Thoughts on the Relationship Between Cleavage and Professional Counseling and Psychotherapy

The following is a short discussion about cleavage in counseling and psychotherapy.  We’re not especially trying to be provocative (which is one reason why no photo accompanies this blog post) and so we’re interested in your thoughts on this short excerpt BEFORE we include it in the 5th edition of our Clinical Interviewing text.

[Excerpt starts here] For the first time ever in a textbook (and we’ve been writing them since 1993), we’ve decided to include a discussion on cleavage. Of course, this makes us feel exceptionally old, but we hope it also might reflect wisdom and perspective that comes with aging. 

In recent years we’ve noticed a greater tendency for female counseling and psychology students (especially younger females) to dress in ways that can be viewed as somewhat sexual. This includes, but is not limited to low necklines that show a considerable amount of cleavage. This issue was discussed on a series of postings on the Counselor Education and Supervision listserv which includes primarily participants who teach in master’s and doctoral programs in counseling. Most of the postings included some portion of the following themes.

  • Female (and male) students have the right to express themselves via how they dress
  • Commenting on how women dress and making specific recommendations may be viewed as sexist or inappropriately limiting
  • It is true that women should be able to dress any way they want
  • It is also true that specific agencies and institutions have the right to establish dress codes or otherwise dictate how their paid employees and volunteers dress
  • Despite egalitarian and feminist efforts to free women from the shackles of a patriarchal society, how women dress is still interpreted as having certain socially constructed messages that often, but not always, pertain to sex and sexuality
  • Although efforts to change socially constructed ideas about women dressing “sexy” can include activities like campus “slut-walks,” the clinical interview is probably not the appropriate venue for initiating a discourse on social and feminist change
  • For better or worse, it’s a fact that both middle-school males and middle-aged men (and many “populations” in between) are likely to be distracted—and their ability to profit from a counseling experience may be compromised—if they’re offered an opportunity for a close up view of their therapist’s breasts
  • At the very least, excessive cleavage (please don’t ask us to define this phrase) is less likely to contribute to positive therapy outcomes and more likely to stimulate sexual fantasies—which we believe is probably contrary to the goals of most therapists
  • It may be useful to have young women watch themselves on video from the viewpoint of a client (of either sex) that might feel attracted to them and then discuss how to manage sexual attraction that might occur during therapy

It’s obvious that when it comes to clinical interviewers showing cleavage, we don’t have all the perfect answers. Guidelines depend, in part, on interview setting and specific client populations. At the very least, we recommend that you take time to think about this issue and hope you might also consider discussing cleavage issuesJ with your class or your supervisor.

Info on Clinical Interviewing – the text and videos – is at: http://lp.wileypub.com/SommersFlanagan/

 

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In Honor of Swin Cash

     I just saw an advertising on ESPN.com with WNBA player Swin Cash is showing off her strength and power and it reminded me of an old newspaper column I wrote back in 1999 or so. When I wrote it I got a 10 page single-spaced piece of hate mail from a man who evidently hated women. I hope role models like Swin Cash make this sort of topic obsolete. Here’s the old column from the Missoulian newspaper.

Chess for Girls

“America today is a girl destroying place. . . girls are encouraged to sacrifice their true selves” 

                                                                                —  Mary Pipher, Reviving Ophelia                       

I recently learned about a special version of the classic game of chess.  This new chess game is designed especially for girls.  While I was busy irritating my wife by doing that male channel-surfing thing (we get 4 channels) I came across an advertising for a product called: “Chess for Girls.” 

The ad began with a boy and girl playing chess.  The girl made a move and the boy quickly countered, “Checkmate!  What a stupid move!”  The girl whined back, “I hate this game.” 

The ad rolls on.  “Aren’t you girls tired of that boring old-fashioned chess game?  You should try. . . Chess for Girls!” 

Chess for girls is just a bit different than chess for the rest of us.  It uses some of the same playing pieces as regular chess, but also includes Barbie and Ken and is based to a large degree on how fashionably the contestants can dress up their chess pieces and the Barbies.

As the ad ends, the girl wins and the boy slumps away muttering something like, “That’s not real chess.”

Turns out I was watching a Saturday Night Live advertising spoof.  Nevertheless, I got the point and those of you who watch television should get the point too.  Our culture goes the extra mile when it comes to messing with girls’ self-esteem. 

Some friends of mine recently told me that their daughter’s gym teacher scolded her for “running like a girl.”  And the teacher didn’t mean it as a compliment.  My friends went straight down to the school to express their concern.  The gym teacher said “Aw, heck.  I didn’t mean anything by it.  You know, it’s just an old saying.”  Of course, the problem is that the old saying is an insult to girls and women.  No one says “You run like a girl” or “You throw like a girl” or even “You play chess like a girl” and means it as a compliment.

Another group of students (boys and girls) at one of our local high schools were told that the reason girls aren’t as good as boys when it comes to math and the hard sciences is because of hormonally-based male-female brain differences. It’s doubtful that statements like that help girls achieve in those fields.

I know some girls who are joyfully in touch with their power.  Some of them flex their muscles for me when I see them.  They want me to know all about their toughness, swiftness, and agility.  Sometimes they’ll challenge me to an arm wrestling match or to race them across the park–or even to a game of chess.  And they really want to win.  They want to show me their power.  Unfortunately, none of these powerful girls are over 12.  Rarely do any teenage girls I know ever flex their muscles.  Usually, they don’t want me (or anyone else) to know about their power.

We need to teach teenage girls that it’s okay to be strong and powerful and smart.  Too often girls are taught that the only arena in which they should compete is with each other for the attention and approval of males.  Girls need to believe that it’s okay for them to compete fully in sports, math, and life.  They won’t always be victorious, but they should never have second thoughts about giving it their best.

In Reviving Ophelia, Mary Pipher describes common experiences of strong and smart girls:

“Many strong girls have similar stories: They were socially isolated and lonely in adolescence.  Smart girls are often the girls most rejected by peers.  Their strength is a threat and they are punished for being different.  Girls who are unattractive or who don’t worry about their appearance are scorned.”

Our girls need to discover and take pride in who they are–no easy task in the face of the loud and persistent messages they get about who they should be.  Pipher and others have offered tips on how to help our girls embrace their identities and survive to adulthood:

  • Encourage girls to find a safe place to explore who they are and what they value.  Usually this place has to be at home or some other place where they can turn off the television and not be oppressed by prominent cultural messages.
  • Actively point out the injustices and absurdities of the ways women are portrayed in the media.  Help them love themselves and their bodies just as they are.
  • Encourage exercise, sports activities, and solid academic effort as sources of development and pride.  Downplay girl-identities based on boyfriends.
  • Moms:  Model self-confidence and pride in being a woman. 
  • Dads:  Affirm your daughter’s worth as your beloved child and as a wonderful female with much to offer.  Communicate to her that you think girls are great, not because they can be like boys and not because they can dress up real pretty.
  • Help girls learn to say no and set boundaries.  Unfortunately, many girls are so busy worrying about how other people are feeling that they have trouble focusing on their own wants and needs.

I have a dream that I’m playing chess with my daughter.  We’re playing the traditional version of chess (not the Saturday Night Live version).  My king is on the run. . . my daughter’s queen is chasing him down.  She makes her final move and claims her victory.  “CHECKMATE,” she roars with laughter.  I smile.  I’m thinking we both just scored a major victory.

Who’s Afraid of a Little Coxsackie Virus?

Like the Papa in the Berenstain Bear series, I like to think of myself as not getting sick. And so when Rylee became feverish and lethargic and didn’t finish her dinner last week, I performed my usual fatherly function of not letting food go to waste. I finished off her plate.

When Chelsea called the next morning and informed us that Davis (age 2) and Seth (age 32) had begun showing symptoms of hand, foot, and mouth disease, my confidence remained unshaken. After all, the little coxsackie virus at the root of the hand, foot, and mouth disease lives happily in our intestines and most adults are immune anyway, having gotten the condition sometime during childhood.

But the last several days have now decompensated into a hazy malaise combined with annoying pimple-like blisters erupting on my hands, feet, and other less mentionable locations. So who’s afraid of a little coxsackie virus now?

Having for years scoffed my way through recommendations for handwashing and concerns about germ theory I am now appropriately contrite. Contrition is another detestable condition, by the way.  

[Insert profanity here.]

Here’s what WebMD has to say:

Hand-foot-and-mouth disease is an illness that causes sores in or on the mouth and on the hands, feet, and sometimes the buttocks and legs. The sores may be painful. The illness usually doesn’t last more than a week or so.

I’m on day 4 or 5 [Insert more profanity here.]

The other problem with this is that I now have the energy of a sloth and attention span of a toddler. In fact, the fact that I’ve written this little essay and stayed on point strikes me as rather a remarkable factoid in this particular lived moment.

There are benefits, however. Because my throat has broken out in hand-foot-and-mouth blisters I’m forced to keep making myself milkshakes. I also discovered that our blender is an excellent ice crusher. Did you know if you add a can of fruit juice to about a dozen ice cubes and blend or frappe, you create a drink that can cool the blisters in your throat. [Very nice.]  

Other updates and thoughts for the day:

  1. I am very sad for the victims of the Colorado shooting.
  2. The right to bear arms is in no way abrogated by regulating and tracking internet (and other) sales of ammunition.
  3. There are lies, damned lies, and statistics.
  4. Being sick sucks, but the measure of my pain is so minor compared to the multidimensional and ubiquitous nature of human suffering that I cannot help but embrace my new friend, the coxsackie virus, who, as it turns out, is named after Coxsackie, NY.

This is not Coxsackie, NY

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Help Children Deal with Frustration and Become more Persistent

Carolyn Webster-Stratton from the University of Washington has developed an incredible evidence based approach designed to “promote children’s social competence, emotional regulation and problem solving skills and reduce their behavior problems.” This approach is titled “The Incredible Years.” More information is at the website:  http://www.incredibleyears.com/About/about.asp

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Below is a short excerpt from our “How to Talk so Parents will Listen” book that focuses on one small dimension of Dr. Webster-Stratton’s program. Our book is at: http://www.amazon.com/How-Listen-Parents-Will-Talk/dp/1118012968/ref=sr_1_5?s=books&ie=UTF8&qid=1342904983&sr=1-5&keywords=how+to+listen+so+parents+will+talk+and+talk+so+parents+will+listen

Persistence Coaching

A part of the “Incredible Years” parent training curriculum includes a unit on what Webster-Stratton (2007) refers to as persistence coaching. Persistence coaching is especially designed for children with attention difficulties and provides an excellent example of intense and passionate social reinforcement. Webster-Stratton (2007) describes the procedure:

During persistence coaching, the parent is commenting on the child’s attention to the task. A parent might say to his child who is working with blocks, “You are really concentrating on building that tower; you are really staying patient; you are trying again and are really focusing on getting it as high as you can; you are staying so calm; you are focused; there, you did it all by yourself.” With this persistence coaching, the child begins to be aware of his internal state when he or she is calm, focused, and persisting with an activity. (pp. 317–318; italics in original)

This example by Webster-Stratton not only illustrates focused and passionate attention as a behavioral reinforcer, it also includes components of mirroring, solution-focused strategies, and character feedback. After getting intensive attention and specific feedback for persisting on a tower-building task, children are more likely to overcome negative beliefs about themselves and to begin seeing themselves as persistent and capable.

Some parents will say their child hates positive comments and prematurely conclude that these approaches are destined to backfire and be ineffective, perhaps even detrimental. This will be most likely when children display oppositional tendencies and/or have very negative internal beliefs about themselves. As if it were constantly Opposite Day, it will seem to parents as if praise is punishment and punishment is praise when they’re trying to work with their children. Webster-Stratton (2007) comments on this phenomenon:

Children with conduct problems usually get less praise and encouragement from adults than other children. When they do get praise, they are likely to reject it because of their oppositional responses. For some children, this oppositional response to praise and encouragement is actually a bid to get more attention and to keep the adult focusing on them longer. Parents can help these children by giving the praise frequently and then ignoring the protests that follow. Over time with consistent encouragement, the children will become more comfortable with this positive view of themselves. (p. 312) 

Our general policy is to closely watch for backward behavior modification and to counter it by teaching parents how to pay attention to positive behavior, ignore negative behavior, and administer passionate and surprise rewards and boring consequences. We’re sometimes surprised (and rewarded) by how quickly parents see that they’re inadvertently and destructively celebrating Opposite Day, when a regular day would suffice. (See Parent Homework Assignment 9-1.)

A Wiley Website with Info about our Brand New Counseling and Psychotherapy Videos

This spring and summer Rita and I have been working with John Wiley & Sons to produce DVDs to go with our textbooks Clinical Interviewing and Counseling and Psychotherapy Theories in Context and Practice. The Clinical Interviewing DVD is out and the Theories DVD will be available soon. There’s a new website with information about this at: http://lp.wileypub.com/SommersFlanagan/

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John reading the new textbooks to his twin grandchildren (who look quite excited about learning how to do psychotherapy).

 

Parenting Advice: Don’t Say it More than Three Times

A Visit to the Mall

Here’s what a parent of a 5-year-old and a 2-year-old explained when she came in for a consultation:

Parent: My friend invited me and my two kids to meet her and her two-year-old at Bellevue Square for dinner and shopping. I knew better. This friend makes me feel insecure. We met for dinner at this nice café and there’s nothing there my kids will eat. After a while, they start running around the café. I settle them down and we walk around to shop and my five-year-old son is running way ahead and I keep trying to get him to get back with us and he won’t listen. We eventually get to a pet store and my two-year-old is climbing on stuff and my five-year-old is knocking on the pet-cage glass right where it says “Don’t knock on the glass” and he won’t stop. Finally, I drag them both to a bench and make them sit there and I yell at them and they start crying and I’m humiliated and have to carry them both outside to the car and yell at them some more. I was one of those parents you see who has out-of-control children and then goes berserk.

Consultant: So, eventually your kids started listening to you? [Focusing on how the negative behavior sequence finally stops can be revealing.]

Parent: Yes. Because they knew it was over.

Consultant: When you tell that story it reminds me of how kids can sometimes almost read our minds and know when something is really important to us and know when they can take advantage of us by not listening. But then when we somehow make it clear that the fun and games are over, suddenly they get it and cooperate.

Parent: I felt so uncomfortable with my friend and her potty-trained little girl and I couldn’t even come close to controlling my kids. And later that night, when I was talking about it to my 5-year-old, I apologized for yelling and losing my mind and I asked him why he didn’t listen to me and he said, “I listened, I just didn’t do what you said.” I couldn’t believe it!

Consultant: That’s amazing. So, he really did know what was going on.

Parent: He did and he still didn’t cooperate.

Consultant: Can I share some ideas with you?

Parent: Yes. I’d love some ideas!

Consultant: We used to have a parent educator here who taught a class called, “They only listen when I yell . . . and other parenting myths.” The point of the class was exactly what you’ve been talking about. It’s not that our kids only pay attention when we yell, it’s that they only comply when they know we’re completely serious. Tell me, how many times did you have to ask your five-year-old to cooperate before he finally did?

Parent: It had to be twenty times. I was trying to get him to sit down at the café, to come back to us when we were shopping, to stop knocking on the glass at the pet shop, and he would sometimes partly respond and sometimes not at all, until the end, when he sat on the bench and started crying.

Consultant: Here’s what I’m thinking. You already said you set yourself up with this dinner with this friend and her practically perfect two-year-old. I’ll bet somewhere inside you were really wanting to avoid a confrontation with your kids and the embarrassment that goes with it. And they sensed you were a little bit afraid to confront them and afraid to give out firm consequences and so they just chose not to listen or cooperate.

Parent: I know. I know. I don’t even take my two-year-old grocery shopping any more because it’s too much. And obviously they knew I didn’t really want to follow through with any consequences. But what can I do?

Consultant: I have two ideas and the first one will sound really weird.

Parent: Just tell me.

Consultant: This is crazy, but you need to start looking forward to when your children have tantrums or misbehave.

Parent: That is weird.

Consultant: I know, but unless you look forward to it, with confidence that you can handle whatever they do, they’ll sense your dread and fear and they’ll be the ones who are confident they can do whatever they want—like run ahead in the mall and knock on the pet store glass cages—because they sense you’re afraid to stop them.

Parent: Okay. I get it. But I don’t know how I can look forward to a meltdown in the mall.

Consultant: And that’s exactly why we need to develop a nice and clear and practical plan for the next time this sort of thing happens. You need a very simple plan for limit-setting with your children. Because if you have to ask them to cooperate twenty times, they know they don’t have to pay any attention or respect to you—until the twentieth time when you’re yelling and screaming. The plan should have one or two warnings and then a small consequence. For example, in the mall situation, it might have been embarrassing, but the first time your kids didn’t respond to your requests to sit down or walk with you, you could have given a clear warning, something like, “Okay, if you don’t walk with me, then we’ll go outside and spend some time on the bench until you’re ready to come back in.” Then, the second time one of them didn’t cooperate, you’d calmly collect them and take a brief timeout on the bench or in your car. Then, if it happened a third time, you could turn to your friend and say, “I’m sorry, but it looks like my kids aren’t cooperating right now and so I need to take them home.” I know that might have felt embarrassing and awkward, but it would communicate very clearly to your children that you are a serious mom who’s confident in her limits and decisions.

Parent: It wouldn’t have been half as embarrassing as the way things turned out.

In this case, we developed a very simple limit-setting system. It involved three steps:

1.  The first time the children misbehave, give a clear warning.

2.  The second time the children misbehave, take them into a brief and boring timeout from the fun.

3.  The third time the children misbehave, the fun activity ends.

In addition to these three steps, we discussed managing the children’s physical needs by checking if they were hungry, tired, sick, or hurting and planning in advance for outings. We also discussed how she could review with her children, in advance of the outing, exactly what she expected and exactly what would happen (brief public timeout, followed by a disappointing trip back home) if misbehavior occurred. Finally, we suggested that she set up some practice outings where she could quickly and effectively implement the consequences without the pressure of a friend looking on. The purpose of these outings was to practice the plan and demonstrate to her children exactly what would happen if and when public misbehavior occurred.

Overall, this procedure is consistent with what we know from the science of behavioral psychology. As Kazdin (2008) states: “Here’s a rough rule of thumb to go by: if you say it twice (the initial instruction plus one reminder), that’s reminding; if you say it three or more times, you’re nagging and nagging can undermine [your credibility and power]” (p. 172). In addition to Kazdin’s good advice, we like to emphasize to parents that most children are amazingly intuitive—like dogs, they can sense their parents’ fear.

Give Information and then Back-Off: A Choice Theory Parenting Assignment

Parent Homework Assignment 8-1 — From How to Listen so Parents will Talk . . . http://www.amazon.com/How-Listen-Parents-Will-Talk/dp/1118012968/ref=sr_1_8?s=books&ie=UTF8&qid=1341892854&sr=1-8&keywords=how+to+listen+so+parents+will+talk+and+talk+so+parents+will+listen

Choice Theory Communication Skills Training: How to Provide Information and Then Back Off, Instead of Trying Too Hard to Control Your Child’s Decision Making

As a loving parent, if you’re concerned about your children’s behaviors, you’ll probably have a strong and nearly irresistible impulse to tell them how to live their lives. After all, you’re the adult and they should listen to your excellent advice. You may feel the urge to say:

  • You need to clean your room now because being disorganized and undisciplined is a bad habit that will make your life miserable.
  • Alcohol and drugs are illegal and so if you go out and behave illegally, I’ll call the police and have you ticketed.
  • You need to start caring about your grades at school and that means scheduling time for homework and studying for tests.
  • Swearing is unacceptable in this house and if you do it again, I’ll wash your mouth out with soap.

Unfortunately, as you may recall from your own childhood, when parents are bossy and insistent about how things should be, children often become more stubborn and resistant. Then parents begin to nag and lecture and the pattern of advice-giving and advice-rejection deepens. This assignment is designed to help you communicate important information to your children without starting an all-out power struggle or negative nagging pattern. The following suggestions are appropriate only if the situation isn’t dangerous and you don’t need to jump in and directly and forcefully protect your children:

1. Ask permission. If you have a strong opinion that you’d like your child to hear, try asking permission to share it. Say something like, “Can I share my opinion on this with you?” Then, either your child will say “yes” and you can share your opinion or she’ll say “no” and then you’ll need to accept her boundary (in response to a “no,” you might say, “Okay. Thanks for being honest with me. Let me know if you change your mind” and then walk away).

2. Express your intention not to express your opinion. You could try telling your child, “I have an opinion on this, but I trust that you can work it out, or that you’ll ask me for help if you need it. So I’m going to try to keep my mouth shut for now.” This gives your child the message that you’re trying to respect his ability to work out his own problems. You can also add humor into this or other power-sharing techniques by adding: “You should really appreciate this, because you know how hard it is for me to keep my mouth shut and not give you advice.”

3. Provide your information or opinion and then back off.  If you can’t resist giving your opinion, just do it and then back off and let your child consider your input. The key to this strategy is patience. Undoubtedly, you’ll provide excellent advice and then your child will look like she’s not considering your advice and so you’ll have the urge to repeat your advice over and over until you see action. Instead of falling into this pattern, try saying, “Look. I’ve got an opinion, which you probably already know. But instead of staying quiet, I’m just going to say it and then let you make your own decision on how to handle your situation. It’s your life. You have to make your own decisions. But I love you and can’t stop myself from telling you what I think, so here it is.”

As you probably already know, if you express your opinion you may get a strong emotional response (e.g., “I’m fifteen years old and I can make my own decisions!”). Although this seems weird, if you give lots of advice, your children may see your ideas and opinions as evidence that you don’t believe they’re competent to make their own decisions. This is why you should always express your advice with love and concern; avoid sounding as if your main goal is to control your child’s behavior.

Finally, if the situation is dangerous or potentially so, skip the less direct parenting recommendations listed above and instead think strategically about how to deliver direct advice that will be heeded. You’ll probably need to use a more direct approach than is described here, and you may need to consult with a professional.

More assignments like this and more are in the book, How to Listen so Parents will Talk — http://www.amazon.com/How-Listen-Parents-Will-Talk/dp/1118012968/ref=sr_1_8?s=books&ie=UTF8&qid=1341892854&sr=1-8&keywords=how+to+listen+so+parents+will+talk+and+talk+so+parents+will+listen

Author, Speaker, University of Montana Professor