Journal post 29; 29th april 2013

 

I began today feeling okay about things. For me; I feel that recently my placement work has really compounded a lot of the theory work we have been doing, and my confidence as a counsellor has increased. Of course, as my out of college workload has increased I have found less time to spend on my written work, not to mention any relaxation pastimes (I can’t remember the last time I picked up  a piece of knitting and sat down for an evening’s TV watching) – but I am okay with that. I am comforted by the knowledge that is the last few weeks of the course now, the final push, so this is what I expected to happen really. Of course, technical issues (like losing an entire weekend’s worth of work due to a computer crash late on sunday night) don’t help matters, but hey – what can you do?

We began by recapping on person centred theory and practise in relation to an existential perspective, and how this should be conveyed in the exam. An exercise on enhanced empathy  was enjoyable, even if I did unconsciously put myself in the ‘rebel’ role again in class discussion, and lay myself open to criticism. I always seem to do that, throw a slightly controversial perspective on things – it’s like I just feel the need to mix things up a little bit all the time. The issue debated was; how much of one’s own personality should be brought into the counselling room in a session? Of course a counsellor should always be congruent, I feel this wholeheartedly, and cannot imagine working in any other way now – but I told the group about my placement experience last week, where a moment of silence and reflection in the session had been rudely interrupted by an engine being revved outside (there is a mechanic working directly behind the building). Upon being interrupted, as we were, I felt the client’s  annoyance at the noise, and had voiced it, saying (not over aggressively, but with a snark in my voice nonetheless) ‘Oh, will you please be quiet?’ towards the window, where the noise was coming from. This felt appropriate to me to say, as it was what I was picking up from the client, and the client certainly didn’t seem to mind my reaction – he was too cross with the noise to be cross with me. Our moment of reflection had already been broken, and voicing our shared annoyance at that seemed to strengthen our togetherness, to me,  and I very much believe, to him as well. The other members of the group were concerned that my voicing of the annoyance might have taken away from his feelings in the moment; that my personality being shown might overshadow his. I listened, and understood what they were saying, but ultimately found that I could not agree – I still feel that therapeutically, it is our relationship that carries the weight of our work, and part of that relationship rests on my personality being involved. Certainly, the session is not about me in any way, shape or form, but to inject a little of me into a reaction doesn’t feel wrong to me. Well, it didn’t, anyway.

After that, we took a long time digesting the concept of Martin Buber’s ‘I-Thou’ construct. This is concerned with the way the individual relates to the rest of the world, bridging the gap between phenomenology and existentialism. Phenomenology involves  working within the client’s frame of reference, in the here and now – by linking it with existentialism we take that internal process and link it with their view of the world, their existence and their place in the world. The relationships between objects (meaning literally, objects, or people)  can be described as I -It ( a relationship which has no empathy with the object, no real connection) or I-Thou ( a relationship where the object holds a place for the individual, the individual has feelings for it, is connected to it) Once a therapist has ascertained whether there is an I-Thou relationship with an object they can begin to work on the feelings towards it. For example, in the case of an addiction – what is the role of the object the individual is addicted to? Is it a transference relationship? How will the therapist work with that? It gives us, as therapists, tools into empathising on a deeper level and direction for our work. This was brilliant for me, as one of my placements involves counselling addicts in recovery. I felt very excited that this had given me new perspectives to take into supervision with me later this week.

After lunch, we were watching skills videos again; this time it was my turn to be the client in the video – quite a traumatic experience, actually. This particular video had been shot 6 months ago – a lifetime in terms of my learning in my way of being. I couldn’t bear it, and spend the whole duration watching between my fingers, as my hands covered my face in horror. Aside from all of my usual annoyances that I have about watching myself (my weight, my voice etc) I felt a huge sadness at the incongruence conveyed by my past self; I laughed almost all the way through, despite talking about really sad experiences. I presented my information factually, as if I were disconnected from it, yet appearing to be open and okay with my dirty laundry being aired – plainly I wasn’t! I know that this video was made before my medication levels had been really looked at in detail, maybe that played a part, but the overall feeling I had was of someone who lacked self awareness in her whole demeanour, as far away from being an effective counsellor as it is possible to be. Funny, yes – quirky, yes, probably quite nice to be with at a party or something, but not a confidante, not a fellow journeyman.  I hope I have moved on as much as I think/want to have, I really do.

Process group was awful. Painful. Literally. My head started hurting towards the end of the video being shown, and built and built throughout one of the quietest, slowest, most torturous process groups ever. Hardly anyone spoke. I know why it was torturous, but I wasn’t going to say. I couldn’t be bothered to – and no one else was going to either. It is because our group has been fragmented, the splits within it have finally been acknowledged – they were out loud during our extra workshop last week. Almost all of the group members were finally present this week – way, way, way too late in the day to change things now, as far as I am concerned. I am not interested in them as participators anymore, I am sorry to say. I ran out of empathy a while ago, having given them the benefit of the doubt again and again. So, as a result there seemed little point in participating in process with them. My head was pounding by then, despite the tablets I took, and after the group had finished, I made my excuses and left the day an hour early, to go home and lie in a dark room. A somatic response to stress, pain, frustration, disappointment? Probably. Definitely. A lack of congruence in not saying anything? Just exhaustion, I think, and a feeling that it is pointless. *sigh*

 

Advertisements

journal post 25; March 25th 2013

Today’s session was, well, odd. It had a very different feeling to previous weeks. I know I am in a different mind-set to how I have been. I confess, although I have been very much on top of the placement, supervision and personal therapy side of this course in the last few weeks, I have fallen slightly behind with the writing side of things. My change of meds seems to have given me a jolt, and I can feel myself in a much more positive frame of mind than I have been for a long time – of course, I am a little concerned that this could send me into a hypomanic phase; the new found emphasis on having a personal life, and the vigour with which I am pursuing it does seem alien to me (it has been so long since I have had any inclination to do so), and the fact that I am suddenly 2 journals behind does feel like a little alarm bell ringing to warn me of a potential danger that could lie ahead. But this course; the self -awareness that it has taught me, the discipline of examining my behaviour and feelings as they happen; my focus on the here and now, the learnt skill of examining both my internal and external processes; has (I think) given me a valuable tool in monitoring myself and learning how to enforce self-care – not just for my own benefit, but for the benefit of those around me, my friends, family, colleagues and clients. After all, no-one can be counselled by a crazy woman!

Self- care has been a recurring theme within our group for many weeks now. In a way I feel  that perhaps I hit that wall before some of the others did, but check in today revealed a strong sense of anxiety resonating with the other members; a fear of the ‘ever sooner looming’ exam ( we have only 8 weeks) , and the end of the course shortly thereafter. It was also painfully clear that our tutor, J, was not feeling her usual self. Check in was much briefer than usual, and an anxiety radiated from her that is not usually present. As it turned out, she revealed later in the day that she wasn’t feeling up to teaching on this day, she was exhausted by a very stressful family situation, and she recognised that she felt a little ‘unsafe’ and took her leave early. Of course, I am perfectly okay with her doing that, but before I knew that this was going on with her I did feel slightly unsettled, and it did make me worry, and immediately wonder if I, or any of the other members of the group, had done something wrong. I guess this is how a client will feel if a counsellor practises when they really shouldn’t.

So, having spent the morning revising exam techniques, trying to keep us within the discipline of writing from a strictly humanistic perspective (not always that easy when the other theoretical perspectives are always there, lurking within my mind), and most difficult of all; sticking to using humanistic language . There are times when each theoretical school will have their own terminology for describing a similar psychological process. For instance, the psychodynamic concept of transference and countertransference occurs, and could well occur within a humanistic counselling relationship too. It’s just that in humanistic terms this would be described as ‘working with the client’s feelings towards the therapist, and the therapist in turn recognising their feelings towards the client, using immediacy, having the feelings brought to their awareness within the here and now.”

The afternoon, without our tutor, was spent discussing further, going through an old past paper and discussing it within the group. One of the other group members took it upon himself to take charge of the discussion and sat in the tutor’s seat, writing on the white board and generally leading the debate, something which the other group members didn’t seem to mind very much, but I got really annoyed by! How dare he think that he knew better than anyone else in the room? My inner rebellious streak was activated, and I found myself disagreeing with him on purpose, actively, and arguing his points, insisting that I was not going to accept what he said, purely because it was he that had said it! The other group members were a little surprised at the open friction between us, but actually he seemed to take it in very good humour, welcoming the debate. Thank goodness. I did apologise for it in the process group immediately afterwards, and he seemed to not be too upset. I explained to him that actually, in a weird way to me, my feeling comfortable enough with him to challenge him and not feel worried that he would hate me for it was a big step forward for our relationship. I think it was.

I took the feeling of elation at the progress I felt our relationship had made further within the process group, and I made it my place to continue being the rebel, and challenged a couple of other group members. I took care not to sound aggressive, but I wanted to make them think. Sometimes (as if often the case within the counselling relationship) it seems perfectly clear what is going on with people, but they can’t see it themselves. A counsellor should never tell the client what their thought process is or means (an abhorrent idea, and the absolute opposite of what a good counsellor should do) but should be able to challenge the client into thinking about their process for themselves, and helping them come to their own conclusion. In fact, this is vital, as no person can ever make an assumption about what another person is thinking or feeling or acting out. Carl Rogers firmly believed that, it is one of the corner stones of person centred theory. It is hard, as a counsellor, to challenge though (as I discovered) as there has to be a huge amount of trust within the relationship for it to be acceptable, and not detrimental to the overall process.

Of course, if choosing to challenge for their own needs, as I think maybe I did at the beginning, one must be able to study why they do that, and whether that is significant. For me, I know that it follows a behaviour pattern for me. I do not like being told what to do or think, particularly not by men, it seems. A hangover from growing up in a house full of women (one of 3 daughters), going to an all-girls school, being ‘the boss’ for most of my working career, and being an independent divorcee in recent years. As behaviour patterns go, it is not one that I am too worried about actually. Maybe if it starts hindering my future relationships this will have to be something I re-address, but for now I am kind of okay with it. I don’t see the harm. I think I have intuition enough to know when to use it and when not to. Of course, my exes may not agree with that, but I like to think that that is why they are ‘exes’, not ’present’s…

Journal 15; Monday January 7th 2013

The first day back at college after the Christmas break – and what a Christmas break it had been for me! Sadly, my holiday had been one of my worst Christmases ever –  I had gone down, big time, and had been put on some very strong medication to try to help me deal with it. Needless to say, it didn’t particularly help; it simply tranquilised me so that I felt disconnected from everything around me. I made a decision to stop taking the drugs that were having this effect a few days before my return to college, and am sorry to say that the effects of the withdrawal were still taking their toll on me, and as such, my concentration levels on this day were, let us say, “patchy”  Even now, a day later, I am struggling to keep my mind focussed on writing this journal – I know I must try to write down how I feel though, as it is important for me, as a counsellor, to remember the chaos of these feelings whilst in crisis, as this is how many clients will be in initial sessions, and possibly again and again, throughout treatment, as the road to psychological wellness is not always a straight line(in fact it rarely is).

Today’s session was spent discussing ‘solution focused brief therapy’; an approach to psychotherapy based on solution-building rather than problem-solving, and pioneered by Steve DeShazer, who is quoted as stating that ‘the essence of psychotherapy was that the client is helped to make a change in their situation.’

SFBT targets the solution; what the client is striving to achieve through therapy, rather than the situation, event or obstacle that brought them to treatment. The therapist works with the client to place their attention on the present and future, not the past. The client begins by first envisioning what their desired future looks like, and then taking small steps toward achieving that outcome. It is an effective treatment model used across a whole range of presenting issues. As the name describes, it is a short course (anything up to 20 sessions) of therapy.

First, the problem is identified and described; “How often does … happen? How long has it been going on? Has it ever happened before? How did you deal with it then?”

Any goals that the client wishes to achieve are discussed, clients to are encouraged to identify these goals, even when they are finding it hard to see any way through their problem – “What do you want to get out of being here? What will it be like when the problem is solved? What will you be doing instead? When that happens, what difference will it make? What else will be different? What else?” The counsellor can use their questions to facilitate the client viewing their possibilities in a more positive light, encouraging them to imagine the ‘knock on’ effects that reaching their goals will have.

Exceptions to the problem are noted and attended to, helping the client to start to take on ideas that could lead to potential solutions. “What about times when the problem is not happening? Or when it is less? You mentioned earlier that some days/times are better. What is it like at these times? What are you doing instead at these times?”

Scales are another useful tool for the counsellor to use, “If you think of a scale from 0–10 with 10 being the best. Nought is how you felt when things were at their worst. Ten is as good as things can be in relation to this problem. Where are you now on that scale right now?  Give it a number, for example 2 or 3. How long will it take to get to 10? Maybe 10 is too big a goal? Is something lower more realistic? What number will be acceptable for you?” his helps to break the goals down into something achievable so a sense of success, and the encouragement gained from that success can be achieved.

The miracle question is designed to elicit a clearer picture of the client’s future without the presence of the current obstacles they face. “Suppose you go to bed and to sleep tonight as usual and while you are asleep a miracle happens and the problem that brought you here today is solved. But you are asleep and don’t know that it has been solved What will be the first small signs that this miracle has happened and that the problem is solved?” This gives the client the opportunity to visualise how there life could be – a powerful tool in itself, in terms of encouragement and inspiration.

DeShazer said “All that is necessary is that the person involved in a troublesome situation does something different.” It was once I read this, that I realised that SFBT is very similar to the kind of counselling that I had been receiving on an ‘every other day’ basis through the christmas holiday break. My counsellor said those very words to me “just do something different”. He asked me to scale in my mood at the beginning of every session, and he asked me the ‘miracle question’. First at the beginning of the sessions with him, and then again as we neared the end (we haven’t quite got there yet – I will still be seeing him once more). Thinking back, more clearly now, we set goals at the beginning of the treatment and he (very skillfully, without me even realising he was doing it) drew my attention to any exceptions to my own ‘bleak prognosis’ of my future.

Finding it as hard as I have to concentrate recently, this simple yet effective treatment outline was more than enough to focus on. As a client in crisis, I can see now, and understand that any deeper probing into the past may have been too much for me to cope with at that moment – even though, when the psychiatrist tried to tell me this, I argued with him, that being a student counsellor myself, I knew the difference, and I wanted ‘proper therapy’(!)

So, big BIG learning for me  – even with my ‘addled’ brain!

I cannot recall many details from the more practical part of the day. I know that I was ‘present’ for the individual skills part – I may have floated off during the process group a little, and I am quite sure that my mind had fully checked out by the time we hit ‘supervision’ at the end of the day, but in my defence I don’t think I did too badly really; considering the medication I was coming off of. In my head, the feeling was similar to as if I had attended a college session at the tail end of having had a bad cold. I know that I wouldn’t have been able to ‘counsel’ for a full hour in the ‘real world’, but I did muster everything I had in order to manage the 25 minutes skills practise we did, and it did seem to go ok. Certainly, when I reported back to my therapist this morning, he was pleased with my progress, in terms of mood, and quite surprised when I explained to him that his techniques were the ones we had been learning about!