Journal post 20; 11th february 2013

A Good Read

A Good Read (Photo credit: Them Elks)

I didn’t go in this week. Again… I know. I feel bad about it. In my defence, it did snow. Fairly heavily, I suppose – I mean, it would have been hard to reverse the car out of the road, but truthfully – there was another reason why I didn’t go in. In my heart I really didn’t want to. I felt wounded by what I perceived as the ‘attack’ the week before, where I had arrived feeling so good about my placement, and felt that I had cold water poured on my joy by (a few of) the others in the group, tutor included.

Anyway, I have discussed it all with my (new) supervisor, and I think I feel okay about it now. She says that she has no worries about the way that I am working, in regards to safety and ethics, and suggested that I have a chat with my regular tutor (J) about it when she returns. Having previously had the ‘okay’ from her about my work there, I can’t see it as being a problem, so I feel better about things.

Oh, did I mention my new supervisor then? *acting faux surprised* I think she is WONDERFUL! I have met with her twice now, and I love going in to see her; I can talk about anything there (provided it is relevant to the work, of course). She works to the Proctor model (normative, formative, restorative ) which suits me very well.

So far it has been like this; I bring my clients in to her, give her a brief description of how I perceive them to be, we talk about the sessions, what work has gone on, how they seemed to react to the work, what has impacted on me the most, what are my feelings are about it, how I felt I was working – success as well as concerns, did I have any ideas about how things may develop, and the measure of the work to both the service provider and my college course. She gives me her feedback and shares her insight on how she feels I am doing. It feels very different in the room, to that of a regular counselling session – even though we use her regular counselling room – for one thing, she likes us to have a cup of tea or coffee together, saying that this is one way she distinguishes between clients and supervisees. I like that; little things like that do mark a difference, and make me feel more like a ‘grown up’ in the room with her. That we are two professionals, sharing case notes together – which is, actually, what we really are! It feels good, it feels that I am a ‘real live counsellor’ finally – which I can still can’t fully believe is exactly what I am these days!

Her input to my work has had many effects; for one, I feel lighter with it. I feel supported, that I don’t have to hold the mass of all that goes on in my counselling room alone. My clients give me some of their heaviest weights to hold – it is my job, and I am happy to do it, but to feel that I have someone to share my load with feels comforting, and lightens it for me immeasurably. She has increased my confidence in my work. To have someone to sound off to; run things past; check out how they think I am getting on with the work is bolstering. She reassures me about this line of work which is, after all, 99% instinctive – and as such, one can never fully know that one has always been ‘correct’ as there is no real check-list to work from. Being a student; being ‘green’, I feel nervous at times – there is a real feeling of having been tossed in to the water, and the gravity of the work, the importance of this relationship to the client and their life, their future, does sometimes pull at me. But she helps me to remember that I can float without even realising I am doing so, and that by applying thought and doing what I have been trained to do, I can actually swim rather well at times! I feel that we have an honest and open dialogue – not everything she says is ‘super positive’ – I feel sure that she gives her honest and critical opinion, but she definitely shows me unconditional positive regard too, which makes me feel safe, and in turn, more able to be congruent with her, and able to confide my doubts and fears.

Coincidentally, the book I am reading at the moment, “When Nietzche Wept” by Irvin Yalom (who I now think can be officially elevated to the position of my all time favourite psychoanalytic writer – I am sure he would be pleased to know) illustrates the three way, client, counsellor, supervisor relationship beautifully – and also, with that, the potential transience of these roles within the triad. After all, we all learn from our clients as well as our supervisors; the learning is shared three ways, and although the non -fictional counsellor should never switch  roles with the client or supervisor (clear contracts have been agreed upon), the beauty of this novel is that it is set at the birth of psychoanalysis, where these rules hadn’t yet been established, and so Freud, Breuer and Nietzche all take on each of these roles at different points through the novel, muddling through and exploring methods of working.

I have spent the last few months working my way through many different styles of writing – training as a humanistic counsellor leads me to read a lot of existential literature, and I have found this Yalom novel to be a breath of fresh air, even though it deals with essentially the same type of content. Mind you, the last few works I had read were by Kafka, Camus and Dostoevsky though, so that is probably why it feels so light in comparison! I must be careful, I suspect I may be becoming a little evangelical, preaching the power of Yalom to everyone that will listen, and we all hate being preached at, don’t we?

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Journal no 9; 22nd November 2012

This week, another skeleton class, as the dreaded lurgy tightened its grip, squeezing our precious group to the bone; I must admit, I was in two minds about coming in myself, but feeling the commitment to the course had to remain, no matter how crappy I was feeling on the inside, dragged myself in. During check in, other members of the group reported feeling a bit angry and resentful of the fact that, despite their own hardships, they had made it in to the session, whereas the others hadn’t managed to make it their priority. I acknowledged this, and certainly empathised – but was quite aware that actually, that was not how I felt in this situation. Me; I felt proud of myself for having made it in, despite feeling like a sack of dung. Maybe I was in an introverted place, and that is why they were so self-centred, but it did not stop me acknowledging, empathising, and – I think – affirming to the others that it was okay to feel angry. I suppose, with  our knowledge of defence mechanisms, I just knew and understood that their feelings of anger directed outwards, were most probably displaced, and were more about their own frustration at themselves and their own personal struggles with how demanding they are finding the course.

The day was focussed on ‘self’ – more searching back into our own pasts, trying to make sense of our lives – in keeping with these last weeks of studying the psychodynamic approach. On this day, we were given a quote from Michael Jacobs, a leading contemporary psychoanalyst, as a springboard for own reflection;

Part of therapeutic work involves finding expressive language (image, metaphors, narratives, statements, outbursts, drawings, songs, movement etc) for aspects of the impact we have on each other, and aspects of the impact life has on us”

This quote was a revelation for me, in terms of understanding how modern psychodynamic therapy has evolved from the early days of a silent therapist, sitting behind a couch. This emphasises a connection (a continuation of the ideas of Winnicott, Fairbairn and most recently, Hobson) between the therapist and the client – that recognition of our mutual cultural touchstones will strengthen the therapeutic relationship further, building further trust and understanding. In my mind, this fixes the eternal issue for me, when looking at the work of Freud, Jung and the like – the fact that a much clearer picture of the client’s psyche will inevitably emerge, if a strong, trusting, warm relationship is built. The divide that I always perceived between psychodynamic and humanistic approaches is now well and truly broken. One can use psychodynamic theory in a more humanistic way, and reap the benefits of both approaches. Using the past as meat for the dialogue, but engaging with the client in a way that is parallel to that that Carl Rogers defined through his core conditions; Bingo!

To bring the power of this idea home to us, we listened to a piece of music by Shostakovich together, and reported back to each other how it made us feel; what it made us think about. There were many similarities – some said that it made them feel excited and optimistic, think of royalty, grandness. Of course, there were many differences as well in our reactions – after all we are individuals with our own perceptions and frames of reference. But I surmised more similarities. We felt connected by them, just as counsellor and client can, when mutuality is established; a bond created. Knowing that the core theory I am training in is humanistic, I do believe that the connection between counsellor and client is key, the most important element of the relationship. Without this, how could any client could trust the counsellor with their inner most thoughts, feelings, dreams and fears – I know I couldn’t. (Very ‘humanistic’ of me? No! I can be psychodynamic and think this way too! Ha-Ha! Michael Jacobs says so…)

The next few hours were spent looking back on key figures in each of our lives who have had impact on us – not just people, but culture too – films, tv, brands, art, songs, and how they have shaped us. We took a long time to think about this alone, and a long time sharing our thoughts together. The strengthening impact on our group as a result, was HUGE. The level of connection and understanding that sharing of personal reference can achieve really is staggering. Our entire lunch hour was spent reminiscing about mutual songs, films and tv shows we have loved, describing what they mean to us. As a team building exercise, it had a phenomenal effect, but even more than that; it reinforced the importance of an affinity between the counsellor and client, and how culture can be used to express so much, how we all emote through it and personalise it. (I am reminded of my many years of making ‘mix tapes’ in a bid to try to let the recipient know how I was feeling, and equally, the amount of mix tapes I received, in turn)

After such an emotional and powerful morning, combined with my general ‘dung like’ feeling that I have already described, it seemed ok in the afternoon skills session for me to take a step back from baring my own soul. I found myself in a session where my client wanted to talk, no – NEEDED to talk about issues she was having with her marriage, and how her growing self-awareness was impacting on that – an issue close to my own heart in many ways, having been in that position myself. I felt the value of my level of understanding, and responded accordingly, by stepping back from taking my turn to be a ‘talker’ (client) and giving her the whole duration –  a double session effectively. She needed it, and I needed to feel the affirmation that I was useful to her too. I enjoyed the separation of her feelings from my own, despite the similarity of her situation to my experiences. To be honest, my own experiences were completely disconnected from what was going on between us as client and counsellor in the room, it was really only afterwards, on reflection of the session that I even thought about them. Whilst I was with her, in the session, I was focussed on the here and now of what she was saying, HER here and now, and mine was only in relation to her and what she was telling me.  During this long, powerful session, I briefly found myself in a moment where the gestalt ‘empty chair’ technique seemed appropriate to use, but, unsatisfyingly, on trying it, found it did not sit well with the feel of our session – although my approach is definitely humanistic; honest and even a little confrontational (in a gentle way, I hope), I don’t think that I enjoyed the feeling of using that technique. Oh well, lesson learned. The session was good, other than that. – I think I pulled it back!

Which takes me to the end of the day; a short debrief and an early finish. For such a short time, we did a huge amount of work – well, I know I did, and I know that I achieved a huge amount of learning…

 

Journal 5; 22nd october 2012

Today; the theories of Ronald Fairbairn, an object relation theorist, who has not had as much written about him as the other theorists we have studied so far, it seems.

We were given a lengthy hand out containing a detailed critique of his views on therapy; his ideas were basically psychodynamic (ie. looking at birth onwards) but also seemed, to me, to bridge the gap towards the more humanistic approaches, by stressing the importance of the therapist entering the client’s inner world. He stated that the interpretation of the transference that occurs in therapy was not enough, alone, to facilitate change for the client. He felt that this transference relationship should be developed between client and counsellor, and gradually replaced by a real relationship that can give the client a model on which they can base future relationships in the outer world. He stated “the distortions of inner reality can be corrected by outer reality” (Fairbairn 1958:381)

Fairbairn was an ‘object relationist’, alongside Klein, Bowlby and Winnicott (whose work we have been studying over the past few weeks), fundamentally believing that all relationships in life are based on blueprints taken from our earliest connections with objects in childhood. I found the paper we were given wordy and confusing, but my basic understanding of his principles (after much searching online and reading around, trying to clarify the ideas in my head) are this;

  • An ego is present from birth.
  • Libido is a function of the ego.
  • There is no death instinct; and aggression is a reaction to frustration or deprivation.
  • Since libido is a function of the ego and aggression is a reaction to frustration or deprivation, there is no such thing as an ‘id’.
  • The ego, and therefore libido, is fundamentally object-seeking.
  • The earliest and original form of anxiety, as experienced by the child, is separation-anxiety.
  • Internalization of the object is a defensive measure originally adopted by the child to deal with his original object (the mother and her breast) in so far as it is unsatisfying.

He came up with a revised structure of the personality, which bears similarities to Freud’s id, ego, superego but has marked differences;

(taken from www. integrativetherapy.com) As shown in this diagram of ‘Fairbairn’s endopsychic structure’, the unconscious part of the mind is divided into the object seeking half – the libidinal ego which is driven towards objects, and the antilibidinal ego, which rejects and attacks objects. These filter into our conscious/ everday self – the central ego, which in turn creates our ‘preserved object’ (ie how we actually do behave toward things/people.

Phew! Theory dealt with (I think). I can’t stress enough how hard it has been to write this journal entry – my problems with absorbing this theory have been a huge block to me, and have sent me back to my old pattern of procrastination. Thank goodness for the half term break – it has given me more time to get my head into focus on this.

Brain drain still fresh – we spent some time thinking about how have dealt with pressure at different points in our lives, to help us to understand how our own individual approaches to counselling have evolved, and will evolve further as we go on.

The particular events we were asked to consider included; dealing with a crying baby, someone (teenager or child) having a tantrum, being with someone who has received news of a loss, someone who you care about being hurt, dealing with a family member having a breakdown, and someone close to you being terminally ill.

Heavy situations, all of them situations that I have found myself in, and all of them have provoked quite similar reactions in me; an instinctive need to be there, remain calm, and simply try to hang in through it; contain it and  allow it, creating a safe space where the crisis can happen in  relative sanctuary.

Well, that is all except the last one – the person close to me being terminally ill – this I couldn’t deal with, and I thought I felt ashamed of myself for that. But when looking back  and reflecting objectively on that situation, I was never really required to be there. It was my Aunt that was ill, and she wanted my Mum to support her, and in turn, Mum turned to me for support– which I did, to the fullest of my abilities. More evidence of me automatically being hard on myself, and turning emotions I found too hard to deal with (grief and worry) into an emotion I was more than comfortable with – guilt. Aaargh! Definitely learning to be done there…

Process group in the afternoon was… erm… interesting? Animated? Explosive? Cathartic. As time goes on, and I grow more comfortable with the group, and more determined to use the group  as a learning place, I get braver, and more willing to take chances, raising my opinions much more than I ever felt able to last year. This week, I think my frustration at the way I had struggled to get my head around Fairbairn  in the morning, and my subsequent ‘block’ on the rest of the day (the result of that earlier lack of engagement) got to me. I thought “f*** it” and I voiced that frustration to the class. The relief that I wasn’t the only one feeling it was huge, but in  trying to devise some kind of better approach to the learning that might be beneficial for more of us, other backs seems to be raised. The conversation grew heated, and this felt good to me. Some might describe the exchange that took place as ‘a fight’, but rather than trying to diffuse things between the group members involved, I found myself adding fuel to the fire; putting my gestalt hat on, and pointing out their body language to them, trying to make them aware of their way of being. Why did I do that? It was instinctive, not thought through at all. I felt a need to shake things up – to make changes happen. Internalising, trying to reflect and keep problems as my own no longer seemed like a viable option to me. And the group responded – vociferously – in a good way, in my opinion. I am quite sure that that was one of the most enjoyable and productive process group sessions we, as a class, have ever had afterwards and the general feeling amongst the group did seem much clearer and more positive .

Am I ‘becoming’ the counsellor – is this my natural way of being? I don’t want to ‘make things better’ any more. I want help people deal with things, even if it is uncomfortable…

 

Journal 3; 8th October 2012

Today began with a recap on Jung and his ideas (one of my favourite theorists), and so I began positively.

We mentioned his beginnings, as the ‘heir apparent’ to Freud, and his break with that association – leading to his ‘psychotic breakdown’, and the ideas that followed thereafter; the innate potential of the psyche to heal itself; his influence by eastern philosophies leading to his ideas on the creative unconscious and archetypes; personality types, and the idea that the psyche is made up of opposites – the shadow being made up of our negative, unwanted ideas, the anima/animus representing our gender opposite characteristics and the persona being the public face assumed, and the concept that the focus of therapy should be in recognising these opposites within ourselves in order to achieve a unified self. Individuation is the name Jung gave to the process of achieving wholeness, and he strived to achieve that in therapy through the use of active imagination – using dreams, visualisations, art and other creative techniques to bring the client into contact with their unconscious – the transcendent function.

Towards the end of our discussion we were asked to consider which archetypes we most relate to, and many of us admitted to relating to the healer largely. Although I may have felt that in the past, these days I find that I am further away from that image internally than I have ever been. If anything, I have felt more like the patient in recent years – and I haven’t enjoyed that one bit. It has been disempowering, and I have resented the idea of allowing my inner world to match my outer world when I am so unhappy with both! Part of me (quite egotistically really) related to Jung himself – this idea of being the rebellious child who takes the ideas of the father and makes his own sense of them; rejecting some notions and choosing to do it his own way, facing the consequences of a complete mental breakdown in search of the ‘truth’ rather than towing the line and never feeling real, fulfilled, ‘actualised’. I relate to the freedom of thought that comes with hitting the very bottom, losing what seems like the last touch on ‘reality’, and admire the way he turned this to his (our) long term benefit, forcing himself to stay in the scary place in order to understand it better. When I hit that place I was terrified, and forced myself back to the ‘real world’ as a drowning man would hit the sea bed and strive to bounce back to the surface, taking huge gulps of both air and water. Sometimes I still wonder if I still have water in my lungs…

This reflection connected well with the next chunk of theory we tackled – the work of Melanie Klein, best known for her Object Relations theory. When we initially learnt about this last year it took me a long time to get my head around these ideas, but in discussing it in class, I realised how much of it I had really absorbed. During the Jung part of the morning, when relating to the favoured son rebelling against the authoritarian archetype, I automatically began to question the attachment between me and my mother – a Kleinian concept. She felt that difficulties in our relationships with our early caregivers affect our relationships in later life, our relationships with all objects, including food, and even relationships with ourselves. Although, I am fundamentally insecure in my attachment style (my mother returned to work when I was very young, and I hated being given to childminders), I have always been in denial about that (as has my mother, constantly reminding me that I was the most spoilt, well-loved child there ever was), and have chosen to ignore obvious signs that relationships aren’t what they appear to be (refusing to admit to myself that my ex husband was having affairs, even when he obviously was)

Klein called our mental constructs of the world around us our phantasies. These fluctuate and change with us as we grow and form our new opinions and perceptions of the world. Often we use the defence mechanism splitting to guard ourselves from emotional pain – separating good feelings from bad feelings, dealing in opposites, understanding the world by placing situations/objects into   opposing places. This is an immature, primitive defence – as we grow older, or work through issues in therapy, and our phantasies are understood and deconstructed we see the world as a less black and white place, containing elements of both good and bad. The clearest example of this for me would be when my ex-husband left me, and I found it impossible to deal with our relationship ending unless I began to hate him (or hate myself, resorting back to the anorexia – impossible, being the sole carer for my two young children; I had to remain functioning). Until I could start to do that, it was unreal to me. Luckily/unluckily – not sure which – he did actually give me very good reasons to hate him, once I deconstructed the phantasy that nobody who loved me could consciously hurt me, and accepted his part in things!

Another defence mechanism Kleinians call projective identification is where our phantasies get rid of our unbearable feelings by pushing them into someone else. My example of this is also from the time shortly after my husband left me. My best friend at the time had, in retrospect, had a slightly -inappropriate relationship with my ex-husband, and I think that when he finally left me, she couldn’t cope with the guilt she felt about the part she may have played in our break up. Unable to face me, she made excuse after excuse as to why she couldn’t be there for me in the months that followed, until I eventually felt hurt and angry by her lack of support, and started to properly question her part in our relationship’s demise. Her negative feelings were projected into me because she couldn’t cope with them.

Hefty stuff! Even though, this was theory I already thought I knew and understood, being asked to apply that theory directly to my own experiences was hard. It is the way to learn though, and although it isn’t always nice to revisit those places, it is necessary if one really wants to absorb these ideas – otherwise they are abstract. This gives them form, even if it is an ugly one.

I consciously chose to lighten things for myself in the afternoon session; choosing a dream to discuss in the practical part of the day, trying to engage with the therapy as ‘play’ (Winnicott’s instructions!) through my ‘speaking’ session. I am not afraid to embrace my ‘shadow’ (as Jung would call it), but I  learned from last week that the exchange of energy within the group can be so powerful that I have to engage an element of self- protection at a certain point – definitely a lesson being learnt for the future. It is possible to engage honestly and directly without giving to the point of exhaustion, and I am beginning to do that. Well, I have to, really…