While doing supervision today, I found myself encouraging my supervisee to be more direct, to embrace his knowledge and his good judgment, and to share his knowledge and judgment with his client. This is an interesting (and perhaps surprising) stance for me to take, because, as some of you know very well, I lean hard toward Rogerian theory. I’m a fan of honoring clients’ expertise and of Carl Rogers’s words that it is “the client who knows what hurts and where to go.”
As I age (more like fine wine, and not like moldy bananas, I hope), one truth I keep feeling is that nearly everything is both-and—not either-or. Yes, I believe deeply in the naturally therapeutic process of person-centered theory and therapy; providing clients with that “certain type of environment” will facilitate self-discovery and personal growth. On the other hand, sometimes clients need guidance. In my supervision case earlier today, my point was that the client was a very long way away from deeper personal insights. That meant my supervisee needed to loan the client his good judgment and decision-making skills. As you may recognize, “loaning clients our healthy egos” is psychoanalytic language. Nevertheless, the guidance I offered my supervisee was to engage in some CBT coaching
All this reminded me of a section I updated in the 7th edition of Clinical Interviewing. The section is titled, “Client as Expert” and I’ve excerpted it below. It captures the essence of honoring client wisdom, which, IMHO, should always precede more directive interventions.
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Client as Expert
Clients are the best experts on themselves and their experiences. This is so obvious that it seems odd to mention, but sometimes therapists can get wrapped up in their expertness and usurp the client’s personal authority. Although idiosyncratic and sometimes factually inaccurate, clients’ stories and explanations about themselves and their lives are internally valid and should be respected.
CASE EXAMPLE 1.1: GOOD INTENTIONS
In one case, I (John) became preoccupied about convincing a 19-year-old client—who had been diagnosed years ago with bipolar disorder—that she wasn’t really “bipolar” anymore. Despite my good intentions (I thought the young woman would be better off without a bipolar label), there was something important for her about holding on to a bipolar identity. As a “psychological expert,” I believed it obscured her many strengths with a label that diminished her personhood. Therefore, I encouraged her to change her belief system. I told her that she didn’t meet the diagnostic criteria for bipolar disorder, but I was unsuccessful in convincing her to give up the label.
What’s clear about this case is that, although I was the diagnostic authority in the room, I couldn’t change the client’s viewpoint. She wanted to keep calling herself bipolar. Maybe that was a good thing for her. Maybe that label offered her solace? Perhaps she felt comfort in a label that helped her explain her behavior to herself. Perhaps she never will let go of the bipolar label. Perhaps I’m the one who needed to accept that as a helpful outcome.
[End of Case Example 1.1]
In recent years, practitioners from many theoretical perspectives have become outspoken about the need for expert therapists to take a backseat to their clients’ lived experiences. Whether you’re working online or face-to-face, several evidence-based approaches emphasize respect for the clients’ perspective and collaboration (David et al., 2022). These include progress monitoring, client-informed outcomes, and therapeutic assessment (Martin, 2020; Meier, 2015).
When your expert opinion conflicts with your client’s perspective, it’s good practice to defer to your client, at least initially. Over time, you’ll need your client’s expertise in the room as much as your own. If clients are unwilling to share their expertise and experiences, you’ll lose some of your potency as a helper.
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So, what’s today’s big takeaway? We start with and maintain great respect for the client’s expertise. . . and then we either stay more person-centered (or psychoanalytic) or collaboratively shift toward providing more direction and guidance. And the big question is: How do we determine whether to stay less directive or become more directive?
If you feel so inclined, let me know your thoughts on that big question.
Over and over—probably because I have a friend who once told me “Redundancy works!”—I told my group class that ending groups is about “learning consolidation.” In other words, we want group members to learn something from group. At the end of each session, and especially during the final session, we want to facilitate experiences that will help group members take their key learning beyond group, and into their lives.
Because role-modeling is a central part of being a group leader, to close our group class, I gave my students a learning consolidation assignment. Although we had been in a group (of 34) together all semester, the “final paper” was, idiographic (like Adlerian theory); students got to do their final paper in their own way. I mentioned poetry as an option, and then told the story of my own risky graduate school strategy of responding to my Advanced Learning professor’s weekly homework prompts with limericks. Turned out, my professor loved the limericks, shared them with his wife who was a writer-aficionado, and I got an “A” in Advanced Learning, while polishing my limerick skills.
Several students took me seriously and sent me fun and creative final papers. But the very last paper I read, by Astrid Santana, was BEYOND MY WILDEST DREAMS! She incorporated Haiku, knock-knock jokes, and a few limericks into her reflections on our group counseling course. I was gobsmacked, and I think you will be too. Happily, I’m here to report that I have her permission to share the paper.
Because WordPress has some difficulty in handling Haiku, I’m excerpting a sampling of Astrid’s work: First, some Haiku; second, a knock-knock joke; third, a limerick. Thanks Astrid!!
Her whole paper is available in a pdf at the bottom of this post.
My Attempt at Brevity:
Reflections on My Reflections
By Astrid Santana
Universality
Even if it sinks,
we’re in this boat together.
I’m grateful for that.
Development of Socializing Techniques
Finally realizing
I was the asshole, and not
everybody else.
Imitative Behavior
They’re so curious,
insightful, calm, and funny.
Could I do this, too?
Phases of Group Therapy
Forming
Knock knock.
Who’s there?
Hugo.
Hugo who?
Hugo first. I feel uncomfortable sitting in this circle and I don’t know if I want to be here
Good news. Yesterday, I got a mysterious email from ORCID–which stands for: Open Researcher and Contributor ID. ORCID is a global, non-profit organization. Their vision is: “a world where all who participate in research, scholarship, and innovation are uniquely identified and connected to their contributions across disciplines, borders, and time.”
Cool.
Anyway, ORCID was notifying me of a change to my ORCID record. A few minutes later, I received an email from Wiley telling me that our Happy Workshop for Grad Students article was now officially published online.
As some of you know, I’ve complained about the journal publishing process, and, although I still think it’s a pretty broken and disturbing process, working with the editors and reviewers from the Journal of Humanistic Counseling was pretty smooth and pretty fabulous. Check them out: https://onlinelibrary.wiley.com/journal/21611939
And so, without further ado, here’s the Abstract, followed by methods to access the article. . .
Effects of a Single-Session, Online, Experiential Happiness Workshop on
Graduate Student Mental Health and Wellness
John Sommers-Flanagan
Jayna Mumbauer-Pisano
Daniel Salois
Kristen Byrne
Abstract
Graduate students regularly experience anxiety, sleep disturbances, and depression, but little research exists on how to support their mental health. We evaluated the effects of a single-session, online, synchronous, happiness workshop on graduate student well-being, mental health, and physical health. Forty-five students participated in a quasi-experimental study. Students attended a synchronous 2.5-h online happiness workshop, or a no-workshop control condition. After workshop completion and as compared with no-treatment controls, participants reported significant reductions in depression symptoms but no significant changes on seven other measures. At 6 months, participants reported further reductions in depression symptoms. Moreover, across four open-ended questions, 37.0%–48.1% of workshop participants (a) recalled workshop tools, (b) found them useful, (c) had been practicing them regularly, and (d) used them in sessions with clients. Despite study limitations, single-session, synchronous, online, happiness workshops may have salutatory effects on graduate student mental health. Additional research is needed.
K E Y W O R D S: depression, graduate students, mental health, single-session, wellness
The 7th edition of Clinical Interviewing became available earlier this year. As a part of the text revision, we updated the accompanying videos, videos that Victor Yalom of Psychotherapy.net considers to be the best of their kind. And, possibly having watched more professional training videos than anyone on the planet, Victor knows what he’s talking about, and we are humbled by his endorsement.
Videos that accompany the text cover 72 learning objectives and are extensive. The bad news is that they usually, but not always, feature me. The good news is that in our video revision and upgrade, we included numerous counselors/psychotherapists of color. . . so it’s not just all me talking about how to develop your clinical interviewing skills.
If you watch them, I hope you enjoy the videos. And, if you feel so moved, please share your reactions or suggestions with me here or via email: john.sf@mso.umt.edu.
We’ve been collecting outcomes data on our Evidence-Based Happiness course for Teachers. From last summer, we have pre-post data on 39 participants. We had VERY significant results on all of the following outcomes
If you’re not an educator, you must know one, and they deserve this, so share it, please!
Now for you researcher nerds. Over the past week, I’ve tried to fit in some manuscript writing time. If you’re following this blog, you’ll already know that I’ve experienced some rejections and frustrations in my efforts to publish out positive psychology/happiness outcomes. I’ve also emailed various editors and let them know what I think of their reviews and review processes. . . which means I may have destroyed my chances at publication. On the other hand, maybe sometimes the editors and reviewers need a testy review sent their way!
Yesterday, a friend from UC Santa Barbara sent me a fairly recent review of all the empirical research on College Happiness Course Outcomes. To summarize the review: There are HARDLY ANY good studies with positive outcomes that have been published. Specifically, if you look at U.S. published studies, only three studies with control groups and positive outcomes have been published. There’s one more I know of. If you want to read the article, here it is:
In my last post, I reviewed the most basic of all therapeutic emotional responses, the reflection of feeling. As noted yesterday, reflections of feeling are, by definition, neutral . . . and providing a neutral reflection has benefits and liabilities.
For clients who have a history of experiencing negative judgments and oppression, instead of remaining neutral, it may be necessary to be explicitly validating. In Chapter 5 of our Clinical Interviewing textbook, we begin by describing and providing examples of the technique called “Feeling Validation.”
If you’re tracking closely, you’ll recall that a reflection of feeling is on the left side of the “listening continuum” and feeling validation is in the center of the listening continuum. Below, you’ll find information on using feeling validation from the Clinical Interviewing text.
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Directive Listening Skills
Directive listening skills are advanced interviewing techniques that encourage clients to examine and possibly change their thoughts, emotions, and behaviors. Directive listening skills can be used for assessment, exploring client issues, and facilitating insight. They include:
Feeling validation
Interpretive reflection of feeling
Interpretation (psychoanalytic or reframing)
Confrontation
Immediacy
Questions
Directive listening skills place you in an expert role. The therapist’s behaviors in this chapter range from being mostly client centered to mostly therapist centered. Client-centered directives zero in on what the client is already talking about, but take clients deeper. Therapist-centered directives shift clients toward what they’re not yet talking about. Directive listening skills operate on the assumption that clients will benefit from guidance or direction.
Feeling Validation
Reflections of feeling (discussed in Chapter 4) are often confused with feeling validation. The difference is that reflections of feeling are more purely client centered, whereas feeling validation includes your opinion, approval, or validation of client emotions. A feeling validation is an emotion-focused technique that acknowledges and validates your client’s explicit feelings. It’s a message that communicates, “What you’re feeling is a natural or normal emotional response.” Feeling validation is an emotional affirmation.
The difference between reflecting feelings versus validating feelings may seem subtle, but it provides an excellent example of the complexities of skillful interviewing. Skilled interviewers use reflection of feeling as a method to prompt clients to evaluate their own emotions. In contrast, they use feeling validation as a method to support and reassure clients. Feeling validation includes a psychoeducational-authoritative-reassurance component. Novice interviewers may not be aware of the difference.
Psychoanalytic clinicians distinguish between supportive and expressive psychotherapy techniques. Based on this distinction, feeling validation is a supportive technique, and feeling reflection is an expressive technique. Clients usually feel supported and more normal when you validate their emotions. Clients may experience greater stress if you use reflections of feeling to have them examine and judge the validity of their own emotions.
Supportive techniques like feeling validation are outside-in self-esteem boosters. They’re based on the therapist (as an outside authority) saying something like “Your anger in response to being unfairly accused of stealing something seems natural.” One drawback of outside-in self-esteem boosters is that they don’t facilitate self-discovery. The boost that comes from external emotional validation may be temporary and not lead to lasting client change. If clients come to rely on validation of their feelings, they may continue to look outward for external validation.
All approaches to feeling validation give clients the message, “Your feelings are acceptable, and you have permission to feel them.” You might even use feeling validation to suggest to clients that they should be having particular feelings.
Client 1: I’ve been so sad since my mother died. I can’t seem to stop myself from crying. (Client begins sobbing.)
Therapist 1: It’s okay to feel sad about losing your mother. That’s perfectly normal. Crying in here as you talk about it is a natural response.
The preceding exchange involves validation. By openly stating that feeling sad and crying is normal, the therapist takes on an expert or educator role.
Another way to provide feeling validation is through self-disclosure:
Client 2: I get so anxious before taking tests, you wouldn’t believe it! All I can think about is how I’m going to freeze up and forget everything. Then, when I get to class and look at the test, my mind just goes blank.
Therapist 2: I remember feeling the same way about tests.
In this example, the therapist uses self-disclosure to validate the client’s anxiety. Although using self-disclosure to validate feelings can be reassuring, it’s not without risk. Clients may wonder if therapists can be helpful with anxiety symptoms if they have similar anxieties. Self-disclosure can also enhance therapist credibility, as a client may think, “Hmm. If my therapist went through test anxiety too, maybe he’ll understand and be able to help me.” Using self-disclosure to validate client emotions can diminish or enhance therapist credibility—depending on the client and the therapeutic relationship (see Case Example 5.1).
Therapists can also use universality to validate or reassure clients.
Client 3: I always compare myself to everyone else—and I usually come up short. I wonder if I’ll ever feel confident.
Therapist 3: You’re being hard on yourself. I don’t know anyone who feels a complete sense of confidence.
Clients may feel validated when they observe or are informed that nearly everyone else in the world (or universe) feels similar emotions. Yalom provided a personal example:
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 [towards my mother], I was beset with death wishes for her, 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 not only offered considerable relief but enabled me to explore my ambivalence in great depth. (Yalom & Leszcz, 2020, p. 7)
Feeling validation is a common technique. People like to have their feelings validated; and, often, counselors like validating their clients’ feelings. However, open support, such as feeling validation, can reduce client exploration of important issues (i.e., clients assume they’re fine if their therapist says so).
Potential effects of feeling validation include:
Enhanced rapport
Increased or reduced client exploration of the problem or feeling (this could go either direction)
Reduction in client anxiety, at least temporarily
Enhanced client self-esteem or feelings of normality (perhaps only temporarily)
Possible increased client-therapist dependency
In many clinical scenarios, clinicians lead with less directive skills (i.e., Chapter 4) before using more directive skills (i.e., Chapter 5). However, there are some clinical situations where feeling validation or affirmation of clients take priority.
As you think about feeling validation, and all the complexities it can include, consider the following case example.
CASE EXAMPLE 5.1: Struggling to Manage the Impulse to Project My Disability Issues onto a Client
Eddy Fagundo, Ph.D., CRC, CVE, a Senior Manager of Education Content for the American Counseling Association wrote an essay on managing his impulse to project his own issues and lived experiences onto a client. Have you ever worked with someone who reminded you of yourself? Imagine yourself in Dr. Fagundo’s role. Would you be able to manage your impulses to be too comforting and too validating? Although this case is about countertransference, projection, and overidentification with the client, it’s also about appropriately validating self-disclosure and countertransference management.
“Mommy Rosemary, why does Eddy speak Russian?’” was an odd question that had become common for my friends (at age 5-years) to ask my mother . . . in Cuba. What my friends did not know was that I was not speaking Russian; I was speaking Spanish, or so I thought! Growing up, I had speech problems, but was determined to overcome them. I never missed any of my speech therapy appointments and was disciplined in practicing the difficult Spanish rolling Rs in front of the mirror before and after school. I did it! In third grade, I won the best reader in class award. Life was bright. Little did I know, that four years later, I would immigrate to the United States, and learn a new language. But I did this too!
These memories flashed before my eyes when counseling a young Cuban immigrant male with a speech impediment. The client felt defeated, isolated, and had low expectations of himself. I was conflicted; this young man was me as a child. If I could overcome my speech problems, I wanted to tell him: He could too! At the time, I was a new rehabilitation counselor. The situation made me keenly aware of potential projection issues. I knew I could not tell the client what to do. I knew I could not tell him he would be able to succeed, just as I did, because I was no more special than he was.
And so, I consulted my colleagues and supervisor. I focused on being aware of and bracketing my feelings and reactions, and on building a therapeutic relationship. I accepted the client unconditionally and respected his right to be himself without having me project my lived experiences onto him. Instead, I used my lived experiences therapeutically by professionally and appropriately self-disclosing my past struggles with speech problems. Counselor self-disclosure, when done sparingly and effectively, builds trust, fosters empathy, and strengthens the counseling relationship.
Today, the client is fully fluent in what some would argue to be the true universal language: mathematics. He holds a doctorate in mathematics, the speech impediments are improved, and he lives a fulfilling life. Even today, I wonder how different the outcome would have been had I not had the self-awareness and professional support to counter my projection impulses.
We will encounter clients similar to us in ways that make us struggle to avoid projecting our own lived experiences onto them. We need to identify those clients, but to do so, we must first ask, “Who am I, and who is standing beside me to support me in this journey of self-discovery?”
[End of Case Example 5.1]
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Our Clinical Interviewing text also includes specific learning activities. If you want to check out a learning activity designed to add nuance to your feeling (emotional) vocabulary, check out this handout:
We’ve been talking about emotions in our Group Counseling course at the University of Montana. Even though focusing on emotions has grown immensely in popularity within contemporary counseling and psychotherapy, some students seem to be missing a few basics. Last week, when I took time to talk about the differences between (a) reflection of feeling, (b) interpretive reflection of feeling, and (c) feeling validation most of the students found the information useful. Consequently, I’m including here (and in a following blog post or two) excerpts from the latest edition of our Clinical Interviewing textbook. https://www.wiley.com/en-us/Clinical+Interviewing%2C+7th+Edition-p-9781119981985
The foundation that guides how clinicians respond to clients is described in our “Listening Continuum” (see below).
This excerpt is from the section in Chapter 4 on Reflection of Feeling.
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Reflection of Feeling (aka Empathy)
The primary purpose of a reflection of feeling is to let clients know, through an emotionally focused paraphrase, that you’re tuned in to their emotional state. Nondirective reflections of feeling encourage further emotional expression. Consider the following example of a 15-year-old male (he/him) talking about his teacher:
Client: That teacher pissed me off big time when she accused me of stealing her phone. I wanted to punch her.
Counselor: You were pretty pissed off.
Client: Damn right.
In this example, the feeling reflection focuses only on what the client clearly articulated. This is the rule for nondirective feeling reflections: Restate or reflect only the emotional content that you clearly heard the client say. No probing, interpreting, or speculation are included. Although we might guess at underlying dynamics contributing to this boy’s fury, a nondirective feeling reflection focuses on obvious emotions.
Emotions are personal. Every attempt to reflect feelings is a move toward closeness or intimacy. Some clients who don’t want relational connection with you may react negatively to reflections of feeling. You can minimize negative reactions to reflections of feeling by phrasing them tentatively, especially during an initial interview:
When using reflection to encourage continued personal exploration, which is the broad goal of reflective listening, it is often useful to understate slightly what the person has offered. This is particularly so when emotional content is involved. (W. R. Miller & Rollnick, 2013, p. 59)
Emotional accuracy is your ultimate goal. However, if you miss the emotional target, it’s better to miss with an understatement than an overstatement. If you overstate emotional intensity, clients will often backtrack or deny their feelings. As we’ll discuss in Chapter 12, there’s a proper time to intentionally overstate client emotions. Generally, however, you should aim for accuracy while proceeding tentatively and understating rather than overstating clients’ emotions. Rogers (1961) would sometimes use clarification with clients after giving a reflection of feeling (e.g., “I’m hearing sadness and pain in your voice… am I getting that right?”).
If you understate a reflection of feeling, your client may correct you.
Client: That teacher pissed me off big time when she accused me of stealing her watch. I wanted to punch her.
Counselor: Seems like you were a little irritated about that. Is that right?
Client: Irritated? Fuck no—I was pissed.
Counselor: You were way more than irritated. You were pissed.
In this example, a stronger emotional descriptor is better because the client expressed more than irritation. However, any adverse effect of “missing” the emotion is minimized because the counselor phrased the reflection tentatively with “Seems like…” and then added a clarifying question at the end. Then, perhaps most important, when the client corrected the counselor, the counselor repaired the reflection to fit with the client’s emotional experience. From a psychoanalytic perspective, the repairing of emotional mirroring or empathy might be the most therapeutic part of listening (Kohut, 1984; see Practice and Reflection 4.3 to practice emotional responses to clients).
Reflections of feeling are often labeled as empathy. If only empathy were so simple. As Clark noted, “Rogers . . . was appalled by this . . . as the rich and nuanced process of empathy was reduced to trivial and repetitive expressions of a therapist identifying a client’s feelings” (p. 23). As we move forward through this chapter and other content on more directive interviewer responses, remember that empathy should be woven into nearly every therapist utterance, including confrontation, advice, and behavioral homework (Clark, 2023).
With clients, mental health professionals engage in emotional clarification, exploration, validation, and education. Your role varies depending on your clients’ needs and situation. As a technique, reflection of feeling aids clients in clarifying and exploring their emotions. For this chapter and reflection of feeling, the best path is a tentative one, wherein you function as a mirror to help clients experience and articulate their emotions with greater clarity. Doing so can serve to help clients explore and gain greater understanding of their emotional worlds. To accomplish your interviewing goals, you don’t need to know everything about the academic and popular debates over emotions; instead, you partner with clients to deepen your mutual understanding of the emotional experiences.
[Several pages of the text are skipped here]
Gender, Culture, and Emotion
Imagine you’re in an initial clinical interview with a Latino (he/him) cisgender male husband and father. He looks unhappy and your impression is that he’s angry about his wife’s employment outside the home. You’re aware that some Latine/x people have traditional ideas about male and female family roles. This knowledge provides you with a foundation for using a reflection of feeling to focus on his anger:
I’m getting the sense that you’re a little angry about your wife deciding to go back to work.
He responds,
Nah. She can do whatever she wants.
You hear his words. He seems to be empowering his wife to do as she pleases. But his voice is laden with annoyance. This leads you to try again to connect with him on a deeper level. You say,
Right. But I hear a little annoyance in your voice.
This reflection of feeling prompts an emotional response, but not the one you hoped for.
Sure. You’re right. I am annoyed. I’m fucking annoyed with you and the fact that you’re not listening to me and keep focusing on all this feelings shit.
This is a dreaded scenario for many clinicians. You take a risk to reflect what seems like an obvious emotion, and you get hostility in return. Your emotional sensitivity and effort at empathy backfires. The client moves to a defensive and aggressive place, and a relationship rupture occurs (see Chapter 7 for more on dealing with relationship ruptures).
It’s tempting to use culture and gender to explain this client’s negative reaction to your reflection of feeling. But it’s not that simple.
Although culture, gender, race, and other broad classification-based variables can sometimes predict whether specific clients will be comfortable with emotional expression, individual client differences are probably more substantial determinants. Comfort in expressing emotion is often a function of whether the client comes from a family-neighborhood-cultural context where emotional disclosure was a norm. For example, Knight (2014) reported that Black and Latino males who were unlikely to disclose to their peers attributed this tendency to their experiences living in violent communities. These young men learned that emotional expression and trusting others were bad ideas in their neighborhoods. Conversely, emotional disclosure is more likely in the comfort range of Black and Latine/x males raised in safer communities. This makes good common sense: Whether clients perceive you as safe to talk with about emotional concerns probably has more to do with their backgrounds and past experiences than you.
Overall, it’s likely that clients’ willingness to tolerate feeling reflections is based on a mix of their cultural, gender, and individual experiences. Although biogenetics may be involved too, how people handle emotions is largely socialized (McDermott et al., 2019). If you have reason to suspect that your client is socialized to be uncomfortable with emotions, you should avoid emotionally specific words. Examples of emotionally specific words include angry, sad, scared, and guilty.
Instead of emotionally specific words, you can substitute words that are emotionally vague (and less intense). Later, as trust develops, you might be able to use specific emotional words. Consider the following phrases:
You found that frustrating.
It seems like that bothered you a bit.
It’s a little upsetting to think about that.
Practice and Reflection 4.4 lists examples of emotionally vague words you might use instead of emotionally specific words.
PRACTICE AND REFLECTION 4.4: USING VAGUE AND EMOTIONALLY SAFE WORDS
Emotionally Specific Words
Substitute (Safer) Words
Angry
Frustrated, upset, bothered, annoyed
Sad
Down, bad, unlucky, “that sucked”
Scared
Bothered, “didn’t need that,” “felt like leaving”
Guilty
Bad, sorry, unfortunate, “bad shit”
Note: These words may work as substitutes for more emotionally specific words, but they also may not. It will be more effective for you to work with your classmates or in your work setting to generate less emotionally threatening words and phrases that are culturally and locally specific.
[End of Practice and Reflection 4.4]
Gender diverse clients may be emotionally sensitive in ways different than clients on the gender binary. Due to their neutrality, reflections of feeling—even when accurate—can be activating if clients are sensing you’re coming from a place of judgment. Consider the following:
Counselor: You said your family is rejecting your sexual identity, and you’re feeling terribly sad about that.
Client: Wouldn’t you?
When clients have a substantial history of interpersonal rejection, emotional invalidation, and/or oppression, neutral comments from clinicians can be perceived as judgmental. In this exchange, the counselor uses an accurate simple paraphrase along, with an emotional reflection, but the client feels judged and responds defensively. Given the client’s history, feeling judged in response to neutral reflections is natural. What the client needs (to feel connected and supported) is a response that’s explicitly affirming or validating (Alessi et al., 2019). In this case, at least until rapport is established, rather than a feeling reflection, the client would likely react better to a feeling validation (“Your sadness in response to your family’s rejection of your sexual identity seems totally normal”; see Chapter 5 for information on feeling validations).
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Thanks for reading. In the coming week, there will be additional posts on the basics and nuances of working with emotions in counseling and psychotherapy.
Last summer, when I taught our Happiness for Teachers course along with Lillian Martz, one of the most powerful assignments involved forgiveness. Even though we emphasized that the teachers taking our class didn’t need to actually engage in a forgiveness process, they shared incredibly deep and profound stories of betrayal, forgiveness, and the struggles in between. Here’s the assignment. Again, we’re not saying you need to engage in a forgiveness process. All we’re suggesting is for you to read this and think about forgiveness. Here’s the assignment:
Whether we’re talking self-forgiveness, forgiving others, or spiritual forgiveness, forgiveness is a big deal and a big ask.
For this learning activity, we don’t expect you to purge yourself of all personal guilt or become free from all resentments. Nevertheless, for this assignment, your job is to explore what forgiving yourself, forgiving others, and being forgiven might look like AND how forgiving yourself, forgiving others, and being forgiven might feel to you.
To do this activity, you’re not expected to actually do the forgiveness work; instead, you get to think about doing the forgiveness work and speculate on its effects. . . FOR YOU. Although forgiveness is probably the biggest issue we’ve tackled in this Happiness Challenge, the plan is for you to just take a small sip from the very large cup of potential forgiveness issues that we all have. If you want to go deeper and take a bigger drink, that’s perfectly fine, but that’s all up to you.
To get yourself oriented toward forgiveness you could (if you want) consider and access some of the following ideas and online resources:
Consider that forgiving others can improve your physical health. As Anne Lamott wrote in Traveling Mercies: “Not forgiving is like drinking rat poison and then waiting for the rat to die.” Is there anyone other there toward whom you might offer forgiveness? You don’t even have to talk with them (although you can, if that works for you). You can just bring yourself to a place where you’ve let go of any lingering anger or resentment that you’re holding.
For the first time in seven years, I’m teaching group counseling this semester. This forces me to think about, “What’s the latest scoop on teaching group counseling?” I’ve been reading and talking and gaining information, but if anyone out there has particular insights to share with me, please do.
In my prep, I’ve decided that there’s tons of content out there, in professional journals, books, book chapters, and everywhere else I look. Nevertheless, to break free from the oppression of content, one of my first decisions is to go experiential. This isn’t much different from seven years ago, but my plan is to be even MORE experiential.
Based on previous experiences teaching group, talking with faculty, and talking with students, the Group course is a place with a complex mix of anxiety, vulnerability, and potential conflict. To manage this exciting and challenging mix, I’ve got several plans.
After my infamous “Group is open” anecdote, I will share my philosophy on brain development and counselor skill development. In the Moodle shell, I wrote: “Hey Everybody, Welcome to our group counseling course at U of M. I love group counseling and I love teaching group counseling. More than any other approach, group work requires that we maintain an attitude of acceptance and hold the statements and disclosures that others make with sensitivity and grace. One big goal in this class is for all of us to continue to grow those parts of our brain that makes us excellent listeners. Mostly, we need to let go of other parts of our brain that wants to debate, argue, and express our opinions. I look forward to this adventure and journey with you. See you Tuesday, John SF”
TBH, I’m not sure how my philosophy will fly with students . . . but sharing it fits with Irvin Yalom’s mantra that the group leader is instantly the primary norm setter and role model. Along with my philosophy, I will also disclose some of my anxieties and insecurities. Yes . . . even after 40+ years as a mental health professional, I still feel the creep of imposter anxiety.
Then we’ll circle up and jump into two rounds of experiential introductions. I do two rounds of experiential introductions to give students a chance to “feel” the difference between more structured and less structured group process. I’ve done this before; it feels like a relatively safe, fun, and process-oriented opening.
Then, in the spirit of Yalom’s “self-reflective loop,” we will debrief and debrief some more.
After exiting the experiential introductions, we’ll stay in the circle, review the course syllabus (assignments), and then talk about our planned feedback process. Once, when I asked Allen Ivey for his best advice on learning counseling skills, he said he could summarize his advice in six words: “Practice, practice, practice, feedback, feedback, feedback.” I thought that was a pretty cool answer. You can check out my ideas about feedback on a previous blog post: https://johnsommersflanagan.com/2020/08/18/guidelines-for-giving-and-receiving-feedback/
The last part of class #1 (time permitting) will be me reviewing a few group counseling basics (e.g., group types, group stages, cultural humility, under-confidence, overconfidence, and the wonder and narrowness of the dialectic of lived experience. Should be a blast.
I’m hoping to blog every week about my Group Counseling class and the teaching and learning experience. Of course, that will depend on my time management skills. I’m thinking maybe I’ll coax one of my students into running a psychoeducational group on time management—and then maybe I’ll actually achieve my weekly Group Counseling goals.
Here’s a screenshot of my feedback prompt (aka ppt slide).
Last week was about emotional journaling. This week, we stick with the power of words and writing and take a dive into an evidence-based therapeutic writing activity called the Best Possible Self.
You all already know about optimism and pessimism.
Some people see the glass half full. Others see the glass half empty. Still others, just drink and savor the water, without getting hung up on how much is in the glass. Obviously, there are many other responses, because some people spill the water, others find a permanent water source, and others skip the water and drink the wine or pop open a beer.
Reducing people to two personality types never works, but that doesn’t stop people from labeling themselves or others as optimists or pessimists. This week’s activity—The Best Possible Self—is an optimism activity. You don’t have to be a so-called optimist to use it. And the good news is, regardless of your labels, the Best Possible Self writing activity is supposed to crank up your sense of optimism. That’s cool, because generally speaking, optimism is a good thing. Here’s what the researchers say about the Best Possible Self (BPS) activity.
[The following is summarized from Layous, Nelson, and Lyubomirsky, 2012]. Writing about your Best Possible Self (also seen as a representation of your goals) shows long-term health benefits, increases life satisfaction, increases positive affect, increases optimism, and improves overall sense of well-being. Laura King, a professor at U of Missouri-Columbia developed the BPS activity.
King’s original BPS study involved college students writing about their Best Possible Selves for 15 minutes a day for two weeks. The process has been validated with populations other than college students. If you want to jump in that deep, go for it. On the other hand, if you want a lighter version, here’s a less committed alternative:
Spend 10 minutes a day for four consecutive days writing a narrative description of your “best possible future self.”
Pick a point in the future – write about what you’ll be doing/thinking then – and these things need to capture a vision of you being “your best” successful self or of having accomplished your life goals.
As with all these activities, monitor your reactions. Maybe you’ll love it and want to keep doing it. Maybe you won’t.
If you feel like it, you can share some of your #writing on social media.
Berkeley’s Greater Good website includes a nice summary of the BPS activity. Here’s a pdf from their website:
Being a counseling and psychotherapy theories buff, I should mention that this fantastic assignment is very similar to the Adlerian “Future Autobiography.” Adler was way ahead of everyone on everything, so I’m not surprised that he was thinking of this first. Undoubtedly, Adler saw the glass half full, sipped and savored his share, and then shared it with his community. We should all be more like Adler.
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John Sommers-Flanagan 