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
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!