No More Boxes

Francis Kaklauskas PsyD

On a sunny Sunday day, I wandered through downtown Philadelphia, but my attention fixated not on the bustling cityscape around me, but on the cardboard boxes dispersed in front of doorways stacked up alleys, and even peeking out of dumpsters. Obliviously, I was mentally calculating their dimensions, estimating their weight, and pondering how many trips it would take to move them into or out of my United Parcel Service truck. In a sudden meta-moment of mindfulness, I realized that I was barely engaging in my past contemplative passions of music, philosophy, and my relationships with those I loved and who loved me. “No more boxes” I said internally and then aloud.

I knew I had to leave boxes behind but was unsure of what was next. My partner at the time was an administrative assistant at the Philadelphia School of Psychoanalysis, and I had been seeing the director there as a client. While every other analyst I interviewed had me lay down with my face away from them and free associate, they had me sit next to them looking out the window together. They immediately saw upon my walking through the door of the office that the traditional analytic methods were mismatched for my stage of development and my stage of life. I needed something that felt less objectifying and anxiety provoking, and something more relational and supportive.

While there were times the conversations could almost seem like small talk at, in retrospect lots of subtle work towards understanding my psyche was being accomplished. At that point in my life, I was grappling with life’s inevitable struggles – interpersonal frustrations, lost and unformed dreams, and a superego that needed to meet an ego.

In treatment, I initially talked more about boxes than most clients. But with subtle encouragement, I started to try to talk about other topics. No more boxes. I began to re-engage with topics of interest and passions, but much of my life’s focus had been and continued to be toward financial survival.

Through treatment, I stumbled upon two of my enduring loves. The first was my curiosity about my co-workers and people on my delivery stops; the second, my love for the history of ideas. Psychology could be a path forward for me, I embarked on a journey that would become my professional life.

I began taking night classes at Temple University and weekend classes at the psychoanalytic institute. All I needed was a master’s in something to become an analyst. Given my own life’s struggles with learning differences and delays, I began with a special education course. The focus then, even in the late ’80s, was that people are different, learn differently, and need different things. In analytic school, my first class was on Karen Horney, and the teacher highlighted that Freud, particularly about gender, was wrong. I also was introduced to Judith Butler and some basic ideas of post structural and postmodern thought that resonated deeply with me.

These ideas of openness, critical analysis of cultural ideas, celebrating difference, and contextual flexibility were already inside me but without these labels. As a young child, I was put in a labeled box of being too cognitively and verbally different to be mainstreamed in elementary school, and my family and I knew that was not the right box. Eventually, with support, I learned the skills needed to return to local public school.

Do It This Way

In the initial ten years of my career, I worked in community mental health. The administration prescribed theories and methods for me to use that would explain my patients’ psyches and the best path towards change. At first, it was eight sessions of solution-focused therapy. I could see the usefulness and pragmatism in the approach, but often both my clients and I desired room for exploring their past with more depth and detail, to reflect on our therapeutic bond and relationship. As I was getting comfortable working within these limits, the center changed its theory to a strength-based lens for a year before an extended period that centralized the emerging Cognitive Behavioral protocols. Of these three, I liked how CBT engaged in particular practices for different mental health challenges and these skills provided a base from which to approach each treatment encounter with some options and flexibility. No client fit perfectly into the prescribed protocols and with the support of my supervisors who had been trained through psychodynamic and humanistic perspectives, I grew more courageous and comfortable working with some needed flexibility.

Since the start of my career, I loved group therapy. I had personally benefited from this approach, and had several charismatic, impassioned, and inspirational teachers. I always jumped at the opportunity to lead as many groups as I could at the center. Coming from modern analytic training, initially I thought I should try to imitate Lou Ormont. I set up the groups so members would explore their resistances to the contract, express and then re-own their transference reactions, as well as use catharsis to manage the biological aggressive drive. But I was leading the psychiatric waitlist and reintegration groups, and if I did not empathically reach across to connect with their pain and struggles, as well as offering some guidance and skills I would not be meeting their exigent needs. While I still admire these foundation group skills and perspectives, I could see how my rigid understanding and lack of clinical experience, led me to initially desire to put the wrong box unto my clients in crisis that would not be helpful.

Even before I met my clients and group members, all the systems I worked in and even within the systems inside myself, led me to enter each treatment situation with prescribed ideas and plans. Building off Klein or Sullivan, I was still in the process of accepting the good, the bad, and potentially evil within the many theoretical boxes that lived inside of me and the various systems.

At that time, my side hustle was leading court ordered criminal justice groups. In that setting, I was initially instructed that psychoeducation was the key to change; however, my groups let me know quickly and in a variety of ways that being lectured at by a now middle-class white college guy was not helpful in any way. Of course, my psychoeducational group leader skills were also not very advanced. I was trying to help and trying to follow what the power structures were requiring of me. In that setting every 18 months, the courts and the state would demand that new models, theories, and curriculums be rigidly followed. Perhaps no other system I encountered objectified and othered those for whom they served. The only place I was taught to be more humane and less oppressive was from the parolees themselves. Given my life experiences, I knew deeply but for the grace of g-d, and we worked across the differences in identities, life experiences, and the power that the system entrusted in me. If I did not follow the protocols, I could lose my job, and financial survival was a reality. But I did start to bend some more in this setting.

I would like to think that I helped many beat the odds of 50% recidivism, but also learned of the limitedness of my best efforts as these groups members and I had to endure, find meaning, and seek healing for the occurrences of suicide, murder, overdoses, and reenactment that unfolded in some of these individuals’ lives.  Sometimes the next topic in the manual had to wait, while we processed missing a member who had been with us each previous Wednesday night but had left treatment.

Neither I, nor the group members liked the forensic system’s processes of placing them in boxes that required this specific brand of psychotherapy. We found a way to connect more authentically and ideographically. I still reported the cognitive skills they were learning in my notes. Over time, we all learned that it was best if the members made sure to tell their probation officers some skills they learned in the group, and make sure to mention that I could be mean and punishing. As that system at that time still vaulted punishment and shame as an essential process to induce change.

I remember at that time I was asked to work with a criminal justice client who only spoke Korean through a bilingual bicultural translator. I was excited for this new challenge, and after doing my research, I came into the first session and tried to show what I learned about Korean culture and how I could help in this cross-cultural context. After a few minutes of getting started, the client and the translator just ignored me and talked back and forth with each other, sometimes laughing, and sometimes shaking their heads negatively. Eventually, in a very polite way, the translator said, “Thank you for your efforts, if you would like we can tell you about our culture and what we think may be helpful.” Of course, I shut up and listened.

When I began going to group conferences, the first question other attendees asked me was, “What is your theory?” The truth is I did not know, but I froze in fear of giving the wrong answer and being banished into isolation with no tribe. Once I started presenting, people asked what I was presenting on, and often it was related to process research as it provided some model for working across populations and contexts. People would say something like, “How boring,” or “I won’t be going to your presentation,” and sometimes just walked away before I could complete my second sentence. The pressure to belong and fit in, to conform, and to follow solely the lead of some specific authority was and continues to be immense.

I guess people wanted to be able to put me into a box and I felt the need to box myself. Throughout the history of psychology, the ideas of context, ideographic approaches, flexibility, and the focus on alliance existed for a long time, this was not the foundation of the clinical settings I was inhabiting in my early career. At that point, finding my own style and beliefs about therapy was challenging as my internal truck was so filled with theoretical boxes of varied sizes, I could not see out the front window to know which direction to drive.


 Moving Forward

Like some aspects of our society and certain pockets of modern science, I continued to dream of eventually finding the one unified theory of psychic organization and resultant interventions that would catalyze progress across diverse clients and all settings. Yet, I have grown increasingly comfortable with the idea that such a perfect fit may never materialize. Instead, I have leaned towards recognizing and appreciating the distinctiveness and uniqueness of each client, group, and organization.

In over three decades of my career, I have observed a paradigm shift in our field towards a greater specificity for each unique situation. Group research now delves more into the nuances of identity and context, and there is a growing appreciation for the thoughtful adaptation of protocols. The field has come to value flexibility, responsiveness, collaboration, and context as key components in group and organizational leadership. Diversity, multiculturalism, and individual perspectives, once fought for, are now expected rather than exceptional. Previous inroads by critical theory, feminist, humanistic, and postmodern views also contributed to this shift from rigid methodologies to one that prioritizes relationships and context.

Today’s group psychologists are called upon to broaden their knowledge base and embrace flexibility as a cornerstone of group leadership and organizational dynamics. Each scenario possesses its own tempo and may evolve with time. We are encouraged to go beyond conventional models and embrace a multitude of possibilities, encourage collective creativity, and nurture genuine relationships.

Organizational leadership and group psychotherapy are increasingly recognizing the importance of responsiveness. Protocols are secondary, when it comes to addressing relational rifts, including microaggressions. While having a plan is important, the ability to remain adaptable in each moment is crucial. Whether it is leadership of a non-profit organization, a weekly private practice group, an intensive program aimed at reducing recidivism among violent offenders, or a support group for those dealing with serious mental health issues, each requires a tailored approach. Groups and organizations evolve through various stages, but no single model fits all. Behaviors within homogeneous or diverse groups differ significantly. As group psychologists, we need an array of tools — metaphorically, boxes of varied sizes and shapes, packing materials, and delivery routes.

Task completion is enhanced through building relationships among team members, openly addressing identity differences, and collaboratively working to dismantle counterproductive paradigms. As I stepped into the presidency of this organization, I reviewed literature on organizational leadership, and adopted certain models while discarding others. My hope was to lay a foundation for active engagement, foster a sense of belonging, and promote teamwork. However, I recognized that no single strategy is perfectly fit the strengths and challenges of this organization at this moment. We operate within the APA’s systems but also enjoy considerable freedom to cultivate relationships and connections that resonate with our members’ current needs. I encourage every member to think about the small steps they can take to steer our organization towards their values and desires, and for the collective benefit.

The balance between standardized methods and pragmatic theories against the creative adaptation to the context is a long-standing challenge in our field. While having standard boxes for certain scenarios is helpful, most require unique approaches, thoughtful planning, and flexible strategies that draw on our accumulated knowledge and guide us towards future insights.


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