|"When Therapy Today dedicated a significant amount of space to Human Givens (HG), I thought, well, there are so many similar things around, it does not do any harm. But when I read the following sentence in Ivan Tyrell's response to a not particularly strong critique in the last issue of Therapy Today, my attitude changed" |
|"I would like to add some observations to Ian Stevenson’s letter regarding Human Givens’ claims about the treatment of clients with post-traumatic stress disorder (PTSD)" |
|"I have never read beyond the first page of the MindFields promotional leaflets. Any therapeutic approach that seems to offer itself as ‘the way, the Truth and the Light’ I tend to bin" |
|"In the March letter titled ‘Extraordinary claims’, Ian Stevenson raised further issues concerning the Human Givens approach: ‘HG doesn’t even believe in the necessity for practitioners to have their own therapy.’" |
|"I would like to raise a question about an aspect of the Human Givens approach, namely their claims about the treatment of trauma. Last year I chaired the plenary of a conference on trauma, attended by 120 people, mainly counsellors and psychotherapists, from all over the South West..." |
|"We were very pleased to see Julia Bueno’s article on the Human Givens approach to mental health and wellbeing in the December issue of Therapy Today. It was an excellent piece, except for a few unfortunate factual errors of which I felt it was important to inform you." |
|"In an age in which, despite over 100 years of Western psychiatry, psychotherapy and counselling, mental illness rates continue to rise and health services are demoralised and crumbling under the impossible expectations people have of them, Michael Soth’s misrepresentation of the Human Givens (HG) approach to psychotherapy requires refutation." |
|"I am all in favour of the continuing development of the profession and the integration of approaches as well as cross-fertilisation between them. The article on the ‘Human Givens’ approach was therefore of interest to me, following some workshops I had attended at various conferences, and it has prompted me to engage with it more deeply"|
The Human Givens approach is building evidence and its ideas are rapidly extending into the public and private sectors. So why is it sometimes met with suspicion from within the counselling and psychotherapy profession?
Do you know who the leading independent provider of trainer days to the NHS and social services is? Or whose courses are being increasingly incorporated into CPD programmes of schools, universities, the MOD, police departments, charities, Connexions teams, and major public and private companies? Apparently it’s the MindFields College, the breathlessly busy training organisation behind the Human Givens school of psychology or, more humbly, the Human Givens approach. Its flyers regularly fall out of this journal, although there has yet to be any editorial on the subject – until now.
Joe Griffin (research psychologist) and Ivan Tyrrell (psychotherapist) are the key thinkers behind Human Givens (or HG as I will now refer to it). In the early 90s they joined forces, as Tyrrell tells me, because they shared ‘the same disquiet about the many hundreds of schools of thought in psychotherapy’. They founded the European Therapy Studies Institute (ETSI) in 1992, which aims to collect, study and publish information on therapeutic method and practice – it now has around 700 members. ETSI published a journal – The Therapist – and in 1996 went on to found MindFields. Griffin and Tyrrell went on to publish their first monograph promoting their ideas in 1999 (published by ETSI), and a decade later, they continue to develop their ideas, with research funded by the HG Foundation, a UK registered charity.
Now if that’s not enough dedication to a way of thinking, bear with me. There’s also the HG Institute, the membership organisation for HG therapists founded in 2001 (over 1,000 of them now), and HG Publishing, which promotes the prolific HG literature – CDs, books and a peer-reviewed quarterly journal (now renamed Human Givens). The HG Institute Practice Research Network is a more recent HG body which aims to ‘provide a focus for research into the effectiveness of the HG approach in as many diverse settings as possible’. If you want to see tuition in action, there’s plenty on YouTube too.
MindFields is the main teaching establishment for the approach, with a rota of nine seminars and 17 workshops running in 12 UK towns throughout the year. Since January 2009, it also teaches the HG postgraduate qualifications up to Masters level, accredited by Nottingham Trent University. Oh, and there are training bodies in the Netherlands and Australia, and enough literature on the internet to keep you busy for weeks.
Griffin is extremely enthusiastic in emphasising the reach of the HG work: ‘Increasingly HG is having a big impact in education, with schools taking on board its principles to treat both pupils and families without referral to CAMHS. Army welfare services, diplomats in the Middle East and human resource departments in organisations are all taking up these ideas too.’ I’m already thinking that the HG approach could be an organising principle that could take over the world (and more of this later...).
A ‘bio-psycho-social’ model
The clearly engaging ideas within HG were first unleashed comprehensively to the world in the 2003 book, Human Givens: A New Approach to Emotional Health and Clear Thinking (HG Publishing). Space doesn’t allow me to do those ideas justice but, to quote from the literature, HG is described as a ‘revolutionary new organising idea derived from the latest scientific understandings from neurobiology and psychology, ancient wisdom and original new insights. It is the first ever bio-psycho-social model of psychotherapy’.
Why Human Givens? Some of these ‘givens’ relate to a number of cross-cultural, innately programmed ‘needs’ that include: security, attention (to give and receive it), volition (a sense of autonomy and control), emotional connection to others (individually and to a community), privacy, a sense of competence and achievement and a need for meaning and purpose that comes from being ‘stretched’ or challenged. Such needs are behind our motivation to become fully human and succeed, wherever we are. So far, so familiar, with Maslow immediately coming to mind.
We know that people seek therapy for a number of reasons, but from the HG perspective, it is because at some level their needs are not being well met. This might be for a myriad of reasons, including damaged ‘resources’ which might be part of our genetic make-up which is further developed through learning, development and life experience – the other ‘givens’. These resources include the ability to develop complex long-term memory; the ability to build rapport, empathise, and connect with others; imagination; a conscious, rational and self-aware mind; the ability to understand the world through metaphorical pattern matching; and the ability to dream (on which Griffin has some new ideas).
An evidence-based practice
The goal of treatment therefore becomes addressing how to help meet identified unmet needs, and heal damaged resources. There is a new emphasis on empirically grounded clinical interventions, with evidence-based practice now integral to the HG approach.
Thinking in relation to particular presenting issues has been refined over the years, with a growing literature on working with depression, trauma, anxiety disorders, addictions, psychosis, as well as autism and Asperger syndrome. While Griffin and Tyrrell are keen to highlight the integration of many long-held ideas, some newer ones have broken new ground. One that has attracted much attention is Griffin’s ‘expectation fulfilment theory of dreaming’, formulated after a decade of research. This states that the main function of dreams is metaphorically to act out non-discharged emotional arousals that were not acted out in the day. Worrying too much in the day will arouse the autonomic nervous system, which then increases the need to dream.
If we dream too much (in REM sleep), this negates the refreshment of the mind brought about by regenerative slow-wave sleep. Griffin saw this as an explanation for why depressed people dream more intensely than non-depressed people, wake up exhausted and struggle with motivation. HG therapists will therefore use a number of techniques to get the depressed person to use imagination in a healthier way (to worry less), which could include the use of guided imagery or helpful stories and metaphors. The idea is that this can then restore sleep patterns, and in turn lift a depression.
This view of depression has tallied with a confident debunking of depression ‘myths’ – it is not anger turned inward or a biological illness, for example. Griffin states that low serotonin is an effect not a cause of depression (for more, see his interview in the New Scientist in 2003). HG also heartily discourages any therapy that concentrates on the past and encourages introspection or emotional arousal – which as Tyrrell told me, ‘The psychoanalytic camp do not take kindly to. But constantly going on about the past is just not helpful here.’ Indeed, the HG approach suggests that depression can be lifted in just a few sessions.
Critics of the approach
There are others who have not taken kindly to HG in the past. I spoke with a couple of colleagues who have attended HG trainings – a few years ago now – and both responded negatively to an overly ‘didactic’ style of presenting, with little time for reflection or debate, which most therapeutic trainings make room for. One, Debbie Vowles, described her experience of an Effective Group Work course as ‘very unsatisfactory’: ‘I wrote a fairly stinky report at the end of it. It felt pushy, as if I was being sold something.’ She was also overwhelmed by the number of attendees – a clear obstacle for shared reflection, but perhaps also an illustration of how engaging the ideas seem to be.
In the course of my research, I came across a few others with similar reservations about the workshops and seminars they had attended. They expressed a feeling that some aspects of the HG approach seem to be confrontational and run counter to some of the values of counselling and psychotherapy. For example, one HG tutor had dismissed the use and purpose of supervision, while another person felt that her workshop had contained too much denigration of other approaches to therapy.
I learn that the strong stand against supervision has now changed, with Denise Winn (editor of Human Givens) writing about having to concede (if grudgingly) to the demands of the National Occupational Standards for Counselling and Nottingham Trent University’s accreditation demands. As with much of HG work, it takes place against a lack of robust evidence, and there isn’t any yet that supports supervision’s benefits. But my sense is, although that may be true, it was the dismissive way in which a long-held practice was rejected that smarted.
I asked Griffin about his ‘ruffling of feathers’, and of accusations of an apparently confrontational approach. ‘I think it’s disingenuous of schools of therapy to say that HG is confrontational. We seek to build bridges. When I talk to CBT-trained therapists or client-centred therapists, they are often convinced their approach is best. We want to get beyond that and take a scientific approach, asking, “What is the best evidence for what we do?” I also think people are annoyed at how practical we are.’
A practical approach
Iain Caldwell is the CEO of Hartlepool Mind, and clearly fully embraces this practical approach. Originally a psychology graduate, he has worked in various mental health settings and with various therapies over many years. ‘I was cynical of some of the claims being made by HG at first. As a psychology graduate I thought I knew it all, but over time it struck me that HG’s core aims are really interested in how people live in a wider social context.’ After an introductory course, Caldwell went on to take the HG diploma and now supervises and trains with the approach. Furthermore, he has helped to fully integrate HG into all that Hartlepool Mind does – dealing with around 1,200 people a year with a wide range of presentations (approximately 20 per cent at the more severe end).
‘It’s an illusion that HG is a model as such,’ Caldwell says. ‘It’s an integration of thinking that has drawn from various therapies. I wouldn’t say it’s a miracle cure but it’s an essential framework or organising idea for wellbeing. We have to look at the full package here – beyond the therapy door – with educational, housing, financial and other needs being addressed. Our team includes psychological therapists, a barrister, a social worker, a business development officer and an occupational therapist. We’ve grown from five people to 50 in under a decade. HG has transformed this organisation completely.’
Caldwell is heavily involved in researching the HG approach he employs, recording outcomes at each session with CORE forms, and reviewing results each month. After two years he says, ‘Our data suggests that between 60 to 70 per cent of our clients rate a clinical improvement in wellbeing, 20 per cent rate an improvement (not clinical) and the rest rate no change or depreciation.’ Caldwell is keen to further develop what works using the HG approach. ‘We still have a long way to go, but we know we make a positive impact in what we do.’
The emphasis on research in HG is now significant, and partly down to Bill Andrews, the chief administrator of the HG Institute Practice Research Network (PRN). He describes himself as a ‘devil’s advocate of HG’. ‘I was bothered from the outset by some of the unsubstantiated claims being made, with nothing beyond anecdote to back them up. I was concerned about any sort of stance being taken against other therapies, again, with no hard evidence to support these positions. I started to ask many challenging questions. As I began to understand the research literature more I became even more problematic. This is why I set up the PRN. I felt that if HG was to really make progress and help many people, it needed to measure its effectiveness robustly. Otherwise it would fail to be taken seriously and I absolutely believed then, as I do now, that HG has a lot to contribute... I think Joe and Ivan were concerned about me at first!’
Andrews goes on to defend the robust methodology the PRN uses – including the recording of outcomes after each session, so that unplanned endings are captured. ‘We all have a lot to learn from evidence-based practice and research in general. Furthermore, unless we enter the debate, nothing can change. We all need to stand up and be counted, even if we disagree with the metrics. Unless we propose more valid metrics that are acceptable to us all, we will have to work with those we are given. Our data is being collected on an ongoing basis.’
The 2003 Human Givens book makes for gripping reading, and I was excited by many of its ideas. I’ve even tentatively used the ideas behind dreaming and depression in my practice already, and they do seem to make real sense with my clients. However, the repeated references to ‘pseudotherapies’ are distracting, and there is an impression of arrogance running counter to a holism that HG aims to promote. My training experience never exposed me to a ‘we’re better than others’ approach, as Griffin suggests. The passionate delivery of these ideas seems, at times, to have masked some very interesting, useful and easily applicable ideas, and even alienated some practitioners. These ideas are clearly working in practice too, as Andrews’ work demonstrates (and there is a wealth of preliminary findings on the PRN website).
But perhaps things have changed. Andrews tells me, ‘I think Joe and Ivan first started out very small, interested in teaching essential skills. The level of interest was so great that the demand increased rapidly. But there were those who felt attacked and went on the defensive. It’s probably fair to say Joe and Ivan also went on the defensive to survive. I feel a more mature approach is emerging. They are far more aware of outcomes. They know there’s no panacea and they’ve become more tentative in their claims.’
And what of these plans to take over the organising principles of the world? Griffin tells me a little about his current book idea with Tyrrell: ‘We have an epidemic of mental illness in our culture. We have a way of government that generates stress. We want to use our thinking to affect organisations and governments. If organisations don’t understand our innate needs for control and to be challenged and stretched, they can cause huge damage to mental health.’ Whether or not HG’s tentacles stretch to governmental level, it seems certain that they will continue to extend their reach.
HG Institute www.hgi.org.uk