Category Archives: Counseling and Psychotherapy Theory and Practice

Opening Thoughts on Feminism

This is the opening section from our feminist chapter in Counseling and Psychotherapy Theories in Context and Practice — written with help from Maryl Baldridge, M.A.

For years, psychiatric journals have touted the salutary effects of antidepressants by printing “before” and “after” pictures showing a woman leaning on a mop looking despondently at her kitchen floor, and then happily mopping it after taking her medication.

—E. Kaschak, Engendered Lives (1992, p. 22)

At the American School Counselor Association National Conference in 2011, Georgie Bright Kunkel, a 90-year-old woman, delivered a keynote address. She bounded onto the stage—not looking a day over 80. She introduced herself as the oldest stand-up comic in Washington state (Was there an older stand-up comic somewhere else on the planet?). She proceeded to crack jokes about everything from sex to . . . well . . . sex, and then sex again. In the middle of her routine, she slipped in a serious story that went something like this:

I was working as a school counselor at an elementary school. To kick off our career day, I contacted a woman friend of mine who was an airplane pilot. She agreed to land her one-person plane in the middle of our schoolyard. We were all very excited. We gathered the students outside and watched as she guided the plane down and smoothly landed on the playground. The students crowded around as she emerged from the tiny plane, helmet in hand. When it became apparent she was a woman, one of our male students turned to me and asked, “Where’s the pilot?” It was clearly a one-person plane, but in this boy’s mind, men were pilots and women were stewardesses. This was a sad truth for many of our students. But what interested me more was the impact of this event on our students’ career ambitions. We had decided to take a student survey before and after career day. Before my friend landed on our playground, exactly 0% of our female students listed “airplane pilot” as one of their potential career choices. After career day, about 40% of the girls listed airline pilot as a career to consider in the future.

This is an example of a feminist working therapeutically to bring about development, change, options, and liberation. Feminist therapy can be transformative. It was designed, in part, to break down unhelpful stereotypes and free all humans to fulfill their potentials.

Reflections on Listening to Irvin Yalom at the ACA Conference

After a few hectic and overstimulating days at the ACA World Conference in San Francisco, I’ve now secured the back table at a Starbucks in Vancouver, WA for brief written reflection. This reflection weaves quotations (and paraphrases) from the great Irvin Yalom into my own personal conference experiences.

My formal conference highlight was watching and listening as NPR’s Craig Windham interviewed Yalom onstage for the keynote. After listening to Yalom’s keynote six years ago, I think the interview format was an ingenious method for capturing a more personal glimpse into Yalom and his writing than a stand and deliver keynote speech.

I especially enjoyed listening to Yalom reflect on his early years. Two statements stand out:

On his career decision-making as a child of Russian immigrants: “We had two choices: We could become a doctor or a failure.”

On his unparalleled greatness within the field of group psychotherapy: “My wife thinks it’s rather ironic that I became an expert in group psychotherapy, because I’m really quite uncomfortable in groups.”

Early in his “speech” Yalom emphasized the importance of counselors to the field of psychotherapy. In several ways he made curiously stimulating statements emphasizing (I’m paraphrasing now) that counselors are the future of psychotherapy. As a hybrid counselor and psychologist, I wonder if he would have made the same statements had he been keynoting at the annual American Psychological Association meeting.

My reactions to Yalom’s claim about counselors being the future of psychotherapy are free-ranging like the chickens in our backyard, but here are two:

Yes, I think counselors will be the future of psychotherapy, but only if we’re able to stop getting in our own way . . . And psychologists will undoubtedly be the future of measuring psychotherapy efficacy . . . if they (or we) can manage to focus on issues more meaningful than pharmacology and neuroscience.

For those curious about where Yalom finds his writing inspiration, in response to Windham’s questioning, he disclosed that as a Californian he has mastered the evening hot tub experience. Subsequently, he’s able to write most productively in the morning about “what I’ve learned in the hot tub.” I suspect there’s a bit more to it than that . . . but for those of us aspiring toward more writing greatness it makes for a solid rationale for nightly inspirational hot-tubbing.

On the popularity of his Group Psychotherapy text, Yalom stated: “I suspect it’s because of the stories in the book that I smuggled in . . .”

On his personal experience of fame (keep in mind that about 4K of us had to line up like rock concert fans to see him), he shared his own sort of dissociated imposter feelings:

“There’s a part of this that is very unreal. I don’t have any foundation. My parents were uneducated. They had very little schooling. I don’t have any foundation behind me. It’s a little shaky for me. I compare it to a lily growing in a swamp. There’s no foundation underneath. No matter how successful I am, I question . . . is this really me. Am I really successful?”

As an existential psychotherapist, it’s not surprising that Yalom believes deeply in helping clients pursue meaning. This is where it gets personal for all of us. He said, “Cancer cures psychoneurosis” and that “Life cannot be postponed.” Over the years he has helped many clients focus on their regrets—which often translate into moments when they weren’t able to face life and life fully in the moment. But we shouldn’t mistake Yalom’s live-in-the-moment philosophy for old-fashioned California hot-tub hedonism.  Yalom’s version of living in the moment is at once emotional AND intellectual; it is inspirational AND intentional.

Yalom also said that “Storytelling . . . may be the very best way I can teach.” Lucky for me I’ve gathered a few teaching stories over the years. Sometimes a combination of reality and my own constructive fiction, at this ACA I had a chance to share many stories. First, in a six hour pre-conference Learning Institute on Wednesday attended by 32 fabulous counselors, and later in an ACA-sponsored Friday session on Connecting and Working Effectively with Challenging Youth attended by about 200. In terms of reaping my own share of attention and praise, this was perhaps my best ACA conference ever.

But then Sunday morning comes. And when I awaken, what grand thoughts trickle into my consciousness? Do I think of the 25 people who lined up to have me sign copies of “Tough Kids, Cool Counseling?” Do I lie on the floor of my high-school educated parents home—where I’ve stopped for a short visit—feeling smug satisfaction about the glory I felt when Craig Windham of NPR fame also stood in line to have me sign a book FOR HIM. Do I reflect on the sweet and ego-boosting comments he shared with me about my work?

Nope. Nothing so grand knocks on the door of my early morning awareness. Instead, I’m transported back to a moment when, immediately after speaking to 200 conference attendees and spontaneously signing a couple books and receiving repeated praise from participants, a bold young woman approached me. She had attended BOTH my six hour workshop AND my 90 minute talk . . . and so forgive me my anticipation of praise as I looked into her eyes. But instead, she tells me that she’s not sure she learned anything from the six hour workshop. My well-practiced response is to welcome the criticism, while fending off disappointment and defensiveness. I feel precariously situated on my own lily pad. She goes on to explain that she’d “accidentally” gotten stuck in the 90 minute presentation and that based on what I’d talked about in there she thought I’d want the constructive feedback. “Of course I do,” I say . . . “Of course I do . . . and thank you very much for that.”

This is the stinging mantra to which I awaken this lovely and cloudy Sunday morning. A mantra of self-doubt . . . of possible regret . . . of wondering what I did wrong . . . of how I might improve myself.

Which brings me back to one of my favorite Yalom quotations (from his Group Psychotherapy text) about universality:

“During my own 600-hour analysis I had a striking personal encounter with the therapeutic factor of universality . . . I was very much troubled by the fact that, despite my strong positive sentiments, I was beset with death wishes for [my mother], as I stood to inherit part of her estate. My analyst responded simply, “That seems to be the way we’re built.” That artless statement offered not only offered considerable relief but enabled me to explore my ambivalence in great depth.” (p. 7)

Thank you Dr. Yalom for helping me and many others more deeply understand ambivalence, regret, self-doubt, personal meaning, death, and many of the other interesting ways the human psyche is built. And thank you, bold young woman, for providing me with hot-tub-free grist for my morning therapeutic writing mill.

On My Way to ACA . . . and Thoughts on Drunken Sexual Consent

Hey. I’m on my way to the American Counseling Association conference in San Francisco. Tomorrow (Wednesday) I’ll be doing a full-day workshop on working effectively with challenging teenagers. If you’re reading this and will be at the conference, I’ll be hanging out at the John Wiley & Sons booth in the Exhibition Hall off and on (especially Thursday evening about 5pm) and will be doing an author signing for ACA on Friday from 4-5pm at the ACA booth. Please stop by and introduce yourself or catch me at the conference somewhere and say hello.

On my way to SF I had a chance to read an exceptionally courageous article in the University of Montana Kaimin (the student newspaper). It was written by a young woman who is coming out about two rape experiences on campus. Both involved her being far too drunk and she was brave enough to acknowledge that. However, as she notes, being drunk and dressing provocatively is not a message to all stimulated males that she WANTS sex.

This is a tough situation. It’s about consent and risky behavior and the many different channels of human communication. What I like about her article is that by disclosing her experiences she is contributing to consciousness-raising and it is ONLY through consciousness-raising that we can hope to shift the social norms away from the acceptability of presumed (drunken) consent on college campuses and elsewhere.

There’s an important message here for college males who might interpret a college woman’s behavior as “asking for it.” We need to resist our natural male urges and think about this. Okay, she is exposing herself to a risky situation and maybe she should know better . . . but think of her as your sister or your daughter or your future wife and make the right decision to control your sexual impulses in favor of a better situation where you can be ABSOLUTELY certain that you’re getting clear and unequivocal sober consent.

Drunken sexual encounters are all-too-common on college campuses. We are all responsible. Neither drunk males or females can really give consent. There is diminished capacity. For everyone I hope the Kaimin article can raise awareness. We all can do better than obtaining sexual gratification under the cloud of a drunken haze.

Flaws in the Satanic Golden Rule

summer-13-long-shadow

Nearly always I learn tons of good stuff from my adolescent clients. A few years ago I learned what “Macking” meant. When I asked my 16-year-old Latino client if it meant having sex (I gently employed a slang word while posing my question), his head shot up and he made eye contact with me for the first time ever and quickly corrected me with a look of shock and disgust. “Macking means . . . like flirting,” he said. And as he continued shaking his head, he said, “Geeze. You’re crazy man.”

The next half hour of counseling was our best half hour ever.

I’m not advocating using the F-word or being an obtuse adult . . . just pointing out how much there is to learn from teenagers.

More recently I learned about the Satanic Golden Rule. A 17-year-old girl told me that it goes like this: “Do unto others as they did unto you.”

Now that’s pretty darn interesting.

Ever since learning about the Satanic Golden Rule I’ve been able to use it productively when counseling teenagers. The Satanic Golden Rule is all about the immensely tempting revenge impulse we all sometimes feel and experience. It’s easy (and often gratifying) to give in to the powerful temptation to strike back at others whom you think have offended you. Whether it’s a gloomy and nasty grocery cashier or someone who’s consistently arrogant and self-righteous, it’s harder to take the high road and to treat others in ways we would like to be treated than it is to stoop to their level to give them a taste of their own medicine.

There are many flaws with the Satanic Golden Rule . . . but my favorite and the most useful for making a good point in counseling is the fact that, by definition, if you practice the Satanic Golden Rule, you’re giving your personal control over to other people. It’s like letting someone else steer your emotional ship. And to most my teenage clients this is a very aversive idea.

After talking about the Satanic Golden Rule many teenage clients are more interested in talking about how they can become leaders. . . leaders who are in control of their own emotions and who proactively treat others with respect.

An excellent side effect of all this is that it also inspires me to try harder to be proactively respectful, which helps me be and become a better captain of my own emotional ship.

A New Book in the Mail

Even though it’s only a textbook, it’s still pretty darn exciting when a new book arrives in the mail with our names on it. It will never be a NYT best-seller, but it’s far and away the funniest book there is out there on Counseling and Psychotherapy Theories. . . which is sort of a funny claim to be making anyway.

And so a small glimpse of this pure excitement, here’s a sneak peek at the . . . yessss . . . the Preface!

Preface

(from Counseling and Psychotherapy Theories in Context and Practice, 2nd edition, John Wiley & Sons, 2012)

One morning, long ago, John woke up in the midst of a dream about having written a theories book. Over breakfast, John shared his dream with Rita. Rita said, “John go sit down, relax, and I’ll sit behind you as you free associate to the dream” (see Chapter 2, Psychoanalytic Approaches).

As John was free-associating, Rita tried to gently share her perspective using a two-person, relational psychotherapy model. She noted that it had been her lived experience that, in fact, they had already written a theories text together and that he must have been dreaming of a second edition. John jumped out of his seat and shouted, “You’re right! I am dreaming about a second edition.”

This profound insight led to further therapeutic exploration. Rita had John look at the purpose of his dream (see Chapter 3, Individual Psychology); then he acted out the dream, playing the role of each object and character (see Chapter 6; Gestalt Therapy). When he acted out the role of Rita, he became exceedingly enthusiastic about the second edition. She, of course, accused him of projection while he suggested that perhaps he had absorbed her thoughts in a psychic process related to Jung’s idea of the collective unconscious. Rita noted that was a possibility, but then suggested we leave Jung and the collective unconscious online where it belongs (see the Jungian chapter in the big contemporary collective unconscious of the Internet).

For the next week, Rita listened to and resonated with John as he talked about the second edition. She provided an environment characterized by congruence, unconditional positive regard, and empathic understanding (see Chapter 5, Person-Centered Theory and Therapy). John flourished in that environment, but sneakily decided to play a little behavioral trick on Rita. Every time she mentioned the word theories he would say “Yesss!,” pat her affectionately on the shoulder and offer her a piece of dark chocolate (see Chapter 7, Behavioral Theory and Therapy). Later he took a big risk and allowed a little cognition into the scenario, asking her: “Hey, what are you thinking?” (see Chapter 8, Cognitive-Behavioral Theory and Therapy).

Rita was still thinking it was too much work and not enough play. John responded by offering to update his feminist views and involvement if she would only reconsider (see Chapter 10, Feminist Theory and Therapy); he also emphasized to Rita that writing a second edition would help them discover more meaning in life and perhaps they would experience the splendor of awe (see Chapter 4, Existential Theory and Therapy). Rita still seemed ambivalent and so John asked himself the four questions of choice theory (see Chapter 9, Choice Theory and Reality Therapy):

  1. What do you want?
  2. What are you doing?
  3. Is it working?
  4. Should you make a new plan?

It was time for a new plan, which led John to develop a new narrative (see Chapter 11, Constructive Theory and Therapy). He had a sparkling moment where he brought in and articulated many different minority voices whose discourse had been neglected (see Chapter 13, Developing Your Multicultural Orientation and Skills). He also got his daughters to support him and conducted a short family intervention (see Chapter 12, Family Systems Theory and Therapy).

Something in the mix seemed to work: Rita came to him and said, “I’ve got the solution, we need to do something different while we’re doing something the same and approach this whole thing with a new attitude of mindful acceptance” (see Chapter 11, Constructive Theory and Therapy and Chapter 14, Integrative and Evidence-Based New Generation Therapies). To this John responded with his own version of radical acceptance saying: “That’s a perfect idea and you know, I think it will get even better over a nice dinner.” It was at that nice dinner that they began articulating their main goals for the second edition of Counseling and Psychotherapy Theories in Context and Practice.

 

My Favorite Imaginary Group Therapy Session

This is an excerpt from our soon-to-be-published Counseling and Psychotherapy Theories in Context and Practice (second edition, 2012, John Wiley & Sons). It is, of course, like most theories textbooks, packed with subtle and less subtle humor. We even recently had a senior in college tell us that it was the first textbook he actually read cover-to-cover. Now if that’s not an endorsement of just how riveting a textbook can be . . .

The following excerpt is from the last chapter (Chapter 14).

A Concluding Image: Group Therapy with Some Amazing Clients

After reading and writing about so many great therapy minds, one of us (you can guess which one) had the following daydream: Imagine many of the historical and contemporary therapy masters gathered together in one location. They form a circle and begin a discussion. Old friends and rivals are reunited. Freud appears and shakes hands with Jean Baker, Miller who has brought quite a number of impressive-looking women with her. Fritz Perls tries to kiss some of their hands. Adler brings his wife. Carl Rogers signs a book for Prochaska. New friends are made, old rivalries rejuvenated. Insoo Kim Berg smiles quietly off to one side. Jung notes to himself that she must be an introvert. What might happen in this circumstance? What might happen in An Encounter Group for the Major Players?

After some initial mingling, the group process begins:

Rogers: I wonder where we might want to start.

Raissa Adler: Here’s where I’m starting. I’m not taking the minutes for this meeting. I did that back in 1912 for the Free Psychoanalytic Society, so I’ve put in my time. It’s someone else’s turn, and I nominate a male, any male. Women have been taking notes in meetings for so long it’s ridiculous. The problem with women’s psyches has more to do with oppression than repression.

Feminists: [Including Jean Baker Miller, Judith Jordan, Espin, Lillian Comas-Diaz, and Laura Brown—all of whom subversively snuck into the group] You go woman! We’re with you.

Freud: That’s it. Say whatever comes to mind.

Ellis: If you want to think that taking notes is oppression, that’s up to you, but as far as I can tell, you’re oppressing yourself with a bunch of damn crazy, irrational thinking.

Beck: You know Al, we’ve been through this before, but what I think you mean is that Raissa’s thinking that taking notes is oppression could be maladaptive, but not irrational.

Glasser: Raissa can choose to take notes or choose not to take notes. She can also choose to think she’s oppressed or choose not to think she’s oppressed. Personally, Raissa, I recommend that you read my book, Choice Theory. I want you to read it, and I think it will help you, but of course, whether you read it or not, that’s completely your choice.

F. Perls: Be here now, Raissa. Act out those feelings. Be the pen. Talk to the paper.

L. Perls: Fritz, she can be the pen without your assistance. If by chance she finds herself, that’s beautiful.

Ellis: She won’t find a goddamn thing in this group of love-slobs without a flashlight.

Skinner: Uh. Albert. I’ve been wanting to mention to you that if you could just keep quiet when people in here say inappropriate things, we might have a chance at extinguishing that particular behavior.

Ellis: Well, Burris, did you have an irrational thought that someone might actually care about your opinion before you engaged in that speaking behavior, or was it just a function of its consequences?

V. Satir: Albert, if you could just get up on that chair and talk down to Burris, I think you could get in touch with your placating style.

Skinner (Whispering to Ellis): Seriously man. Just ignore her. I’m talking about a complete extinction schedule. Just like I’m ignoring you – except for when you sit quietly and listen to me like you’re doing now.

Rollo May: Freedom and dignity are the essence of being. There’s far too much freedom, with very little dignity in this room.

I. K. Berg: If a miracle happened and we all got out of this group without anyone getting murdered, what would that look like?

A. Adler: My God, I just remembered an earlier memory. No wonder I felt so inferior.

Freud: I hate that word. I just want to be recognized for my contributions. It would make my mother proud.

Rogers: It’s like if only I can make my mother happy. And getting recognized, being remembered, that’s one big way you can have that experience.

Ellis: Siggy, my man. Let me just say this. That crap about being recognized and making your mother proud is the most f—ing ridiculous thing I’ve ever heard in my life. What’s the big deal if everybody forgets you? What’s the terrible, awful, very bad thing that will happen? I mean, think logically about this. You’ll be dead and it won’t make a white rat’s ass difference if people remember you or not.

Feminists: That’s right. I can’t believe we’re agreeing with Albert Ellis. White males can afford to play with such big ideas. Immortality. Do you have a clue about the legacy you’ve actually left? There have been decades of girls and women with destroyed self-esteems. Do you recognize that they litter your road to “greatness”?

Mahoney: I can see Freud as great and I can see feminism as great. Even this lived moment in our genetic epistemology exudes the potential for greatness. We are not a passive repository of sensory experience, but instead, we’re co-constructing this reality right now.

Prochaska: This entire group seems to me to be in precontemplation.

D. W. Sue: Yeah, well, I might consider change if we could construct in a minority voice or two? Most of what I’ve heard thus far is the construction of a very narrow, White reality. Culture is primary, and we need to include color if we’re to meet the needs of everyone, including Raissa, who happens to have a strong Russian ethnocultural identity.

Raissa Adler: [Slowly stands and walks over and embraces D. W. Sue.]

Rogers: What I’m seeing and what I’m hearing, if I’m getting this right, is affection and appreciation. Two people who have, now and again, felt marginalized are able to connect more deeply with each other right now in this moment than with anyone else.

M. White: Actually, Carl, I think I’d just call this a sparkling moment.

Good Ideas about Multicultural Counseling and Psychotherapy – Part II

Three More Ideas About Multicultural Counseling

4.  Developing your Self-Awareness is Central

Both the American Counseling Association and the American Psychological Association place self-awareness of the therapist as a central factor in developing multicultural competency. This is a great, but tricky idea. It’s tricky because of the nature of awareness is such that it’s all too easy for us to remain unaware to very significant multicultural issues. If you’re interested in exploring your multicultural awareness further, you should check out the Implicit Association Test at: https://implicit.harvard.edu/implicit/.

I have a friend who often claimed: “I’m not insensitive, I’m just oblivious!” Of course this was offered in humor, but obliviousness—especially if you’re aware of it—is no good excuse for being insensitive to diversity issues. I’m also reminded of the insensitive and oblivious response of many White Montana students to multicultural discussions. It’s not unusual for some of them to say things like, “I just haven’t had much contact with people from other cultures because we don’t have many minorities in Montana.” When I hear this I try not to gasp aloud as I, or a Native or First Nations Person points out that, in fact, 6.8% of Montana’s population is Native American and that several people IN THE ROOM are Native American.

The initial splash of multicultural awareness is often accompanied by an emotional response . . . and occasionally a bit or a bundle of defensiveness.

5.  As you Work Towards Multicultural Competence, Remember the Concept of Multicultural Humility

Although it’s standard procedure in the counseling and psychotherapy literature to refer to multicultural competence, one major problem with the term multicultural competence is that it implies that there’s an endpoint in the multicultural awareness, knowledge, and skill acquisition process. For this reason, I prefer the terms multicultural humility or multicultural sensitivity.

Similar to awareness, I think humility is central to good multicultural work. Unfortunately, within the dominant cultural media-based messages humility is typically viewed as being weak and confidence, swagger, and even arrogance is seen as more desirable. Thomas Merton (quoted in part I of this blog series) has a quotation that speaks to the tendency for entire countries to engage in self-superiority. He wrote:

“The greatest sin of the European-Russian-American complex which we call the West (and this sin has spread its own way to China) is not only greed and cruelty, not only moral dishonesty and infidelity to the truth, but above all its unmitigated arrogance toward the rest of the human race.”

It’s crucial for multicultural counselor and psychotherapists to move beyond thinking in terms of competence and tolerance (both of which speak to Merton’s ideas of arrogance). Instead, we need to embrace our fallibilities and humility and approach cultural and individual differences with what Marcia Linehan might call radical acceptance and what Carl Rogers would have referred to as unconditional positive regard.

6.  Keep Making Efforts to Understand a Collectivist Cultural Perspective.

In collectivist cultures, values and norms are shared. The self and the personality are defined in terms of group memberships, and the group needs and values are more central than those of the individual. Some people with collectivist perspectives avoid the whole idea of the concept of self or self-esteem or self-image. Instead, Collectivists tend to evaluate themselves based on attaining group goals.

For lots of us folks who have been deeply involved in American individualism, the idea of collectivism can feel odd and repeatedly difficult to grasp. This is where exposure, discussion, and real listening to others becomes so important. Rather than trample on the idea of collectivist being, we need to persistently take extra steps to maintain awareness of this concept that can be so slippery for individualists to grasp.

To close this blog, in 1975 Robert Hogan wrote,

A central theme in Western European history for about 800 years has been the decline of the medieval synthesis or, alternatively, the emergence of individualism. Two hundred years ago individualism was a moral and religious ideal capable of legitimizing revolutions and inspiriting sober and thoughtful minds. Sometimes in the last century, however, social thinkers began to regard individualism in more ambivalent terms, even in some cases as a possible indicator of social decay. (p. 533)

This is interesting stuff, even if it’s sometimes difficult to completely and consistently understand.