The British Journal of Psychotherapy Integration

Albert Zandvoort & Michelle Zandvoort

Trauma and the Use of Co-operativeInquiry to Develop a 'Survivor Mission'

Abstract

This article describes the lived experience of twotherapists (daughter and father) of complicatedbereavement and trauma and their creationof a survivor mission. Integrating reflectivepractice, cooperative inquiry and heuristicresearch principles, this deeply personalaccount, spanning eight years, argues for thesocial and perhaps even universal applicationof meaningful personal experiences. Theauthors elucidate the impact this processhas had on their work in terms of theirtransformation of being in this world and thetransformation of their practice as therapists.

"Co-operative inquiry... embraces what iscalled action research. It is... concerned withrevisioning our understanding of our world,as well as transforming practice within it."

Reason & Heron, A short guide toco-operative inquiry (2012)

Introduction

How do parents and siblings deal with thedeath of a child and brother? How do daughtersdeal with the loss of their mother? How doesa father deal with the loss of the motherof his children? What are possible copingstrategies for the survivors? What if there werecomplicating factors, like addiction and suicide?

In May 2004 our brother and son, Marius,suddenly passed away and just over ayear later, in October 2005 Marius' andMichelle's mother Petro, unable to deal withthis devastating loss, followed her son.

Where did this leave the surviving daughterand father? Initially we both plunged intostudy and work with an energy borderingon the obsessional. Our conversations aboutour traumatic bereavement were oftenfragmented, a cry, and a shout from painedsouls, looking at each other and asking: why?

Over time our conversations turned into adeeper dialogue as we developed an abilityto manage our emotions by simply beingpresent to them and by accepting that wewould feel the pain. Slowly and gently westarted to engage with a "search for meaning"in our "unavoidable suffering" (Frankl,1969).Through our many conversations we developeda deep "participatory spirit" (Heron, 2009,see fig. 1), which inspired and motivated usas two traumatised individuals to developour "survivor mission" (Herman, 1992) andto advance our daughter-father/therapist-therapist relationship to new depths.

We engaged in a very deep form of co-operativeinquiry described by Heron & Reason (2000:171)as ".. .a way of working with other peoplewho have similar concerns and interests toyourself, in order to: (1) understand your world,make sense of your life and develop new andcreative ways of looking at things; and (2) learn

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RelationalThe Co-active Presence

Between Persons inRelation

MotivationalThe Co-dynamic groundof Human Motivation

Figure 1: Heron's Model of the Participatory Spirit

how to act to change things you may want tochange and find out how to do things better."

After many conversations which moved broadlyalong the lines of the Heuristic research modelproposed by Moustakas (1990), we were able toformulate our 'survivor mission' as a 'researchquestion': "How can we, as a team, provide aspecialist, confidential and quality service thatwill enable addicted healthcare professionals toregain and maintain their well-being, return towork and in turn be able to continue to providehigh quality care to their patients/clients?"

And, the second question for us wasequally important: "How will thisimpact our practice as therapists?"

In this article, we offer a retrospectiveview on our process through a reflectivedialogue. The dialogue between us (Michelleand Albert) took about two hours on abeautiful Sunday autumn morning earlySeptember 2012 and loosely followed thereflective practice and structured debriefingmodel developed by Graham Gibbs (1988).

We hope to provide an insight into our livedexperience, which, as Moustakas (1990:15) points out: "... is autobiographic, yetwith virtually every question that matterspersonally there is also a social - andperhaps universal - significance".

We will try to illuminate our process andthe resulting outcomes by offering salientverbatim parts of our dialogue followedby our reflections on our own processes,the process of co-operative inquiryand the heuristic research process.

Description of Our Initial Experience: AFirst Bereavement 18th of May 2005

On this day we were informed of the suddendeath of our brother and son Marius inSouth Africa, where he had been working as aphysician in the pediatrics department of a ruralhospital. Marius had previously been addictedto heroin as a student and a young doctor.

Albert: ".. .1 was teaching on a Tuesdaymorning. My administrator knocked on thedoor of the teaching room and asked me tocome and look at something urgent... She hada message for me to phone Marius's friend. Idid that, I phoned him. He just said, 'I'm verysorry, but Marius is dead." He said it just likethat Then I tried to think about a way ofcalling you and letting you know about this..."

Michelle: "... It wasn't until I got home, justafter 5pm, that you gave me a call.. ..You brokedown and you just said, 'Marius died.' I felta real shock come over me. I said, 'No, thatcan't be true.' You said, 'Yes, he died thismorning.'.. .You said you were going to get a

The British Journal of Psychotherapy Integration

flight so that you could go and be with Mumand go and see him at the morgue before hispost-mortem examination. I asked if I couldjoin you. You said you would get me a ticketand you would meet me at the airport."

Comments

One of our great difficulties at this stage of thereflective cycle, was to deal with our distress.We were deeply aware that we wanted to be clearabout the key experience we wanted to sharethrough our dialogue and, at the same time, weknew that we would not be able to move on if wehad not dealt with our distress. In line with thesecond step of Gibbs' (1988) reflective cycle, wetherefore decided to work through our feelings.

What were Our Feelings, then and now? Then

Michelle: When I put the phone down Ifelt I lost it. I just screamed in agony. I wasin pain. I couldn't contain it. I just let go. Iyelled and yelled and yelled and cried for mybrother It was so painful that it really feltas if someone had ripped my soul out. It's apain that is very difficult to put into words."

Albert: "When I left my classroom, part of mewas really in denial. Part of me said it can't betrue. I knew it was true but it's one of thoseconflicted things where I didn't want it to betrue. I felt pretty numb.... I can't even rememberhow we went through the night on the plane. Ihave a very clear memory of the next morning,coming to the hospital and, I know that's whereI totally lost it when they pulled Marius outin a drawer. I thought, 'How can they do that?How can they have your child in a drawer?'...I just remembered crying and shouting andtrying to wake him up. Then looking at yourmum's face, that brought me back a little bit,actually, just to see her devastation and pain..."

Michelle: Yes, it's a trauma. We all wenttogether and got led down this corridor. Theygo around to the back, past the bins evenand into the back part of the morgue. It wassuch an awful experience, having him pulledout, lying there naked on this cold drawer. Itwas awful seeing him there. For me, it was sotraumatic, so terrible, seeing him. It didn't feel

real. I just wanted him to wake up as well Iwas holding him. I wouldn't let go and I wastelling him to wake up. I was telling him, 'Whathappened?' It was a stupid mistake; wake up.'You can't be dead. You have a daughter.' I wasrefusing; I was kissing his face. I was crying andwilling him to stand up. I was saying, 'Comeon, you don't need to be here. It's cold, let's getyou dressed.' I was just-, I couldn't let go. I wascrying and hollering. I wouldn't let go. It waslike something inside me wouldn't let go...."

Albert: "Yes, we both felt this..."

Michelle: "We had to prepare for the funeral.That's my recollection of this horribleexperience, that we could see him."

Albert: "Then, of course, there was the funeralservice. I knew at that point that it was the finalgoodbye to the living Marius. I don't think I'llever really say goodbye. Then we came home."

Now

Albert: "It's very hard... now, actually."

Michelle: "Yes, in such depth. I can see it'svery painful for you." Albert: "And for you."

Comments

Peter Reason (2012:) comments as follows: "...the group must be willing to address emotionaldistress openly when it arrives: to allow theupset persons the healing of self-expression,which may involve the release of grief, angeror fear." This process of dealing with ouremotional distress in the here and now clearlymirrored our original pain, and despite all ofour attempts to work through these feelingsthen, we accepted that we had just learnedto live with them and to accept them.

Evaluation and Analysis

Michelle: "I think it's painful for me losinga brother. I'm a parent myself now andthe thought of losing one of my childrenis just awful. It would be devastating. Toknow you've lost your son, I think it's

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unnatural. It's a pain that I think onlyanother parent can comprehend who hasbeen through a similar experience."

Albert: "Then when you came back,what did you do to cope? I know Iworked a lot. What did you do?"

Michelle: "I just threw myself back into mystudies. I had a thesis to complete.. .1 wasdoing a large quantitative study on alcoholuse and problem drinking.. .and I continuedworking at the drug and alcohol service. Iexplained what happened. People wereshocked.... They could see my pain and thedevastation that it had caused family members.A lot of them thought about the impact thattheir drug use had had on their families. Itwas a very reflective period.... I had personaltherapy, went to see my therapist to workthrough this. Yes, therapy, support from Tal(Partner). We came to see you every weekend.I think we spent most weekends with you."

Comments

During those weekends we spent manyconversations honouring the memory ofMarius in the realisation that he wouldnever really leave us. We did this withoutany sense of bitterness and we both felt asense of spiritual catharsis through theconversations and the love we felt for him.

Description of our Second Bereavement

10 October 2006

On this dark day we were informed of Petro'ssuicide as a result of shooting herself. Marius'mother, a non-practicing Psychologist,had been living in South Africa with herpartner and we were aware that she wasexperiencing depressive episodes and usingvalium and alcohol. She had agreed to comeand live with Michelle in England as soonas she sold her house later in the year.

Albert: "I can't remember what it was like."

Michelle: "... I spoke to her at night. You spoketo her during the day. I spoke to her about

half an hour before she actually committedsuicide. So.. .it was really traumatic....You had a trauma reaction and it makesmemory become vague because you're sooverwhelmed from what's happening..."

Albert: "Actually that's true. That's whathappens. I do recall coming into her housein South Africa and just seeing some of thestuff that was there. I remember going to thenext room and just seeing the sheets that werestill there. They had forgotten about them."

Michelle: "The sheets were dumped in thewardrobe and they had forgotten so we foundit still with the blood on it. It was difficult.That's why it seems fragmented for you, alsofrom what happened before, leading up toit.... I can see the pain on your face as you talkabout this now and try to piece it together."

Comments

Once we emerged from our despair, ourconversations moved to a new and deeperlevel. These dialogues led to a further spiritualawakening which added immense depth toour initial sense-making process and to theresulting phases of deeper knowing describedthroughout this account of our journey.

Feelings then and now:

Albert: "And you coped well. I wasn't ableto do anything. I just couldn't do it. I havethought about it often. Even though we hadbeen divorced, it was just a paper thing. Wewere so locked in with each other even thoughwe had different partners. I had spoken to hera few hours before she killed herself as well.I noticed she was very down.. ..Somethingmust have triggered it in the moment. Iknow that was difficult for you because Iknow I wasn't very helpful. I just couldn'tbe helpful. I couldn't deal with helping."

Michelle: "No, don't worry."

Albert: "To be honest, I'm still notdealing with it very well."

The British Journal of Psychotherapy Integration

Michelle: "I never blamed you. I knew youcouldn't. I knew you had this massive traumafrom Marius that you hadn't really properlycome to terms with, and then mum's deathwas a real blow.... I know how involved youhad been in each other's lives since you wereten and twelve. You know, you couldn'tmake the marriage work but it doesn't meanyou were able to let go of each other."

Albert: "A bit... part of me couldn't saygoodbye. Actually, to be honest, thebiggest part of me hasn't said goodbye."

Comments

The above exchange reflects the differencesin the way we were coping with our secondbereavement at the time and also currently inrelational terms. It signifies that bereavementis an ongoing sense-making process and thatthe process of acceptance can stretch over along period of time. In the months after Petro ssuicide we continued our dialogue with eachother, thus expanding our meaning makingprocess into a heuristic 'research' process. Weread voraciously, wrote, listened to music, hadtherapy - or, in the words of Moustakas (1990)did some serious 'indwelling' in our experience.

Evaluation & Analysis of ourDouble Bereavement

After this period of'indwelling', we were evenmore driven to find meaning in these traumaticevents. Reflecting on the struggles our lovedones had with drugs and alcohol, we startedthinking about how we might be of help topeople with similar challenges and startedmoving towards a deeper engagement withthe formulation of our survivor mission.

Albert:".. .1 remember going to rehabs in SouthAfrica where he was and thinking, 'How cananybody get better here?' He would say tome, 'Dad, you need to come and get me outof here, this is not working.' I went there andI thought, "There's nothing here, there's notherapeutic programme,' you know, 'People justhang out.' I think that memory of his rehabsalso galvanised us to come up with somethingdifferent in terms of how we wanted to, first

of all, honour both Marius and mum, butalso find something that would be different. Iwonder what your recollection is on that?"

Michelle: "I remember.. .we had this idea andmany discussions, because I was visiting youon weekends. I remember being in a class,supervision class, at university, had a coupleof months left or so, and I said that-, becausewe were talking about what everyone's planswere for after graduation and I said, 'Well myplan is that my father and I are thinking ofopening up a rehab home in memory of mybrother and my mum.' I remember sayingthat we wanted to open up a therapeuticcommunity, and .. .you had come acrossthe concept of therapeutic community."

Comments

In terms of Heuristic research this could bedescribed as the period of immersion, the stagewhere the researcher lives the topic and comes

".. to be on intimate terms with the question."(Moustakas, 1990:27) It also seemed to us tobe the first stages of prepositional knowing,i.e. knowing about something and developingideas and theories about how we might work.

Conclusions

As part of the incubation stage of our heuristicprocess (Moustakas, 1990), we read everythingwe could find on addicted health professionalsand found that no or little help was available tothem. This had been our experience in the UKto find help for Marius when he was practicingas Locum doctor prior to returning to SA.We decided that we would start a drug andalcohol rehabilitation clinic that would considerthe unique needs of health professionals.

Michelle: ".. .there was a lot of negativity andstigma towards healthcare professionals whoneed help.. .so we thought we could create asafe place where they could come to and bewith other healthcare professionals... becausemany of them don't want to go to mainstreamservices, because they don't want to comeacross their own patients or the stigma that'sattached to that, or the real feelings of havinglet family down and friends down and patients

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down, and it's awful.. ..so that's how we saidwe'll make it bespoke and different..."

Albert:" I remember that both of usdeveloped a lot of passion aroundthis, it was not just a fleeting idea, wereally wanted to make this happen."

Michelle: "Oh yes, people were saying.. .we werea bit nutty and, 'Oh, how are you going to dothat?' and, 'How are you going to open a rehab,do you know how much trouble it is?' and allthat. We were like, 'No, we're going to do it.'

Albert: "I remember that too, yes."

Michelle: "I think when you talk aboutthe passion, it really geared me up to alsofinish my doctorate, because I think thatafter mum's suicide, I threw myself into mystudies, but I really started to struggle. I gotpregnant a month after mum's funeral, whichwas a nice surprise, a surprise, a shockingsurprise, I was not at all ready for having ababy. You know, with pregnancy, that was alot, I decided to keep the baby and there wasa spirituality aspect to it for me, you know,sort of life having been taken away, I wasgiven life. That helped me cope.. ..I rememberworking every weekend, I had a nanny comethree days a week, and every weekend wecame to your place, and I was just...."

Albert: "In there"....

Michelle: Working to get my deadline, sothat I could qualify. I said, 'Well, I need tobe qualified in order to open up this rehab,'and it just gave me, I think, life. It just gaveme drive, and I knew I could do it, you know,and we could do it together, no matter whatpeople's doubts were that we're going to do it. "

Albert: "We thought we'd just start"

Michelle:" 'We'll just start there was somuch involved in this process, and after Ifinished my thesis, then we were really ableto start putting our ideas into it. We hadto do a lot of groundwork I remember, andreading, and research, and the more we read,the more we knew what we needed to do, themore we thought, 'Shit, this is a lot of work,but we're going to do it,' we set our minds

on it and... I think the two of us combined,there was no way we were going to not doit, despite the hard work. We just becameso focussed on it. You went to America.."

Albert: That's right, I did.. .research, and lookedat some really good places. You know, I alwayscarried this idea, of creating a field of care, andwe both agreed, because we felt it so stronglythat there must be something -, I think also, interms of what mum wanted to do, you know, aplace where you're not lonely. A place whereyou're in a surrogate family, and where peopletake decisions together, and get empowered.Then, finding the staff that would be able tosupport all of that, to be in our philosophy oflove and care and empowerment, and not haveit as a commercial enterprise, but at the sametime trying our damnedest to try and run itas a business, so that we could survive. So allof these things came together for us, and..."

Michelle: "Also the prevailing narrative atthe time was... 'We'll break you down inorder to build you back up again,' whichwas.. .very traumatising for people. Wedidn't agree with that, because thatdidn't go with our philosophy of love andcare and compassion, and overcomingloneliness, which addiction feeds on."

Albert: "Yes, I think we both felt that theoriginal.. .twelve step approach was a bitmoralising, and I think we wanted people totake power back over their lives. And doingthat in a way that our loved ones didn't getwas it..., You know, we wanted a place wherepeople can actually be in a surrogate family.I think, when we opened our doors, that itwas the good feeling people had when theywalked in, and people said so of course, andthat's how they got better. I also remember thepersonal commitment that we put into it"

Michelle: "Oh my, yes!"

Comments

The above dialogue describes quite accuratelywhat Moustakas (1990) formulates as themovement from "illumination", where weuncovered new meanings and essencesabout our topic to "explication" which

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involved a period of nearly obsessive focuson our topic. It also constitutes a furtherdevelopment of our prepositional knowing.

Actions

In the following excerpt we have moved tothe phase of "creative synthesis" (Moustakas,1990:32) ".. .where a comprehensive expressionof the essences of the phenomenon investigatedis realized". At the same time we moved to thelast area of knowing, i.e. practical knowing -actually having the skill to put something intopractice - and we would like to provide a flavourof the ways of working and the values andprinciples we developed in our conversationsthat informed the work at our clinic.

Albert:" .. .you had the clinical directorrole, and were actually designing the wholething from a psychological perspective. Wealso both agreed that there was going to bea big spiritual component, I think aboutthis often, I think the spiritual componentwasn't teaching people spirituality, it wasthe way that we were with each other."

Michelle: "It's the principles, spiritualvalues that we tried to put across."

Albert: "Yes, and I'm wondering, if we look atit now, what was that like for us to work as atraumatised father and daughter team? I recallbeing very, very close to you, I recall beingvery respectful of you as a professional, andI recall being very proud of your willingnessto, sort of, go into this adventure together withme. I recall very clearly that this was a thingthat we both really wanted. I think that spirit...stayed throughout our venture with the clinic.I recall-, it's not things that we did, the bestthing that sticks in my memory, is the spiritof love in the house, you know, and everybodycontributed to that. What is your recollection?"

Michelle: "Yes, it's very similar. I mean, I knowI had a lot of comments with people saying,'What, you're going into work with your father,how is that?' You know, I was happy to be inthere.. ..You know, and I think we have mutualrespect.. .You know, we had each other, that'swhat we had left as father and daughter, and-it was that wanting to really strengthen that

relationship through something like this, thatwould honour the memory of Marius andmum, that we could work side by side on this.. .1felt that this was right, on a feeling level..."

Albert: "I also think that in the build up tothe opening of the clinic, I was able to be veryhonest with you about who I am.. .and whatdrives me. Also be vulnerable, you know... Ithink it's often thought that it's partly difficult,partly good to demystify your role as a parent...So I think there was a sense of: 'Yes, we're justtwo human beings.' Vulnerable, full of pain,full of trauma, and both, in a sense, partlyorphaned, just wanting to get together and dothis. I remember people saying to me, 'Howcan you work with your daughter, does shedo what you say?' I said, 'It's not about that.'It was never about that, it was about findinga way, together, of making this work."

Michelle: "Yes, side by side."

Albert: Side by side. We had a superordinategoal.. .a bigger goal, and we

were both working for the biggergoal, rather than for our egos.

Michelle: "Exactly."

Comments

We knew that if we did not work with emotionaland spiritual integrity, if we were to treat ourclients as objects to be processed as quicklyas possible, if our clinic was cut off from thecommunity it was meant to serve, then we andour 'treatment facility' would not be a healingagent. We wanted to work with residents andstaff holistically (including spiritually), buildcommunity inside and outside the workplace,provide relationally oriented care, and makedecisions based on these values, not merelythe potential for profit. We felt that deep andsustainable healing can only take place within aweb of supportive and caring relationships - thatis, within a community. True healers representthe community and life itself, conveyinghealing energy in sacred acts of service.

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Final Reflections

Over the years we tried to remain open andcurious about the impact of our experiencesand our relationship on us as clinicians.We also reflected on the impact thisdialogue had on us in the here and now.

Michelle: "Yes, because we had that...adult - adult relationship, you know, notparent, daughter... I never felt any kind ofdifferential between us when we worked,it just flowed. There was a flow that Ifelt that we could do, and I think..."

Albert: "... it was the absenceof a power differential."

Michelle: "Yes."

Albert:" I think there was that sense of flow. Iremember we sometimes would look at eachother, or not even look at each other, and thatwe just built on each other's work with theclients in the room and it just was easy actually."

Michelle: "Of course.. ...we were very reflectiveon the impact that that could have on our clients,we didn't just, kind of, put it under the carpet,because you can't ignore that kind of stuff, so-,but we managed it, we managed it well. Likeyou say, it was just... the constant awareness,and we would give feedback to each other."

Albert: ".. .we would take it as an opportunityreally, to look at it and see what the impact is. Ithink that, for me personally, has been a greatgrowth process. So I think, overall, in termsof a sense-making process, we understoodwhat mum and Marius stood for. We lookedat their compassion and their way of being inthe world, and we just wanted to take it further.So what was it like to have this conversationfor you, are you okay to finish here?"

Michelle: "Yes.. ..I think it's good .. ..it was reallyreflective and.... I think, this conversationparallels the feelings we had at the time of ithappening, so it was very painful, a lot of painand sadness in connecting at the beginning, inreal life at the time and in this conversation.Then, as it progressed, and we started talkingabout what led to the clinic, I felt a lift in me."

Albert: "Yes, I felt that too."

Michelle: "I felt my feelings lift, and I kindof... reconnected with that passion thathelped us establish it in the first place.You know, talking about it and feelingmore animated in my discussion."

Albert: "Feeling the joy of thewhole enterprise, yes."

Michelle: "Feeling the joy, I think, you know,and I think it's okay to feel the sadness, andit's okay to reflect on that, fine, it's good to feelthat, not to avoid it. I can see the difference inhow I was at the start of this conversation andhow I am now, and talking about it, that we,having established the community, you know,and how much it had meant to me and meantfor us as a father, daughter team, really. It'salmost like a, as you have described as well, likea healing-, it's healing journey, it's a journeythat we have been through, that helped us withour healing in the process of helping others."

Albert: "Right, yes, and I agree with you, I alsohad the sense-, I was very, very emotional at thebeginning, and very pained at everything. Youknow, as we reconnected with the sense making,it felt like a parallel process, what happened thenhappened now, so I fully agree with you. At themoment I'm okay to finish the conversation here,because I'm actually in pretty good shape now,I'm thinking, 'Yes, this was good.' It was a veryhealing conversation, so thank you very much."

Michelle: "Thank you."

Reflections on the Process of Writing

How do you write up a process that is essentiallymessy, emotional and convoluted. Althoughour dialogue may create a possible impressionof organised linearity, the actual process wascharacterised by many reflective cycles, periodsof stuckness, sense making of the stucknessand transforming the experience into furtherlearning. West (2001:129) points out thatheuristic research "is not necessarily a linearprocess and certainly does not constitute arigid framework" and Moustakas (1990:44)reminds us that: ".. .every method or procedure,however, must relate back to the question and

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facilitate collection of data that will disclosethe nature, meaning, and essence of thephenomenon being investigated". We felt thatour use of co-operative inquiry and heuristicresearch was in line with the above statements.

Why did we do it?

As therapists, we wanted to focus on thewholeness of our experience rather than onlyon its constituent parts. We felt that writingup our lived experience and making senseof the process at the same time would lendat least a small measure of support to JohnHeron's call for a paradigm shift in researchreporting: "The purpose of such reports isexhortatory: to point a way, suggest a method,evoke and portray a competence and how toexercise it, and so to inspire and invite readersto inquire into their own transformation andconcomitant skills. Thereby, of course, readerswho become active co- inquirers will alsounveil a revisioned universe within whichthese outcomes are manifest" (Heron, 2000).

Implications for our Practice as Therapists

John Heron (2000) identifies twoprimary outcomes as a result of theco- operative inquiry process:

1. Transformations of personal beingbrought about by the inquiry,which are inseparable from

2. Transformative skills, the practicalknowing-how involved in the domain ofpractice that is the focus of the inquiry.

Transformation of being: presence - as a resultof our co-operative project we experienced deepconnections between our personal learningand our being-in-the-world and how we arenow different in the world. We experienceda very potent change within ourselves andbecame aware of our, often radical, impact onothers. Through our work and the on-goingprocess of reflective practice we were able todevelop a heightened sense of empathy with ourresidents, which led to a deeper understandingof where our residents were in their process. Atthe same time, our self-awareness as well as ourcultural and contextual sensitivity increased.

Transformation of skill: practice - aspractitioners we experienced a great shift inthe way we were able to present ourselvesand our work. We developed an activeanti-oppressive stance, especially against thebackdrop of the potentially subconsciousimpact of having lived under the apartheidregime in South Africa. We promoteddiversity in our staff group and reached outto GLB and other minorities. Communitydiscussions and practices were inclusiveof all spiritual traditions and we carefullyavoided the emergence of one dominantdiscourse - even in 12 steps. We had developedthe ability to stand back from our experienceand look upon it with critical subjectivity.

We carefully developed the use of therapeuticdisclosure to our residents. In the entrance hallof the clinic we placed a picture of Marius andPetro with a commemorative plaque, conveyingthe message to our residents of our realexperience of loss related to drug and alcoholaddiction. It also served as an inspiration forthe whole community - their death was not invain. To quote one of our residents: "If it was notfor Marius, I would not have had my life back."

At the same time we were mindful that residentsmight want to take care of us. We held ourprinciples of a modified democratic therapeuticcommunity with strong internal boundaries andwere deeply guided by our love for residents.

And finally we became able to contain vastamounts of distress exhibited by our residents.We grew more aware of own clinical intuition,yet remained reflectively critical and consciousof working within the limits of our capability.

Our continuing reflective process consistentlyinformed the way we worked with our residentsand helped us, as a community, to achievesome of the best recovery rates in the UK.

Where are we now?

Just before we expanded the client targetgroup due to funding cuts and demand fromnon-health care professionals, Michellehad a second child. The boy had healthproblems demanding constant care andwe decided to meet once again to check

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where we were in our process. We askedourselves the question if - given the emergingcontext - we were the right people to sustainthe therapeutic community in the long term.

Together we decided that we had achievedour 'survivor mission' and that it wouldmake sense to pass on our work to peoplewho could move it into a new era with a newremit - a wider population should have accessto high quality therapeutic programme.

On 6 October 2012 we delivered a joint talk onour experience of bereavement and our survivormission at the annual DrugFam conference.DrugFam is a charity supporting familiesbereaved by addiction. This talk presented theopportunity for further reflection, a properending and letting go of our clinic and sharingour experience in a way that could be helpful tothe delegates in their own bereavement process.

We had a thirty minutes to deliver our talk tonearly a hundred delegates. Inspired by ourreflective dialogue we spoke about the impactour traumatic bereavements have had on us,how we had learnt to cope with the pain andhow we had channelled our suffering intogrowth to develop our 'survivor mission'. Wealso spoke about the process of moving onfrom the clinic and handing it over to investorswho could ensure its future sustainability.We ended with talking about letting go andfocusing on different projects i.e. for Albertit is working as a psychotherapist in privatepractice and being a dedicated grandfatherand for Michelle it is combining part-timeprivate practice as a Counselling Psychologistwith being available emotionally, spirituallyand physically to her young children.

The talk was a cathartic emotional process andreflecting on the talk afterwards we sharedfeelings of sadness, hope and joy and concludedthat this talk represented the final sense-makingprocess of our entire experience. It culminatedin a deeper acceptance and a fuller realizationof being able to live with the trauma and moveon to other fulfilling and meaningful activitiesin which we can celebrate the memory Mariusand Petro in a daily lived experience. Delegatescame to us afterwards and thanked us for givingthem hope, enabling them to cry, and others

thanked us for feeling permission to let go oftheir preoccupation and guilt and move on.

References

Frankl, V.E. (1969) Man's search formeaning: an introduction to logotherapy.London: Hodder & Stoughton.

Gibbs, G. (1988) Learning by Doing: A Guideto Teaching and Learning Methods. Oxford:Further Educational Unit, Oxford Polytechnic.

Herman, J.L. (1992) Trauma and recovery: Theaftermath of Violence -from domestic abuseto political terror. New York: Basic Books

Heron, J. (2000) Transpersonal co-operativeinquiry. In: Reason, P. and Bradbury, H. (Eds),Handbook of Action Research, London: Sage

Heron, J. 2001. Spiritual inquiry asdivine becoming. http://www.human-inquiry.com/SpInasDiBe.htm

Heron, J. (2009) A psychological perspectiveon participatory practice. http://www.human-inquiry.com/Spiritis2wp.pdf

Heron, J. & Reason, P. (2000) Co-operativeinquiry: research with rather than on people'. In:Reason, P. & Bradbury, H. (Eds), Handbookof Action Research, London: Sage.

Moustakas, C. E. (1990). Heuristic research:Design, methodology, and applications.Newbury Park: Sage Publications

Reason, P. & Heron, J. (2012) A shortguide to co-operative inquiry. http://www.human-inquiry.com/cishortg.htm

West, W. (2001). Beyond groundedtheory: The use of a heuristic approachto qualitative research. Counselling andPsychotherapy Research, 1, (2) 126 - 131.

Dr Michelle Zandvoort is a CounsellingPsychologist registered with the HealthProfessions Council and a full member ofthe British Psychological Society. She holds aPractitioner Doctorate in Psychotherapeutic

The British Journal of Psychotherapy Integration

and Counselling Psychology, a MSc inCounselling Psychology and a BSc Rons inPsychology. She is also an experienced EMDRpractitioner. She specialized in the treatmentof addictions and co-occurring mental healthdifficulties and continued to practice in this fieldpost-qualification with the establishment of theBayberry Clinic. At present Michelle practicesas an independent Counselling Psychologist andprovides consultant cover for an independentclinical rehabilitation company whilstbalancing the needs of her young children.

Dr Albert Zandvoort, BA, BA Hons, MA,MSc, PhD, DLit et Phil, is a Metanoia trainedintegrative psychotherapist registered withthe UKCP. He works in private practice inHertfordshire and London and, together withhis daughter Michelle, founded an addictiontreatment centre in Oxfordshire. He is atrustee of Drugfam, a charity supportingfamilies, carers and friends affected bysubstance abuse. He is also AcademicDirector of the Witten School of Managementat the University of Witten/Herdecke inGermany as well as a visiting professorat several European business schools.