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*

 

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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 posts 22 and 23 ( a week missed, off sick); march 11th 2013

It felt like I had been away from college for a very long time; it had been half term, and then I had been ill, so I was pleased to be back, despite not feeling quite one hundred per cent recovered. I was relieved to see everyone, and feel that they weren’t too let down by my not being there last week – everyone seemed incredibly understanding, none more so than J, our tutor, and so on check in my first tears of the day were spilled, as she made sure that I – and everyone else in the room- acknowledged just how awful the last few weeks had been for me. Oh, there is nothing like feeling a bit sorry for myself to get the waterworks flowing, and it seemed that today was going to be one of those days that examined my ‘life deficit’ in even more detail, prompting even more tears. Still, painful as it is, I am doing it, I am not shying away as I used to (although I do still try the odd trick, to get out of owning up to my upset – not because I don’t want to face it as such, but because I am embarrassed at how much crying I seem to do in our sessions). This last time last year, when we were studying our CBT module, I managed to avoid being the ‘client’ for the entire process! Nothing like that is going on any more, and I feel proud of myself that I am facing up to my stuff in a much more congruent way these day, even if I am, erm, ‘soggier’ for it…

We continued after check in with a quick recap on the work they did last week – the concept of working at ‘relational depth’ in person –centred counselling (meaning ‘A sense of connectedness and flow with another person that is so powerful that it can feel quite magical. At these times, the person feels alive, immersed in the encounter, and truly themselves while experiencing the other as open, genuine and valuing of who they are.) Developed by Dave Mearns and Mick Cooper, the idea is that the core conditions are not simply ‘tools’ that are used, that they become an integral part of the counsellor, the very principles by which we work from, enabling this work to take place at ‘relational depth’, where change can happen, where communication does not skim over the surface, but is used to facilitate movement from deep within. A hugely powerful concept, and to me, the essence of person centred counselling; something that couldn’t possibly be attained without congruence, unconditional positive regard and empathy being at its heart.  In my experience, the very best work that we do with clients is when it comes from the soul, and to touch someone’s soul, requires you to access your own. To me, it is reminiscent of those late night chats with your best friend, after a bottle or two of wine, where the real truth is revealed and dissected; pored over and pounded. We counsellors want the conversation to reach that level (but in a clear headed state, where the content can be remembered the next day!) Clients interviewed after  reporting back as having achieved this, have said they felt it was; Empowering and useful as a catalyst for change, that it lessened painful feelings; that there was a positive effect on the therapeutic process, a deepening and  equalisation of the relationship, greater trust in their therapist, and that they were more able to vocalise their innermost thoughts and feelings;  that from that they gained a sense of connectedness to their own selves, greater self-knowledge and understanding and acceptance and that with that they felt more able and powerful to move on and break their patterns of thinking, and enjoy better relationships with others.

Powerful stuff. This led on to this week’s subject – ‘the divided self’; the idea of sub-personalities, as written about by John Rowan (‘Discover your Sub Personalities’; 1993, Routledge, London). Immediately, this sounded very Jungian to me – akin to ‘personas’ and ‘archetypes’. Sub –personalities are pieces of the whole of the overall personality, which have a life of their own, beliefs, thoughts, feelings, intentions and agendas. There’s the rebel and the martyr, the seducer and the saboteur, the judge and the critic and a host of others, each with its own mythology, all co-existing within a person.  Counsellors must recognise these facets within both us and our clients, and understand that one of them has a story to tell. Each one views the world differently. Each one interprets the events of life differently. Which ones control behaviour, thinking, and choices? Attention needs to focus on those that constantly provoke, react and attack. They are hurt and angry, wounded and in need of healing, if there is to be any inner harmony.

This was both incredibly hard and incredibly easy for me to get my head around, simultaneously.  I am bipolar; I naturally exist in extremes – I am very well aware of the inner conflicts within me. I got the concept in a heartbeat, but when we went on to do a survey that measured our sense of self, in terms of pluralism, my results came out completely opposing everyone else’s in the room, and that made me extremely upset! For a bipolar person to be okay with themselves, they have to be comfortable with that level of multiplicity operating within – it is all right, they are all a part of me, and coexist within me; I have to accept myself as being multiple and opposing at times. It doesn’t mean I don’t know who I am – quite the opposite; I know exactly who I am, a person who exists in extremes (when not properly medicated, anyway).

We were asked to identify five inner sub personalities, and share them with the class – I couldn’t possibly get it down to less than eight (I could have named hundreds) they were; dreamer, healer, vulnerable child, perfectionist, muse, clown, explorer and rebel. I would say that these are the main ego states I flit between. I could go on to describe how, but it would take all day, and may well be enough for a book, not a journal entry!

The morning ended with a creative realisation, where were asked to firstly focus on a part of our body, then to associate a symbol with that part of the body, then to full imagine that symbol as being alive and real, and to have a conversation with it. Here is what I managed to remember and jot down of mine;

(I had focussed on my stomach and imagined a warm, soft, red heart.)

Me; Love, how do I feel about you? You have deserted me.

Heart; No, I haven’t – you have love all around you, Ungrateful Girl – your family, your friends…

Me; But I want more than that. I want romance, to feel safe, protected and warm, again

Heart; Maybe you could have these things if you made yourself open to them, and ready.

Me; I can’t do that, I got too damaged before. When I lost you before, and lost my family along with you, I broke beyond repair.

Heart; you’ll never be like you were before again, but you can still be ready for me.

Me; How? What do I need to do?

Heart; Take risks again…

 

Wow! Yet more powerful stuff, and more tears. It was lunch time straight after that, and I needed the break. I felt exhausted and a bit ill again – probably from the strain of it. I can’t remember a morning where I had been more present and focussed, for ages…

We watched another skills video after lunch, filling me with more dread about showing mine next week, and then it was the process group; lovely process group. Actually, this week wasn’t so bad. I was really trying hard to be attentive and alert, but as often does happen, the conversation at points drifted into boring drivel. When it was alive though, it was really honest, brutal and raw – and it was  for these moments that I tried to stay with it ( the trouble is with my brain, particularly after a bout of illness, and some  new mind meds that are still settling, it goes off, and it takes all my energy to bring it back, to re-engage with myself, let alone those around me, at times), and so I tried my best to participate with the others, experience them fully. I found myself pulling them back to the here and now at various times – there was much anxiety about the future being talked about; about the exam, about next year, about completing this year and where it will take us, how we will manage. I couldn’t handle it; I was going there too if I wasn’t careful, so I kept  on bringing it back with, “but we’re here, now..,” and “what would you say to a client who told you that?” and it felt pretty good to do that. It was exactly what I would do when working with a client (and probably in my outside relationships too).  I chose not to share in the anxiety though, I didn’t want to, not just to show empathy – I mean of course, I do have fears about these things, but to actually try to empathise, more than I already do, could definitely push me over the edge into anxiety, and mania, somewhere I can easily end up anyway, without taking silly risks that I know could take me to that place!

The final part of the day, the supervision section, another part I often struggle to make it through –often being quite emotionally exhausted by that time of day – was another very conscious effort from me to stay alert and participate fully. A fellow student was sharing his experience of counselling in a drop in centre; his frustration when a client didn’t turn up, and his struggle to keep boundaries in place with a centre that is new to having counsellors working there. I have first-hand experiences of these issues, and through being thrown in at the deep end somewhat, have learnt some valuable lessons and strategies that could be useful to him, so I tried to share them with him. I think he took them on board; I was very aware that he was feeling quite defensive about it – again, just as I had during my first group supervision session, and so I tried to be sensitive, yet constructive with him by offering him suggestions of techniques that have worked for me and sympathy to his situation. (Normative and restorative, perhaps?) I hope he was okay with it; I think he was.

So, to finish the day off, a quick run through of the last essay we had to do, with a fellow group member who feels she is struggling academically at the moment. I told her “I am no expert but I can show you how I went about it,” and she seemed to be appreciative of that. It made me feel good to try to help. My inner healer, rising up again for fulfilment…

 

Journal Post 19; 4th feb 2013

 

Quite a different kind of day today – our tutor is away for a few weeks, so we have another lady standing in temporarily, and although she is basically sticking to the same format that our days have always run to before, her style and approach is so very dissimilar that the entire day felt completely unlike any other. Not in a bad way, though; and illustrating clearly for me how two counsellors can practise from the same theoretical background, yet so many other factors become relevant to the type of therapy that will be created; connection, personality, mood, energy levels, intuition – basically, the qualities that go into making every person an individual, every relationship an individual relationship, and thus, every therapy an individual therapy.

‘Check in’ was so much more in depth than it had ever been before – we were questioned not just about where we were, right there and then with our feelings and our mood, but D (the new tutor) wanted to get to know us quickly, so she asked us about our theoretical preferences and leanings – a sure-fire way to get to know what a counsellor is all about. She cut to the nub of me straight away and I got a strong feeling that she felt that vulnerability within me that people so often do, making me feel upset with myself. I had invoked that again – do I need to start recognizing this more clearly when I see it? Is it a warning to me that I am either dipping or flying, and not realising, myself? If I am to be an effective counsellor, employing all the BACP ethics and guidelines regarding self-care, and safety of practice, I must pay close attention to these signals. Yes, I know that I know myself, but my condition can mean that I have a tendency to sometimes ignore myself too – I must make sure that I don’t do this if I am to be safe in my work.

After a visualisation exercise, focussing on grounding ourselves, putting our roots down in this room, in the here and now, making us feel so much more present with ourselves and each other – we began discussing Egan’s ‘Skilled Helper’ theory – a very well used approach throughout the NHS in Britain, and a highly effective strategy used within brief therapy. It is broken down into three simple parts, questions – What is going on? What do I want instead? How do I get to what I want?

Stage I, Current Scenario – What is going on? This is where the counsellor uses their exploring skills to gain an understanding of the story – what has led the client to seek counselling. Skills used by the counsellor would be; open-ended questions, silence, focusing, empathy, paraphrasing & reflecting both meaning and feeling, structuring, summarising. Stage 1 can take five minutes or five years – it may be all someone needs – to get their story out and be heard.

Stage 2, Preferred Scenario– What do I want instead? In this part the counsellor will take a more directive role than in the previous stage, exploring possibilities (akin to the ‘golden question’ from SFBT) – what would the client prefer ideally? Using brainstorming techniques, imaginative thinking, prompting the client into further exploration; ‘what else?’ How might that feel? What would you be doing/thinking/feeling? What will be the benefits when you achieve this? How will it be different when you have done this? Reality check; are there any costs to you achieving this? This part of the approach can be used to regain positivity and really play with ideas – give the client an idea of how their life could be and an idea of what they could strive towards.

Stage 3, Action Strategies – How will I get there?  More brainstorming and creativity initially – ‘Let’s consider as many different ways of achieving this as we can’ leading to an exploration of what action would need to be taken, and eventually formulating a plan. The use of SMART goals is recommended here (Specific, Measurable, Achievable, Realistic and Time-phased), and the strategy is broken down into bite sized chunks of action –‘what will you do first? And then…?’

The key with using this model is that the client’s needs must be kept firmly in the centre of what is going on – the model should be used for the client, not the client for the model. Although, as we found when experimenting with using this in our practical part of the session, it is an extremely easy and effective model to use – such a simple strategy can lend itself to many different situations.

During my (brief) session as the counsellor (our group overran with the timing, so I only ended up with a five minute session – seemingly impossible, but strangely, using the highly focussed approach of Egan, it still worked) we found that stage 1 seemed to contain the bulk of the material; in exploring stage 1 fully, the client’s natural coping strategies were revealed, revealing that she had already pulled herself through to stages 2 and 3 without realising. Upon this being noticed, the client felt much more positive about the situation; a few new strategies were batted about, but her confidence was bolstered by the realisation that actually she had already acted in a positive way intuitively, and she felt encouraged to continue with the approach that she had already embarked on. Bingo!

I felt positive after this session, and the feedback given to me by the tutor on the counselling skills I used was lovely; very, very, encouraging. We spent a little bit of time after that watching a video from ‘Ted Talks’, which was great; very informative, and we had a good old group chat with Donna (our course facilitator) after that, which felt productive, but meant we didn’t get any time for a process group (every cloud has a silver lining! I secretly hate process group, I find it so boring and awkward…)

I was excited to get to the supervision part of the day – having recently started my placement; this was the first college supervision session that I would be able to get involved with properly, and I wanted to tell the group about a particularly troubled client I was seeing, who I felt I needed help with.  When I did though, I felt quite upset though at the reaction I got from the tutor. She seemed to leap at me, barely giving me a chance to explain. An awareness of ‘Safety in my work’ seemed to be her primary feeling that she wanted to communicate to me – she felt that I was possibly taking on too much for a student at my point in my training. But the fact of the matter is that in this placement, all of the clients are in extreme crisis, and it does involve taking on heavy issues. I have had real problems finding a suitable placement, and as long as I don’t feel that this is too much for me, I am very reluctant to let this one go. Yes, I have had an extremely positive response, initially, to this new service that has been set up, but I am well aware that this is probably because it is a new thing for the kids at the hostel, and that once they are used to me being around things will probably settle down and I will be less busy. I think that as long as I am aware of how much I am taking on, and make sure that I don’t bite off more than I can chew, so to speak, I will probably be okay. The overwhelming feeling that I have from this placement is one of positivity, and I do not want to let that get squashed. I have an appointment booked with a new supervisor next week, to discuss my work there fully, and I am excited about that, so I hate to sound so terribly rude, but *blows raspberry* – I will be carrying on with this for the time being, at least! Although, in linking back to the first paragraph of this entry, I am well aware of my own issues, and am keeping a self- critical eye on things, don’t worry…

 

journal post 17; monday 21st january 2013

Today was a snow day. The weather had turned, the schools were shut, it was impossible to get cars moving out of the side roads, and so I reluctantly had to accept that I would not be attending college on this day. To be truthful, to have an enforced day of rest was probably a bit of a blessing. I was quite exhausted, having spent a busy week getting my new counselling placement organised.

I am very pleased to say that I have committed to working two days a week at a Young Person’s hostel –  assisting clients aged between 16 and 25 by providing them with accommodation, and expecting them to participate with the helping services provided within the building, of which there all sorts of activities and support available – counselling being one of them. These kids present with many different situations; there are young mothers living there, ex-offenders, drug users, orphans,  victims of dysfunctional families and abuse, mental illnesses and learning disabilities, to name a few of the obstacles up against these clients. I think the only assumption it would be fair to make about the work will be that no two days will ever be the same!

On my initial meeting with the service manager , I was immediately grabbed by the challenge of the work, and very pleasantly surprised at how well we seemed to ‘click’ and understand what our task together was going to be in this capacity. I suppose you could say, we straightaway realised that we were reading from the same page! He is also a trained counsellor, and firmly believes  that the key to success in the work of the hostel is by dealing with the mental health of the clients – the trouble that he has had in the past, though, when trying to provide counselling services, is that of engaging the client. He currently has two other counsellors working there, also on placements, who are working to a traditional counselling model – one of pre-agreed contracts, firm boundaries regarding venues, times of sessions and durations, and both have reported back with frustrations about the clients not sticking to the contracted arrangements; taking mobile phones into sessions, arriving late – if at all, not engaging with process generally. Carl Rogers stated that in order for any counselling to be successful the client must be in psychological contact with the therapist; put simply, these clients are not!

T (the manager) and I discussed how we felt the service needed an ‘in-between counselling service’; one where the clients could be gently acclimatised to the process involved. With these clients, some  have never experienced any real kind of boundaries in their lives so far, for one reason or another – they kick against rules purposely and instinctively. For most of them this is their first home of their own, and they are testing out what that freedom means to them; many don’t get out of bed till late, many struggle with working or attending college, with paying their bills, and the day to day drama that being any adolescent involves, let alone a traumatised adolescent (which of course, most of these clients are – how they came to be living at the hostel).

Ellen Noonan’s book ‘counselling young people’ (Routledge, London) which, although drawing heavily on the ideas of Klein and Winnicott, also puts forward the idea that adolescence can be seen as a period of mourning – an extended grief, made more complicated by fluctuating hormone levels and the fact that there seems to be nothing tangible on which to base the focus of the feeling of loss. Even in a non- traumatised young person (and the people surrounding), there is a natural denial (the 1st stage of grief, in the Kubler-Ross model, as we all know) that the end of childhood is something to be mourned. Anger, bargaining, and depression are common reactions to be seen in young people as they go through this; they are forced into change and growth, often against their will, and the lack of control they experience will often push them into a mind-set and behaviour that appears confusing and unfathomable to those around them, often leading to even more problems than they began with.

If you consider this myriad of trauma which presents to every teenager, even those with the most ‘normal’ and ‘understanding’ of upbringings – consider how very hard it must be to be facing this when coming from a ‘dysfunctional’ background; coming out of care, being kicked out of the family home because Mum has a new boyfriend (horrific I know, but it happens),  perhaps a strict religious family that can’t cope with the teen’s newly discovered homosexuality, or as already mentioned – drug abuse, alcoholism, the list goes on and on… These kids really, really need the psychological support that counselling can offer them – sometimes the ones that can’t stick to the terms of the counselling agreement are the ones that may even need it the most – and my discussion with T was about how the service needs to be made more flexible, in order to give these kids a chance to make use of it.

We agreed on a strategy, which is perhaps a little unorthodox, in terms of the traditional counselling placement, where I will set up a new ‘drop in’ counselling service; a clinic type operation, advertising my availability between certain hours on certain days, and inviting clients to book time with me as and when they feel they are in need and/or able to attend. In order to promote this service, and really let the clients know what counselling is for, and about, I will try to get to know the clients a little better; perhaps knocking on their flat doors and introducing myself, asking questions where I try to ascertain what kind of counselling service would suit them – would they like me to come to them? Does the thought of a whole hour seem daunting? Is the idea of sitting in a room with ‘what is essentially a stranger’ to begin with seem frightening? How can I bridge the gap between these kid’s lives and the traditional counselling format? Once I have feedback, T and I can design a counselling service that serves the clients more effectively.

Exciting? Hell yeah! I was itching to get cracking straightaway, and did so, with amazing results almost immediately! I can’t express how happy I am with how the placement is working out; the clients are fabulous, the rest of the staff support team are fabulous too, and I feel completely at home there already; totally valued, totally respected and a real sense of validation from the work that I have done there already. There have been learning curves (don’t expect too much in the way of non-pre-arranged client contact before midday – they are all still in bed!) But overall, the response to the service I am offering has been positive, and in only a few weeks of being there I have already completed many valuable counselling hours.

So as you can see, although the Monday college session was missed this week, there has still been lots and lots of hard work going on – and so much learning, and joy gained from this learning, too! The pleasure of being taken out of my own head, and into someone else’s for a few hours during the day, has been phenomenal!  I have loved the work, really REALLY, loved it; Affirmation that despite all of doubts in my own abilities, I think I have made the right choice in this path. I really do.

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!

 

Journal post 13; Monday 10th December

The following day, and my head is still reeling from this session! It began at check-in, with the same feelings of anger and upset that I have already reported in these journals, resulting from the impact of absence on the group as a whole, and a need for self-care arising from both this, and the general increase in the workload (it is accelerating, as the term goes on) And again, as I have also reported in these journals – I did not particularly share these feelings, although I certainly empathised. My outlook at the beginning of the day was actually quite bright and optimistic (!), as I had had a good weekend and was feeling quite together and organised about my workload.

A more experienced counselling student came in, to do some work on ‘mindfulness’ with us. I already had a fair idea of what mindfulness involves, having been a yoga and meditation fan for many years, but I think a fair definition would be to say that Mindfulness refers to being completely in touch with and aware of the present moment – essential for a humanistic counsellor. The process of constantly checking in with yourself throughout the therapeutic process (and at all other times too, actually); questioning how you are feeling, what this is creating for you, how that may manifest and therefore how must the client be feeling in relation to both that, and what is going on for them at that moment – valuable, valuable process material that must be noticed in order to have an authentic process and relationship.

The exercise itself was similar to other meditations I have done in the past – what I felt was interesting about it was the questionnaire that we did, both before and after. It was the same questions, but the answers were quite different. I found that I had pots and pots to write on the ‘before’ sheet (it asked us to note what our thoughts and feelings were, what was distracting us – any physical feelings; aches pains etc. and that sort of thing) – my mind (even though it felt quite relaxed and happy, to me) was busy; active, even. In contrast, after having done the meditation, my answers flowed out of me quickly, with ease. There were no blocks – everything had been cleared, and strangely, I suddenly felt ravenously hungry! What was that all about? Had the blocks which I automatically put up within my body, the ones which shut out hunger and pain (being a ‘sort of ex anorexic’ living with crohns disease, pain and hunger are ongoing feelings residing within my stomach) been released by the slow deconstruction of the thoughts within, that the exercise had taken us through? So interesting…

After a break (and some food) we returned to read a piece describing a demonstration counselling interview that Carl Rogers did with ‘Gina’, a client who was struggling with death anxiety. It was a transcript of a session they did together, showing how Carl Rogers’ non directive technique, combined with his core conditions; empathy, unconditional positive regard and congruence, could be so very effective in leading a client through her fears, so that she could feel that they were fully acknowledged, understood and that she therefore, felt more able to deal with them.

It was wonderful; so simple, natural, honest and effective – and yet again, in my life – this acknowledgement of synchronicity (Jungian, I know) as reading this piece where Rogers dealt with darkness, fear and existentiality, and most importantly – ‘Gina’, so beautifully, seemed to coincide with the place I had been finding myself in recently when considering my own theoretical leaning; the full circle I feel I have travelled, through many other theorists and back to Rogers again. The power of the core conditions cannot be underestimated – not just in a counselling relationship, but in almost all of the key relationships in our lives, and I love that!

We followed that piece with a quick survey that assessed our own levels of unconditional positive regard towards ourselves – it measured how we regarded ourselves, and contrasted that with how much our own self-regard was dependent on how we perceive others as seeing us too. I realised that although I am working hard to build my own self- esteem, and I am succeeding to a degree – so much of that is still dependent on how I think the rest of the world sees me. As if I don’t full trust my own judgement? Hmmm… I don’t think so; I like to think of myself as intuitive and fairly insightful, but I am aware that the last few years have ‘knocked the stuffing out of me’ somewhat, and this has had a marked effect on how I, and in turn others must, perceive myself, and how much I now trust my own perception. I discussed this further with K – my partner for the practical part of the day – and discovered much more that I must take to my therapy sessions.

Next, the process group, which completely blew up!

I described at the beginning of the journal, how others in the group were feeling the pressure at the moment, and struggling with that. Combining that with the theme of ‘unconditional positive regard’ that we had been left with before lunch, the  break had been spent trying to assist that group member with her issues. She was at a real crisis point; even feeling that she was on the point of leaving the course (and as other group members have left us along the journey, knowing that impact, I think I am not alone in saying that as a group we do not want to lose anyone else) As a result we arrived back to the classroom late. Not just a bit late, ridiculously late. It was completely accidental – the 4 of us involved had been so engrossed with trying to help this lady that we simply lost track of the time, but nonetheless  – an awful breach of our group contract, understandably upsetting for the others in the group who felt let down by us.

And so, it was raised in the the process group. Except it wasn’t raised in that guise; it came out in a much more aggressive way, with one of our tiny group exploding in a rage; upset and tearful at what she felt to be ‘a small inner group within the group leaving her out’.  She was new to the course this year, and as such, felt insecure within the group; understandable. But I really thought I had understood; I have made a point of working with her several times; I always stop to chat with her whenever I can – I was new to this group myself at the beginning of last year, and so I fully remember how bewildering and intimidating it is, trying to fit in to a bunch of already formed group dynamics. Still, she was angry with me – she conceded, not as angry as the others, but that I was still guilty. I felt horrendous!

I am glad that she got it off her chest – it had obviously been troubling her for quite a while, and I am glad that she finally felt safe enough with us to be able to. Now it can be worked on, and we can try to improve things, and finally – we have a feeling of being congruent as a group.

For me personally though, I am sad, really sad (my eyes are filling up a bit even as I write this). I feel awful that I made someone else feel awful, even if it was unknowingly. I guess others perceive me totally differently to the way I think they do. I had thought I was trying. Not only that, I am aware that the last few weeks I have been quite self-absorbed, getting deeper and deeper into my own self-awareness and the counselling process than I ever had before. I had sort of thought that was a good thing though, what I was meant to do on this course. I suppose the lesson learned is that I must keep a foot on the outside too; not get to focussed on myself, even within this group – there are bigger things going on, that I am not always aware of…