Biography from childhood to adulthood: mirroring as an educative and therapeutic strategy in caring for carers

Abstract

The Assert programme (Gardner 2006) is A Semi-Structured Empowering Reflective Therapy for unpaid carers. It is based on Butler’s (1963; 1974) life review therapy and incorporates Pennebaker’s (1990) narrative writing paradigm. This single-subject study (Sinclair 1962; MacIntyre 1985; Erben 2000) sought to determine whether Assert was safe and effective in an individual setting and whether mirroring (Winnicott 1971) was effective as an educative and therapeutic strategy for a carer on a one-to-one basis.

Underpinned by humanistic, person-centred principles (Rogers 1951; 1961), fortnightly life review sessions alternated with opportunities for narrative writing during the sixmonth programme. ‘John’, the participant, aimed to reduce his stress and ‘put the past in the past’. An additional aim of the study was to ascertain whether engaging in the Assert life review process improved John’s childhood autobiographical memory recall.

Qualitative data analysis employed verstehen hermeneutics (Dilthey 1976) with grounded theory (Glaser and Strauss 1967; Patton 2002) and biographical research methods (Erben 1998). The most noticeable outcome was a positive shift in John’s biographical reflective focus indicating increased psychological congruence together with some startling improvements in his sense of selfhood. Conversation analysis (Sacks, et al. 1974) also revealed a change in John’s interaction style. John achieved his personal aims but retrieved no ‘new’ memories; however his narrative assumed greater coherence.

It was concluded that the Assert programme was safe and effective and that mirroring was effective as an educative and therapeutic strategy on a one-to-one basis with a carer. To compare the programme’s long-term effectiveness with other conventional therapies a randomised control trial is recommended with pre- and post-programme brainscanning of participants to detect any change in neural activity. Potential applications for the Assert programme are more wide-ranging than originally envisaged, including the amelioration of burnout in what is termed in this study as the ‘unpaid carer’s syndrome’.

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