I have the urge to blog again, and that can only mean one thing: I have papers to write for the end of the quarter. Projects to complete. Assignments to be turned in. Instead, I am blogging, running, kayaking, and … Continue reading
I decided a few days ago that B was going to be for Boundaries—a relevant topic now that I am a counselor and caregiver (see A is for Alzheimer’s). But then life intervened in unexpected ways and while I should … Continue reading
“The doctor is effective only when he himself is affected. Only the wounded physician heals.” … Continue reading
Turns out that April is Counseling Awareness Month. Isn’t this just a serendipitous turn of events? I’m writing a blog a day, A to Z about my adventures as a graduate student in Mental Health Counseling and the American … Continue reading
I can’t believe I haven’t finished my first blog for the A to Z challenge yet. I’ve been thinking about it for weeks, planning, scheming, writing it in my head, but clearly I’ve not put any words down yet. Until … Continue reading
Writers and therapists live twice—first when they experience events and a second time when they use them in their work. Mary Pipher, Letters to a Young Therapist
A few months ago, I met up with a former therapist, a woman I hadn’t been to see in about 20 years and who had since retired. I wanted to talk to her about adoption and addiction since she had been known as something of an adoption guru while she was still practicing. As I explained my course of study and my intentions for becoming a counselor, she exhorted me to pick a theory, a modality to call my own. “You need to decide which theoretical model you’ll work from,” she said. “You need to pick one to ground yourself in and work from there.” She then ticked off a list: Bowen, Adler, Rogers, Jung. I looked across the table at her and shrugged. “I think they all have something to offer,” I said. “I guess if I had to describe my orientation, it would be diverse.”
“That won’t do,” she exclaimed. “You need to be grounded in something. Anything. Just pick one. Bowen is good.”
I shook my head slowly at the thought of Murray Bowen taking up permanent residence in my head. Sure, I can see the value in looking at a person’s issues through the lens of intergenerational patterns and family systems, but as my only, primary orientation? No. So many others had much more to offer, from Jung’s wounded healer to the post modernists and narrative therapy, feminist theory, attachment theory. I couldn’t imagine latching onto just one way of being a counselor when so many modalities offered so many ways to work with people with a variety of needs.
And now this quarter we added Carl Rogers’ Person Centered Therapy and his Unconditional Positive Regard, along with Fritz Perls and Gestalt, John Cabot-Zinn’s mindfulness as well as Pema Chodron to the mix. I am even more convinced that limiting myself to one theoretical lens would be a mistake. Shortsighted.
The metaphor is overdone, but apt—the more tools I have in my tool belt, the more useful I can be to more people. Every client is going to be different. I need to be able to adapt. There aren’t many similarities between working in technology and working as a counselor, except this one: sometimes there are a variety of ways to approach a problem and finding a good solution is often a matter of “testing and tweaking” to see what works best.
As a writer, reader, and storyteller, I’ve always found narrative therapy to be the modality that draws me in. I am attracted to counseling for the same reasons I am a writer—I want my misery, and indeed everyone’s—to be meaningful. As Mary Pipher writes in her Letters to a Young Therapist, as counselors and writers, we get to use our experiences twice and encourage others to do the same. Additionally, I am attracted to narrative therapy’s post-modernist bent, the idea that it is not the individual who is sick, but the culture in which the individual lives. That depression, anxiety, PTSD for example, are legitimate responses to living in a culture that too often demands we abandon our authentic selves. Not to mention that we live in a world that insists on dividing us by race, socioeconomic status, ability, sexual orientation, gender, ethnicity, religion, and more.
I began this graduate program with the vague notion that I would emerge in two years, somehow qualified to sit and listen to people for a living. As I progress through each quarter, I become evermore convinced that two years is not nearly enough time in which to prepare me to not just listen to people’s stories, but to help them make sense of their stories, make meaning in their lives, forge on into the future with hope and a sense of purpose, with a deeper understanding of what serves them, what doesn’t, how to make good choices, how to hold onto their dreams, how to have a voice, leave an abuser, nurture their children, their relationships, find meaningful work.
How do I become that mirror, sounding board, holder of stories, cheerleader, confidant, advocate?
From the client side of the couch, I have found Gestalt and mindfulness to be the most effective therapeutic methods. Most breakthroughs in my personal therapy have come when I’ve been talking to the chair, role playing, or acting something out with my therapist. Mindfulness and meditation have worked for me outside of the therapist’s office as a way to self-regulate and deepen personal awareness. So, it’s not really surprising that over the course of this quarter I have gravitated to both, though I see Gestalt methods as being more relevant to therapy and mindfulness as a useful (and indeed maybe even necessary) adjunct for clients to use between sessions.
Gestalt therapy with its focus on the body/mind connection, lends itself well to supporting other interventions and modalities. Rogerian Person-Centered Therapy (PCT) with its mandate for unconditional positive regard seems like it should underlie every therapeutic encounter, particularly the initial few sessions.
Gestalt works well, too, with mindfulness, attachment, and sensorimotor therapies, which focus not only on how the body holds trauma and past experiences, but also on awareness and connection between the client and therapist. By encouraging clients to stay in the here and now, Gestalt leaves room for the therapist to introduce the client to mindfulness techniques which support being present and staying in the moment when things get emotional or difficult in session.
In my initial session with my practice client, employing PCT worked well to establish rapport and an initial baseline of trust. Once we got to the primary issue, however, Gestalt would have been a great way in to exploring how she was feeling in the “here and now.” I might have employed the empty chair technique had the session gone longer—I could have had my client talk to any number of representatives from her past: her parents, her younger self.
I also might have had her explore her stress about her issue and how it was sitting in her body—what does the stress feel like? Look like? How big is the stress? What color is it? Where does she feel it the most? My therapist often tells me to invite my distressing emotion in rather than trying to banish it. “Invite the stress in,” she says. “Ask it what it wants. Have tea with it.” This technique, of anthropomorphizing the disturbing emotion or feeling and dwelling on it, illustrates one way of working with an issue. When we avoid something, it gets bigger and more intense. By inviting our distressing emotion in and asking it to stay, by getting to know it, we rob it of its power.
In our second practice session, I employed both Gestalt and mindfulness (as well as Roger’s unconditional positive regard), encouraging the client to make her physical agitation bigger (I had her stand up and shake out her anxious feelings) and to incorporate some breathing techniques. This session took the client deeper emotionally than the first session, even though both sessions lasted about 20 minutes and demonstrated my improved ability to sit with a client in their discomfort. I was able to witness her experiencing emotion and hold the experience rather than try to rush her through it in order to alleviate my own discomfort.
As always, I need to be mindful of my clients’ particular culture. Every client, regardless of how they present at first glance, brings with them an individual set of circumstances that sets them apart from every other client. To be an effective therapist, I must refrain from making assumptions, and instead listen, learn, ask clarifying questions, and give the client the space and safety they need in order to fully reveal themselves, their wants, their needs, their problems.
Probably one of the most challenging aspects of counseling this quarter has been keeping tabs on my biases, assumptions, and privileges. While I am nearly always aware of my sexual orientation, my age, and do think a lot about race and how these parts of my identity might influence my interactions with a client, I’m not always thinking about ethnicity, socioeconomic status, or disability. We are, often and on the surface, a homogenous population at Antioch. I have not counseled a person of color or a person with a visible disability. I’m sure I’ve worked with clients who come from a different socioeconomic background, and though I am currently as broke as the next graduate student, I do have to remind myself that I come from a relatively privileged background and have robust support systems should I need them.
As this quarter wraps up, I feel as if I am finally getting my counselor feet under me, that I can work effectively and comfortably within a specific therapeutic framework. This quarter is the first time I have experienced authentic connection with a client, where I seem to have actually helped another person via a counseling session. I am excited to hear my clients’ stories, to listen to them as together we find meaning in and a way out of their suffering.
This quarter, as I continue working towards my Master’s degree in Clinical Mental Health Counseling, I am taking a course on counseling the LGBTQ population. Here is the course description as it appears in the syllabus: This course provides an overview of clinical issues, contemporary theories, interventions, and research relevant to the treatment of sexual minorities. This population includes Lesbian, Gay, Bisexual, and Transgender clients, as well as those clients who identify as other than heterosexual (e.g. Queer, Pansexual, Omnisexual, etc.), or are questioning their sexual orientation or gender in any way. Psychological, social, cultural, and developmental issues are explored within the contexts of theory and practice. Emphasis is on affirmative mental health services for sexual minorities, including the importance of developing an awareness of the cultural, historical, and social realities of gay, lesbian, bisexual, and transgendered individuals. Readings, discussion, videos, presentations, experiential activities, and guest lectures/panels will serve to heighten awareness of problems such as homophobia and heterosexism as they affect the therapeutic setting, the counseling relationship, and the process of psychotherapy.
Students have to pair up to lead class discussion each week, so I signed up for week two (last week), which was to cover Lesbian Identity. I wanted to be done with the assignment early on in the quarter, AND who better to lead the discussion on Lesbian Identity than an actual lesbian?
Imagine my dismay when I realized the articles we’d been assigned to read were all sadly out of date. Two were at least ten years old, and the third, a study done on 15 lesbians who lived in the UK, looked at clothing and hairstyle choices and how they correlated to coming out, data that hardly seemed relevant for a counselor in training in the Pacific Northwest.
The findings certainly didn’t match up at all with my own experience. Coming out for me had nothing to do with how I dressed—I started shopping in the boys’ department when I was a child. Ask my mom. My short haircut has nothing to do with being a lesbian and everything to do with being lazy. And the fact that I look hideous in long hair. Never mind that all the women in Bellingham—lesbian, straight, queer, bisexual—look and dress alike. There’s a uniform: fleece, jeans, hiking shoes, short hair. We all look the same, a confounding and complicating fact of life for the women (and men!) who reside here.
So, armed with my indignation and determined to find more useful data, I put out a call to my Facebook friends. Would any of them give me permission to use their pictures and their sexual identities for a Lesbian Identity Quiz? The responses overwhelmed and heartened me. Assent and identities flooded my inbox. My friends—lesbians, straight women, bisexual women, queer women, were all intrigued and excited about this project. I began creating a PowerPoint slide show, the most stunning one I have ever made, full of my friends’ bright, shining, and beautiful faces.
And it wasn’t just about the pictures. Women sent me stories too, about their sexual orientations, their choices, their gender identities. Intimate stories. I had been gifted with very personal revelations. My excitement for the project grew as I realized I had tapped into something elemental here. Don’t we all want to be seen? Don’t we all want to know how others see us?
The enthusiasm for this project caught me a bit off guard. I heard from some Facebook friends I hardly know, from others I hadn’t heard from in years, from some I have never even spoken to in person. A few I had been close to once upon a time. And a handful with whom I have just a nodding acquaintance. The eagerness surprised me, heartened me.
A couple of people sent me specific pictures, but the rest told me to use whatever I wanted from their Facebook photos. I set about culling just the right pictures from dozens of Facebook feeds. Some were easy to find, others not so much. Many pictures were taken with significant others: wives, husbands, lovers, kids. I needed clear, easy to see photos that wouldn’t reveal anyone’s identity in an obvious manner, i.e. no wedding or family pics.
I didn’t want to bias the results via the pictures I chose, but I faced a dilemma: what picture actually best represents someone? Given the opportunity to choose a picture of a straight woman in a dress or a cowboy hat, which would I opt for? Or, my friend who has a biracial baby—what message would it send if I included a photo of her holding her child? For my lesbian friends, would I choose photos of them that emphasized their more masculine traits or their more feminine sides? I have to say in retrospect that my choices probably skewed the results.
I set up the slideshow with six pictures per slide, and when I clicked the mouse, the pictures disappeared one at a time, revealing each woman’s sexual identity (lesbian, bisexual, queer femme, or straight). I printed slideshow handouts to give to each class member, so they could write their best guesses next to each picture. I looked at my work and was proud. This was going to be a kickass class discussion and presentation. I could hardly wait.
Imagine my surprise then, when I introduced the quiz in class and the instructor immediately objected. “Wait a minute,” she said. “Is everyone comfortable judging other people like this? I’m not sure this is okay.”
I stood there, stunned, and wondered for a moment if I had made a serious error in judgment. I explained that I had everyone’s permission, that each participant hadn’t just agreed but had enthusiastically and wholeheartedly opted in. My classmates rallied to my defense, shutting down the instructor’s objections in short order. I passed around the handouts and fired up the slide show.
When they had finished the quiz, I went through the slide show quickly so they could compare their answers. I didn’t linger over individual identities, nor did we discuss anyone’s picture or what made someone look like a lesbian or a straight woman. Instead we talked about what it was like to judge people based on appearance. One female student said she refused to make any judgments about the individuals, saying they all looked like beautiful women to her. The instructor refused to take the quiz, as well. But she also refuses to label herself. Honestly, I have to say I have some judgments about that.
We discussed the safety of being identifiable, the politics of passing for straight. I (being the only self-identified lesbian in the room) talked about the changes in the past ten or fifteen years. How I used to feel like no one would know I was a lesbian because gays and lesbians weren’t part of the social or political discourse. Now, I feel like I’m always identified, categorized, and labeled. The discussion meandered from there, eventually covering a variety of topics, but one that we kept bumping up against and then turning away from, how to meet this population in our counseling offices.
And there’s the lesson—or should have been. How will we counsel lesbians when they come to us? What will we know about Lesbian Identity? Is it important that we know how a dozen or so UK lesbians changed the way they dressed when they came out? Or better that we know it’s nearly impossible to identify someone by the way they look? That 50% of the time we can tell a straight woman from a lesbian? That hardly anyone will know a queer femme when they see one, and more often than not bisexuals are invisible?
My tiny experiment revealed that, in this instance at least, we are right about our assumptions approximately 50% of the time regarding sexual orientation. I’m sure there are many more ways I can exploit the data for better/more interesting information, and I have my more mathematically inclined friends working on that for me. I’ll publish those results when I get them. In the meantime, here is what I have.
What are your thoughts, Readers?