Many speech and language therapists specialising in stammering have trained in PCP. Adele Pile describes the ideas behind it and how it can help people who stammer.
Elsewhere on this website tributes have been paid to Fay Fransella and Peggy Dalton as pioneers in the application of Personal Construct Psychology (PCP) by speech and language therapists to the field of stammering. Since then many speech and language therapists have integrated PCP into their clinical practice with clients of all ages, presenting with a variety of communication difficulties.
How did personal construct psychology develop?
George Kelly devised personal constructs theory as a result of his psychotherapeutic work in the poorest areas of the USA during the 1940s and 1950s. He wrote two large volumes to guide his students and trainees, and these were published in 1955 under the title The Psychology of Personal Constructs. These are still vital resources, and his theory has been further researched, explored and elaborated by psychologists in the fields of psychotherapy, education, organisations, ethnicity and displacement, crime, culture and the arts. There are now prominent centres of research and postgraduate training in many countries including the UK, USA, Australia, Italy, Spain, Germany and Serbia.
Other psychological and counselling approaches have sprung from George Kelly’s work, most notably Cognitive Behavioural Therapy (Aaron Beck) and Acceptance and Commitment Therapy (Steven Hayes). These have also been found to be beneficial for people who stammer.
What are the main ideas behind PCP?
Kelly’s fundamental philosophy was ‘constructive alternativism’: in other words, whatever view of things might currently be held it is always possible to construct an alternative, thus all our current perceptions and understandings are open to question and reconsideration. This awareness that an alternative view can be constructed leads to the hope and expectation for changes in behaviour, since alternative views offer the prospect of alternative actions. Thus PCP is an optimistic and creative philosophy of life that enables us to make choices about who we are and the way we wish to lead our lives.
PCP enables us to make choices about who we are and the way we wish to lead our lives.
The second principle of personal construct psychology is that knowledge stems from an awareness of difference and, by implication similarity, and by noticing repeated patterns and themes. Because the awareness of difference emerges from the earliest moments in life, constructs are created for which we have no verbal symbols. These are called pre-verbal constructs and will be the origin of the development of some verbal constructs, many of which will form our sense of personal identity.
Construing is the process we all use to make sense of our worlds, and by comparing and contrasting aspects of our world we create a unique system of bipolar (two-ended) constructs that influence all aspects of our lives, for example I might have constructs about shoes as being either ‘comfortable or fashionable’; constructs about other people as being either ‘friendly or distant’. But these are my constructs so if I asked someone else what is the opposite of ‘friendly’ they might say ‘bossy’. By using an open question and giving the other person time to think about its meaning we can follow the trail of these apparently superficial constructs and can elaborate this area of the person’s construing. A therapist’s questions might go something like this:
“How would I recognise someone who was bossy?”
“Would you rather be friendly or bossy?”
“Why is it important to be like that?"
“Are there any disadvantages in thinking of yourself as ….?”
“What might it be like if you saw yourself differently?”
Using this dialogical approach with you we would find out what is most important for you and identify core constructs that are key to your sense of identity and which give meaning to your life.
How does this relate to stammering?
Research evidence shows that the psychological reaction to a communication problem will include anxiety, fear, guilt and anger, and these constructs will become associated with many speaking situations.
Communication is at the heart of establishing and nurturing different types of social relationship, so when working with someone who stammers I often find that the client has many constructs about dysfluency but little understanding of all the other factors that constitute good communication. This may lead to the creation of a physical or psychological distance between the client and those around him or her.
I often find the client has many constructs about dysfluency but little understanding of all the other factors that constitute good communication.
If you stammer you can probably describe your problems in detail, for example “I don’t like talking to people I don’t know; I can’t talk when I’m in a group; other people think I’m stupid; I can’t apply for a job that requires lots of talking”. These constructs about talking are created from experiences viewed from a particular perspective and can be loosened, or freed-up, by taking a different perspective and imagining how that experience could be different. The relationship between you and the therapist is seen as two experts coming together to explore experiences and to achieve greater awareness of your meaning-making processes. Together we create a story and develop a choice of alternative stories that can be tried out in the real world.
An essential aspect of retelling the story is taking another look at how you think other people view you. PCP holds that each of us creates a ‘community’ of role relationships and our construing of these roles will determine our behaviour. The following propositions may help to clarify these constructs:
- What experience do you have of these roles and what might happen if you try out a different role?
- How would you change the way you interact with people?
- What might their responses be?
- How would this impact on you and your construing of this situation?
- Could you start to imagine yourself as a good communicator?
Personal construct psychotherapy can be integrated with fluency strategies if this is what you, the client wishes. For example, if you are at the stage of experimenting with a technique or focusing on improving your listening skills in your day-to-day life, we would work together to explore the constructs that relate to role relationships. As a result you might decide to act ‘as if’ you are confident and outgoing and approach a colleague with a friendly smile and ask about her holiday instead of trying to avoid speaking to her. Observing the other person’s response and reflecting on your feelings about this experiment may help you to reconstrue core role relationships.
What happens in personal construct psychotherapy?
There is no how-to-do-it manual for personal construct psychotherapy. We use whatever resources are useful and meaningful to you and your situation.
One of George Kelly’s statements often quoted is “If you want to know what’s wrong, then ask. It is just possible that your client will give you an answer”. In other words, therapists should not jump to conclusions relying on their construing system; find out from the other person how he sees his world. It is tempting sometimes to put forward our own theory about why someone is behaving in a particular way but this pre-emption is likely to be mistaken. Instead we should start by asking the client for their theory or version of events.
Therapists should not jump to conclusions relying on their construing system; find out from the other person how he see his world.
You may think that a PCP approach is only suitable for people who are highly verbal and able to explain complex ideas using words. It would be true to say that the tools and techniques that are most widely known are the ‘self-characterisation’ and the ‘repertory grid’, and these are most often completed using constructs that we can give verbal labels to. But we all have experiences that are difficult to put into words and the feelings of anxiety, depression, fear or guilt are real enough arousing sensations that we may not understand. It is important that I acknowledge this and support you to express yourself in whatever way you wish. You may be able to focus on the sensory experience within the body, create visual or auditory images or use drawings, pictures, collections of objects as metaphors.
As a personal construct psychotherapist I would not take up a judgemental position and use terms such as ‘negative thoughts’ or ‘unhelpful thinking’. Instead I would listen to your story and accept that your beliefs and values are core aspects of your construing system, recognising that these contribute to your sense of an integrated self. However, if you feel that you have a problem or symptom that is getting in the way of leading your life we need to identify those constructs that are no longer useful for you. The process of reconstruction is not a quick-fix and we proceed with caution to reconstrue events at a superficial or peripheral level before addressing more core constructs that will have more serious implications.
Where can I find personal construct therapists?
Many speech and language therapists who specialise in stammering have attended foundation or postgraduate levels of training and integrate personal construct therapy into their practice. Personal construct psychotherapists registered with the UK Council for Psychotherapy www.ukcp.org.uk are listed on their website and on the PCP Association website www.personalconstructuk.org
For more information about PCP and to find out about training events, workshops and conferences across the UK and Europe visit www.personalconstructuk.org
Introductory books on PCP
Dalton: A Psychology for Living, Second Edition (2005) Whurr Publishers
Butt and Burr: Invitation to Personal Construct Psychology, Second Edition (2004) Whurr Publishers
Fransella and Dalton: Personal Construct Psychology in Action (2000) Sage Publications
Adele Pile is a Specialist Speech and Language Therapist at Kent Community Health NHS Foundation Trust, and a Registered Psychotherapist and Counsellor.