This paper describes a unique technique of training social work students: self observation via guided meditation. A workshop was conducted with two groups of students: one participated in a single-session mindfulness meditation; the other participated in this as well as three additional sessions. The workshop trained students in creative focusing while facilitating connection to inner guidance (inner voice). Tuning in to inner guidance is presented as a developmental process and an important source of knowledge about the "self." Students' experiences included various bodily sensations, interactions with a guiding figure, verbal messages or advice, and significant insights. Messages and insights were content analyzed; examples presented illustrate transitions in students' personal and professional self-concept.
It has been argued that the essence of social workers' work in the context of a therapeutic relationship is their ability to use the "self" as a tool. This entails an ongoing focus on workers' self awareness. Similarly, in the course of their training, social work students are expected to demonstrate flexibility in altering the perception of self and other (Shulman, 1993). This paper attempts to explore the possible impact of mindfulness meditation on the transformation of professional self-concept among bachelor level social work students. It follows the guidelines of a qualitative inquiry by placing the highest priority on individuals' subjective experience (Creswell, 1998). The emphasis here is on students' self-observation, via meditation, as a potentially powerful mediator in the process of professional development. In other words, rather then asking how students fit into different stages of professional development we ask how it feels. The project described here was not aimed, at first, at changing students' professional self-concept; it simply attempted to teach self-observation. Such observation of the moment-to-moment flow of consciousness allowed for insights of a personal nature to surface. Among them we identified insights that reflected disturbing professional matters.
According to Zen-Buddhist religion, the function of meditation is to heal and transform (Goldstein & Kornfield, 1987). Transformation of professional self-concept through mindfulness meditation was assumed, based on existing research on changes in the perception of self, to be facilitated by practiced meditation (Ellison & Smith, 1991). Based on well-documented support of mindfulness meditation promoting self awareness (Shyam, 1994), this technique was developed into an experiential workshop bridging between professional training and spirituality, allowing students to get in touch with their "inner voice." Inner voice refers here to a deep part of the self, which has pure wisdom and knowledge about the individual's true nature, and can provide guidance at times of need (Birnbaum & Birnbaum, 2004). A review of relevant research reveals that high scores on spiritual well-being tend to be found among people who are motivated by an inner guiding force (Ellison & Smith, 1991). Spiritual well-being is also associated with psychological well-being, like self esteem, assertiveness, sense of wholeness and empathy toward others (Kotler, Boudrew & Devlin, 2003). This evidence suggests that spiritual and psychological well-being combined with a sense of inner guidance can determine the way we perceive ourselves.
The workshop's goals included experiencing inner quiet, expansion of consciousness, and listening to the voice of inner wisdom. The methods selected were mindfulness meditation followed by guided meditation. Qualitative means of data analysis were used in order to organize and present students' varied experiences, which demonstrated the benefits of the workshop. Possible obstacles to the use of mindfulness meditation are also considered
Mindfulness meditation is a technology composed of two different, although related concepts. The therapeutic potential of mindfulness is now being recognized and is being researched in a diverse range of healthcare settings including mental health (Beddoe & Murphy, 2004; Brown & Ryan, 2004; Hayes & Feldman, 2004; Hirst, 2003; Ma & Teasdale, 2004). Therefore, it has become increasingly important to carefully define the nature of these constructs as well as the relation between them. According to Hirst (2003), being mindful presupposes that individuals whose awareness is not impaired have a choice in what phenomena they attend to and how they act. Hayes and Shenk (2004) define mindfulness in terms of self-regulation of attention and a posture of acceptance. The most common definition used in the literature refers to mindfulness as intentionally bringing one’s attention to the external and internal experiences occurring in the present moment (Baer, 2003; Deikman, 1982; Goldstein & Cornfield, 1987; Marlatt & Kriseller, 1999). Mindful awareness is based on an attitude of acceptance, rather than evaluation, and is often taught through a variety of meditation exercises to allow looking deeply into the authentic 'self' (Goldstein & Kornfield, 1987).
Meditation is widely considered a spiritual practice with various purposes. For most it is associated with a silent and calming process that is often used to foster self-reflection. In Christian spiritual training, meditation means thinking with concentration about some topic; in the Eastern sense, meditation may be viewed as the opposite of thinking about a topic. Most forms call for quieting of the mind (Goldstien & Kornfield, 1987), but there is more to meditation than just closing ones eyes. The subtle state of mind, which is the ultimate stage of meditation, requires a tremendous amount of energy to reach, hopefully resulting in being at peace with oneself. If the function of meditation is to heal and transform, then the energy used is mindfulness.
Perhaps the most significant clinical application of mindfulness meditation is the capacity to adopt an “observing self.” In mindfulness meditation, also known as “opening up” or insight meditation, the person is instructed to be aware of any mental content, including thoughts, imagery, physical sensations or feelings as they occur in consciousness on a moment-to-moment basis (Marlat & Korenfield, 1999). Mindfulness meditation was found to be an effective and efficient way to reduce psychological stress and prevent relapse of depressive episodes among depressed patients (Baer, 2003; Ma & Teasdale, 2004; Teasdale, Segal & Williams, 1995). Beddoe & Murphy (2004) followed a group of 16 nursing students throughout an eight-week mindfulness-based stress reduction course, combined with guided meditation exercises. They found participation in the intervention significantly reduced students' anxiety, increased their empathic capability and improved their coping skills. These findings suggest that being mindful may also decrease tendencies to take on others’ negative emotions. Based on these proved benefits we decided to train students to get in touch with their inner self, and voice, as to see how this tool can be useful to them in their studies.
The ability to observe ourselves is acquired and entails listening and tuning in to ourselves and the world around us. The observing self is better able to listen and identify the different voices that exist within and around it. The external voice may be described as that of the mind or ego. The ego contains our ambitions, needs and goals, which are the result of evaluations and value-attributions emanating from our environment, i.e. significant others. This external voice is important. It accompanies us throughout life and assists us in defining who we are, understanding ourselves and how we function in the world. It develops right along with us, and is therefore inextricably connected to our subjective "self-concept." As such, it may take on a variety of roles representing various aspects of our personality: the aggressor, the knower, the innocent, the guilty or the rebel (Birnbaum & Birnbaum, 2004). Indispensable as it is, this is also the voice behind harmful behaviors such as suicide. A voice coming from wounded parts of the self may provide a destructive type of "guidance," encouraging one to carry out a suicidal plan. While this voice may be connected to such wounded parts of the self, it is not the true voice of inner wisdom.
The inner voice may be described as the voice of inner guidance, inner wisdom or intuition, and serves as a direct and immediate source of knowledge about the self, independent of conscious ego-function and sense perception (Birnbaum & Birnbaum, 2004). Linehan (1993) has described the presence of "wise mind" even in severely disturbed clients. This part of the person, or this state that a person can access, is precisely what provides the necessary potential for positive change. As we use the term inner wisdom we speak of a deeper level of consciousness, in which the person is directly in touch with authentic needs, desires, and values at the core of their true self.
Qualitative research is concerned with the opinions, experiences and feelings of individuals. These subjective data are gathered through direct encounters with individuals, through interviews, observation, or in our case, students’ written responses (Straus, 1987). These responses along with transcribed participant comments in the concluding group processing, were subjected to content analysis, which employed inductive ground theory methods to extract significant themes (Creswell, 1998). These themes, or categories, are labeled topics or issues identified by the researcher as repetitive. Relevant analysis units such as words, sentences, metaphors etc. are listed under those themes creating major or sub-categories. Adding or changing categories is an ongoing circular process by which the “map” of the research changes constantly as new data is gathered. In more developed research projects, additional analyses may identify relationships between categories and even develop a new theory on the researched phenomenon (Straus, 1987).
The workshop was conducted with first, second and third year social work students, in the course of their "Methods of Intervention" class, upon consent (N=50, 37 female, 13 male, average age of 25). Among them, 35 students met only once for a single workshop (in their groups), while 14 first-year and one second-year student met for three additional sessions, at three-week intervals (for a total of four sessions). In an introductory meeting the nature of mindfulness meditation was explained. Although the initial goal of the project was to get in touch with inner guidance, students were advised that past or present personal issues might surface. The right of all participants to withdraw from the project at any time was emphasized, and the group was informed that the facilitator was available for further in-depth discussions regarding what was framed as professional self-concept. However, as a matter of principle, students who felt the need to focus on personal issues would be referred elsewhere.
The workshop included several stages: general relaxation, mindfulness meditation, and a guided meditation seeking connection with inner guidance. The relaxation involved awareness of breathing, finding an inner center, and releasing tension in the various muscle groups. The mindfulness meditation asked participants to notice any and all thoughts, feelings and body sensations, in and around the body, and simply observe them. While in deep relaxation, connection to inner guidance was facilitated via visualization of a safe place, followed by instructions to invite or open up to inner guidance. Just as the safe place could evolve according to personal preference, participants were reminded that inner guidance or wisdom could appear in various forms, including an image, presence, figure, message or intuitive knowledge. If they noticed a figure or presence, they were asked to connect to them and receive any relevant message, advice or image which seems right at this point in their life. If no presence was noticed, they were encouraged to imagine how one might appear, and what message it might have brought. Participants were asked to be conscious of any evaluative attitude, and to avoid judging the experience on any level. It was explained that inner wisdom uses our internal repertoire to deliver messages, therefore there is meaning to every occurrence as well as to what is perceived as a non-occurrence. Based upon results of previous workshops, participants were not asked to fill out a structured questionnaire, in order to avoid imposing rational organization on the experiential data. Rather, participants were simply asked to describe their experience or reactions such as images, thoughts, feelings or body sensations in writing.
We identified a two-step process based on participants' written data. The first step consists of messages received from what was experienced as inner guidance, while the second step consisted of developed insights. Insights were defined as knowledge about the 'self' that seemed to emerge from the messages themselves, and came to awareness during the intuitive writing. Students seem to take the message "one step further" in terms of being able to "make sense" of some aspects of their lives. These responses, both messages and insights, along with transcribed participant comments in the concluding group processing, were subjected to qualitative content analysis, which employed inductive ground theory methods to extract significant themes (categories). Each category was then divided to sub-categories, according to common foci (Creswell, 1998).
Forty-four of the fifty participants reported receiving a message, either from a presence or intuitively, in the first session. The experiences were approximately evenly distributed between two basic types, tangible versus abstract. Illustrations of the tangible variety include: "I saw myself at the age of five;" "I'm sitting in front of a reflection of myself like in a mirror;" "My mother was there except she was behind bars…;" "…an unfamiliar male figure, surrounded by light, radiating warmth, approaching me." Typical responses of the abstract sort: "There was some kind of undefined presence near me which emanated a clear energy of love, acceptance and compassion for me...I felt hugged;" "…shining light, undefined…a mutual touch of joy and intimacy…" Physical and emotional sensations reported throughout the meditation were varied: 15 participants reported feeling very relaxed, a sense of comfort and closeness to 'self'. Eight experienced feelings like love, longing, happiness, joy and excitement. Five participants felt different types of energy in or around their bodies. Three reported the need to cry, which they did, and two others felt sadness. One participant sensed danger, and one reported feeling tired and confused.
The following major categories and sub-categories were identified based on messages received in the first sessions (n = 44). They are presented in a descending order with the more dominant categories, and their sub categories, listed first.
"Don't judge … learn to love yourself..." "Keep calm and focused … don't forget yourself among others." "Don't be afraid, you are not alone… safe… loved." "Trust your inner abilities…you are at the right place doing the right thing." "You can face the difficulty you buried inside you, accept it and learn to love it."
"Your 'self' is overly controlled, let go…" "There are some fears in the 'self' associated with your mother…let them go." "Your mother's desertion (at age five) was an act of helplessness…find comfort…release the anger…"
"Listen to your inner voice more often…you'll find answers." "Listening to your intuition will connect you to your true self." "Be with your self more… connect to your authentic feelings and intuition."
"I felt restless, could not focus…my thoughts haunted me…I didn't see anything and didn't get any message" " I got a headache ...was busy trying to speculate what the others are doing...meditation didn't do anything for me...it brought back undesirable thoughts."
"…I felt danger…my thoughts brought about fears of things I usually try not to think about." "I felt such sadness…great pain and fear, I didn't want her (mother) to come…I couldn't stop crying...didn't hear a message."
While messages were generally directed at the "personal self," some insights included information pertaining to the "professional self." In addition, the link between insights and professional self-concept became more apparent as students continued to meditate. That is, insights involving any professional aspect were more prevalent in the group participants who meditated four times. Insights from all sessions were collected and analyzed, and examples are presented below. Interestingly, the content categories derived from the received messages lack equivalence to those of the insights. This will be discussed later on.
"Me and my inner guidance are inseparable, I can turn my emotions into actions and creation." "I know my guidance has answers for me, but I'm unable yet to utilize them." "Usually, discovering things about me is painful and causes me to shut down. With my guidance, the transition was easy, full of light, joy and wholeness." "I know that re-locating is not going to solve the problem, we may have taken the wrong decision."
"I realize I can ask my 'self' for help, and be connected to my real abilities." "All of a sudden, I can see a new angle to things, even in daily events." "There is a new sense of wholeness in me, which I would like to preserve." "This process of self observation must continue for me."
The following category illustrates a continuum between a message and an insight, as developed in the different workshops, showing how a specific content resonates with students' perception of themselves as future professionals. This continuum was observed among students who participated in the four-session workshop, thereby demonstrating the benefits of an ongoing process.
Gina, Message from single-session: "I met myself without any masks or 'shows'… I felt a lot of love surrounding me…and peace…information arrived which I hadn't thought of before: 'Your inner center is your heart and it needs love, focus more on it and less on your rationality. Good things happen to people who are willing to accept them.'" Insight: "That made it clear to me that I'm walking the wrong path for my self fulfillment. I'm no longer sure about the professional choice I made. I need to be more attuned to other aspects of myself and my abilities." Here, Gina is becoming aware of the possibility that the choice to become a social worker was influenced by an external rather then her inner voice.
Jane, Message from session 2: "I met an older man, I don't know him, he is telling me I should be working with youth… this would make my father very proud of me." Insight: "Am I really connected to my authentic self? What is happening to me vis-à-vis my father? Why is it so important to me to please him?" Here Jane identifies a false "guiding" inner voice by realizing that the image she saw simply reflected the way in which her relationship with her father influences her choices.
Laura, Message from session 2: "I met the reflection of myself, there was a flow of energy between the two figures… Everything is in me; my love allows me to contain myself and to communicate with others." Insight: "I recognize that I have special needs when it comes to giving and taking in intimate relationships--will I know how to set boundaries between myself and clients?" Message from session 3: "I was trying to feed myself a special fruit… as soon as I started eating, the image vanished and I was left with disturbing thoughts." Insight: The part in me that needs nourishment is my independent part… I still need a lot of external love to fulfill me… and I need to get over this in order to treat others." Laura was able to make two observations: One has to do with patterns of emotional exchange in the context of close relationships, and the other involves the need to become more emotionally self-sufficient. Both reflect on her future work with clients.
"I compare myself to others too much; actually, I'm the one who is responsible for my life." "My strong needs for control detach me from my spirituality." "I didn't really let myself deal with my brother's death until now and it has affected my life." "I'm strongly motivated by a force that's pushing me ahead, which clashes with my desire to slow down and relax. If I don't find a way to connect with myself, I'll collapse just like last week."
Yael is a married, female, social work student who is currently enrolled in field work. She reacted very strongly to the first meditation session, by prolonged uncontrolled crying which she later explained as connected to her mother's image "forcing" itself on her. Her report included feeling "heaviness on my shoulders, pressure on my head, I had no control over my legs, I wanted to run away; I think it's dangerous for me to be with myself." In a private discussion, she expressed great distress regarding her relationship with her mother and was interested in checking whether meditation could help. She felt it was blocking her professional development. The continued work with Yael was done separately so as to allow her more privacy. Also, keeping in mind Yael's need for control and the gender of the facilitator being feminine, it was decided to let Yael set a goal before each meditation. This was done in order to minimize possible transferential reactions that might have interfered with the meditation. Based on the complicated background she presented, we decided to add daily meditative homework followed by journal writing. A few self affirmations were mutually selected focusing on Yael's desirable relationships with her immediate family members for her daily meditations. In addition she was asked to write her mother a daily "letter" in her journal expressing her real thoughts and feelings. There was no mention at any point of the social work profession.
Background: Yael's mother left her family when Yael was 13 years old, and immigrated to a different country with her lover, leaving Yael with a depressed father and a younger brother. With no family around to help, Yael assumed the mother role for many years. Mother and daughter exchange short, casual letters several times a year, but haven't met since the mother left. Yael expressed great anger and resentment towards her mother, in contrast to love and longing for her father. She remembered having sexual fantasies toward him, as a child. Surprisingly enough, despite the distance in time and space, she experienced her mother's image as overly present in her life. She described how she kept herself constantly busy so as to prevent her mother from intruding upon her thoughts ("I can't let go of my defenses…I feel like I'm running away from myself, denying that I need a mother"). Based on her group experience, a repeated session of connecting to inner guidance was conducted. The sessions were analyzed so as to highlight the sequence of observation, retrieved from Yael at the end of each meditation, together with the initial goal delineated, and the intuitive insights she developed.
Session 1 Observation and Goal: To re-establishing contact with guidance. "I felt heaviness on my shoulders, pressure on my head…I sensed some presence near me…lots of light and energy of love, I could feel it in my body, I knew I wasn't alone." Insight: "I don't need to cry any more, I feel less alone and more protected."
Session 2 Goal: To gain emotional balance by distancing from mother's image, and to stop feeling guilty. Yael decides to invite her mother, in this meditation, to an internal meeting in a safe place with her inner guidance.
Observation: "Heavy, pressure on my head… Am I running away from the topic?... mother is here, looking simple, she is quiet…she is behind bars, I have a lot to say about all these years, she is only listening…I feel my guidance is holding my hand, strong energy from him, I'm getting stronger…I can handle her without crying, I have control." Insight: "I'm very complicated with myself but it's more bearable… If I give up on my anger, I'll need something else to feel instead… I can forgive her for the damage… There is joy in me, more strength."
Session 3 Goal: "I’m bothered by my relationship with Susan (Yael's teacher of intervention course). "Nothing is arriving from her, I expect a more intimate attitude, more attention… others get it from her, I feel unsafe in class, I have to compete, I would like to gain confidence, face Susan so she can see me." Observation: "It's hard to express needs of the 'self'… I was told I don't deserve to be heard…I was taught to focus on the needs of others." Insight: "My current lesson is to be in a situation of 'providing service' (social work), and to learn how to negotiate boundaries between giving and taking." "I need to mature some parts of myself; does the way to Susan go through mother?"
Session 4: Yael appears distorted and fearful: "Mother is intruding into my work with clients… Every time I see my elderly client (a woman), I can't stop thinking of her… I'm having trouble with my process recording notes, I can't express any feelings there… If I'm not interested in her (mother), why don't I let her go?"
Goal: Get advice from inner guidance. Observation: "I see myself at age 13" (when mother left home)… Stop crying and start working, the road is only blocked in your own imagination, the limitations are yours, you are knocking on an empty door." Insight: "Why am I interrupting myself?" "I chose a new way but I’m afraid of the responsibility, and of self-fulfillment." "The painful past determines my present and might get into my future as well." "I'm used to explaining difficulties in terms of the relationship with mother, separating from her means separating from this defense as well." "I'll have to explain success or failure in terms of my 'self'."
Yael's developing self-awareness clearly demonstrates her struggle for her own authentic voice: Initially her mother's voice felt stronger, intruding to the point where she dared not be by herself. As she started de-fusing the two voices, a 'transitional space' was created. Within it she was able to identify her mother's voice as external and became acquainted with her inner guidance and inner voice. This process led to her experiencing her 'self' as more distinct. She seemed to have made a shift in focus from private to professional aspects of the 'self' after the third meditation when she chose to focus on her relationships with her teacher and classmates. At that point, Yael became concerned with what she can get from Susan, the need to be heard, her ability to set boundaries with clients and be authentic in supervision. In a concluding session, five weeks later, Yael reported feeling she is in the midst of a process. Her self-awareness grew tremendously, as a result: "I started distinguishing my self emotionally from my mother." "It's a long way to go" "…I learned to mind me and my needs instead of turning to anger…" "My harsh feelings towards my mother allowed me not to look at my self…" "I'm open now to new options at work and got involved in something that used to scare me." "When I see my elderly client, I don't see my mother anymore..." "The ending academic year symbolizes a big step in my professional life. I took a decision to continue and develop without fear; I have help inside me to assist me."
We have presented data and described a method which seems to have potential for helping social work students become attuned to internal processes that they undergo during their professional development. The main goal of this project was to observe how the 'self' behaves in short and long term meditations seeking inner guidance. The purpose was to try and see how meditation might be developed as a training tool in academia. Therefore, unlike most quantitative projects, we did not define specific hypotheses needing to be confirmed. The following concepts are the result of our own observation based on hours of mutual meditations, individual and group discussions, and analyzed written material.
Mindfulness meditation and attention to inner wisdom seem to have allowed students to become aware of new information regarding personal or professional issues and choices, in a way that is basically self–directive. The connections between new knowledge and self-perception were intuitively formed after or between meditations. The transitions in perception were very much subjective, meaning that the link between a message ("I use the love in me to communicate with others") and the insight that followed ("I need external love…need to set boundaries between myself and clients") didn't always follow logically for others. That can explain the lack of equivalence between the themes of messages and those of the insights. Some transitions simply took longer. Yael's new self-perception occurred after shifting from feeling that it's "dangerous to be alone" in the first session, to "my lesson is to provide service and negotiate boundaries between giving and taking", in the fourth session. It's exactly those transitions that may open up new psychological or professional opportunities. The space created after releasing a "stuck" issue can explain why insights regarding professional matters tended, in general, to surface later on in the process of meditation.
A question often asked in meditations is: Who is the observer? —Thus implying that the main goal is self-understanding. The workshop was designed to invite students to freely explore their 'self'; however two components distinguish it from individual meditation. One is its semi-structured nature and the second is the presence of a facilitator. These factors may activate individual emotional reactions to issues such as dependency versus autonomy, and 'self' versus parental authority figure, both known to interplay in supervisory relationships (Watkins, 1992). Dependency on the facilitator was demonstrated by a student who was wondering whether she would be able to communicate with her inner guidance by herself: "I need you to be the one who asks the questions for me: If you don't tell me what to ask, it won't happen." Strong need for independence was demonstrated by a student who said: "When you said to look for a tree I wandered to the beach, I didn't listen to your instructions, I made my own journey." Dependence and autonomy issues are often linked to the process of separation-individuation (Mahler, Pine & Bergman, 1975). The question posed in the meditation was: "What is important for me to know about myself at this point in my life?" Yael's self-journey clearly shows how the conflictual mother-daughter relationship immediately surfaced in meditation, reflecting its importance as her most burning issue. Later she was able to connect between this unresolved conflict and professional relationships relevant to her at that point, with her teacher and client.
The level of openness to new knowledge depends greatly upon the level in which the individual is used to defend his 'self', showing again that self observation is always a choice. "I kicked away every image that came to me, and only thought of familiar places I've been to before"; "I completely detached myself from the meditation"; "Meditation interrupts me, it makes me think of things…I do not see any connection to my 'self'."
We observed an interesting gap between student's general external experiences in school or field and their internal experiences in meditation. In our experience, first year students are mainly concerned with their "right choice of profession" and whether they are "going to make it through." Second year students seem to be occupied with starting field work and establishing relationship with their supervisor, while graduating students are worried about their level of professionalism and having to compete in the work market. In their written and oral reports, most students at all levels experienced or got messages of reassurance, support, acceptance and love. Even those who began to question their choices didn't report feeling anxious about it; rather, they seem able to deal with it with acceptance.
It is important to note, that because of the effects of meditation on repressed memories and the resulting psychological impact, this technique may not be suitable for everyone. Hence, it is necessary in our view that the facilitator be well-trained in guided meditation and well-connected to his own inner wisdom. Familiarity with spiritual guidance may come in handy in cases of unexpected or difficult reactions. Beyond a voluntary participation, the facilitator should observe closely, during and after the meditation, for extraordinary physical, verbal or written responses, and appropriately support the participant. People with high control needs may feel frustrated at not being able to "let go" and experience themselves differently, and may therefore need extra help. People who declare that "nothing happened" may need assistance in realizing there could be a message for them behind what they are able or unable to experience in meditation.
Finally, we feel our students were exposed to a new and challenging possibility of getting to know their 'selves' as well as their guiding parts. Both can be critical in shaping their professional journey.
Guided meditation and connecting to inner wisdom may be powerful training techniques. Integrating spirituality into social work is often the outcome of an individual enterprise and it should not be that way. Based on students' reactions to this topic in general and to the workshop in particular, it is our feeling that time and space should be given in class to address people’s spiritual needs. This particular workshop was offered to first year students as part of their "basic skills workshop" as a means of developing self-awareness. Second and third year students, enrolled in field work, experienced it as part of their clinical intervention course while the purpose was to present them with a unique way of self-consultation. Further investigation is required to increase our understanding of the nature of guiding images and level of receptiveness to them, demonstrated by students of diverse levels of training. Exploring patterns or stages in the development of the relationship with a spiritual guide in different phases of training is another area for further study. Integrating spirituality into students' training is like helping to bring up an internal trainer: we have often discovered that the trainer was already there, and permission simply had to be given.
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Liora Birnbaum, Ph.D. can be contacted via e-mail at: