loosely associated set of patterns (called "symptoms" or "syndromes" under the medical model) lacking any thoroughly documented pathophysiological "cause." Nonetheless, a hypothetical "biochemical imbalance" is proposed, and drugs are then marketed and prescribed to treat it. In sum, so-called "mental illnesses" do not fit the medical model at all well.

Medicating problems which would respond to psychotherapy (i.e. medicating codependency) exacerbates the fuzzy boundaries characteristic of the condition being treated (Beattie, 1987). Codependency issues arise from fuzzy ego boundaries, from being unable to distinguish self from non-self in important domains (such as emotional and social domains). Of course, taking a pill that alters brain chemistry increases the fuzziness of the ego boundaries, making that worse. If you get better, is it you or the pill doing it? If you get worse, the same question arises. What if nothing happens? Is it that the pill is ineffective? Or, is it helping, but you're getting worse? Or, is it making it worse, but you're getting better, so it cancels out? I for one have never understood how taking a medication that creates and/or exacerbates the selfsame problem it's designed to treat can possibly be helpful. Apparently the research literature on antidepressant medications is most consistent with the idea that any benefits of taking an antidepressant are largely if not entirely attributable to the therapeutic relationship between the client and the health care professionals involved in administering the prescription (Duncan et al., 2000), and not to the substance contained in the pill.

It makes no difference at all whether the pill is made from a plant extract or a bunch of chemical reagents (Pagliaro & Pagliaro, 1998). It's still a pill. Vitamin therapists, naturopaths, homeopaths, and even acupuncturists would do well to illuminate the difference between the model of treatment they are using and that used by most physicians. I am not an expert in any of these helping disciplines, but as a philosopher I see them as being identical in structure to the medical model. As such, I expect these practitioners to be as vulnerable as are physicians to becoming enablers in the Victim Trap, unwitting agents in the client's maintenance of an external locus of control.

Nonetheless, it seems that while rejecting or calling for alternatives to the medical model practiced by physicians, we wellness types may easily buy into "politically correct" versions of that model (vitamins, minerals, herbs, nutritional supplements, Homeopathic remedies, acupuncture, Reflexology, Reiki; in short, all of the have-the-therapist-operate-on-a-passive-client type therapies). To be frank, in the usual course of events, when the medical model is to be practiced on me, I think I'd prefer that a physician do it (or some other licensed health services professional who understands the philosophical model being applied).

3. Methodological transformation: No-mind Heart-Centered Therapy

I find the firmest basis for my Heart-Centered practice in the Buddhist concept of no-mind, or unknowing (Glassman, 1998). This concept, incidentally, is remarkably similar to T.W. Betz's aforementioned preference for scientists with no-status. I am most able to practice unconditional love when I break free of any preconceived notions about what my client (or my client's diagnosis) is or is not. Of course, my inner hard-nosed empiricist will always be there, considering the DSM (among other models of my client's condition, Wylie, 1995). However, my inner hard-nosed empiricist is well versed in the medical model of diagnose/treat/cure. In the same way that I am a better-functioning adult when I take care of the needs of my inner child, I am a better therapist when I attend to the needs of my inner hard-nosed empiricist. But, the idea is to be an adult with a happy child inside, to be a therapist with a happy hard-nosed empiricist inside. Then I can practice unknowing. In all of our modeling of personality disorders (borderline, co-dependent, multiple, etc.) I think we risk simply replacing or rearranging concepts (i.e., thinking) rather than relieving the need for concepts in the first place (i.e., intuition, compassion). I am unsure whether every teaching method (i.e. every method of attempting to share experience) is vulnerable to this problem due to the requirement that phenomena be labeled. To be sure, at WI we use a different system for labeling our client's condition than is described in the DSM, and the treatment methods we employ are certainly nontraditional. But the model still looks like diagnose/treat/cure, and that is still the medical model.

When I come from a place of unknowing, my client's diagnosis is the same as their name. Ultimately, I have no diagnosis either (Duncan et al., 1997): I am no-teacher no-healer no-doctor no-therapist. I am Paul. I have no-philosophy. I make right action my philosophy. I have no-script. I make right speech my script. I have no-specialization. I make helping this client here/now my specialization. I use no-labels. I make intuitive knowing my label. I have no-status. I make beginner's mind my status. If I am successful in practicing unknowing, the model for my Heart-Centered practice becomes connect/interact/become rather than diagnose/treat/cure. This model transcends the medical model's necessity for diagnosing either my client or myself.

Preliminary description o fa conscious alternative model

The model presented below emerges from local transitions ongoing in at least three domains. Of course, the model itself is in transition, a work in progress. As the model is based in clinical experience with real clients, descriptions of relevant clinical observations and issues are an important part of its presentation.

Connect

The importance of the therapeutic connection is widely noted in the scientific literature related to psychotherapy and AS work (e.g., see Gilligan, 2001). To connect is to form and maintain a therapeutic alliance. The process of connecting is itself an intervention, and is a prerequisite to any other kind of intervention.

It is probably fair to say that in the initial phases of therapy, connecting proceeds through the orientation processes conducted over the telephone and face to face.

Especially when initially establishing and beginning to grow the therapeutic relationship, connecting is a stepwise process. As people allow one another to come to know one another apace, connecting involves some measured self-disclosure on the part of the therapist (Jourard, 1971). The right measure of self-disclosure invites the client to self-disclose. Too little or too much self-disclosure is off-putting. I can think of no better reason than this for Heart-Centered therapists to be involved in a professionally-facilitated growth process themselves: Remaining in touch with one's own needs so that one can accurately intuit (or otherwise know) the client's needs is essential in discerning when to use self-disclosure, and what to disclose. All therapists make errors in choosing and timing interventions; however, the best choices are made by therapists who are able to differentiate their own needs from those of their clients (Butler, 1992).

Some of the greatest difficulties I encounter in connecting occur with intelligent people who have embraced a medical diagnosis as if it were their identity. Obviously they resist letting it go: They can't let it go without letting go of the identity (along with the rationale for any misbehavior or lack of accountability) it provides. But they can't embrace the label without embracing the symptoms it implies. So, they remain symptomatic regardless of any attempted intervention. In essence, what has typically happened here is that at some time in the past health care professionals and/or self-help-textbook authors have used a model which meets their needs to have a name for what is wrong, but which fails to meet the client's needs for the capacity to transcend the wrong-ness (Wylie, 1995).

It is especially difficult to intervene when such clients have seen a hypnotist prior to coming into Heart-Centered Therapy, especially when the previous hypnotist has reified the medical diagnosis by accepting its nomenclature as fact (i.e. by treating the diagnosis rather than the person). Usually the previous hypnotist has used an authoritative, suggestive, directive strategy. In these cases, I find it useful to switch from even the gently directive approach of Hypno-Behavioral Therapy to a more permissive strategy. When clients are invited to have their own personal experience of hypnosis (or breathwork, or any other altered state technique or therapeutic intervention) every phase of the process becomes theirs. From whether or not they choose to close their eyes through whether or not they choose to speak of their childhood to whether or not they choose to heal their woundedness, the client is the proprietor of the entire process.

Interact

Once connection is established, the therapist invites the client to participate in a therapeutic interaction. The invitation may be the same as a hypnotic induction or instruction in conscious connected breathing. Of course, it may take many other forms (Kertzer, 1989).

Interaction extends the process of connecting into the realm where issues may be identified and addressed in a manner driven by the client's important and deeply personal needs for growth. Throughout interaction, connection is maintained, along with the therapeutic relationship.

I propose that the distinction between hypnotic suggestion and hypnotic permission/invitation is real and clinically important. In bringing the scripted Hypno-Behavioral Therapy process into my professional practice, I have come to use a method of guiding intervention that is more permissive/inviting than it is suggestive (Jourard, 1971). Especially when working with clients having well-developed intellectual faculties, the invitational/permissive form of Hypno-Behavioral Therapy I have been exploring apparently evokes less resistance/balking than does direct hypnotic suggestion. I have come to call the approach Invitational Hypnotic Therapeutics.

The sound background for Invitational Hypnotic Therapeutics is noteworthy. I prefer silence or distant background noise to any type of music with a beat or a chord progression. All such music, no matter how sweet it may be, grows expectations, develops and resolves tensions, and otherwise contributes to a process where the client may easily and quite unconsciously be lead in a particular direction: toward relaxation, or cycles of a particular temporal structure. Using resonant bowls made of crystal or brass can create a form of music apparently having no such drawbacks. Using these personally would of course distract the therapist from the client. Surasu (1998) has authored a disk that is more appropriate to an invitational, open-centered process. Clients report that the sounds gently yet insistently invite them to steadily continue working. When using an unstructured, chakra-opening sound background, I am inclined to leave the music playing throughout the process.

When conducting Invitational Hypnotic Therapeutics I generally use no script. Experientially, the process becomes increasingly unpredictable as it progresses, both from the beginning to the end of the session and from the beginning through the termination phases of therapy. I find that this approach has much in common with some of the Ericksonian processes contained in C. Hammond's Handbook of Hypnotic Suggestions and Metaphors (1990). I am grateful especially to Eleanor S. Field, Ph.D., for the inspiring offering upon which the following annotated narrative example is based. There is a modicum of creative contribution from myself, too.

Examples of Hypnotically Permitting/Inviting the client to:

1. Close Eyes/Entrance: So, I'd like you to get just as comfortable as you can right now. Many people are most comfortable taking off their shoes and lying down. Good. And now as you continue relaxing, you may find yourself wondering just what your eyes want to do. You may find them looking at the ceiling, comfortably, not staring, just letting the ceiling fill your visual field completely, and yourself wondering what is going to happen next. You may find it is more comfortable for you to close your eyes now, in a peaceful sort of way, and either way that you do it, continuing to breathe deeply, comfortably, and rhythmically.

Note: If the client does not appear to be easily participating at this point, it is always reasonable to try a more directive approach. This happens only rarely, especially with personal growth clients.

2. Experience a Safe Space: And either way that you do it, I would just like for you to, to let yourself focus, on the idea of just, being comfortable. And there have been many times, many places, many circumstances where you have felt so comfortable that all that mattered to you was the feeling of that comfort. And you might think of them now, and let your subconscious mind zero in on one such situation where you really have experienced feeling mentally and physically comfortable.

3. Remain in Interactive Contact: And you may choose to keep me with you by telling me about this situation.

Note: The client may or may not choose to inform you about where they are at this point. Usually they do, but if they do not, the process simply continues after a pause.

4. Anchor the Safe Space: Perhaps there is for you now a shift in the position of some part of your body which can function for you like a string around your finger ... as a reminder or a passport or a boarding pass ... such as touching your thumb and forefinger together on the same hand ... which will bring you back to (use the client's precise words) and anchor you there comfortably. And there's one thing that can remain fixed dead center in your mind: You can return to this place any time you want to or need to. This is your safe place, and your enjoyment and sense of ownership of it can be heightened with every moment you spend here. And as you rest here, this experience may remind you of other places and other experiences where you've felt peaceful and contented, and filled with feelings of security and happiness

Note: In my experience, the facilitator does well to fail to ask the question of whether or not the client has a spiritual connection at this point, as it is potentially experienced as disorienting and suggestive (even commanding).

5. Commune with a spiritual connection throughout the process. If you now find meaning in the idea of a spiritual connection through a god of your own understanding, or a great spirit of nature, you may choose to invite that being into your process to help, guide, protect, heal, now. And if it seems right to you now, knowing that anything you say will be fine with me, you may tell me your name for your connection, or that you have none.

6. Have a Deeper Trance: And you can recall and re-experience all the sensations, the sights, the sounds, even the aromas, the inner feelings which go along with being safe and comfortable. And you may notice that there is a place in your body, a location where those sensations begin to manifest. And you can invite it to spread from there, profound relaxation covering your body, the feeling of every muscle in that part of your body just releasing, relaxing, and letting go ... lying flat like a limp piece of string ... very deeply relaxed ... and very likely that part of your body that most needs it will re-experience that relaxation first ... feeling every nerve in that part of your body becoming ... quiet ... flaccid ... doing no more than is absolutely necessary ... And you may wonder what direction that relaxation is going to move through your body ... And you may also wonder what direction this process is going to take

7. Release Both the Anchor and Conscious Control: Soon you get the feeling that ... you don't even have to answer that wondering ... that question ... anymore. You don't have to be aware of it at all. You can simply allow yourself to become part of that relaxation ... as it becomes part of you. And when that happens, you find that your anchor is no longer necessary, and you can let it go.

8. Further Deepen the Trance, Maintain the Connection, and Identify the Issue: You may discover now, to your interest, that you are not even listening to me ... because the sound of my voice and the response it evokes in your ... conscious mind is completely unimportant ... Perhaps your conscious mind is already off somewhere, daydreaming as during a not-too-interesting lecture, out the window to somewhere you'd rather be ... and you lose track of what is being said ... and it doesn't matter because your subconscious mind is picking up on everything which is being said now ... your subconscious mind is here with me -- and it can hear me -- and respond in its own time -- in its own comfortable way

You can enjoy whatever it is you are experiencing ... and right now ... you can take pleasure from every sensation -- floating or sinking -- heaviness or lightness -- warmth or coolness -- and let them become part of your calm relaxation. You can go ... as deeply into trance ... as you want to or need to ... just for now ... for whatever it is your subconscious mind wants to do to help you ... more and more deeply ... enjoying this experience ... And you might enjoy this experience of going so deeply into trance that it seems to you that you are ... all energy without a body ... energy radiating in space and time -- completely free -- able to go whenever and wherever it wishes to go

9. Free the Subconscious Mind to Explore and Resolve the Issue: And I wonder what your subconscious mind wants to explore right now -- what doors it wants to open -- perhaps taking a look through the file cabinets in a remote corner of that marvelous data processing system that is your mind. Searching through the files and examining things that ... stay the way they are -- things that need to be updated -- what needs to be erased -- what items can be eliminated -- and you can continue to rest comfortably ... just knowing that ... you can rely on your subconscious mind to explore what needs exploration, however remote it may be, and to do whatever it is that needs to be done ... and you may keep me with you by sharing what it is your subconscious mind seems to be exploring ...

Note: At this point the client may go silent for a time. They may go silent until the end of the session. In that case, I simply close with a generic and positive healing narrative. It may be useful to provide feedback if the breathing is shallow, or if the brow is furrowed.

Integrating breathwork into the invitational narrative

Note: A smooth transition into breathwork can be accomplished here, simply by commenting on shallow breathing and inviting the client to deepen and speed the movement of the breath. Thus, this permissive, invitational approach links the approach of Hypno-Behavioral Therapy with that of Integrative Breathwork.

10. Identify the Feeling and/or Name the Issue:

Note: When the client describes an historic event or situation, the therapist does well to note it and facilitate its exploration with questions. Ultimately an emotion is identified, or an issue or belief described. When the therapist refers to the issue or the feeling the exact wording the client uses generally evokes the best response.

11. Explore Close and Remote Incidents Involving the Feeling/Issue: And there have been numerous times -- numerous places -- numerous situations when you have felt this way (or experienced this issue, or had this belief confirmed) ... I wonder what your subconscious mind may discover to its surprise when exploring more remote occasions when this (use the exact words again) has (proven so, arisen, happened) ... nothing else matters except this feeling right here

Note: It generally takes several sessions to get a garden variety Edmontonian to respond positively to an invitation to use the energy release hose. The idea can be introduced as part of connecting, and the invitation uttered as part of a gentle narrative akin to the following:

12. Release the Historical/Behavioral/Belief-Based Ties (Become Free of the Issue): And it is very comforting for you to discover for yourself ... that ... you can really ... let go ... of what you don't need ... of what no longer serves you ... and you may use the energy release hose now to release this (name the emotion) about (name the issue) ... otherwise your subconscious mind can do this in its own way ... and in its own time

(Give Teddy Bear) ... and let this teddy bear be an important part of you. (The part that for years obeyed the rule (stipulate), or kept the poison secret (stipulate), or believed him/herself incapable of (stipulate).) A part of you that grew for itself the adult you've become ... An adult, with adult capabilities.

Note: Here the client may respectfully discard any outdated beliefs and habitual strategies.

   You can begin to explore your adult capabilities ... that you never had
   suspected you had -- the seeds of which have been there all the time -- and
   find for yourself a ... very ... deep ... sense of just who and what you
   are -- and what you are capable of -- doing all those things -- perhaps you
   just haven't been aware of them before -- but your subconscious mind can
   make them available to you ... at the time you need them. That's right --
   and you can continue drifting along ... very comfortably wherever you are
   in time and space -- just enjoying the restfulness of not having to do
   anything in particular right now (clients dealing with issues related to
   perfectionism may be invited to know that they have nothing to live up to).

13. Experience a Heart-Centered, Spiritually-Connected Healing: And I wonder if you might begin to notice some change in the atmosphere around you -- perhaps becoming more luminescent -- more transparent -- spinning all around you in all directions ... as far as you can see -- and that atmosphere seems to be radiating a calmness you can experience with every one ... of your senses -- a calmness ... moving all around you ... and all over you ... softly ... moving itself into every fiber of your being ... until you get the feeling that's all there is -- nothing ... else exists ... for you ... except that calmness -- deep sense of peace -- and you feel the pressures dissipate -- nothing to think about -- nothing to live up to - and absolutely nothing to do except let yourself be -- and on an even deeper level, experience a sense of your own being -- who you are -- what you are capable of -- becoming more aware of your own inner resources (possibly insert the Zimberoff narrative "Visualizing Your Healing Resources") ... and now you can anticipate the joy of discovering those resources and what you can do to make use of them to help yourself... and other people as well

14. Completion and Return to Here-Now: And now, for the next few minutes -- you can allow yourself to relax -- even more deeply -- as your subconscious mind continues the important work it has started for you -- working to reach an even deeper understanding, and the realization or making real for you of the healing changes you are making -- and whenever your subconscious mind is finished ... with what it needs to do at this time -- it will find its own way of letting you know -- and in your own time -- at your own pace -- and only when your subconscious mind is ready for you to do so -- you can begin to drift back quietly -- easily -- from wherever it is you have been -- reorienting yourself to ... here-now ... this time -- this place -- and become aware of feeling ... very refreshed, alert, energized, comfortable, and with a very deep sense of having ... accomplished something ... of tremendous importance -- just for you -- and you won't do it ... until your subconscious mind is ready for you ... to do so.

Accepting client presentations of various selves during interaction

When considering the process of interacting with clients, especially when inviting the client to go deeper, the question of what it really means when I say I'm speaking to someone's inner child, or to their subconscious mind often occurs to me. The same question arises when I find myself speaking to an "attached entity", or inviting a part of the clients "soul" to return to them. My perspective is that everyone practices dissociation to one degree or another. Dissociation is socially sanctioned (arguably even required). Certainly there is no reason to pathologize dissociation; at least, not in most cases. For example, at work I may become the Paul who brings home an overdue project. At home, I may well become the Paul who looks at his briefcase, sees there the tracks of work-Paul, and wonders "what was I thinking?" This is clearly dissociative, but there's nothing particularly disordered about it.

The practice of dissociation is highly individuated, and is a definitive part of every personality (Schwartz, 1987). All clients have parts of their persona whichare more central to their conscious role in the therapeutic relationship. All clients have parts of their persona which are less central to that role. When I speak to a dark or light force entity, a spirit, an angel, a retrievable soul, an inner child, a wise adult, a memory person, or the subconscious mind, I believe that I am speaking to my client and only my client. This is true no matter how like a separate force the "entity" appears to be. Clients have come here equipped with spirits so "real" they arrived before the client did, moving doors and chairs, castigating the client during AS work for arriving late, and expressing emotional bonds so intense as to bring tears to both of us. But the important bond is between the therapist and the client. Therapy is never about the bond to the "entity." When I treat the "entity" with respect, the intrapsychic schism that creates the entity in the first place is resolved and the client experiences a healing.

As part of a therapeutic interaction, every action I take with respect to any dissociated fraction needs to make sense in terms of actions taken with respect to the client. For this reason, there are occasions when the most Heart-Centered Therapeutic action I can take is to avoid AS work entirely. I have a number of clients who have taken to doing 90 minute talk sessions. I let them; however, I do disclose my opinion that AS work would go faster and be more productive were they to choose it. My belief is that they are resisting; however, it's their right to do that.

Interaction as offering

Jukichi Yagi says: "There is nothing to be found, even if I search. There is nothing to do but to warm myself on my own. There is nothing to do but to burn my own body and light the place around me" (Schiller, 2001). I frequently think about therapeutic interactions as offerings. When I light a candle or some incense at an altar, the nature of the objects on that altar (be they gold or silver or brass or paper mache) matters not one jot. Neither does it matter if my candle blows out or the incense stops burning in the middle of the stick. I do well to practice detachment from that which I am offering, and the one to whom I am offering it. What matters is my intent. Why am I making the offering? Am I trying to win merit points? Am I trying to be the world's best therapist?

Every day I go to my office I make an offering of another day of my life. I burn my offering on the altar of interacting with and bearing witness to my client, hoping to light the place around us. In terms of my most important offerings (providing a safe place, being a safe and attentive person, and spending the time in which to do the listening) my clients' nature (diagnosis) matters not one jot. Neither does it matter if my interventions "work" (whatever that means). When I am present simply because it's good to be present, I become a healing presence.

Time and again I have offered my best (and frankly, memorized) interventions, only to have my client feed back to me subsequently that it was the short spontaneous phrases I used (either as conjunctions between those interventions or as links to the client's reported experiences) that evoked the deepest healing response. When I bear witness to whoever my client wishes to be and to become through conducting an interaction with me, the exact outcome is never completely predictable. However, it is always therapeutic. The right words and actions emerge from my burning day just as naturally and spontaneously as does smoke from an incense stick.

Become

However psychotherapy is defined, at least in important measure it consists of an interaction between therapist and client having as its intent constructive change to which neither party can honestly be immune. Becoming is a product of the therapeutic relationship. Both client and therapist become. If the exchange with the client is conducted in a manner which protects the therapist from the need to learn and grow, the resulting interaction cannot change the client (at least, not for the better). When therapy happens, nobody stays the same (Jourard, 1971; Duncan et al., 1991). Certainly in the process of facilitating Heart-Centered therapeutics, I have experienced significant personal change. The result feels like an auspicious circle, where positive changes in me evoked through my transactions with therapy clients have produced positive formal changes in the therapeutic transactions I facilitate, the experience of which in turn evokes more personal changes in me, and so forth.

I sense that being trained in clinical applications of the Heart-Centered modality may suit one particularly well for dealing with crises such as client reaction to the World Trade Center attack. This is so because we have had the opportunity to become accustomed to the notion of dealing with clients with whom we share issues and growth-producing change. We know our clients are mirrors for our own issues, and that we function as mirrors for theirs. If we've been paying attention in Heart-Centered practice, we know that we cannot facilitate in a Heart-Centered fashion from the detached position generally prescribed for and assumed by medical model therapists. By definition, Heart-Centered therapists push the envelope of clinical detachment. So, when an issue arises affecting everybody (ourselves included), an issue in short in which we are as much awash as any of our clients, we are equipped through our training to know how to recognize that and how to proceed in clarity.

Conversely, training in clinical applications of the Heart-Centered modality may also render one less fit for dealing with issues for which one was formerly more suited. I find I have less to offer clients who rigidly adhere to 12-Step techniques, for example. I have come to question the medical model of addiction, and to wonder if it is in fact a disease. It certainly matters less to me today how that question is answered: I abstain from mind-altering substances because I have no desire to use them, and believe they can only interfere with my personal growth. It's not a struggle. I can recite the memorized interventions of nearly two decades ago, and my newly recovering clients seem not to notice. But my heart isn't in that, and I question whether I'm the person they ought to be seeing now. Conversely, I do much better work with my 12-Step clients who have longer-term recovery and are reaching the limits of that self-help model.

As Heart-Centered therapists, we know that through our transactions with our clients we are bound to change and grow. Heart-Centered Therapy is conducted with the heart chakra open. When the heart chakra is open, experience automatically evokes productive shifts in our own nature (Judith, 1994). It may be less apparent that there are going to be shifts in our therapeutic abilities and client preferences. This is neither out and out increase nor decrease: As one door closes, another opens. However, it is especially incumbent upon us to remain aware of these changes, as we may find that we have for historic reasons come to command a reputation for being "good" at providing some types of intervention to which we no longer are fully committed. Of course, where such a commitment is lacking, our best work no longer is possible.

4. Ongoing growth and development of the Heart-Centered movement

In analyzing dreams, Dr. Sigmund Freud (1900) differentiated manifest from latent forms of content. The manifest content is the story line of the dream; the events in sequence and the characters involved in those events. The latent content is the deeper meaning of the dream, consisting of interpretations and analysis of transference issues. According to Dr. Freud, the potential latent content always dwarfs the manifest content in which it is inherent. As a Heart-Centered therapist and as a student of Buddhism, I look at all experience as illusion, and therefore as dreamlike in nature. As such, it may well prove useful to look at concrete experience in terms of manifest and latent content areas.

The manifest content of our introduction to the Heart-Centered modality through WI training includes (1) models of conditions which create in our clients a need and/or a desire for therapeutic intervention and (2) methods of treating clients which create in their beings the sense that their condition is improved. The latent content of our introduction to the Heart-Centered modality through WI training certainly includes demonstrations of how to operate as a client in Heart-Centered therapeutics. To be fair, WI training in this regard is probably no different from training in any other form of therapeutics conducted anywhere else. However, when I am wondering why it is that so many of my clients respond in ways so unlike anything I witnessed or learned to expect from my WI training, the question of the possible impact of a subtle (even unintentional) instruction to respond in ways that fit the script certainly comes to mind. When it does, I wonder if other Heart-Centered therapists ask themselves the same question. When I consider the ambivalence I have experienced when contemplating making my own thoughts on this matter public, I wonder whether other Heart-Centered therapists with similar questions and similar feelings of ambivalence have simply kept still.

Open-hearted participation in transactions with clients evokes nonlinear change in both therapist and the conduct of therapeutics. In similar fashion, one can only realistically predict that open-hearted participation with Heart-Centered therapists ultimately will evoke changes in the WI, its founder, those identified as WI "teachers", and the conduct of Heart-Centered therapeutics. Although the precise form of this growth cannot be predicted, at least some of the channels through which the change-evoking transactions are conducted can be described, developed, and made clear and approachable.

Some of the channels supporting ongoing exchange between Heart-Centered practitioners include the WI website, the Journal of Heart-Centered Therapies, and the Heart-Centered Therapies Convention. It is important that Heart-Centered therapists contribute their input to these channels, so that growth of the movement can continue. It may be useful to recall that the psychoanalytic movement did not fail because Freud was wrong. Freud was right about most things, and caught most of his own errors in time to make all but one of them public before he died. The psychoanalytic movement has stagnated, not because of an absence of modern creative thought (see inter alia Miller, 1981), but rather because it has failed to respond to the only important error that Freud failed to catch before he died. The error? Psychopathology is not caused by guilt. It is caused by shame (see inter alia Karen, 1992). Methods useful in discerning and resolving guilt do not generally work with shame. In my opinion, psychoanalysis does not work well; and it is not made to work because Freud's followers have adhered to his teachings too rigidly to allow optimal growth of the discipline. Channels for growing psychoanalysis from its Freudian roots into a vibrant movement alive today apparently are nonexistent. The present document is offered in the hopes of energizing the Heart-Centered movement so that such channels are formalized and used by Heart-Centered therapists to keep the movement alive and workable now and in the future.

In his book The Different Drum (1987) Dr. M. Scott Peck describes three phases in the development of community. The first of these is pseudo-community, where a diverse people feign unity by obscuring their differences through remaining silent about them. The result appears peaceful, but it is only a social facade. The second phase emerges when people begin to risk articulating their differences. The resulting phase is called chaos. Chaos seems, well, chaotic; but it represents a necessary transition to true community, the third phase. True community emerges after numerous chaotic differences are resolved successfully, leading to a basic trust or expectation among the members of the group that differences between them represent no danger, and will ultimately be resolved, reconciled, or compromised. For true community to emerge, members of a group need to risk airing their differences. With respect to personal issues, Heart-Centered therapists learn to do this through the WI clearing process. Techniques for "clearing" professional issues affecting Heart-Centered therapeutics lag behind the WI clearing process in their development, in my opinion.

Perhaps it is fair to say that it could well prove useful for training in Heart-Centered therapeutics, and for the Journal of Heart-Centered Therapies to come to include more discussion of cases which challenge the model, fall outside of the scripted solutions, and work with people who don't know what is expected, and frequently do the unexpected. Of course, for that to happen, Heart-Centered therapists with abundant no-status need to contribute time and energy, risk criticism and chaos, and trusting that differences will be resolved, bear witness to them.

There are important professional issues facing Heart-Centered therapists. As an example, for legal purposes, where client files may be subpoenaed (as can easily happen in Canada), the kind of notes taken during the Heart-Centered process can easily be misinterpreted and misused legally. I go into an AS when facilitating client processes, and the notes I take reflect that, together with the demands of the process. They are not at all the equivalent of medical progress notes. In my opinion, if it is to be legal that case notes can be subpoenaed, it is absolutely senseless to apply the same legal criteria to both progress and process notes, when process notes disclose so much more than do progress notes.

Heart-Centered therapists do well to consider and discuss the professional implications of the lack of a commonly-used linguistic distinction between progress and process notes and between hypnocounseling and hypnotherapy (see above). These are salient distinctions for us, and the professional organizations through which most of us are licensed have not given them the emphasis they deserve. The implication that we may not be able to safely engage in Heart-Centered practices within the confines of tradition-bound professional organizations that fail to grasp the nuances of what we are doing is not easily discarded. Heart-Centered therapists may or may not need to become a freestanding profession; however, we certainly need to seriously discuss this and other important ideas among ourselves.

For the foregoing reasons I have risked making public views which I know will be controversial among those interested in the Heart-Centered modality. Although my life would perhaps be simpler were I to keep my questioning to myself, I fear the Heart-Centered modality will ultimately fail to continue to respond to our changing world. This article commences with the assertion that I am a committed Heart-Centered therapist. I have taken my experience of the Heart-Centered modality into my heart and allowed it to change every aspect of my psychological practice. In the process, I have come to have a practice that at once differs from what I was doing before, and from what I was taught to do at the WI. I am convinced that something like this has happened to each of us who risked opening our hearts to this modality. We do well to risk chaos and communicate openly about it. The result will be true community among Heart-Centered therapists.

Only if Heart-Centered therapists achieve true professional community will the Heart-Centered modality be alive and vibrant enough to meet our children's needs for professionally facilitated personal cultivation. We will know that is happening when our public communications contain more questions and fewer answers.

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Paul S. Sussman, Ph.D., Sussman Psychological, 10042-117 Street, Edmonton, Alberta Canada T5K 1X2.