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| Living with developmental disabilities is not necessarily a dead end; sun shines when there is support and high quality of life. |
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| Socrates |
“John D.” is a 22 year-old Greek American male, of Greek Orthodox Religion (Eastern Christianity) diagnosed with Mild Mental Retardation (IQ 65) and Expressive Language Disorder living with is father at a small apartment in Astoria, NY. He is the only son of Greek immigrants, both diagnosed with depression and his father also with sleep disorder. He is fluent in both English and Greek with a better command of English as his first language. He doesn’t have obvious signs of his condition, except that he does not speak very clearly or confidently express himself in any language, though his problem is mostly in written rather than oral language.
John is very sociable, and a high functioning consumer. He has friends of his age, he participates in his local church’s activities and religious services, and he even has a girlfriend, though they recently did not get along very well and finally they broke up. John is able to pay his bills, independently take care of his grooming, and he successfully displays telephone and computer skills, such as writing simple business letters, taking care of personal and family matters on the phone and using the Internet or playing video games. He has been also trained by his father, who is a building superintendent and a painter, in doing handy work and even to a professional level, since his father has taken him with him to construction jobs.
John’s mother passed by a few moths ago. He found her dead one Friday midnight, laying on the bathroom floor half naked. Doctors attributed her death to heart attack. Her profound obesity and her movement problems may have contributed also to her death, since she could hardly move in the very narrow bathroom. Her movement problems as well as her husband’s mental disabilities had resulted the poor maintenance of their apartment, which was very frequently a main reason for quarrels in the family and repeated requests for finding a new home, since that one was very dirty. John is also very obese and does not have a good diet, since he drinks too much soda and eats junk food. John is a brave young man, vary courageous and full of life and although the recent death of his beloved mother, he did not show any sign of depression, melancholy or withdrawal or any phobia, which is quite common to occur to people with Mental Retardation after having a death in their family.
John has already a rich history of job experience, as a security guard and also as a helper and bag boy in supermarkets and retail stores. He was already a Medicaid Services coordination consumer at our small Medicaid vendor & volunteer agency located in John’s neighborhood, when he joined our new Day Habilitation/Job Training Blended Program, where I was the head teacher, recently promoted after being already a Medicaid Service Coordinator for a few months. John had expressed the desired
to seek for Supported Employment in our agency. At the same time, he would be able to attend a series of educational activities within the Day Habilitation program, such as English reading & writing remediation courses, Greek lessons, since he wanted to learn how to write and read in Greek. Also, lessons in social and behavioral skills were added to his schedule, since John has to work intensively on his procrastination and punctuality progress. For instance, he has the tendency to come very late to the center and he quite often he doesn’t even show up without any notice. He is also somewhat naïve when it comes to friendship and relationship with his peers. He cannot use his judgment effectively to understand the group dynamics of peer friendly and/or romantic relationships and he feels frustrated with peers who “use” him as he says and do not care about him and at the same time they do drugs and tend to juvenile delinquency, though he insists that he has no involvement in such activities and stay away from them when they do so.
In collaboration to Suzan, a certified Mental Health Counselor and the Medicaid Service Coordination team, I and John came up with a series of Valued Outcomes that he approved and liked. When I teach John English reading & writing (literacy skills), I narrate a story to him, either a Greek myth, a fairy tale, a folk story or a story form a picture book. He looks at pictures while listening to the story. I ask him open-ended listening comprehension questions to see how much he retains form the story and how he processes information. Then he draws and colors on a paper using crayons or markers on a topic related to the story. Then, using the picture he draws, I ask him what he draws and how that relates to the story. Using Socrates’ questioning for inner meaning, a method called “Socratic Inquiry” or just the “Socratic Method”, I focus on the rationale or moral lesson of the story and I engage him in a higher thinking process, making sure that it is not too abstract or inappropriate for his mental capacity. For instance, I may ask him about what makes a good friendship or what makes somebody to be a good friend. Then, I ask him questions confronting and reflecting directly on his responses, thus leading him gradually to the point of realizing contradictions between his previous statements or between his words and his actions. He, for instance, may say that he doesn’t like his friends, because “they are bad kids and they do drugs and shoplifting” and yet he continues hang out with them. This type of questions is called in Greek elenchus, which actually means refutation or examination (Brickhouse & Smith, 1994, p.5).
Beside the individual sessions, there is an hour of “social and behavioral skills” session, where all five consumers in our new small Day Habilitation program come and sit in a circle, where in the form of group therapy, I introduce a topic that concerns community, health, behavioral or social issues and using the Socratic style of making questions, I guide the group, after each and every one says his or her own story related to the topic or if there is something of relative urgency to be discussed or shared with the group for support, the consumer is encouraged to talk a little bit about it before the discussion of the current topic of the day’s agenda. This sharing of –personal information leads to encouraging empathy and sympathy being expressed by all members of the group, thus facilitating communication and building community bonds and cultivating interpersonal and intrapersonal skills for each and every consumer.
For the group sessions, I used Gustav Heckmann’s version of Socratic Enquiry modified to suit the needs of groups and real classrooms. Socrates (470-399 BC), the famous Greek philosopher, one of the most influential ever, came up with a method of asking questions based on two basic ideas: “know thyself” (self-awareness) and “an unexamined life is not worth it” (need for self-examination) (Lageman, 1989, p.222). Heckmann’s version consists of six pedagogical measures of Socratic facilitation: i) content impartiality (here Hawaiian Talk Story gets integrated to the process in order to initiate dialogue); ii) working for the concrete; iii) mutual understanding; iv) focus on the current question; v) striving for consensus; vi) facilitator interventions. Everyone comes up with a personal story and shares it with others, as contributing a part to the impartial whole of the group process. Then, the facilitator has to make sure that, feelings, thoughts, and ideas are expressed in a concrete way and that everybody has mutual understanding of the process and that the dialogue does not stray form the current question that is been observed, especially if the group consists of people with Mental Retardation and Developmental Disabilities. Finally, the facilitator guides the group toward reaching a closing, which more than reaching a mere conclusion or summarizing, but is even more, about reaching a consensus, as everybody needs to be on the same page with the others in the group and thus they all discover a common truth after the dialogue. Facilitator must intervene when needed, especially when the dialogue prolongs inconclusive and derails from the question observed or when there are disruptive side talks, negative arguments, conflicts, and contradictions (Heckmann, 2004).
In addition to the Socratic Method, I also used Talk Story, a traditional Hawaiian method of informal conversation that may take the form of storytelling in a group of, at least, two or more participants. The content of the talk may range from something interesting one saw or heard to mere gossip in the local grocery store line on a beautiful exotic island of Hawaii. A definition of talk story might be “rambling personal experience narratives mixed with folk materials” (Taosaka, 2002, p.1). Talk story requires cooperation and collaboration from the participants. In the therapeutic process, however, talk story may most likely resemble an informal and flexible model of group therapy or group counseling. I found talk story quite suitable for John, since he prefers informal and friendly contacts rather than structured therapy/counseling. Besides, talk story has some affinities with the Socratic Method, since it requires a lot of asking questions *Taosaka, 2002, p.10).
Cultural sensitivity is an important factor in talk story and that is also why this model was also appropriate for John. John is a Greek-American, who native language is English, but he also has a good mastery of Greek, as well. He is first generation of American and because of his close tight with and his dependence on his family, due to his condition, he reflects a lot of typical Greek or Mediterranean cultural characteristics. This can be easily deducted from his food preferences, his favorite music, his values, his interests, and even the fact that he likes to come late or he needs more privacy especially during religious observance in the Easter, which is of very great importance for the Greek Orthodox faith.
In talk story, the questions may help each party understand the story and internalize some of its meanings or moral lessons, but it also shows cooperation and collaboration and it is a way to express sympathy and care to the speaker who wants to share his/her experience or problem with you. The Socratic component into this process might be the reach of a common ground, a mutual understanding of a universal reality. So, every time John would report to the center, I engage in an informal 30 minute talk with him, where he would just tell me how was his day, “what else is new” or what current issues may have emerge in his life. From the most irrelevant experience, something that he saw on TV or on the Internet and captured his attention to some memories of his mother who just died a few weeks ago and were rekindled by her cloths or personal accessories he accidently discovered in the closet. All these free associations, as Freudians would say, may emerge during the talk story and transform it into a more therapeutic or cathartic entity.
The positive results of Talk story were that John became even more motivated to show up in time, thus becoming more punctual, as he would not like to miss a meeting with a good friend. He confessed that although he has some friends, he felt different and alienated from them and he thought that they may have used them or they may have not taken him seriously. Also, he didn’t like the fact that his friends smoke marijuana, and he stated with emphasis that this is the reason he avoids them, because he is not a user and he would not like to become one. John seemed to be more dependable and responsible after a number of sessions and invested genuine trust in me, thus making our rapport really positive and solid.
After six months of using this teaching and therapeutic modalities of the Socratic Method and the Hawaiian Talk Story, me and my colleagues at the center noticed that John was more eager to report to the center in time, he felt more responsible and sensed the consequences and the impact of his absence of tardiness to the others and became more aware of himself and less prone to giving cheap excuses for his mistakes. He also built trust and care for the center, its staff and his fellow consumers. The small size of the group helped also a lot. We shouldn’t forget that Socrates’ circle of disciples in his dialogues recorded by Plato was actually small and everybody was familiar with or related to each other within that circle.
The Socratic Method is also called Philosophical Midwifery, since like a midwife, the counselor, teacher or philosopher extracts rational thinking, repressed thoughts or desires and finally leads to self awareness and inner peace and congruity with one’s thoughts and actions. This method helps us pinpoint the pathologos, as Pierre Grimes calls it, which is the pathological or abnormal logos or reasoning, expressed in thoughts, inner speech, daydreaming and oral and written words. This abnormal or irrational reasoning/thinking impedes and backfires everyday relationships and it is quite frequently the source of miscommunication and family pathology (Grimmes & Uliana, 1998). Pierre Grimes, a professor of philosophy and philosophical counselor and Regina Uliana, a clinical psychologist, run together a clinical study of patients who copied with everyday problems, ranging from emotional and family problems to vocational and academic performance and career choice problems and who were treated with a series of sessions were the Socratic Method was integrated in cognitive therapy. They found out that from their data that not only this therapy tremendously helped their patients, but it also stood at the same level of effectiveness and function as the Rational-Emotive Therapy. Thus they named it “Grimes’ Dialectic Rational Psychotherapy” (Grimmes & Uliana, 1998). The Socratic Method has also been successfully implemented in regular classrooms, of both elementary (Delgehausen, 2004) and secondary schools (Saran, 2004), originally in England and Germany and now everywhere in the world.
In combination with the Socratic Method, another ancient one and very traditional in its nature, but still very fresh and commonly used, is the Hawaiian talk story. As a technique of alternative healing rather than a mere family or tribal ritual of getting together and sitting around the hearth, Talk Story has been integrated in counseling and psychotherapy and it is used in cultural events, community centers and other public places in Hawaii, not only as a demonstration of Hawaii’s rich cultural heritage and spirituality, but also for the practical benefit of those who practice it. As it is obvious in the aforementioned case study, both the Socratic Method and the Hawaiian Talk Story can be used, the first in individual sessions in the form of individual counseling and the other in group sessions in the form of group counseling. From my own experience both work with real clients. We live in the age of loneliness and alienation from our inner self and the others around us, and when the true values of humanity are put aside in favor of easy money and no-brainer solutions offered by technology. It is, therefore, the right time for us to return to our roots and start making use of traditional and ancient methods that the eons have tried and prove effective for the best of humanity and the future generations to come.
References
-Brickhouse, T.C. & N.D. Smith (1994). Plato’s Socrates. New York: Oxford University Press.
-Delgehausen, I. (2004). Experiences with Socratic Dialogue in primary schools. Enquiring Minds. Virginia: Trentham Books, Ltd, pp. 41-46.
-Grimes, P. & R. Uliana (1998). Philosophical Midwifery: A New Paradigm for Understanding Human Problems With Its Validation. California: Hyparxis Press.
-Heckmann, G. (2004). Six pedagogical paradigms and Socratic facilitation. Enquiring Minds. Virginia: Trentham Books, Ltd, pp. 107-120.
-Lageman, G. A. (1989). Socrates and Psychotherapy. Journal of Religion and Health. Vol. 28, No 3, pp. 219-223.-Saran, R. (2004). Experiences with Socratic Dialogue in secondary schools. Enquiring Minds. Virginia: Trentham Books, Ltd, pp. 53-70.
