 Thank you, Simon. And Bob, I want to thank you. You know, it's been more than 20 years, and I've at least done one five-day workshop at your place, sometimes two for more than 20 years. So thank you, Steffi, for your hospitality to me and to you, Bob, for continually making it possible. All right, is this even better for you in the back? Okay. Oh, one other thing, a little disclaimer. If I don't shake your hand, it's because my hand is in pain. I've just had carpal tunnel surgery, and the other thing is that I cannot write any dedication if you buy a book. I can probably sign my name for a while until my hand goes numb. So if I'm not shaking your hand, give me a hug instead. Oh, Bob, you've given me what, at first, I thought this is an impossible task. You know, you've given me a topic of compassion, hope, and forgiveness in the therapeutic dialogue. My first thought was, I don't know anything about that because I've never talked about it formally. But then I realized, as Simon said, this is something part of every workshop. And it's when I've been working with individual clients. It's so central that sometimes we don't talk about it overtly, but it is very much a part of what we do. The word conjures up images of Jesus healing the sick and Buddha suffering because others in the world were suffering from hunger or oppression. The word compassion comes from the Latin, calm, which means with and passion, which means to suffer. So compassion means to suffer with the other or to suffer together. Compassion involves both a physiological and an emotionally sensed experience of suffering with the other is a total sense of the other, a moving out of our own experience by being fully aware of the pain of the others. Compassion is selfless. Compassion is about the welfare of others. It may involve putting the welfare of another person above our own, much as when a hero jumps into cold water to rescue someone they do not know. In psychotherapy, compassion begins with our ethics. We are compassionate when we practice our profession with a constant perspective on ethics. The most significant ethic of all is our commitment to our client's welfare. That's it, just our commitment to their welfare. It is the client's welfare then that guides us in all we do and say, all other ethics emerge from this central ethic that involves our commitment to make our client's welfare the most important in all of our actions. Compassion then is a central element in psychotherapy. Compassion is what may have motivated some of you to become a therapist. It is that felt sense of experiencing the other's suffering and a simultaneous desire to relieve the other's pain, anguish, or loss. Compassion is what motivates us to put our arm around a person who is grieving. We want to comfort them to alleviate their grief. Compassion is what motivates me to attune to the client's affect, to attune to their rhythm and their relational needs, to fully connect with them. In my practice of psychotherapy, compassion emerges from a conviction that each person is of value in his or her own unique way. Carl Rogers called this valuing of the person unconditional positive regard. Martin Buber described how this aspect of compassion is based on what he called an I-thou relationship. Martin Buber used the biblical word thou to reflect the spiritual nature of a fully contactful and compassionate relationship. A quality of relationship that is without any perceived notions of the other, so there's no preconception who the other is. A relationship built on continually discovering the uniqueness of the other person and a relationship that attends to the other's affect and relational needs. I want to go back and cover those three again. A relationship without any preconceived notion of who the other is. A relationship based on continually discovering the uniqueness of the other person and a relationship that attends to the other's affect and relational needs. When we foster such a contactful relationship, we are naturally empathetic because empathy is based on compassion. Although the words compassion and empathy are frequently used interchangeably in the English language, empathy often refers to the emotional connection with a specific person, whereas compassion is often associated with a response to the suffering of all human beings. Empathy is a word used to depict our ability to feel the emotions of another person, to experience those emotions and feelings as though they were our own. A saying attributed to the natives in America is you cannot really know another person's experience unless you have walked a mile in his moccasins. Empathy is about being deeply connected to the other person's affect and experiencing what it is like to be in his or her skin. Carl Rogers in defining the theory and practice of client-side psychotherapy, which unfortunately I think has been renamed in this country person-centered therapy and they miss some of why Rogers called it client-centered, but that's another story. Carl Rogers elaborated on this idea when he defined empathy as our capacity to feel the other person's affect so that when they're sad we can feel that sadness, when they're scared we can feel that along with them. To feel their sadness, their fear, their anger, their joy, their sadness. But that's different than the psychoanalyst Heinz Kohat, who writing about psychoanalytic self-psychology referred to empathy as a form of listening. A listening to the other person's phenomenological experience without any preconceived notion or judgment. And that's a hard task for many of us to listen without having some preconceived idea. For Kohat, empathy was about wanting to understand the other's subjective experience. And in order to do that, he could not impose his own ideas on it. Now that's particularly important for those of us who were trained in my early days, particularly in my TA days, where we had all our TA theory and our job was to impose it on the client and give it to them rather than really listening to them because our theory gave us the impression that we knew everything. When we are engaging in psychotherapy with a client, and this kind of empathy occurs automatically if we have the attitude that I know nothing about the other person's experience. So I must continually strive to understand the subjective meanings of his or her emotions and behaviors. Let me say that again, because I think this is a fundamental attitude that allows us to have this compassion, I know nothing about the other's person's experience. And so I must continually strive to understand the subjective meanings of his or her emotions and behaviors. And how do we do that? We listen, we inquire, we stay attuned, and we inquire, and we inquire, and we inquire to pull out their phenomenological experience. As psychotherapists it is essential that we have both of these forms of empathy, the forms that Rogers and Kohat both describe to feel the client's affect and to strive to understand how they experience themselves. Although empathy usually refers to our ability to feel both the emotions of another person as well as an understanding of the other person's reasoning, compassion generally refers to the desire to help. This is the type of compassionate psychotherapy I described in the book Beyond Empathy, a therapy of contact and relationship, and also in the book Integrative Psychotherapy, The Art and Science of Relationship. And unfortunately I think they don't have that second book, The Art and Science of Relationship here. We go beyond empathy when we attune ourselves to our clients. Attunement is our yin to the client's yang. The affect of attunement provides the necessary understanding of reciprocity that the other needs to feel emotionally whole. Reciprocity, it is a very important concept in psychotherapy. It describes that the other needs something from us in response to his or her affect. I've noticed that in group many times people will say something emotionally important to them and the group members sit there quietly. When I ask why they're quiet, they say, oh, I'd be respectful, but you know, I think that's not respectful. What's respectful is some kind of reciprocity. If you say something emotionally important to you, what you need is the other person to respond in such a way that acknowledges and says I'm with you. Let me share four examples of reciprocity that our clients may need from us. When our client is sad, they need us to provide expressions of sensitivity, or warmth, or tenderness, or acceptance. Or when our client is angry, we respond by taking them seriously. Just think about that for a moment for yourself. You've been angry about something, you tell the person and they just turn and walk away. What happens to your anger? He either deflates or you have to escalate. Or you're angry about something and the person escalates and they are angrier than you are. You can't make an impact with your anger. And then imagine a situation where you're angry and the person says, oh, okay, tell me about it. And what else? And what would you like me to do? That's a reciprocity. That's taking your anger seriously. Or when the client is afraid, we feel protective and may act protectively. Sometimes I can't even act it, but I can think it. My client is sitting there and he's remembering his father sending him out to the yard to get a stick to beat him with. And he has a dilemma. Does he get the piece of oak that's on the ground that he knows is going to leave bruises? Or does he take the willow stick that he knows is going to leave waltz? And he's sitting there trembling in my office. And I'm sitting there imagining getting right between him and his father. And he looks up at me and he says, something's happened inside. That we had that transmission, that reciprocity of my feeling protective to his tremendous fear. And when the client is joyful, we meet him or her with our vitality and celebration. We take a while to tell you a story, but I learned that a lot with one client who was about to tell me about her probably one hundredth affair. And she saw the look on my face and she got up and ran out. Two weeks later she came back after a lot of cursing on the telephone to me and she said, you're just like my mother. You couldn't be happy for me. Even though I know this man wasn't good for me, you couldn't be happy for me. I learned a lot about it from that client about the importance when the client is experiencing their joy, that they need our vitality. When we provide such emotional reciprocity, we are empathetic and compassionate at the same time. Recently, I was typing up a video transcript of a therapy session and trying to describe compassion, empathy and attunement that the client required in order to heal from the emotional wounds of neglect and abuse. As I typed the transcript, I realized that the words I was using only slightly conveyed my compassion. Those words barely expressed the empathy I felt because the most important component of compassion was in my nonverbal behavior. Compassion was expressed in the sustained eye contact. Compassion was expressed in the muscles of my face, in my hand gestures and in the tone of my voice as well as the words that I was using. My eyes, face and voice tone conveyed my presence, my commitment. They conveyed that unconditional positive regard. Such therapeutic presence requires that we be fully with our client's experience as well as there for them. That's with them and for them. And at the same time that we de-center from ourselves. To be fully present, we make our own concerns not important. Yet simultaneously, and this is paradoxical, we draw on all of our personal and professional experience as a resource to further our attunement and connection with the client. So it's a very paradox. It's about de-centering, putting aside your shopping list, worrying about your kids who are at school and being really their present with the client. And yet allowing them to stimulate you to go to your resource library. What's in the resource library? Your own therapy experiences, your own supervision, your training, the novels you read, the movies you've seen, the music you love. All of what has happened in your life becomes that rich resource library to draw on. And yet paradoxically at the same time, putting that all in the background and focusing on your client's experience and taking the position. I don't know anything about this client so I've got to listen and I've got to inquire. It is our presence and attunement that allows an authentic person to person connection. Our client's capacity to heal from the wounds of neglect, ridicule, or abuse is directly dependent on the quality of interpersonal contact and attunement that we provide. Hope. Though word hope reminds me of the children book entitled, A Little Engine That Could. I think I can, I think I can, I think I can, I think I can was the motto of the little engine. Some of you may know this story as well as I do if you read it over and over to your young children like I did. In this children's story, the little engine eventually was able to climb the hill and finally explain, I knew I could, I knew I could, I knew I could. This is a delightful story to teach children about the importance of hope and perseverance. Webster's dictionary has two definitions of hope. The first, a desire with anticipation. And second, a desire accompanied by expectations or the belief of fulfillment. They're almost the same. But I like the second definition because it is central to the process of psychotherapy. Our clients come to us because they have an expectation that they will change and grow. Otherwise they wouldn't come. Even those that are pushed there by the court or pushed there by their spouse, right, they're still at some level, some expectation. They are looking for some form of fulfillment. That is why in transactional analysis we often begin with a clear contract defining the client's expectations and how they will know when those goals have been fulfilled. Hope is optimistic. Hope is a state of mind based on anticipation that something good will result and that events and circumstances in life will turn out well. One of the important teachings from my mother was about hope. When things in my life were bleak and I was discouraged, she frequently said, life always turns out. Not necessarily the way you expect, but life always turns out. More than 70 years later I realize how instrumental my mother's message of hope has been in my life. Her message has served to keep me enthusiastic and enjoying the adventures of life. Several writers on psychotherapy have also commented on the sense of hope. Alfred Adler sees hope as central in our mental health when he describes the importance of goal seeking. He encouraged clients to make plans and divine various ways of making their plans come true. Lawrence Lashotte, the cancer researcher, described his research with people who were diagnosed with terminal cancer and only had a year or two to live. He encouraged them to dream big, to make big plans and do what they have always wanted to do but have usually postponed. And then he helped them find the resources to implement those big plans. Interestingly, the patients who activated their dreams, who dared to follow their desires, lived from two to five years longer than their previously diagnosed time of death. Isn't that amazing? To live your dreams, to get out there and do what you really hope to do, must have a tremendous biochemical influence inside the body. Donald Winnicott saw hope in children's disruptive behaviors. He said those disruptive behaviors, that delinquency those kids get into, the bad boys and bad girls have hope. It's an unconscious desire to make an impact on the adults in the child's life. And he thought how important it was to deal with this as a form of hope rather than in reprimand. If we expand on Winnicott's ideas, perhaps our client's resistance is their desire to impact us. Think about that for a moment. What if the concept of resistance did not exist? But instead you saw it as your client's way to make an impact on you because you weren't in tune with their internal experience. What would happen in your practice of psychotherapy if you saw your client's behavior not as a resistance, but as an unconscious desire to influence you, to encourage you to see the world from their perspectives? The psychologist Charles Snyder describes the connection between hope and mental willpower. In my personal experience, hope emerges most strongly when there is a crisis. Because it is hope that opens me to new and creative options. My client may be despairing about the circumstances in his or her life. And in that moment of crisis, I'm often propelled to find some important way of connecting with that person. My task then is to maintain a sense of hope. I hold the hope even if the client doesn't. Hope in both our relationship and in the process of psychotherapy. The crisis propels me forward with a new hope, with courage to experiment with different ways of our being together. Hope then offers us a challenge. But hope is much more than wishful thinking. Hope is not passively longing for something to happen to us. True hope is realistic. It must include real possibilities with a clear plan on how to reach what is hoped for. An important aspect of psychotherapy includes helping clients identify their aspirations and to find the step-by-step ways to achieve their hoped-for goals. If you have read or will read the book Relational Patterns Therapeutic Presence, there's three chapters in there about my work with a rather profound, borderline kind of narcissistic woman. And the last chapter ends with my supporting her hope to change her whole life, to finally settle into a meaningful relationship and to go back to school. And I remember, and I tried to write in that chapter how the last several months of after five years of therapy was all about helping her dream and make that dream come true. If you get a chance to read that, there's a good example of what I'm talking about. As psychotherapists, we may also involve helping our clients be realistic about what may never happen, such as the client who is hoping that maybe their father will apologize or that some long-lost lover will return. Part of hope is helping them realize what is realistic. And let go of the illusion that many of our clients will have is I can't change or grow until somebody else changes. Freud described how depression was the loss of hope. If the loss of hope then results in depression, hope must be essential in every element of psychotherapy. Not only is hope instrumental in recovery from psychological effects of neglect, abuse, and humiliation, hope is so central in all the psychotherapy that we do. Hope helps people recover from physical illness and may even prevent illness from developing in the first place because our beliefs and expectations can simulate the body's hormones to enhance recovery from illness. And I didn't take time in this paper to put in the work of Cosolino and DeMascio and Sheer and Deluxe, all of the new neuropsychological literature that clearly supports how the body chemistry changes based on whether we have hope and positive expectation or not. The author Alexander Pope writes about how people are blessed because hope springs eternal in the human breast. You know that phrase? Hope springs eternal in the human breast. I pondered over that and I think he means to help to tell us that hope gives us a sense of liveliness filled with a desire to achieve something. Hope is that which gives sparkle to our lives. This zest for life is something that the ancient sages have emphasized for millennium. For example, St. Paul says, for in hope we are saved. All of the world's religions emphasize hope as a necessary aspect of overcoming the drudgeries of life. I hope that you use a lot of hope in your work. Forgiveness is about letting go of resentment. It is about finding an end to our angry actions and our bitterness towards someone who has offended us. It is about freeing ourselves from the physical and mental pressures that occur when we continue resenting someone. Forgiveness frees us to move out of the past and into the present and future with new and different perspectives. Resentment results from holding on to old angers. It is a living in the past. Resentment is often accompanied by fantasies of getting even or possibly withdrawal. But you know there is something very powerful in those fantasies. By having those resentful fantasies, I'm never going to talk to him again or I'm going to get even in some way, we have a false sense of power that distracts us from the disruption and the awareness of the hurt in the loss of relationship. Resentment includes a fantasized misperception that we hold some power over the other person. But in actuality, resentment is a distraction from the disappointment and pain that occurs when there is a disruption in relationship. When we hold on to anger at someone, the body is stimulated to produce cortisol and adrenaline, two major stress hormones. And interestingly, if we stay in that kind of resentment, our body becomes addicted to living with this overproduction of stress hormone. The addiction to stress hormones is one of the reasons why some of our clients will hold on to old resentments for many years, perhaps for years after the other person is already dead. The prolonged release of stress hormones within the body often interferes with both physical and mental health. This is why forgiveness is so important in the process of psychotherapy. Forgiveness brings peace to body and soul. With my psychotherapy clients, I find that forgiveness begins when they make a conscious decision to let go of resentment. I mean it, a very conscious decision. And I think a lot, I do a lot of deep emotional therapy, but I think a great deal of it also is very cognitive. And that's part of that conscious decision to let go of the resentment. I think that's the first step. The second step occurs when the client examines his or her own behavior and attitude towards the person he or she resents. I guide my clients into challenging themselves with a question, how did I possibly contribute to the conflict? I want to make a distinction here. I do not do this if I'm dealing with a little child in conflict with an adult. This is much more for two grown people, such as a husband and wife at the end of a marriage, or an employer, an employee, when there's a crisis in the job. This is not particularly appropriate for when you're addressing that child who's been in conflict with an adult. But how did I possibly contribute to the conflict? The question involves a process of soul searching and facing some truths about ourselves. It consists of examining our attitudes, our fantasies, and our behaviors toward the person we resent. This soul searching is a central part of Alcoholics Anonymous 12 Step program. The A literature describes the important step as taking a searching and fearless moral inventory of ourselves. Some people consider that forgiveness is about forgetting. And no longer remembering what occurred. That's not forgiveness. Forgiveness does not mean forgetting. Forgiveness involves being fully aware of what occurred, as well as taking some responsibility for what occurred. And I want to say again, but not for little kids who have often taken much too much responsibility for self-protective reason. Because if it's my fault that mama is drunk, if it's my fault that daddy's beating the other kids, what hope? What hope? Because if it's my fault, then I can change, I can do something, I can grow up, I can move away, I can even kill myself. That's a very different kind of resentment. There our treatment is not so cognitive as it is very emotional and regressive, allowing that child to set some boundaries and express their anger. By responsibility, I do not mean self-blame. And that's one of the problems when particularly I'm working with couples and I ask them to look in a very sober way about taking responsibility. They turn it often into self-blame. But I mean being soberly aware of what is my role in the conflict. Forgiveness does not mean that we excuse the other person for what they did. And again, this is a popular misconception. Alright, you've wronged me, I excuse you. Because they too are responsible for their behavior. So it is not about forgiveness, I mean forgiveness is not about forgetting and it's not about excuse making. But central in forgiveness is taking responsibility for what one believes and feels because forgiveness is based on our attitude toward the other person as well as our attitude about ourselves. The third step in resolving resentment includes not only telling the truth to oneself as in step two, but also telling the truth to an interested other person. The truth telling to an emotionally attuned other is essential in achieving forgiveness. I think this is one of the reasons why the Catholic Church had originally instituted confession. When confessing to another person, we not only hear our words and explanations, we observe the facial expressions and hear the voice tone and words of the other person. Such intersubjective communication often helps to calm resentment and restore internal peace. To help clients maintain an attitude of forgiveness and not lapse back into resentment, I try to convey to my clients the idea that at any moment in time we each do what we think is best given the limited perception we have of options. And I think that's a wonderful philosophical way for all of us to approach things we don't understand that the other person as well as us does at any moment in time given the options that are in mind what you think is best. A few seconds or minutes or hours later, you may realize that that wasn't a very good choice. But at the moment you did it, I think we are always making the best possible choice given our limited perception. Later we may realize that our choice of behavior was a poor one. But at the moment we said what we said or did what we did, it often seems like the only choice. Forgiveness does not mean that we have to reconcile with the other and make everything okay. It means letting go of the false idea that we have some control by remaining resentful. We can engage in the process of forgiveness even if we never talk to the other person again. And keep in mind forgiveness may take a long time. It is a process of self-awareness and knowledge that this resentment and anger that I feel hurts me as much or even more than it hurts the other. Now if you can get that concept, that cognitive idea, that thought through to your clients or even use it for yourself, that this resentment hurts me much more than it hurts the other person. And that's a major movement in changing and finding a sense of inner peace. Forgiveness is based on our attitude, not on the others behavior. Many clients spend years in bitterness waiting for the other person to apologize for what they did. Forgiveness cannot be based on the other's actions or attitudes. The other person may never change but we can change how we feel and respond. We can stop our fantasies of resentment and that's a hard work. It requires almost constant self-confrontation. Forgiveness is a process of growing. It is not a specific event. It is not just talking to an empty chair and then say, well father I forgive you. It is doing it every day, sometimes every hour. I am concerned that some therapist may push clients into premature forgiveness and that the client merely adapts to what the therapist wants. In 1973 I published an article entitled Six Stages of Treatment in which I described the last stage of therapy to be forgiveness of other people, specifically in that article of one's parents. I wish I hadn't published that because I've sat on a number of clinical exams in transactional analysis and watched people present a tape where they were very proud of how they were encouraging their client to make forgiveness. Some therapists have misunderstood this stage and have actively encouraged clients to forgive someone but forgiveness must come naturally or least systemically. It cannot be programmed by the therapist. You can challenge, you can talk about the possibilities but I think we cannot push it to happen. One of the tapes that I listened to is the therapist said, all right, we've talked about this enough now it's time to put your parent on the empty chair and forgive them and how the therapist almost put the words in the client's mouth to do it. And then she turned to me and said, see, I did what you wrote about. I wish I could take back that article. Some clients are very quick to say, my parents did the best job they were capable of doing. In some situations this may be true because all of us do what we think is right at that moment. But in many situations the parents did not do the best possible job. They may have been drunk, intentionally critical, inflicted physical pain or were sexually abusive. At least that's the population that I work with. In such situations forgiveness based on excusing the other is not transformative and it is not growth producing. It is merely avoiding the realizing and accepting the impact that the other has actually had on the individual. Forgiveness requires that we not deny the reality of what occurred, but that we put the events into the past, that it did happen, it was real, it affected me profoundly and it's over. And I have to let go of the fantasies of getting even or withdrawing. Putting it in the past so that the events no longer affect what we imagine or the way we feel and behave. So we're talking about compassion, hope and forgiveness. Compassion, hope and forgiveness are central in a relationally based integrative psychotherapy. These three areas of therapeutic involvement are frequently in my mind when I'm carefully listening to my client's narrative. I'm continually monitoring my expressions of empathy and desire to be compassionate so that I am affectively attuned to the client's internal experience. I need to make sure that my compassion isn't greater than their capacity to receive it. I want to emotionally connect with my clients, but I'm also cautious that my expression of compassion not overwhelm my client by evoking more emotional stimulus than he or she can internally process. Affect attunement is always a challenge because it requires a moment to moment emotional balance of my affect in resonance with my client's affect. And I want to infuse my client with a sense of hope. Hope is the antidote to despair because it provides us with direction and enthusiasm. Yet I want to make sure that I'm not offering hope as a panacea, but that the hope we share together is realistic and vitalizing. Hope and the accompanying sense of well-being is based on realization that a fully lived life is a process of learning and growing from each and every experience. That a fully lived life is that process of learning and growing from each and every experience. No matter how good or how bad that experience can I learn and grow from this. Forgiveness is an important ingredient in a relationally based psychotherapy. When working with my clients I want to make sure that any expressions of forgiveness are coming from the client's desire and readiness to let the emotionally consuming past be over. I do not want to suggest that they forgive before they are internally ready. The desire to forgive must come from the client's sense of hope. A hope to be relieved of the burden of resentment. And I think that's accompanied by the knowledge that this resentment hurts me more than it ever will hurt the other. Forgiveness then is transformative. When the impetus for change is the result of our client's realization that their resentment hurts themselves even more than the other. Compassion, hope, forgiveness, these are three important elements of a psychotherapy relationship that are instrumental in the healing of the psychological wounds of neglect, stress, shame, and abuse. As psychotherapists we have a very humbling and important mission. Thank you.