Category: Articles

Articles on the profession of counselling & psychotherapy.

Categories
Couple Relationships FAQ

On Bringing Couple Counselling to a Close

Couple Relationship Counselling is about working in therapy with conflicts in a couple’s relationship.  The couple can be married, in a civil-partnership, being romantically involved or just simply colleagues who have a relationship (business or personal) that has developed conflicts (read more…).

Closing States of Couple Counselling.

There are two states for the end of couple counselling: resolved and unresolved.

Resolved: when the initial conflicts – plus conflicts that appeared during the course of couple counselling – have been worked through to the couple’s satisfaction. Satisfaction may mean: enough so that the couple can work on the issues themselves without further therapeutic intervention.

Unresolved: when the initial conflicts – or conflicts that appeared during the course of couple counselling – have only been partially worked  through & the couple are still distressed at – or helpless from – the conflicts.

Both of these states can be worked with during an ending to couple counselling. Although resolved might appear to be a better state, it depends upon what the couple want as it’s their relationship (and always has been even with therapeutic intervention).

When a couple decide to end counselling, working toward an ending is an appropriate choice (rather than simply stopping counselling without notice).

Topics for Closing Sessions.

In the final sessions it can be helpful to discuss the following:

  • What matters presented at the assessment for couple counselling (read more…).
  • What matters came up during the couple counselling?
  • What matters do both partners agree that we have worked through?
  • What matters do partners disagree on.
  • What matters are left outstanding (any “unfinished business”) – for both partners together, or for each individual partner?
  • What might the couple wish to do about the unfinished business?
  • What has been gained from the counselling process … and what is being lost as it ends.

A purpose of such a review is so that couples counselling can end with the work being reviewed openly.  Both partners can leave therapy knowing what is agreed as being resolved, and what matters are left unresolved.  Knowing what work is left to do means the couple can consciously continue to work on further matters in their own time and their own way.

Number of Sessions.

The number of sessions to bring couple counselling to a close will be decided in a discussion with the couple.  It’s preferable that an ending to counselling is brought about once the presenting issues have been worked through – so the ending is a case of how many sessions would be required to discuss sufficiently the closing sessions topics.

This, plus any outstanding matters the couple wish to talk about.

Ending Counselling without Final Sessions.

Leaving counselling without such an ending as discussed above can be unhelpful to the couple’s relationship.  Unresolved conflicts can continue in the relationship – assuming that the relationship continues.

Sometimes the couple decide they wish to separate and they leave the relationship (couple counselling can also be used to help a couple to separate) and when the couple no longer maintains the relationship, the counsellor’s “client” (the relationship) can no longer be brought to counselling.  Other types of endings can then be discussed.

So, working towards an ending in couple counselling are an important part of the counselling process.  whether the couple involve the counsellor in the ending or not.

Categories
Couple Relationships

Counselling for Couples after an HIV Diagnosis

Counselling following an HIV Diagnosis.

If you are in a relationship – regardless of either of your sexualities – and you are having relationship problems after an HIV test gave a positive result then contact Dean Richardson today to arranging a no-obligation initial session to see if couples counselling could be helpful for both of you.

It has not been unusual for a couple – gay, lesbian or straight – to come to see Dean Richardson for private couples counselling after one (or both) have been diagnosed as HIV-positive.

  • Sometimes the couple counselling is about dealing with the shock of receiving a positive diagnosis.
  • Sometimes the counselling is about dealing with trust issues raised by one partner being diagnosed.
  • Sometimes the diagnosis is cathartic in releasing other matters that have been delayed – but now need someone to help the couple discuss.

Whatever the core reasons of seeking couples counselling, Dean is a qualified and experienced couples counsellor who works with couples that have received a positive HIV diagnosis (amongst many other couple relationship reasons for counselling).  His couples counselling service in Portsmouth can help a couple negotiate their way through difficult problems resulting from HIV diagnoses.

The GU clinic may give you and your partner support after an HIV positive diagnosis, but longer term therapy is available privately through meeting with Dean.

Arranging a Couple Counselling appointment.

You don’t need to be referred to Dean via your local GUM clinic, nor your doctor, you can make your own appointment directly. Initiating private counselling is totally up to you both and can be arranged very quickly. 

Dean is a systemic and psychodynamic qualified couples counsellor that is ideal for assisting a couple in finding their own newly inspired solutions to their own relationship conflicts. Dean’s couple counselling is a confidential service that can compliment the medical treatment that you will continue to receive through your GUM clinic and/or your doctor.

Categories
Couple Relationships LGBT

Mixed-Orientation/Sexuality Relationship Counselling

STOP PRESS: Dedicated Website for Counselling for LGBT/QIA+ Couples.

Relationship Counselling for Mixed Sexual-Orientation Couples.

Couples who are in an intimate, mixed-sexuality relationship or an intimate mixed gender-orientation marriage can experience relationship problems in just the same way as any other couple relationship.

Whist any trained & qualified couples counsellor could be able to work with your relationship,  sometimes mixed-orientation couples choose to work with a systemic couples relationship therapist who specialises in working with mixed-orientation couples.

In Hampshire, and on Skype, that therapist is Dean Richardson.

What is a mixed-sexuality / mixed-orientation relationship?

Not all intimate couple relationships have be composed of people of the same sexuality.  Mixed-sexuality relationships are when both partners identify with a different sexuality to their partner; for example a gay man and a straight woman.

Whilst such relationships work perfectly fine without therapeutic intervention, they can also develop conflicts that are particular to this type of relationships.  As an example, whilst sex does not have to be the centre of an intimate relationship, when sexual intimacy becomes a problem, mixed-sexuality couples may require a special kind of support in helping the couple to find  their own solutions to such difficult problems.

Dean Richardson – Mixed-Orientation Couple Counsellor.

Dean Richardson is a fully qualified and experienced couple relationship therapist.  He specialises in working with LGBT couples and couple relationships of mixed-sexualities and mixed-orientations.  He doesn’t impose traditional values on relationships that are incomparable with heteronormative standards.

Working with Dean means the mixed-sexuality/mixed-gender-identified couple can continue to feel proud of their relationship. They can regard their relationship problems as an interesting obstacle to be worked with curiosity & inspiration – a healthy approach through systemic couples counselling.

You, your partner and Dean will work with the relationship style that you bring to counselling, and we’ll work with resolving the problems that you bring too.

How to begin Couple Counselling.

Long Distance Counselling.

Couples who are separated by distance – or away from Dean’s Portsmouth practice – but who still want couple counselling – may find Dean Richardson’s Skype Couple Counselling Service useful (read more…)

1) Pick a date/time from Dean’s availability.  You and your partner will be attending together – and if you and Dean agree that couple counselling is a suitable form of treatment for you, you will both be attending with your partner for each week’s session.

2) Contact Dean to arrange an assessment for couple counselling – or to discuss with Dean your questions or concerns for couple counselling.

Couples counselling for mixed-orientation couples can be a helpful resource to a couple who are struggling with problems that seem unique and insurmountable.  Choose Dean Richardson to help you attend to your unique relationship … together.

Categories
Christmas

‘Tis the Season of Projective Identification – Fa la lah!

A brief hypothesis on the painful loneliness experienced by some as a hypothetical result of projective identification from others.

‘Tis the season to be jolly.

Fa la la la lah, la lah, lah, lah.

As I said a pre-Christmas farewell to a colleague last week, he referred to this period as the ‘nonsense’ season.  It got me thinking: if this holiday season could be nonsense … to whom might this period make no sense?

Opting-out of Christmas.

“How do we opt out of Christmas gifting w/o being Scrooges?”
Jenney – Savings Advice Forum.

For many people, the approach of the season switches on certain automatic behaviour.  Behaviour coming from certain assumptions and certain expectations:

  • We must prepare to buy gifts for people.
  • We must buy the right sort of food.
  • We must write and sends greetings cards to people.
  • We must begin deciding with whom we will spend days like Christmas and New Year’s Eve.
  • We must remember people whom we’ve barely given a thought to during the year.

Notwithstanding this list comes from this author’s keyboard, there’s an interesting lot of ‘must’ in the list.

For most, preparation for the seasonal behaviour can be stressful and it’s a chore.  For some, this behaviour is natural and pleasant. For some, this behaviour (whether acted out by themselves, or observed in others) it is a painful reminder that there are few-or-no reasons to participate in this seasonal ‘must’ behaviour.

For those who are without families – whether biological or extended – or few or no friends, the holiday season becomes nonsensical. How easily it seems one can be forgotten whilst it seems everyone is running around preparing for a jolly season. Those not participating in the season can, perhaps, emulate the jolly behaviour of buying gifts for people, yet one may also be carrying a heavy heart suspecting that what few social contacts they have will disappear during the holiday season as people venture off towards their families-of-original loaded with tokens of ‘musts’.  One can emulate the behaviour or buying the right food for Christmas day, yet one knows that the food won’t be shared with anyone.  One can decided with whom they will spend holiday days, but it’s likely that friends and and those who are reasonably close will have already decided to attend family events – leaving others who are not family behind.

Rather than simply being ‘nonsense’ for some people, I’d offer that this seasonal period can be an extremely painful reminder of the solitude that some tolerate.  Solitude that is tolerated – even embraced – with pleasure during the counterpart of the year, but a solitude that borders on becoming unbearable loneliness during this  holiday season.

Year-Round Solitude versus Seasonal Loneliness.

“You’d like some other bears!”
Dr. Gina Toll – ‘In Treatment‘

A human being is a social being – he needs to not be alone.  So, how can it be that solitude (the state of being on one’s own) does not feel lonely (sad at having no friends/company)?

From an object-relations perspective (Wikipedia), our psyche grows in relation to our position with respect to others, and our experiences of them.  Good and bad experiences of significant people from our lives (parents, siblings, teachers, lovers etc), are stored within the psyche as mini-templates: in theory, they become ‘internalised’ objects.

One’s good & caring mother stored away in the ‘loving mum object’ gives some of us the sense that we are cared for, even when mum has passed away a long time ago. 

Conversely, those of us who were given the experience that we were not cared for, could be stored away in the ‘persecutor object’, remaining a reminder that as a human being we are someone who others will not care for.

I’d offer the thought that internalised objects can be a factor in how one approaches being on one’s own.  The word “solitude” is used to describe a choice – that in being without company one feels good.  Loneliness is used to describe no-choice – that in being without company one feels bad.  Solitude is pleasant because one does not sense being alone when accompanied by supporting internalised ‘good’ (or good-enough) objects, whereas perhaps loneliness is the lack of good objects/the presence of bad ones.

Object Relationships & Seasonal Nonsense.

“the self, exists only in relation to other ‘objects,’ which may be external or internal.”
New World Encyclopedia – Entry: Melanie Klein

It makes me wonder how in our society the change in social behaviour (eg the approach to Christmas) effects the meta-structure of the psyche’s internalised objects of participants, observers and affectees.

If, during the year, one can tolerate one’s place in social relationships (e.g. occasional social-meetings with friends, but primarily spending time on one’s own) there would appear to be something in the shift of social behaviour (“we must now prepare for Christmas”) that shifts the meta-organisation of the internalised objects for some (“I am in solitude” shifting to “I am lonely”).

Containment of ‘the loneliness’.

“projective identification may unconsciously aim to get rid of unmanageable feelings but it also serves to get help with feelings”
Patrick Casement – Further Learning From the Patient (cited in Wikipedia Article)

It would be my hypothesis that those who are capable of tolerating, even enjoying, being on one’s own become those who, hypothetically, are capable of holding the fear of loneliness that rest of society must split-off and discharge in order to participate in Christmas.

It’s not uncommon to read Twitter and Facebook posts that many people complain of the commercialisation of the season.  Minor, barely-heard protests from some people about feeling caught-up helpless in the season.  I’d offer that in order to participate in this season – that one must not be alone during this holiday period – that wish for non-compliance must be temporarily blanketed.

From the works of Melanie Klein, and later Wilfred Bion, we have come to understand that the mechanism of ‘projective identification‘ (Wikipedia) intolerable pain within the infant is, unconsciously, sent out to another person ( a care-giver ) who will contain the projection, maybe process it into something more tolerable, and hold it until the infant psyche is able to take it back later.

This meta-process allows something that is very painful – or in conflict with other mental demands –  to be sent away from the psyche that cannot manage it for now, placed into a psyche that can manage it better for the period.

This process is made use of in most psychotherapies (psychoanalytical, psychiatry, psychodynamic counselling) where the therapist may become aware of ‘containing’ or ‘receiving’ something on the patient’s behalf.

A patient revealed some news that the therapist believed he was meant to find worthy of congratulations; whilst the patient sounded excited about the news the therapist, instead, felt huge waves of rage that he was not able to associate with the apparent glad-tidings.  The therapist pondered that he may have been ‘containing’ something split-off that the client could not manage; could not manage at the same time of holding onto the thought that this news was good. 

Notwithstanding other explanations (such as the therapist’s own personal constructs: possible jealousy about the news), the therapist used this experience to inform his questions: gently wondering out loud with the patient about the news and its implications.  What later appeared in the work was the patient’s terrible fear about the responsibilities this news would require of him; that the patient was terrified of the implications and responded to his fear in a very angry manner.

Hypothetically, therapist had experienced the patient’s split-off and unconsciously communicated rage.  The therapist had found himself in a state of conflict:  being expected to reply ‘congratulations’ but filled with something quite opposite.  The patient – without the rage – was able to participate in a normal celebratory appearance whilst delivery the news. The therapist appeared to have been left holding the unacceptable part until the patient was able to take it back.

During this time of the year for Christian-based societies, people either have to participate in the ‘jolly season’, or be able to tolerate the shadow-side of not-taking-part. Those who do not follow the masses have to have huge courage to go it another way.

After all, we still refer to ‘Scrooge’ as a warning to all who do not participate in this meant-to-be-jolly time.

A Seasonal Hypothesis.

  • The holiday season approaches and folk are filled with ambivalence: good times ahead / bad times ahead.

  • To be participating in this holiday season, the psyche may need to split-off the more ‘horror’ parts that would interfere too much taking part in Christmas.  The need to be away from the celebrations (to be on one’s own) are split-off.

  • Via projective-identification, others who are more capable of tolerating ‘be on one’s own’ can hold the ‘horror’ during the season. 

  • Result: a part of society is able to participate in seasonally-expected behaviours, is able to cast off the parts of one that would wish to recognise the nonsense of the period for what it really might be (commercial etc), and others in society who are, perhaps, more used to the pain of non-participation will contain the seasonal-pain until the holiday season dies away for another year.

In Closing.

This is not a jolly hypothesis.

But it is intended intended to offer a thought – perhaps a rescuing thought – to those who are subject to massive-yet-unexplained changes in their feelings during such holidays seasons as Christmas (and as it’s author, I’m aware that this brief essay turns a blind eye to other hypotheses in order to focus on this one).

Perhaps, whilst you are enjoying your holiday season and a moment of ‘Oh I wish I wasn’t here…’ creeps into your thoughts, maybe that might be your Jiminy Cricket moment.  Perhaps someone might enjoy a thought or a message sent their way.  After all, someone may be suffering extra painful loneliness, tolerating in order for you to be able to participate in what you must consider as a Happy Christmas.

Nonsense?

Comments welcome.

 

Categories
Therapies

Being ‘Bullied’ in the Therapy Room

Whilst naturally getting caught up in Jonah’s distress & pain (link) I had forgotten that the bully(ies) is(are) also in need of support – albeit from an angle that’s perhaps not immediately appreciated.  

The thoughts in this article come from a psychodynamic understanding of individuals’ psychology and from a systemic understanding of relationships through my practice as a counsellor/psychotherapist.

Why might a bully bully?

I’d suggest that bullying occurs due to the bully’s projected hatred/disgust of themselves.

As we are all people who need to be loved, cared for, taken care of etc, we don’t like to think of ourselves as being someone who is incapable of being loved.  Whilst some of us do have these thoughts, others avoid such torturous ideas through a process known as a psychological defence.  I’d suggest such a defence’s purpose might be:

…make sure that I don’t know about something that would cause me great pain if I were to become aware of it.

Being an unconscious defensive process, the bully psyche would be using projection to help the bully avoid recognising himself as being the person “in need” of being bullied.  I mean ‘in need’ as being the bully’s psyche’s conclusion of what to do with the psychological pain the bully is carrying: destroy.

The bullying process continues whilst the bully’s defence continues to successfully keep the bully from recognising that it is himself he’s attacking through bullying.

I’d suggest this is why, anecdotally at least, it’s said that bullying parents create bullying children – the pain is passed down from parent to child … as is the way to deal with it.

So, bullying is taking place and now we have two people participating in the bullying:  the bully (the initiating participant) and the bullied (the unwilling participant). The two have entered into a psychologically torturous relationship.

This relationship is why I suggest that both participants in the bullying are in need of help: the bullied because he (probably) didn’t see it coming, and the bully to help him understand (and then deal with) his own pain.

Like a hook-and-eye closure, both participants have something that makes the bullying relationship succeed; both are contributed (at some level) something to the bullying relationship. The bully contributes something so that he gets to avoid his own pain, and the bullied contributes something for the distress to take root.  The bullied acts out the distress that the bully causes (and which may also be the distress that the bully himself is hoping to dispose of – psychologically he’s done it successfully by physical means).

Psychological “Bullying” of the Therapist.

Therapists in the therapy room can also find themselves bullied – but it’s those who work with unconscious processes (psychoanalysts, psychotherapists & psychodynamic counsellors for example) that will struggle use understand their experience of the bullying process (sometimes a very subtle process, not clearly an attack or bullying) to empathically help the bully come to understand what they’re not aware of doing.

Whilst there won’t be physical torture (discharged by the boundaries & contracting at the start of the therapy), through unconscious processes called projective-identification and counter-transference, the therapist can find himself under various forms of mental and emotional attack.

Attack through unconscious processes.

Over my decade+ of work I have found myself:-

  • Feeling as if I were going to be physically harmed by a client.
  • Have vomited after a client’s session.
  • Being continually contradicted, put right, getting the impression I rarely get things right, but the client still comes to sessions.
  • Felt attracted to a client that I would not normally have been attracted to, then shortly afterwards feeling rejected (though I have not acted out the attraction).
  • Felt inadequate to a client, no matter how I tried to be helpful.
  • Whilst listening to a client tell me how wonderful things are in his life, I have felt utter rage and and a sparkling, tingling, need-to-do-something feeling in my arms and wrists.

Just a tiny set of examples – and you may notice how often the word ‘feel’ crops up in these examples where I’ve ‘felt’ that I’m coming off worse as part of the therapy work.

Plus – I’d like to reiterate that these responses, whilst very much in my conscious experience, are hypothetically in response to unconscious material being received from the client.  The client isn’t sitting there consciously sending me “be sick” thoughts.

Part of my responsibility as a psychodynamic therapist is to struggle to understand what sort of responses I’m privately having with a client.  It is not my usual practice to reveal my responses (my counter-transference) directly – although this can be appropriate too (an article for another time).  Instead, I will work privately on understanding my responses, my feelings, so that I might gain an understanding of them in the context of the patient.

If I am feeling as if I were going to be physically harmed by a client, perhaps I am receiving an unconscious communication from the patient – something being communicated about the very real alert about harm. 

Sometimes de-attributing ownership of my feelings/thoughts can be helpful:  re-framing my fear that instead of thinking…

‘I’m afraid that my client is going to harm me’ 

…I re-frame this into something like:

‘someone is afraid that someone is going to harm someone’.

This can lead me into wondering if my client is in fear of being harmed by someone – someone else, themselves, me?

Preparing to share an interpretation.

When I’m ready to offer an interpretation of my counter-transference, I find Winnicott‘s ‘spatula’ concept helpful.  Donald Winnicott, worked as a paediatrician (and later a psychotherapist) the 1920s to 1970s.  He found that when he offered a tongue-depressor (‘spatula’) to a child and allowed the child to discover the spatula for itself, the child would invest more play into the spatula than if Winnicott had indicated the spatula to the child. 

When discovered for itself, the child might invest in the spatula becoming an aeroplane, a giraffe, a car … or just something that could be held in the hand and waggled a lot! 

When I offer an interpretation of my counter-transference to a client, I allow the client to try and discover the interpretation-meaning for himself (and if he takes no interest I wont force the issue).  I might say something like this:

Y’know, I’m a bit puzzled by something;  you see whilst I experience a man who seems perfectly capable to take part in the world, you’re effective, you take charge, you get things sorted out, I’m still left with this puzzling sense sometimes of someone who’s… I’m not sure … maybe concerned of being harmed himself?  …of being vigilant for attack sort-of-thing?

(I’m aware that my style can sometimes come across a little like stage spiritualists perform: ‘I have the name John – does anyone here have someone called John in their lives…?’ – and perhaps we are using a similar psychological technique of laying out something for someone to discover for themselves).

As I offer my interpretation, as I’m offering my ‘spatula’ to this client, I’m trying to allow him enough space so that he might pick it up and play with it himself.  If my counter-transference is accurate (my sense of feeling afraid of being harmed) then the client may invest in what I have just said and flesh it out.  If my counter-transference is not accurate (or I have just hit an area that the client is not ready to go into just yet) then the client may tell me he doesn’t know what I mean, making no investment in the interpretation at all.

In offering to understand the sometimes-terrible experiences that I will get from some clients, I’m working to get to a place where I can invite the client into be curious about what they might be responsible for.  Usually this will be in the context of the problems that they are talking about in therapy – and sometimes what I have to say challenges the client’s beliefs.  I try and do this with empathy … and without necessarily telling them how I am being impacted upon (we’re here to understand the process, more than we are to watch the content).  At the same time, because I’m challenging the client’s defence when I do this, the client may wish to strengthen the defence and not wish to take responsibility for their unconscious part in this interaction.  This will be OK. 

But often I find I have allowed a client’s door to be opened a little further and more details about the client’s reasons-for-being-in-therapy come out.  All this from working to understand the impact a client sometimes may have upon me.

In Closing.

Bullying has purpose. 

When we’re faced with bullying we quickly recognise the pain that the bullied are suffering and our attention is pulled towards those who are suffering (incidentally, also neatly turning our attention away from the pain that the bully may be projecting outwards too – neatly falling in line with the bully’s unconscious intention).

I’d offer you the thought that the bully is in great need help and understanding too.

Categories
LGBT LGBT Video

LGBT Teenage Bullying…

“I’m not going to kill myself.  I just need to get this out here.”

LGBT Bullying – What’s goin’ on?

This video was made in August 2011  and I’ve only just see it due to a friend on Facebook sharing it with me.

I would encourage you to spend just a couple of minutes reading what this guy, Jonah, has to say (that’ll make sense once you click ‘play’).

External link: “What’s going on…”

Finding Support due to LGBT Bullying.

If this video has effected you – it brought tears to my eyes – then maybe it’s time to start taking some action.

If you are a teenager

 who is experiencing this kind of torture – and my opinion is that it *is* a form of torture – please …. please realise that you’re not alone and there are people and places that will help you:-

 

 

If you are an adult

 who has buried away this experience from somewhere in your distant history (or even currently), and you think now might be a good time to talk it through and finally put it to rest – you can make contact with me: Dean Richardson in complete confidence and we’ll see about arranging a time and place (or Skype or email correspondence) to talk it out (read more…) … and don’t worry about the fees if private counselling would be a struggle for you to afford; we’ll talk about how we can manage this too.

 

If you are an adult bully

 … or someone who suspects that they might be judging by some odd responses you’ve seen from people … and you would like to understand this behaviour so that you might be able to change, you can also make contact with me: Dean Richardson in complete confidence and we’ll talk about arranging a time and place (or Skype or email correspondence) to talk it out.

 

Update from Jonah.

Update 4-Dec-11 – Jonah says thank you 🙂 – http://www.youtube.com/watch?v=G7HkOaLFzGw

 

Categories
Therapies

The A, B & C of Working with a new Counsellor.

When you have the opportunity to begin therapy with a counsellor, the initial meeting will bring up anxieties for many therapy-newbies.  Even experienced patients can get the heeby-jeebies before the assessment, and whilst this is probably the same social anxieties as you might experience when meeting with anyone new, the counselling assessment may be just that little more distressing.

It’s untrue that counsellors, psychotherapist and psychiatrist can read into your very soul!  At the same time, it’s particularly true that many experienced counsellors do gain the experience of being able to understand where a new client is coming from during the client’s story.  Counsellors call it empathy, and the more ethical ones of us counsellors use it to try and help you understand yourself. But, this isn’t going to be an article on how kind and amazingly helpful we, as therapists, are! 

Because of recent reports of counsellor/client imbalance (who knows – maybe it’s always been so) I’d like to give you three tips that may help you face your new therapist for the first time.  I’d like you to feel a little more empowered than you may normally do.  Introducing my A, B, C of working with a new Counsellor.

 

A is for Authenticity

[dropcap style=”font-size:52pt;color:black”]A[/dropcap] is for Authenticity.

During the first meeting with a counsellor, you’ll probably be asked a series of questions.  This isn’t always true, though.  Some therapists pride themselves in being able to work therapeutically without asking any questions at all. Amazing (even frustrating) as thatm ight be, we’ll save that discussion for another time.

So – “A” is for authenticity – meaning: be true as yourself to yourself as you can be in any of your replies to the counsellor.  The counsellor isn’t trying to trap you or catch you out.  The therapist is trying to learn about you and your story, primarily so that the therapist can judge if they are the right person to be working with you.  If you don’t know an answer, say so.  If you’d rather not answer a question, you can say you’d prefer not to answer that.  The counsellor may be curious (and hopefully respectful of your reply too) and may ask you to say a little more.  Again, if you’d prefer not to go into a subject area you can decline to do so.

An assessment should be a mutual one – you’re assessing the therapist too. Being authentic means that you will get a better experience from a counsellor who is, too, trying to be as authentic with you as possible.

 

B is for Behaviour

[dropcap style=”font-size:52pt;color:black”]B[/dropcap] is for Behaviour.

Don’t change your usual behaviour.  Or, if for reasons of social niceties you feel you do have to change your behaviour, share with the counsellor your change in behaviour and try to describe how you might normally behave.

Socially, we humans can have a whole series of different behaviours that we bring out depending on what situation we’re in.  Sometimes we’re the life of the party.  Sometimes we’re the businessman that invites new business orders.  Sometimes we’re the dad picking up his kid from school surrounded by female-conversation we feel awkward to join in with. But meeting with a counsellor is about you, the inner person, and behaving just as your true, authentic self is best.

If your behaviour is effecting your life, and it’s something you want to change as part of the therapy, then it’s useful to discuss this with your counsellor too – your counsellor may need to learn about those behaviours … and you’re the tutor

 

C is for Challenging the Counsellor

[dropcap style=”font-size:52pt;color:black”]C[/dropcap] is for Challenging the Counsellor.

You’re meeting with a counsellor, presumably, to find to help.  If the counsellor is asking questions that make you uncomfortable, or the counsellor says something that disturbs you, challenge the counsellor.  You don’t have to feel that you must comply with the counsellor because you’re feeling forced to do so.  If you’re not receiving help, you have the right to point this out.

Challenging doesn’t have to be confrontational or impolite.  It can be a simple way to show that you don’t agree with the counsellor, or that you would like the counsellor to be somewhat more clear about what he or she has just said.  if we remember that counselling is a partnership there are a vast number of studies that it is the relationship between counsellor and client that makes the difference – not what the counsellor does to you. 

So, if you feel uncomfortable about what’s been said to you, challenge the counsellor to explain more.

Addressing Client/Counsellor Imbalance.

This article has had a hidden agenda – it’s been about addressing a reported-increase in the imbalanced between the some counsellor/client relationships.

At the present time, Increased Access to Psychological Therapies (IAPT) at the NHS has introduced an increase of newly trained CBT counsellors.  Whilst this is a good thing, unfortunately the practice of IAPT low-level CBT intervention offered by newly-qualified IAPT therapists has, somehow, embraced the medical approach to therapy.  Doctors practice the role:  “there’s something wrong with you, and I have to cure you.”  This is leading to an unfortunate counselling-practice of “I am the counsellor, so I have to cure you.”

Studies show that counselling and psychological therapies are effective because of the relationship between the therapist and client.  The effectiveness is not because of being given instructions-to-follow in order to be cured by the counsellor.

This is not an attack on CBT.  This therapist incorporates CBT in his private practice.  I incorporate CBT from a position of collaboration and empathy between myself and my client – we’re in this shit together.  In my professional opinion, the client experiencing a newly qualified therapist’s sometimes-dominant instruction is counter-productive.  You cannot be cured of anything by being told what to do (except, perhaps, allowing for a sadistic/masochistic relationship being played out between the counsellor and client – a discussion for another articl).

This article offers you, the client, the very legitimate and very real approach that you’re a fellow in the therapy. You are not a subordinate, and I hope you won’t feel like you are when you next go to meet with a new counsellor.

A, B, C and meet your counsellor with the expectation of equality & collaboration.

Enjoy your first meeting with your new counsellor!

Categories
Couple Relationships

Five Secrets of Happier Couples

As a professional couple’s counsellor, it’s an occupational hazard that I only get to work with unhappy couples.  Fortunately, I often do get to experience a transitional stage where a couple begin to transform their relationship into something that’s more positive and more happy for the two of them.

I am sharing these five “secrets” (not really secret!) based upon my observations.  Whether heterosexual, gay or lesbian, how couples moves their relationship from an unhappy state into a more happier state have common features.

1) Couples spend quality time on their relationship.

At least by the time a couple begins to meet with me for couple therapy, the couple have stopped spending time on the relationship.

This is sometimes due to the fact that sometimes couple learn to not communicate for very good reasons – and by not spending time on the relationship those reasons can be kept under lock and key

Living together is not spending time on the relationship.  The relationship is that thing that the couple have created together (and sometimes begin to destroy together).  Learning what the relationship is for a couple (it can be different for each couple) is the first step. 

  • Some couples set a “date” night once a week. 
  • Some set a meeting night once a week to discuss their relationship.
  • Some keep a “relationship” diary where both partners can write messages to the relationship about what’s going well (or not).

Sometimes a poorly relationship needs some focussed time spending on it.  It can simply be that the couple have forgotten that their relationship needs care, and for a while it needs to be nursed back into help.

2) Couples can hear each other’s communication.

One of the more frequent interventions I make in couple’s counselling is “What did you make of what your partner just said, there?”.

Couples who are in a distressing relationship can often answer “I don’t know”, or misunderstand their partner, or say things like “Well if he/she loved me I wouldn’t need to explain”.  These couples have have lost their skills in communicating.  It can be a very painful state to be in.

Inviting each partner to learn what the other partner is saying can be very helpful.  If a partner gets the communicate message wrong, it’s helpful for the partner to patiently teach the other what was meant (avoiding chastisement).

3) Couples can be comfortable when apart from the relationship.

Some couples have found they have unintentionally excommunicated all their friends to the point where only their partner exists in their world.  There may have been an unintended plan in doing this – I’m talking attachment styles.

When thinking about attachment styles (eg the early relationship of the infant to its caregiver) the infant may be secure; that when mum goes out of the room the infant will carry on playing, knowing at some level that mum will be back in a bit.  On the opposite scale, an insecurely attached infant will be greatly distressed when mum disappears for a little bit. For more on attachment styles, read “Attachment Theory – an Overview”.

Deeply felt insecurities may manifest in the relationship.  Jealously (“where were you all night?”), suspicion (“who are you seeing behind my back?”), are just two manifestations.

Having partners understand how each other attach in intimate relationships can help both partners appreciate where unpopular behaviour stems from (sometimes way back in the past).  Showing consistency (eg going out with the lads every Thursday night causes anxiety, but coming back home at an hour both partners agreed) can greatly help address initial change from insecure attachment to something more secure.  Secure attachment can handle unplanned behaviour (eg coming home late) where as insecure attachment may not.

4) Couples can share the truth / show authenticity.

No-one can tell when you’re lying.  Honest!

There are many reasons why people lie, and as a therapist one of the greatest demands on my practice is consistently authentic.  It’s essential that I demonstrate trust-able behaviour, consistent responses, holding boundaries agreed up front.  It’s a form of replaying the holding care that a care giver does (or should) when the infant is very small.

In the beginning, it’s likely that you and your partner were more truthful with each other than later in the relationship (ever heard of “pillow talk”, for example?)

Introducing inauthentic behaviour or telling lies will be felt at some level by our partner.  If you find there isn’t a place to tell the truth, maybe secret #1 might be the first place to address this.

5) Couples recognise their relationship as being unique.

When problems arise, everyone may have a say: your family, your friends, your partners family & friends, work colleagues, the people next door.  They’ve all been through it… but have they?

In couple therapy, part of my role is to provide an encouraging atmosphere of promoting the couple coming up with ideas and solutions of their own.  I don’t have any exercise that if performed correctly will cure the relationship’s problems.  I have no magic words that will make the unhappiness go away.  But what I do do is help a couple to realise that their relationship is pretty much unique and that they do not have to adhere to what society says is the behaviour of a happy relationship (see Secret #4!).

In society, we usually want to fit in, so we make our behaviour fit with everyone else.  We know that mum and dad never had a bad word and never argued.  We know that the couple over the road were married for 70 years and never spent an might apart.  Except … what people say about how their relationship works may not be quite the truthful story.

Helping a couple to disengage with what they think is supposed to be the right way to behave in a relationship, and helping them engage creatively and with inspiration with what they would both like in the way of relationship-behaviour can contribute greately to making their relationship work … after all, there’s no relationship quite like theirs.

Categories
B2B Ethics

Did your client read that Tweet?

Over on Facebook, the Business & Marketing Skills for Therapist Group (here) are helpfully discussing how they can get their message about their practices (etc) out into a wider world.  Some members of the group are professional marketeers, some members are professional therapists.  Something happened to me today that made me notice something that’s essential to therapists as we learn to market our services using public social networks. 

Let me share with you a story…

Tweeting? Twittering? Tweeping?

Over the past month or so I’ve been posting information about counselling on Twitter. I have only 90-or-so followers (compare this with Stephen Fry who has nearly 4 million followers). It’s good fun, it strengthens my reflective practice, it gets me known a little more and brings some new folk to my website.

One might think that 90 people – some of whom are porn stars, one of whom I’m sure is not really a hedgehog, and some of whom seem to hope I’ll be buying their obscure products any moment now – are all who are reading my posts. Maybe not even 10% of the 90 are really reading what I haven’t say.  So little feedback, you see.  So, what might it matter if I might casually slip in a small case example to demonstrate a point in a Tweet?  What harm could 140 characters cause?  It’s only 9-ish people that’ll ever read what I tweeted.

The issue, though, isn’t how few people are reading me (or you, dear fellow therapist, once you hit that Tipping Point).  The issue is that once my post goes into the world, anyone can get at it. 

Any.

One.

Do you know who reads your tweets?

Today, I was surprised (though delighted) to find that some of my Tweets have begun appearing in online newspapers recently. Surprised because these are online resources that I do not follow, they don’t follow me, and I haven’t sent them any of my tweets.  But they’ve still gotten hold of them (“public”, remember!). 

By some mathem-agical power of the InterWeb, my little tweets have somehow spread out into the big, scary world and, by chance more than design, have gotten included in publications that I’ve never heard of.  My words are circulating around (at least for 24 hours until the next publications go out tomorrow, at least).

How thrilling!!

But, can we return back to that little case example I might have Tweeted about?

I put to you – dear ethical reader – the query…

…what if one of the readers of these online papers happened to be the client that I referred to in my Tweet?

What if he recognised himself?

What damage would I have done by, perhaps imagining that non of my followers had anything to do with my client; that they were the only ones who would have read my misplaced comment* ?

Ethics & Marketing.

In the Facebook group earlier discussed, therapists and skilled marketers are passing around valuable information on how a therapist might get their message out there into the world.  I would suggest to you that sometimes it happens – and when it happens BOY does it get far and wide out there.

Marketing experts will teach us therapists these things… but the ethics in what we, as therapists, put out there are entirely our responsibility … and ours alone. 

Anonymising a case is not the same as protecting its confidentiality.

And anything you write on the Internet is not private :p

I’ll leave you with that thought.

Comments are welcome, below, but preferably back on the Facebook group if this is where you found this post.

Just to clarify – I don’t discuss online/in public forums any current case work at all.  When demonstrating a point, I tend to make references to generalised examples or to casework that is already in public circulation (eg a case discussed by Patrick Casement in one of his books) .

Categories
Articles

How to Find & Vet a Counsellor

How to Check if a Counsellor is Legitimate.

Counselling, Therapy & British Law.

A current problem (2011 when I wrote this article, and still current in 2014) in British Law is that counselling, psychotherapy, hypnotherapy, spiritual/religious counselling, alternative therapies (and so on) are not regulated by law. 

Anyone can set themselves up as a “therapist” or use the word “counsellor” without (legally) requiring any formal therapeutic qualifications to prove their ability to practice as a counsellor.

This situation leads to counsellors not being required have to have any insurance.  They don’t have to be answerable to a professional body to oversee their practice.  These therapists can advertise themselves as a “counsellor” without actually having any training, qualifications, nor any actual experience as a professional intended to help you therapeutically.

Some organisations use ‘counsellor’ in forms such as “Travel Counsellor” or a “Debt Counsellor” – and by the true definition of the word counsellor they’re not intending to mislead the public into thinking they’re offering a therapeutic approach to your mental well-being.

Unfortunately, by the lack of British law, that the responsibility lays on the client who is seeking counselling/therapy to find someone who is appropriate for their treatment.

Going through a GP may not be enough (limited to offering only NHS IAPT treatment … often with a waiting list) to gain access to suitable counsellor. 

All of this can leave a person at risk when trying to find a counsellor who is not an unqualified fake.

Help in Finding a “safe” counsellor.

There is good news, though.

Finding a qualified, experienced, professionally accredited and insured counsellor can be straightforward if you know some helpful things to look out for. This article describes how to find a suitable counsellor – and offers some topics to check out with your potential therapist.

At your first meeting with your counsellor, most – if not all – counsellors should not be phased by you asking about any of these topics (in later sessions, however, certain therapists may not answer questions about themselves, but be interested with you in the purpose of your question – keeping the focus upon you.  This is a legitimate approach to some forms of counsellor (i.e. psychodynamic / psychoanalytical) but I mention it here for your knowledge).

Search Counsellors’ Professional Bodies’ Online Directory.

An easy way to find a suitable therapist is to use a professional counsellors’ body that offers a “find a counsellor” type of service. The counsellors listed may have had to pay for an entry, but would also have had their qualifications checked before being allowed to pay for an entry in the list.

… however, if you wish to find your own counsellor – or you would like some advice on what to check out about your potential counsellor – then click the next page for…

“The iCounsellor’s Guide to Finding a Counsellor“.

Other sites of interest: Counselling via Skype, Online Zoom Counselling, Havant Counselling & Counselling for LGBT Couples