People often wonder what counselling is and what is it for? Is it just a place to moan, does it make a difference? Psychotherapy and Counselling, (I see the two words as interchangeable) is a confidential, boundaried, contractual relationship between the therapist and the client; for the sole purpose of the psychological wellbeing of the client.
The client is troubled, having the courage to go to the therapist, to seek help. It is an intensely personal relationship, and yet what protects it, is the professional framework that surrounds it. This encompasses the training, supervision and qualifications of the therapist. Equally important, is the ethical framework that underpins their practice. Research shows, clearly, it isn’t the ‘model’ of therapy that will predict positive or negative outcomes, but the ‘quality of the relationship.’
These tenets most therapists would agree on. How the therapy plays out between them will be as varied as there are practitioners. Their style of working will depend on their own model of training, their history, strengths, frailties, experience, personality and the current circumstances of their life. So the only counselling I can describe with any confidence, is my own.
My training has been the essential foundation of myself as a therapist, and is embedded deep in my system. It gave me the theoretical building blocks and skills that first enabled me to dare to sit with someone who was in pain, in the hope that I could help them. The value of the training processes, all the research and theories I learned over time, is for me, that they give me a route to understand both myself and the person in front of me. A language, a structure, a way of thinking and a way of being, that facilitates the relationship between us. But as Jung said ‘Learn your theories as well as you can, but put them away when you touch the miracle of the living soul. Not theories but your own creative individuality [should be in the front seat then]." [Carl G. Jung, Contributions to Analytical Psychology. (1928)
Clients come to teach me, my learning is on going directly from experience, as well as my training and teaching. Yet the attitude of the ‘beginners mind,’ paying attention to the present moment, is the one I strive to hold, with every new person that comes to see me.
I am often asked what can I do to help clients who are so distressed, when someone they love has died. People wonder is it all about God? Do I have techniques that can heal them?
I don’t do anything. I offer a relationship. A contracted relationship, framed by time, which is for the benefit of my client. It is the only time and place that I will meet them. It isn’t equal, because I set it’s perameters and I am paid, either by them or by the NHS. And it isn’t equal because my clients talk to me about their worries, their fears, their struggles, their internal world - they know very little about me.
Yet my intention is that they do know me, in the sense that my attitude is open, responsive and authentic. I reach towards them. Offering myself in the service of this person in front of me. I’m curious. I want to know what is going on in them, what hurts and what hinders them. I want to know their story. I find that I can put my own needs down, whilst I listen closely with my eyes, my head and my heart. I try to understand the content, the feelings and the meaning beneath the words, I am hearing.
With my clients, the starting place to build trust in our relationship is the silent presence, of ‘a kind of loving’. Non-possessive love. Or maybe a better way of saying it, is, ‘there has to be love in the room.’ Sometimes it is a very quiet presence, sometimes a little more overt. Never voiced. Some clients would run a 100 miles at the mere mention of the word, it scares them. And me. Even I, am uneasy in saying the word, it is so overused, sugary. I can hear thousands of therapists shouting “no,” and maybe they are right for their practice. Yet reluctant as I am to write it, it is true for me. Non possessive love is the most straightforward way of describing its components: genuine warmth, compassion, and non judgemental, is the attitude I aim for.
I tentatively step into my client’s world, and discover what it feels like for them, treading lightly, I don’t want to intrude. I am working for the beneficence of the person in front of me. It is a relief to find them more important than me, and is deeply satisfying if I can begin to help them to support themselves.
The power of this human being in front of me being fully heard, as they tell their story, is often underestimated. Exploring their relationship with themselves. Their perception of their world, not an assumption made by what they look like, or where they come from. Discovering words to describe what may never have been voiced before. The freedom not to have to protect me from their deepest pain, their worst fears or thoughts. In voicing their worries, their preoccupations, feeling lighter, and often making new connections in themselves.
Exploring the different versions of themselves that may be doing battle; or that whispering critical voice that overlays every action. Having the space to find out what is really going on beneath their defences, which has protected them in the past, but maybe thwarting them now. Revealing to themselves more fully, what they have known and haven't wanted to know, the parts that are like their parent or caregiver that they’ve most hated and find themselves being.
There is something about the structure of seeing me every week, the time regularly clocked in their diary. Knowing this is the place they can talk about the person who has died. Clients often feel they've tired their friends out. Having somewhere they can bring the build up of thoughts and feelings that are whirring through their system, dump them - or sift through them for the nuggets of truth - or unravel the twisted entangled parts of them that have been coiled in them, poisoning silently. Somewhere safe they can bring unalloyed, how much pain they are in.
In the studies you will see that I am very aware of my first responses, and my ongoing responses to my clients. It is my awareness that is the key. They give me information; is this someone I am instinctively drawing away from, or someone who is blocking me? Is their pain so great they can barely see me? I try to remain open to my response, and to offer my client my understanding, by reflecting back what I sense is going on. Not everything. Not promiscuous honesty. That’s just a way of hurting someone. I will hold onto judgements or wonderings and remember them; for when it might be appropriate to find a way to say them. Or not, they may no longer be relevant.
I use myself, my experience, my feeling as the first place to get a handle on the essence of what they are saying. For instance, if someone brings up the issue of emptiness. ‘Feeling empty;’ I connect it to my experience, as a reference point. Then I calibrate it through the lens of my client. I begin to build a picture in my mind of their internal world. Sensing, exploring their emptiness as they speak to me, and I reflect back their process. Wanting to meet them where they are. There is a simple magic that can happen in the process of reflection; when the client sees aspects of themselves sensed before, but not fully known, and in recognising themselves clearer, and can feel themselves grow internally.
At my best, it brings the best version of me to the fore. The bitching, impatient, obsessive old bag (all very much alive and well) go quiet. There is a stillness that happens as I move towards the person in front of me. My engaged curiosity is looking to attune to my client. Developing the channel of communication between us. Building trust and openness.
My responses are intended to both affirm that I can hear them as they see themselves, and maybe adding something on the edge of our understanding. A wondering. Trying something out. I can be straight talking if I think my client is harming themselves, not shaming or critical but honest. Maybe I will get something wrong. Times they will be angry with me and I need to respect it, and find out what they are so angry about. I will acknowledge it and work together to repair the rupture. At times we will get stuck, and I will name it. Sometimes we will hit on something new, other times not. There maybe questions that emerge. It is all information, and the clarification builds our understanding together.
When I’m counselling clients who are suffering from a very profound loss, probably the single most important thing I can do is acknowledge that loss. The extent of it. Let them know that I know I can’t fix it. I am not trying to. Let them know I can hear how devastated they are. How much pain they are in. That I want to know what that is like for them. I won’t flinch away from it, or shut down in the face of it. I will sit with them and bear witness to their experience. I use the cadence of my voice and the timing of when to speak, as a centring conduit between us.
Is there a direction we are heading? How do we both know we have done enough? There are no pat answers. The case studies show most accurately, how that progresses over time. Each one so very different.
When we do decide to end, I am very aware that it is by no means the end of their grieving or their relationship with the person who has died. It is the end of this particular phase of it.
A central part of my counselling practice is Supervision. A non therapy version of that is debrief. Every month I see my supervisor, and I am also part of a peer supervision group. Their value to me is incalcuable.
It is the place I use to reflect on my work, on what I am having difficulty with. To clarify my understandings. To express my own sadness about the stories I’ve heard. Say the unsayable thoughts I’ve had. Maybe they will bring into my consciousness aspects of my responses that are more about me, than my client. Help me unravel complex threads I don't understand. Acknowledge the good, the bad and the interesting aspects of my work and caseload. Suggest papers or books to read to deepen my understanding. It took me years to trust enough, to be confident enough, to be truly open with my supervisors. To tell them my errors and worries, my fears. Now of course, my learning from them is key to my practice.
By their very nature, the type of clients who seek help, are likely to be on the higher end of the suffering spectrum; than the majority of people, who don’t see a counsellor when they are bereaved. Often clients ask me if what they are feeling is ‘normal’, do others find it as difficult as they do? My hope is, that by showing what can feel so abnormal, is actually normal in grief, will help anyone reading this book, by finding something of their own experience here. That it will help them understand themselves and help them find ways to support themselves.
Whilst I feel exposed in showing how I work, and know other therapists may view how I work differently, even critically. A message has stayed with me since my early psychotherapy training from Carl Rogers: ‘the most personal is the most universal.’ My work with these clients although a professional relationship, couldn’t be more personal. How I approached it, and my framework determined the nature and outcome of the therapy. My hope is that it will connect to anyone reading them, who may borrow ideas of the kind of relationship that is helpful; it needn't be with a therapist. A loving friend, or family member who can really listen, without judgement, is curative.
All the case studies in this book are based on my reflections and learning from clients I have worked with. Wherever possible I have consulted past and present clients to ensure they are in agreement with what is being published, to avoid them any distress or harm. An overriding preoccupation whilst writing this book, has been maintaining confidentiality and anonymity of my clients. To which end, every effort has been made to anonomise people and actual events, whilst remaining true to the spirit of work.