Due to my poor time management skills, I ran out of time for comments during my Tuesday internship class. This error provided a sudden inspiration to continue making comments to my students via email. I asked their permission and they seemed interested. It reminded me of a technique Rita used to use when running groups. Following every group, she would write her own insightful reflective comments and send them out to the group members.
Here’s what I shared with me students . . . with . . . of course . . . all identifying information removed.
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In class I mentioned that I wanted to email you some ideas I didn’t have time to share . . . so here we go.
Based on the small amount of recording we listened to together, it sounded like our rock star counselor-in-training (aka “Rocky”) has established an excellent “relationship” or working alliance with her client. That being the case, many things are possible.
The first thing is what I already mentioned at the very end of class. Using her relational connection as a foundation, Rocky can use any of a number of strategies to open up a discussion about her changing her approach to less listening and more engagement. This doesn’t mean I think Rocky “should” be more active, but because Rocky feels it to some degree and brought it up with us, it’s a signal to me that it might be an issue worth exploring. Here’s an example:
“I’ve been thinking about how I act during our counseling sessions. Sometimes I notice myself sitting back and listening as you tell me a story about your life. I think the stories are important, so I mostly just stay quiet and listen. But I’m also wondering if, because the stories are important parts of your life, if maybe I should be more active and engaged with you as you share your stories with me. It might be better for me to ask questions, make comments, or try to identify patterns. If it’s okay with you, I’d like to talk a bit more. Would you be okay with that? If I try it and you don’t like it, we can always switch back.”
This way of bringing up the issue places the focus on Rocky’s behavior and it models how part of counseling involves self-reflection/analysis. It also introduces the idea as an experiment that both Rocky and her client can comment on.
The second issue I wanted to discuss more is the client’s reluctance to “get into her emotions.” Of course, this is a very common reluctance. If we look at it through a motivational interviewing lens, it’s very possible for her to be ambivalent about getting emotional. Part of her can see the value and part of her is afraid or reluctant.
One possible strategy, among many, is for Rocky to affirm that it’s okay to avoid talking about emotions (at least for now), but that in the meantime, it might be helpful to explore what makes talking about emotions feel so challenging. The point is to focus on “what gets in the way” of talking about the emotions directly first, and only then, after greater understanding is obtained, possibly move forward and experience the emotions.
Using this strategy, the assumption is that there are negative expectations (cognitions) linked to directly feeling/experiencing emotion. One of the following could be possible: (a) “I’m afraid once I open the emotional box, I won’t be able to stop” (then you explore if this has happened and examples of how she has recovered after being emotional in the past); (b) “I’m worried that you’ll judge me” (then you explore the possibility of that happening; (c) “I feel weak when I get emotional” (this might inspire a discussion about whether facing emotions directly is an example of being weak or being strong, or something else).
These are just some examples of the thoughts/expectations that can interfere with emotional processing. Many other unique scenarios are possible. In my experience, if you use collaborative empiricism to explore negative expectations, sometimes the expectations can be managed . . . and sometimes clients will spontaneously start talking about the benefits of emotional expression.
My last idea is related to a component part of EMDR. When clients have an image or situation linked to a specific trauma, EMDR practitioners employ two questions that are IMHO quite powerful. Here they are, using a made up scenario:
- “When you imagine the scene at your mother’s funeral, what negative belief about yourself comes into your mind?”
You might have to repeat that question because it’s complicated. The assumption here is that the trauma memory is linked to a core negative belief about the self.
Then you move to the opposite question:
- “When you imagine the scene at your mother’s funeral, what positive belief about yourself would you rather have come into your mind?”
You don’t have to be using EMDR to find your client’s answers to these questions very useful. The first answer is the disturbing or dysregulating belief. It needs desensitizing or disputing or something. The second answer is a new belief about the self that may constitute a major therapeutic goal. It needs supporting; it needs to become a possibility.
So . . . how do you get there? Well, I’d go on, but we need to have something to talk about next week:).
Have a great evening.
John
John Sommers-Flanagan 