There is a tension between multiplicity and singularity.
In my research this singular:multiple tension is evident in considering the practice of counselling. It's called counselling when its face2face, f2multiple faces, verbal but not f2f, nonverbal and not f2f, synchronised or non-synchronised.
In order for counselling to occur, at least two people are required. The practice occurs in relationship.
One initiates the conversation, and one makes themselves available to hear the story of the other. If counselling is to be enacted, it is crafted from the story of the one and the communication skill embedded with the other.
In this agency, responses from those who 'do counselling' suggest a singular entity, a set of skills or processes that fit together. The skill set of listening, affirming, being client-centred, a strengths based approach. A single reality. Definite and singular.
What then of differences? Obviously not every story is the same, nor every skill set. How is listening shown when the conversation is non verbal? What is meant by being client-centred, does this extend to intervening when the counsellor identifies saftey trumps autonomy? There are hen examples of contradictions. Differences in counselling when the story differs, when the actors differ, when the actors might include non-human actors such as mobile phones, computer screens...
The inconsistency with what is counselling is altered. How then is difference contained?
Mol suggests the need to work with multiple possible truths. What counts as best depends on circumstance. And points to Wittgenstein on how rules do not make their own applications. Rather than an actual inconsistency, the scenario is described in terms of apparent inconsistency. In respecting autonomy but acting on a person's safety expressing concern by contacting emergency services despite the client asking you not to, gets described as "if they were in their right mind, less tunnel visioned, less distressed, less drunk, less depressed, they would appreciate it ... they are telling us for a reason...at least they will know that we take their safety seriously..."
The implication is that what is best, desirable, advised as best practice, depends on the circumstances. Thus inconsistency gets explained away. Such storytelling of practice help to sustain the singular version of a cohesive practice. Such an analysis would suggest that concern for inconsistencies is one of perspective. However this does not do enough to explain how the same actor tells of their own practice.
When the counsellor says:
"no difference, phone, text, health.
then 15 minutes later says
"I am aware of doing it differently, role of psychodrama. Everyone does it differently, brings different backgrounds.
I am the triage(insert name), phone counsellor (insert name), text/email (insert name )counsellor.
Such an example supports what Law describes as poorly coordinated realities. Or what Mol points to in distributed practice. Contradictions evolve in enactment, working out what to do. In shifting between medium there's a sense that some things change and some stay the same, and even described as the same and different. Law picks up on the implications brought about by this same and different discourse.
He identifies how the contradiction provides opportunity to work out best options where there are contradictions, in the less than perfect world of health practice the work involved requires adaptation. In addition, this requires an ability to make judgments. The craft of counselling growing out of past experience, conversations and reading.
At the site of this study, the past experience in counselling was predominantly to use the medium of choice of the target group, telephone counselling. With a shift to the target group using mobile phones, an attempt to provide a portal to counselling by text was also initiated. The standard for counselling comparisons is frequently made. A need for judgments being contingent led to policy development. A guide for judgments when the situations were contingent on the type of 'call' or on the medium being used. The decisions required are even more complex. As expressed by one counsellor:
"I worry of how young the caller might be, could be 10-11 not teens, and I might be affirming sexual activity and stuff and assuming [they're] old enough and sending a mesage that might be colluding with activity that might not be appropriate for the age....on verbal if they sounded young we would probably find a way of asking that. Definitely makes [me] text cautious. If i have a 10 yr old saying my boyfriend wants to have sex with me, that's very different than an 18 yr old."
The type of response is contingent, shaped by the realities experienced in the moment. In texting a cautious response is then given based on how little is known, this counsellor describes herself as not being able to work with instinct or intuition on a txt platform. Nor having enough knowledge to do more than affirm that the situation sounds difficult and inviting the person to phone up.
What this reflects is that difference is produced with difference assemblages, there is an overlap but it is not the same, there are some things that stay the same, such as affirming, but there is also difference, call us. A move away from being client centred, or a reinterpretation of what it means to be client-centred.
Enacting is not then a matter of perspective, and includes more than a crafting by the people involved. The non-human actors too have influence. A combination of people, technique or skill, and text and technology evolves. The realities of practice are produced in relationship and these relationships extends beyond the people directly involved to include the technological actors. It also includes unseen actors, invisible actors and invisible work (and power differentials...all of which point to a new posting opportunity).
Tuesday, August 12, 2008
There is a tension between multiplicity and singularity.