One of the highlights of the year comes in the form of the Easter Workshop run by the Psychological Society of Ireland Learning Disability Special Interests Group. This year Professor Chris Conliffe did not disappoint when he addressed the topic ‘Beyond IQ’, accentuating the positive in our approach to people with learning disabilities. During the workshop Chris emphasised the pool of potential that lies in people of all abilities that we can begin to actualise by searching for simplicity. Chris referred to the ‘one puff of simplicity when you are born that is rapidly replaced by the complexities of life’. Chris lamented the clinical conditioning around IQ when it is used to predict the trajectory of a person’s life, fashioning it and shaping it based on the limitations versus the gifts of the individual.
Chris spoke of the frustration that people with intellectual disabilities experience which frequently result in challenging behaviour. He stated simply, ‘What they want is consonant with what they need.’ Chris urged psychologists to listen to the true reality of the person’s life versus the rhetoric reality. He encouraged clinicians to empower persons with intellectual disability so the individual is moving along a pathway of ownership, mapping a small change that makes it easier.
Chris referred to the work of the Scottish group Pamis (email@example.com), in partnership with people with profound learning disabilities and their carers in promoting communication with people with severe and profound disabilities.
Chris showed film footage of remarkable individuals with significant disabilities, demonstrating their joy at listening to classical music, and their body language communicating their choice. Chris illustrated the passport system that gives comprehensive pictorial information on a person’s life. Pamis promotes the use of talking photo albums from the Gadget Shop, concluding that well-chosen words can be priceless. The talking photograph album allows you to record a personal sound message to accompany every image in the album. Messages can last up to 12 seconds, and anyone who looks at the album can hear the soundtrack at the touch of a button (see www.gadgetshop.com).
Chris spoke of the importance of Emotional intelligence versus Intelligence Quotient (EQ vs IQ). The essential premise of EQ embraces two aspects of intelligence:
- Understanding yourself, your goals, intentions, responses, behaviour and all.
- Understanding others and their feelings.
EQ has five domains:
- Knowing your emotions
- Managing your emotions
- Motivating yourself
- Recognising and understanding other people’s emotions
- Managing relationships, i.e. managing the emotions of others.
Emotional intelligence draws from neurolinguistic programming, transaction analysis, empathy and other branches of applied behaviour analysis and communication theories. Chris talked about transaction analysis, demystifying the three-ego states:
- the parent—that part that is influenced by our parents
- the adult—that part is analytical and judgmental
- the child with wants and needs.
Chris concluded that in intellectual disability one is constrained to be in the child’s ego state. It is the challenge of clinicians, thus, to ‘ensure the candle of hope stays firmly lit … with feet on the ground’. Look out for Dr Conliffe’s forthcoming publication, Face to face: Counselling people with learning disabilities–~Training and support programmes’-– email firstname.lastname@example.org.
Alan Corbett from CARI Training spoke of the incidence of sexual abuse in the lives of people with learning disability, quoting research done in 2004 at St Michael’s House which indicated that each year in Ireland there are 125 cases of sexual abuse where the victim has an intellectual disability. He quoted research from Professor Hilary Brown on vulnerability concluding that:
- People with intellectual disability are more exposed to risk.
- Crime and abuse are not noticed or acted upon when the victims are vulnerable.
- Vulnerable people have fewer avenues for recovery or redress.
- Vulnerable people don’t always make credible witnesses when dealt with by the criminal justice system.
The aim should not be to provide extra protection but to ensure that vulnerable groups are protected at least to the same extent as other citizens. Unidentified core clinical issues centre around guilt, shame, rage, ‘The damaged goods syndrome’, fear, sexualisation of anxiety, disability, confusion, and dissociation denial. Alan emphasised the risk assessment respond model involving:
- Gathering reports,
- Meeting with the team.
- Meeting with the client.
- Formulation of a treatment package.
Working therapeutically involves things such as anger management, sex education, self-esteem work, family work, advocacy, risk assessment and management, staff work, support work, team work and psychotherapy.
Alan’s recommended reading included the following, all of which are used by CARI Training.:
- Noelle Blackman, Loss, attachment and learning disability (Worth Publishing 2003)
- Alan Corbett, Tamsin Cottis and Steve Morris, Witnessing, protesting and nurturing: Working therapeutically with people with learning disabilities (Taylor and Francis 1996)
- Sally Hodges, Counselling people with learning disabilities (Palgrave Macmillan 2002)
- Sheila Hollins and Valerie Sinason, Jenny speaks out, and Bob tells all. (Titles in the Books Beyond Words series, designed for people who have a learning disability, which are available from the Royal College of Psychiatrists, 17 Belgrave Square, London SW1X 8PG.