Let Us Practice with Mindfulness and Integrity

Keynote Address of Ma. Lourdes A. Carandang, Ph.D.

48th Annual Convention Psychological Association of the Philippines

August 17, 2011, Iloilo Grand Hotel

Good morning. I stand before you this morning on a joyful and triumphant note. Today, on the first day of our 48th Annual Convention, we are celebrating a milestone in the history of the practice of psychology in the Philippines.

The Psychology Bill which was first drafted in 1981-82 was finally signed into law in March 2010 (after 30 years). It is now known as Republic Act No. 10029. There are good reasons why it took so long but they will be explained by the next panel of speakers.

The Statement of Policy of RA 10029 reads: “The state recognizes that psychologists have an important role in nation-building and development.” It reads further: “In particular, it recognizes the significance of psychological services that practicing psychologists provide to diverse types of clients, but also recognizes the need to protect the public by preventing inexperienced or untrained individuals from offering psychological services. Hence it shall nurture competent, upright and assiduous psychologists whose standards of practice and service shall be excellent and globally competitive…through…licensure examinations, programs and activities that enhance their professional growth and well-being.”

To understand and underscore the significance of this Act, let us turn to a little bit of history: In 1981 (1982), when the alarm bell was sounded by Fr. Jaime Bulatao, I was the President of the PAP. I remember that it was during our Annual Convention at Philamlife Auditorium (which we got for free), Fr. Bu approached me with urgency because he heard that the psychiatrists drafted a bill that would prevent us psychologists from practicing psychotherapy of any kind.

To appreciate this better, let us go farther back and here let me share my history with PAP. I have been part of PAP since 1964, when it was still in its infancy. It started in 1962. I was then a senior AB Psychology student in UP. We grew up together and our histories are tied up. So I think this can also give us a glimpse of the struggles in the practice of clinical psychology in the Philippines.

As an undergrad, I read a paper during the Annual Convention in NSDB in Padre Faura. I was an RA (research assistant) of the renowned Clinical Psychologist Researcher, Dr. Lee Sechrest, who did pioneering work in unobtrusive measures. The paper was later published in the 1968 Journal of Social Psychology by Sechrest, Flores, Arellano (my maiden name) entitled “Social Interests in a Bilingual Culture.” I think Dr. sechrest asked me to read the paper instead of the second author, Luis Flores, Jr because he wanted to add a touch of glamour or ‘freshness’ to the otherwise very serious research atmosphere. I say that because I was the only undergrad, I was wearing a short (mini) sleeveless white dress and high heels, long hair, as I bravely faced the small but intimidating audience.

Upon graduating from UP in 1964, my beloved mentor, the late Dr. Alfredo V. Lagmay, then chair of the UP Psychology Department offered me to teach in the department with a possible Fulbright Scholarship (Dr. Lagmay is one of the founding fathers of PAP). But I met another founding father, Fr. Jaime Bulatao. Fr. Bu invited or rather enticed me to enroll in the MA Clinical Psychology program of Ateneo. My heart was really in clinical psychology so I enrolled in 1964 and finished my MA in 1969. While pursuing my MA, Fr. Bu got me a job in a bank near Ateneo in Padre Faura so I could walk to my classes. I also worked as an RA in IPC (Institute of Philippine Culture) for visiting professors doing research in the Philippines. My practicum was a one-year course, that was required in the MA curriculum then (where I was the only student). It consisted of doing psychological assessment, diagnosis using the Rorschach and other projectives on the patients in the Psychiatry Ward of PGH. On Mondays, I would present my psychological report and diagnosis during the psychiatry conference or grand rounds with the eminent late psychiatrist, Dr. Balthazar Reyes, Dr. Lourdes Lapuz (the mother of Psychiatry) and psychiatry students, interns and residents. My mentor was the Rorschach expert, Mrs. Concepcion Diy. After that, the PGH Psychiatry Department was able to acquire an item for a psychologist through the UP Board of Regents and I had a real job. But even so, the scope of my work was limited to assessment and psychodiagnostics.

Shortly after, my husband got accepted as a Neurology Fellow in Harvard and UC Davis. Since Harvard’s stipend was not enough to support me and our two kids, he opted for the University of California. I can’t forget what Dra. Lourdes Lapuz said when I told her I was leaving for the US to join my husband. She said, “Why are you leaving just to be with your husband? You have a very good practice here. Where’s your identity?” I said, “I’d rather lose my practice than lose my husband.” So off we went to California.

But not to forget, before I left in 1973, I became a member of the PAP Board, and was made Board Secretary. At that time, I was the only non-PhD member of the Board. But the MA then was a terminal degree. We didn’t yet have a PhD Program in Clinical Psychology in the Philippines.

To cut the story short, I got accepted into the Clinical Psychology Program of UC Davis and trained in Child and Family Therapy with a two-year internship. I enrolled in 1973 and finished in 1977. Before I could get off the plane, I was assigned to teach four courses in the Ateneo Psychology Department as a full-time Assistant Professor. Then I, Fr. Bu, and Dr. Tatti Licuanan started the PhD programs in Clinical and Social Psychology at the Ateneo de Manila University.

The struggle for clinical psychology practice began. Fr. Bu and I would attend conventions and speak up. Two incidents illustrate this struggle. I attended a PPA Convention where a case of a child with encopresis was presented. The moderator kept asking, “Are there any psychiatrists in the audience?” At about the third time he asked, I stood up and said, “I am not a psychiatrist. I am a clinical psychologist, and from my experience doing therapy with encopratic children, I find that the family dynamics plays a big part.”

Another occasion was with another psychiatrist convention where the discussion led to the practice of family therapy. They were saying that family therapy was not applicable to Filipinos because we don’t talk to each other. I argued that perhaps that is also the reason why we need it, and maybe it’s not practiced because we don’t have enough trained family therapists. In the meantime, Fr. Bu was accepting so many clients/patients and he was already talking about “dwendes”, hypnotherapy and altered states of consciousness in his clinical practice. There were many instances where we had to assert our competence and training in therapy as well as psychological diagnostics.

So, we see why the need for drafting a Psychology Bill was important to our profession in 1981.

It was also our way of declaring our competencies. My Presidential Address then was about how we must define our own identity and not wait for others to prescribe or determine it for us. How the Psychology Bill became RA 10092 will be the topic of Dr. Allan Bernardo and the other speakers in the next panel.

As the profession developed, the PAP Convention tackled many different themes in the 80s and the 90s. Some themes stood out. One was the theme of RELEVANCE. We asked: “Is Psychology being relevant to life, to the country’s concerns? How come we were not consulted in vital issues like education, family relationships, human relations, parenting, etc.”

Another main theme was Indigenous Psychology, the use of western concepts and research methods and the need to have our own concepts and methods.

So it took a while for us to focus on the PRACTICE.

One major and very significant step that has focused on our practice is the accreditation or certification of psychologists of different areas by the PAP. It’s really the PAP, the recognized national organization of psychologists that should accredit psychologists and set our own standards. Now, we have the law, RA 100921, which tasks us to form a Psychology Board for licensing psychology in practice. The way I see it, the PAP certification and the licensing complement each other. It is similar to the medical licensure. The law grants license to the general practitioner while the specialty organization accredit themselves. The Psychology Law RA 10029 licenses the psychologist and the PAP accredits the specialists (like a diplomate in medicine – Assessment, Clinical, Counseling, Developmental, Educational, Industrial-Organizational, Social, Teaching.

Now we got it. As they say, “Psychology has arrived.” We can see how much we have grown as a discipline and as a profession by taking a look at the convention program, the wide variety and range of papers starting today, we can appreciate how rich and diverse we have become. For example, we have a symposium on the Journey of the Clinical Psychologists as Clinicians, Researchers and Advocates, OFW families, the practice of Music and Expressive Arts Therapy, working with survivors of disasters like the Ondoy, on coping and resilience, Autism, sexual abuse, on social identity, leadership, social representation of Philippine government, symposium on the use of advanced quantitative methods in the development of psychological scales, on Filipino positive youth development, on studies on learning, education, work, well-being, the Adversity Quotient, on parenting, child development and family relationships, on group practice, on helping co-dependent families, on social curiosity, lamig ng ulo, on the Filipino personality, on the learner, achievement, unusual trends in Industrial/Organizational Psychology, on Play Therapy and the Filipino Play Therapist, psychological disorders, on values, spirituality, resilience in disaster, on LGBT psychology, stress reduction, sports psychology, burnout and compassion fatigue, the gifted, Positive Filipino Psychology, etc., etc. Name it, we have it. That’s how far we have gone in our discipline and in the practice of our profession.

So… we have made it up to here and now we have the law and we just need to do the next step towards its implementation. What now?

Today, we must not only celebrate, but we must pause, think, reflect: how do we nurture our practice and how do we nurture ourselves as practitioners?

Now more than ever before, we need to practice with MINDFULNESS and INTEGRITY.

MINDFULNESS: To practice with mindfulness means TO PAY ATTENTION. To pay total and careful attention to what we are doing here and now. To look at what we are doing, why and how we are doing it. In Psychotherapy, it is to practice with our TRUE PRESENCE and DEEP LISTENING (Dr. Thomas Bien, Mindful Therapy, 2006). To observe what we are doing, to make sense of it, to ask questions, to formulate concepts and theories from actual experience. To test these concepts and theories in practice, to do further research on these concepts and feed them back into our practice, then to go into further research in a productive cycle. One example of concept coming out of practice is the TAGASALO (the western translations “co-dependent,” “caretaker,” “rescuer” do not quite capture its meaning and dynamics in the Filipino family) topic of MA theses and dissertations. Another is “Pakikipagkapwa-tao” which has its own nuance. In research, letting the data speak for itself by paying attention to ALL the data in front of you, not rejecting what does not fit into your preconceived concept. Knowing that, we, our own person, affect the data we get whenever we interview people. It also means to self-observe, a skill necessary for mindful practice. How am I feeling while I’m listening to this person? What is happening inside me? To be aware and to be honest to one’s self, to be authentic. Dr. Thomas Bien (2006): “Mindfulness, indeed, helps me integrate my experiences, and helps me to be at home wherever I am. It helps me both to find healing for myself, to offer healing to others.” This leads to the other core value in practice which is INTEGRITY.

INTEGRITY: In training psychologists, we not only teach or model skills and competencies, but also and most important of all, we look into the PERSON of the psychologist, especially the clinical psychologist. But this holds true for all areas of psychology and of other disciplines like medicine. We know of medical doctors who have all the skills, are extremely competent but do not have compassion, do not connect with their patients. They do not thrive in our Filipino culture where the person interacts and relationship is a very important factor in a successful practice and healing process. A person with integrity is not just honest. She is whole, solid. She has solid moral anchor inside that cannot be swayed bypower, etc. For example, she can be with corrupt people, but she will not be corrupted. She can be who she is, whoever she is with, wherever she is.

If we look at what’s happening in our country now, we may lament the fact that there is a loss of core values of respect and integrity. The MAP put it so well . A few months ago, when I was a panelist in the forum entitled, “Living Virtuously in the 21st Century: Do we see the loss of values and ethics? Mapping a culture of integrity.” We cannot deny that corruption is a serious and rampant virus that has infected all levels of society and all the institutions of our society during the past 9 years of the past administration where lying has become normal, a way of life; where truth-telling is dangerous to one’s life; where respect and dignity are the most violated core values. Now, we are uncovering the lies, finding the truth, that’s why to live and practice with integrity is so important in these critical times. We, psychologists can now lead the way towards MAPPING A CULTURE OF INTEGRITY. For example, let us not be pressured by influential people to favor them on the cases we handle. Let us give high quality service equally to bank president or the senator and to the poor man from the province. We stand by what our tests and data show as scientist-practitioner. Let us not be pressured to favor the influential.

Let us review our Code of Ethics (the topic will be discussed in the next panel). But just to note that in our Code of Ethics, we have Principle I: Respect for the Dignity of Persons and People. It states, “Respect for the dignity of persons is the most fundamental and universally found ethical principle across geographical-cultural boundaries and across disciplines.” Principle II: Competent Caring for the Well-being of Persons and People. “Competent caring for the well-being of persons and peoples working for their benefit and above all, doing no harm. Principle III: Integrity. It says, “Integrity is vital to the advancement of scientific knowledge and to the maintenance of public confidence in the discipline of psychology. Integrity is based on honesty, and on truthful, open and accurate communication…” It is vital to the life of our discipline, it is vital to our lives as persons. It is vital to the life of our nation today. As psychologists whose subject matter of study is human beings or persons, let us lead the way towards a culture of integrity. We now have all the tools and competencies, the legal support to practice our profession. Let us first of all be PERSONS who have a deep respect for ourselves and for all persons. And as psychologists, let us always practice with mindfulness and integrity.

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