Opening channels #24 The things we know

Counselling practice placements are a very small pool to fish in, it seems.  I am working for an agency that recruits a large number of trainee counsellors, including a colleague from my course.  Last week, I was allocated a new client  and in the introduction, the placement co-ordinator mentioned that the client had worked previously with my colleague.  I was immediately intrigued – what had made him return so quickly to counselling if he had completed his twelve sessions with my colleague?  Had there been difficulties, challenges in that relationship or had his previous counselling unearthed an issue that he needed to explore?  The placement co-ordinator gave me an overview of a domestic issue that the client wanted support with and introduced us for the first session.

I started with my introductions and explanation of my boundaries and contract.  My client (I’ll call him Bill for ease here) stopped me to explain that he understood the contract because he had had fourteen counsellors before.  I joked that, as I was a trainee counsellor, he probably knew more about contracts than I did but that I still felt it was important to go through the contract with him.  As usual with clients who have had counselling before, I asked what had worked best for him and what hadn’t worked.  Bill went into detail here about a counsellor he had had for two years and who had asked him the ‘right questions’.  When I asked him to give an example of these questions, he couldn’t but explained that he felt ‘loved’ and that this had been absent in his life.

Empathy and unconditional positive regard can feel like ‘love’, especially if we are not used to receiving this ‘warm prizing’ and understanding from others.  If I’m honest though, I started to wonder about Bill’s background and his need for validation from all of these counsellors?  To have met fourteen counsellors and to have spent two years with one of these started to feel like a person stuck in the revolving door of care or possibly a professional story-teller – clients who thrive on presenting their life and issues to a succession of professionals.

So stop it, I told myself, and view the unique human being unfolding in front of me.  It is my privilege, I told myself, to witness and walk with Bill as he explores his experience and meaning.  Bracket that crappy pre-judgement and tune into Bill’s frame of reference!  I gave myself a quick talking to and tried to get back out of my head but something was nagging and getting in the way of any chance of connecting with him.  Then it hit me.  A few months back during group supervision,  (a great place  for us as trainees to bring our client work and its challenges), I remembered my colleague discussing a client that she was having difficulty connecting with.  She had described working with this man for eight sessions and feeling that he was simply using the sessions to talk rather than feel.  She had questioned the value of those hours for him and the ethics of sitting with him when, deep down, she felt that it was not working.  I also recalled that she had made the decision to end counselling with this client on the basis that she wasn’t sure how much use any further sessions would be for him.  I felt absolutely sure at that moment that Bill was the client she had agonised over.

While all this was rattling around for me, Bill was still in front of me and well into relaying his story.  I tried to tune back into the ebb and flow of his experience, and building our relationship in the here and now, but I recognised that I was distracted by ‘knowing’ Bill.  The mythical Bill that had troubled my colleague was in front of me and I was horrified that I wasn’t able to shake this off.  The session was coming to an end and I summarised the information that Bill had offered. As always at the end of a session, I asked how it had gone for him and whether he wanted to continue the following week.  Bill told me that he felt that we could work together and was looking forward to returning next week and I was struck by how easily I could offer an image of caring counsellor with all of this going on behind my eyes.

Now here is the dilemma:  I know Bill will be an excellent client.  From his history with previous counsellors, he appears to be reliable and I know he will attend regularly and promptly to relay his stories.  He declared that he had a lot of stories.    I have practice hours virtually guaranteed here.  I know Bill is an adult, he is self-directing and will use the counselling hour in any way he wants.  I also know that it is not my place to decide if it is useful for him and I cannot set a criteria for success.  I can bracket what I think I know about him and try to work genuinely and honestly with him to support his development.   I can ask what brings him back to counselling over and over again in the hope that he will examine this for himself.

Okay.  And yet I know that this doesn’t feel right.  I know what brings him back.  He is lonely and he wants a place to be heard and us professionals will provide this temporarily without him ever being able to get to what prevents him from having a genuine, equal and fulfilling relationship with a person who will be there longer than twelve hourly sessions.  His stories are carefully crafted and I know they will stand in the way of him making meaning out of his current experience.  Despite my best intentions to work congruently and authentically, I know that I will eventually question what I can actually do for him.  As Alice Hoffman declares…

“Once you know some things, you can’t unknow them. It’s a burden that can never be given away.”

Alice Hoffman, (Incantation)

 

 

Opening channels #18 The Walk

the-walk

 

The Walk

I’m wondering if other counsellors have a similar difficulty?

If you, like me, meet clients in a waiting area then walk together to your counselling room, what do you talk about? I have tried all of the usual topics – travelling and the idiosyncrasies of public transport, questions about the quality of directions and ease of location and, of course, The Weather, as the mainstay of all British small-talk. At one agency, ours is quite a long journey through a public area then up the stairs and, as there is no space to walk side by side, I find myself shouting over my shoulder. These small conversations are essential to client care I believe – Desmond Morris (2002) calls these ‘grooming signals’– smiles, eye contact, small elbow touches, questions about travel and the weather – which show the other that we are caring for her/him. I know from personal experience that, when I am nervous or anxious, these small conversations can really help me relax so I try to use The Walk as a precursor to the counselling session.

My difficulty is during The Walk back. After the session, despite our work to negotiate an ending that suits the client, she or he is, at best, thoughtful or contemplative and at worst, sad, tearful, embarrassed, angry, uncomfortable. We know that much of the change work done in counselling frequently happens towards the end of the session with the familiar ‘door-step comment’ and more is done after the session on the journey home when the client begins to process her new understanding or senses around the issues she brought to counselling. With this in mind, The Walk takes on new significance and I wonder what works best. Do we chat again or stay quiet?  In the interests of balance, do I resume the small talk that I started with on meeting?  Walking in silence obviously allows the client some quiet time and enables her to start or possibly continue processing. It also allows me a pause to get ready for the next client. Does the client need the fuzz of the small conversations to detract from where she is at the moment? I wonder if it is better to allow the client to walk out alone and whether she needs me to see her to the door.

Separating after the counselling encounter feels difficult. I understand cognitively that we are alone in our experience of the world and that the counselling relationship allows me only a small glimpse into the experience of the other. There is an intimacy though in witnessing another human’s innermost thoughts, hopes and fears and it feels cold to step away from that abruptly at the end of the hour. I am aware however, that the client remains alone with her experience and will continue to exist even after I have stopped witnessing. I cannot be there for every moment and this is why I must stick with my boundaries and take care with time to make sure that the client returns to her aloneness with a comfortable sense of ‘ending’. My challenge is for me to accept the comfortable sense of ending.

Any counsellors/therapists out there with any advice? How do you do The Walk?

 

Reference:

Morris, D. (2002) Peoplewatching. London, UK: Vintage

Opening channels #15

warhol-wait

I’m sure this is painfully familiar to every counsellor and therapist – the client that doesn’t arrive.  I’ve made a number of appointments for clients; I’ve spoken to them over the phone, checked that the date and time works for them, given them a number to cancel the appointment then sat and waited for them in the Centre, only for them not to show.  There are a myriad of reasons for clients not attending – the women I am working with have numerous challenges to their time management and organisation.  Some are fleeing abusive partners and are vulnerably housed – often sofa surfing with friends or family.  Most have children and often cancel our appointment because of childcare falling through or because a child’s appointment at school or the doctors takes precedent.  Some women are still with their partners and make the appointment with full will to attend but find themselves locked in the house or fearful of explaining where they are planning to go.

I sit and wait (we have a 15 minute rule at the Centre) then I try to phone, if it’s safe to do so and usually leave a voicemail asking if the client wants to rearrange. It is a rare treat if the client rings back.  I get what’s going on and I empathise with each woman’s difficulties in attending and I have tried to use the waiting time to check out my frustration and test how patient I have to be.  I’m not good at waiting – I have a real horror of being late and I’m frequently irritated by people who have a more relaxed idea of punctuality.  I have to consciously convince myself that the client will have a reason.  So during those long fifteen minutes, I find myself wondering what the client might be like – tall or short? Hair and skin colour? Sad or angry? What she might bring to the session.  Then I wonder how I can start the session – contracting and business-like or friendly and informal?  Should I ask straight away for permission to tape the sessions?  Shake hands or just smile and say hello?  Those fifteen minutes are full of possibilities and uncertainties and I feel the butterflies.  As sixteen minutes pass by I feel the cold certainty of a ‘Did Not Attend’ creep in but I ignore it, thinking about town centre traffic and missed buses.  By twenty minutes, it’s all over and I’m acknowledging my frustration as I’m firing up the computer to record DNA in the notes.

Waiting is work for me but counselling is harder work for the client.  I know that not everyone is ready for that work – facing the reality of choices and consequences, the uncertainty of change and progress, spilling your darkest thoughts in front of another person.  It is my work to wait – those testing fifteen minutes are practice for the waiting I’m obliged to do in the  counselling room while the client is trying out her possibilities and uncertainties.   This placement is pushing me to become patient and work at another person’s time frame instead of mine.