Tag Archives: Counseling

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.

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.

Serious Advice for Parents of Teens

When Parenting Teenagers — Age Matters

Most parents easily recognize that when it comes to parenting, age matters a great deal.  If you’re not convinced, try giving your teen a nice, cuddly hug, preferably in public.  Not surprisingly, what’s fun and rewarding for one age group, is stupid, incomprehensible, or embarrassing for another.

Teens can be especially challenging for parents. Forgive the blunt language, but the truth is:  Teens often think adults in general, and their parents in particular, don’t know squat.  When I recently shared this well-known fact with a teenager, she gently corrected me by saying, “I think what you mean to say is that adults only know squat.”  I just rolled my eyes and said, “Whatever.”

In contrast to some of my teenage friends, I happen to believe that adults usually do have their squat together.  Therefore, I’ve written a short guide (with attitude) for anyone who has the daunting task of communicating with teenagers.

Principle 1: Always remember, on average, adults are usually smarter and wiser than teenagers.  This fact comes with a certain responsibility.  It means we should strive to really act like we’re smarter and wiser than teenagers.  This means, unfortunately, we have to act mature.  Sometimes we have to go the extra mile when trying to understand today’s youth.  It also means quickly forgiving them when their brains seem to malfunction.

Think about what it means to be more mature – and maybe even wiser – than your teenager.  Think of how to demonstrate your adult maturity in a way that your teen will respect.  Be concrete and specific.  For example, don’t think: “I’ll show my wisdom and maturity by trying to be more patient when he talks on and on about skateboarding.”  Instead, think something like: “I’ll make a point of asking him about his skateboarding at least twice a week. Then, if he’s up for talking, I’ll pay attention to him for at least 5 minutes before I change the subject or get distracted with something else.”

Principle 2: Many teenagers have a special invisible antenna that sticks out from the top of their head. Don’t bother looking for this antenna because it’s invisible.  It’s a “Respect Antenna.”  It functions to instantly ascertain whether a given adult likes or respects a given teen.  Consequently, although teens may act like they’re not paying any attention to you, they’ll still be able to psychically determine whether or not you like and respect them.  And if their invisible antennae signals that you don’t like or respect them, they’ll treat you miserably. Oh yeah. One more thing about this: Like everyone else, the teenager invisible respect antenna regularly malfunctions.

Principle 3: Many teens have dysfunctional eye rolls that appear completely beyond their voluntary control.  For some unknown reason, these eye rolls are triggered when adult authority figures make serious comments.  If you notice teens having this eye roll problem try your best to treat them with the sympathy they deserve.  This means you should smile while looking deeply into their eyes with every ounce of kindness left in your heart. You may think your teen is being disrespectful, but really she or he really needs your sympathy for this problem.

Principle 4: Teenagers are insecure.  Often, they cover their insecurity with a thin veneer of self-confidence and bravado.  This veneer has the effect of making adults assume that young people are confident or overconfident. Such an assumption can cause adults to back off and not offer help, when sometimes, help is exactly what your teen needs.

Principle 5: Young people are very good at tuning out adults while following the sometimes incredibly bad advice of their peers.  The best weapon we have against this sad trend is to sit and listen to young people as they talk about their lives, while, at the same time, resisting the impulse to give them our sage advice.  After listening for a considerable length of time, it can be effective to dress up one of your good ideas as one of their bad ideas and pretend that they came up with it.  If this subtle technique for influencing young people gathers no moss, then you may be forced back into the Dr. Science approach.  The Dr. Science approach essentially involves informing the youth that you know more than they do and therefore they MUST abide by your wishes.  This approach is usually effective only if you have way more money and way more valuable property than the young person.

Principle 6: Scientific research has clearly shown that, down deep, young people really want positive relationships with adults. . . AND that they greatly profit from such relationships.  Try to ignore the fact that adults conceived and conducted this research.  Instead, just go right on doing your best to develop positive relationships with as many teenagers as possible and go right on assuming they want those relationships.

Principle 7: In the end, you’ll find that communicating with teenagers is a lot like baseball.  In professional baseball, if you get a base hit 3 out of 10 times you go to the plate, you have a great chance of getting voted onto the All Star team.  The same is true for communicating with teens.  If you’re a lifetime .300 hitter, your child will probably eventually vote for your induction into the parental Hall of Fame!

If you want additional information about how to communicate more effectively with teens, we recommend parent education classes. You might discover several things: (a) there are other parents out there, besides you, who are struggling and want a better relationship with their teens; (b) many parents (and maybe even the class leaders) will have great ideas about how to improve your teen communication skills; and (c) by meeting with parents and talking opening about our challenges, we’re conspiring to prove that we’re indeed wiser than our teenagers.

[This blog is adapted from an old newspaper article in the Missoulian and from “The Last Best Divorce Workbook” (written by John and Rita Sommers-Flanagan and published by Families First Missoula, 2005)]

Four Good Ideas about Multicultural Counseling and Psychotherapy—In Honor of Martin Luther King, Jr.

1. Don’t think about multiculturalism as being about tolerance. Instead, approach other cultures with an attitude of “what can I learn?”

The Trappist monk Thomas Merton (1974) wrote about his deep regrets for the ways religious missionaries contributed to cultural genocide. He wondered:

“What would the world be like if different cultures had encountered each other with questions instead of answers? What if the questions went something like these?”

What can you tell me about yourselves?

  • What would you like to know about us?
  • What can you teach me about the Creator?

This same idea forms the foundation of affirmative therapy for GLBTQ clients. Because they’re so used to and sensitive to negative judgments, we should approach GLBTQ clients not only with openness, but with a positive and affirming attitude. When I really think about it, it doesn’t make much sense to approach clients who may be different from us with anything other than a positive and affirming attitude?

 2.  Try to Understand the Implications of White Privilege

As a White male I sometimes have difficulty stretching my neck far enough to be able to see all the White privilege I carry around in my invisible knapsack (see Peggy McIntosh’s 1998 article for more on the Invisible Knapsack). White privilege is defined as the unearned assets associated with being an upper or middle class member of a dominant culture. Although White privilege is often hard to see (because unearned assets are invisible), Prochaska and Norcross provide three darn good examples in the 2010 edition of their psychotherapy theories text. They wrote:

  • · “White privilege is when you can get pregnant at age 17 and everyone is quick to insist that your life and that of your family is a personal matter, and that no one has a right to judge you or your parents, even as Black and Latino families with similar challenges are regularly typified as irresponsible and pathological.”
  • · “White privilege is when you are a gun enthusiast and do not make people immediately scared of you.”
  • · “White privilege is when you can develop a painkiller addiction, having obtained your drug of choice illegally, go on to beat that addiction, and everyone praises you for being so strong, while being an ethnic minority who did the same thing is routinely labeled a drug addict who probably winds up in jail.” (p. 408)

3.  When Counseling, Make Cultural Adaptations

Not long ago it was reported that 50% of diverse clients dropped out of therapy after only one session (S. Sue, 1977). This suggests that it only took one therapy session to convince half of all diverse clients not to return for session number two. This is not very impressive.

To address this and other issues, counselors and psychologists now talk about making cultural adaptations so the therapy experience is more appealing to clients from diverse cultural backgrounds. Several cultural adaptations have proven at least somewhat helpful. Two of the most significant are: (a) Language Matching (Surprise! Clients tend to benefit more when they can do therapy in their native languageJ); and (b) explicit incorporation of cultural content/values into the intervention (Griner & Smith, 2006).

 4. Remember that multicultural counseling is like qualitative research; you may not generalize.

This is one of the puzzling paradoxes associated with multicultural counseling. Of course we should learn as much as we can about other cultures—but, because skin color, ethnicity, sexual orientation, disabilities, and other client characteristics all exist within unique individuals, groups, and communities it’s inappropriate to make assumptions about clients based on knowledge about any of these factors. Just as you would never generalize your findings from eight clients in a phenomenological-qualitative study, you shouldn’t use your knowledge of any “categories” to make generalizations about the person or people in your office.

Related to this, S. Sue and Zane (2009) commented on how, when it comes to multicultural knowledge, a little bit does not go a long ways (and often a large amount of knowledge won’t take you very far either). They wrote:

“. . . cultural knowledge and techniques generated by this knowledge are frequently applied in inappropriate ways. The problem is especially apparent when therapists and others act on insufficient knowledge or overgeneralize what they have learned about culturally dissimilar groups.” (p. 5)

Working cross-culturally or interculturally is both a challenge and a privilege. This is part one of a three-part blog about how we can meet this challenge and honor clients who have diverse characteristics. Thanks for being interested enough in this topic to read this and stretch your multicultural competence.

Reflections on Magic

I have a former graduate student (you know who you are) who always talks about using magic. If she wants something to work out a certain way, she simply “casts a spell” to make things right. Of course, like most of us, she expertly avoids paying attention to evidence refuting her magical abilities, while studiously attending to moments when it appears her spells have somehow affected reality.

This was all in good fun. We were driving many miles back and forth to an internship site at Trapper Creek and in some ways her spells were designed to counter my tendency to construct a firm deterministic viewpoint. Although I agree there are many mysteries in life and that there’s likely room for magic, I get quickly impatient with too many attributions about magic, miracles, past lives, and sinister ghosts in the halls of the female dorm at Trapper Creek Job Corps.

Despite my general avoidance of magical thinking, I find myself very intrigued with this old quotation of Freud’s that Steven de Shazer turned into a book title:

“Words were originally magic and to this day words have retained much of their ancient magical power. By words one person can make another blissfully happy or drive him [or her] to despair . . . . Words provoke affects and are in general the means of mutual influence among men [or women].”

I do think words have powerful influence . . . but it’s equally true that what we don’t say—the nonverbal, and listening in particular—can be just as magical. All this is a way of introducing the following excerpt soon be published in the 2nd edition of our Counseling and Psychotherapy Theories in Context and Practice textbook as food for thought this Monday morning. Here it is:

The Magic of Person-Centered Listening

Person-centered listening isn’t in vogue in the United States. It might be that most of us are too busy tweeting and expressing ourselves to dedicate time and space to person-centered listening. The unpopularity of person-centered approaches also might be related to the prominent “quick fix” attitude toward mental health problems. And so, call us old-fashioned, but we think that if you haven’t learned to do person-centered listening, you’re missing something big.

Years ago, when John was deep into the “Carl Rogers” stage of his development, he decided to create a person-centered video recording to demonstrate the approach. He recruited a volunteer from an introductory psychology course, obtained informed consent, set up a time and a place, welcomed a young woman into the room, and started listening.

Lucky for John, the woman was a talker. It’s much harder to get the magic to happen with nonverbal introductory psychology students.

It wasn’t long into the session when John attempted a short summary of what the woman had said. He felt self-conscious and inarticulate, but was genuinely trying to do the person-centered listening thing: He was paraphrasing, reflecting feelings, summarizing, walking within, and doing all he could to be present in the room and make contact or connect with the “client.” After his rambling summary, there was an awkward silence. John remained silent, trusting that the client knew where to go next. And she did. She cut through the awkwardness with a disclosure of having been sexually molested as a child. John continued listening non-directively as the woman told her story, shed a few tears, and spoke powerfully about her journey toward building inner strength.

The demonstration recording was a huge success . . . except for the fact that the audio was terrible. To hear the powerful disclosure and share in the magic of person-centered process, John had to force his class of 15 graduate students to gather within three feet of the television in perfect silence . . . which was also rather awkward.

The lesson of person-centered listening is that sometimes when you put it all together the client can take you places you never knew existed. There are many things about our clients that we’ll never know unless and until we listen empathically, communicate genuinely, and experience respect for the other person with our heart and soul. As Rogers (1961) said, “. . . the client knows what hurts. . .” and so it’s up to us—as therapists—to provide an environment where clients can articulate their pain and re-activate their actualizing tendency.

A Black Friday Tribute to Mary Cover Jones and her Evidence-Based Cookies

In honor of Black Friday and the opening of this blog, I’d like to sell you on why the story of Mary Cover Jones and her evidence-based cookies is one of the coolest in the history of counseling and psychotherapy.

Mary Cover Jones probably wasn’t big on shopping. That’s because she was a woman scientist in the 1920s. She was too busy working in John Watson’s lab (yes, this is the same John Watson who, at least according to historical accounts, turned out to be a bit of a turkey.)

Mary Cover Jones was amazing. She’s best known for her work with a young boy named “Little Peter.” When everyone else was focusing on how to create fear in humans (or out shopping for Black Friday bargains), Mary was discovering how children’s fears could be extinguished or eliminated.

Little Peter suffered from a specific fear. As silly as it sounds, he was deeply afraid of white bunnies. This fear had generalized to white rats, white cotton balls, and just about anything white and fluffy. Using cookies, Mary Cover Jones counter-conditioned the fear right out of Little Peter. She started by having Peter enjoy his favorite cookies in one corner of the room and gradually brought a caged white rabbit over to him until, eventually, Peter was able to eat cookies with one hand and pet the bunny with the other.

But Mary Cover Jones didn’t stop with Little Peter. Over time, she worked with 70 different institutionalized children, all of whom had big fears. Not only was she successful, but her conclusions (from 1924) still constitute the basic foundation for contemporary (and evidence-based) behavioral approaches to treating human fears and phobias. This is what she wrote toward the end of her 1924 article:

“In our study of methods for removing fear responses, we found unqualified success with only two. By the method of direct conditioning we associated the fear-object with a craving-object, and replaced the fear by a positive response. By the method of social imitation we allowed the subjects to share, under controlled conditions, the social activity of a group of children especially chosen with a view to prestige effect. [Other] methods proved sometimes effective but were not to be relied upon unless used in combination with other methods.” (M.C. Jones, 1924, p. 390)

Mary’s findings remain deeply profound. They have implications not only for how we treat children’s fears, but also for how to work effectively with resistant or reluctant teens and adults. In later blogs I’ll often be serving a batch of Mary’s evidence-based cookies in one form or another.

After her work with John Watson, Mary Cover Jones continued working in a research lab. She moved across the U.S. and 50 years after her publications on children’s fears, she reflected on her life and her work. Here’s what she said:

“[M]y last 45 years have been spent in longitudinal research in which I have watched the psychobiological development of our study members as they grew from children to adults now in their fifties… My association with this study has broadened my conception of the human experience.  Now I would be less satisfied to treat the fears of a 3-year-old, or of anyone else, without a later follow-up and in isolation from an appreciation of him as a tantalizingly complex person with unique potentials for stability and change.” (Jones, 1974, p. 186).

Just minutes before she passed away, Mary said to her sister, “I am still learning about what is important in life” (as cited in Reiss, 1990).

We should all strive to never stop learning about what’s important in life and therefore be more like Mary Cover Jones. Although the famous psychologist, Joseph Wolpe, dubbed her “the mother of behavior therapy” she was obviously much more than a behavior therapist. You can learn more about her (she would probably have liked that) from a web-based article by Alexandra Rutherford of York University at: http://www.psych.yorku.ca/femhop/Cover%20Jones.htm. Rutherford’s article was originally published in The Feminist Psychologist, Newsletter of the Society for the Psychology of Women, Division 35 of theAmerican Psychological Association, Volume 27, Number 3, Summer, 2000.

And, believe it or not, Mary Cover Jones is on Facebook. You should become her friend . . . just like I did.

Mary  Cover Jones