Thursday, 29 December 2016

Learning Journal 50


50 journals!
This week in my placement I saw 2 clients for the final time. They both were very different sessions in so much as one was quite underwhelming and the guy pretty much wanted to shake hands at the end and go. The other was a little more connected, a little more important and a little more like it was something we would both miss. Clients are different. Looking back these 2 sessions went entirely to a predictable ending script. Both ending left me wondering about what it is that I had achieved, if anything, and how to respond in my self to the feedback that the clients had left.
The first ending was quite matter of fact. I tried out something that Tony the tutor had touched upon in a previous session in college, that we should acknowledge the ending, so I tried this out. I feel that I made more of it than it really was for this particular person. That we would never ever meet again in this space and time was perhaps an overshoot for this semi-alpha male who really had come to the end of my usefulness anyway. That I didn’t use immediacy was the problem I feel, looking back, and say just this.
When working with this client, throughout, I had a large amount of personal resonation with his issues. R, the client, had arrived with presenting issues around his biological father coming back into his life and over the six sessions we had compartmentalised that and he had moved on. We had begun instead to unpick the person. This is something that I am starting to do a lot with clients. I wonder if it is a habit, a leaning or a bias in my practice?
Anyway, in exploring the person and his traits it transpired that R was quite the outsider. He lacked trust for others and struggled with social situation, especially large groups. While this is all perfectly understandable from a personality perspective perhaps he went much further and I began to find it uncomfortably like my own experiences.
R described having a very analyitical mind, constantly evaluating others in a cost benefit methodology. This I know as extremely wasteful and tiring and resource heavy, making social interactions very draining as I recognised his description of not really understanding the point of many encounters. He tired of nights out and made excuses not to attend. He liked his own space to just be. For him to be in large groups was tiring and undesirable. That’s me too I screamed, inside! I know! I know that! But I couldn’t say anything quite so direct. I felt that would be needy of me and create some sort of weird dynamic. I am here to listen and to reflect in a way that helps R make sense of himself, not to be partners in crime.
I wondered if R might too benefit from simply realigning his acceptance of himself as someone with a lot in common with those on the aspergers spectrum, albeit at a level that was very easily hidden. That too seemed like a step too far for me. To suggest or even use the terms seemed like a walk down diagnosis lane, and I know that’s a breach of the rules and my training and expertise.
I did wonder for a time about how I could possibly go with a client to places that both resonated with me and that in many senses I had not come to be at ease with myself. With R talking about such similar experiences of being an ‘outsider’ and on the periphery of his social group was an allied journey for me. However, dipping into Yalom’s work does much to ease my angst on this. He states that ‘to take someone further than a therapist has been’ was not really a worry. It is entirely ok to be a witness to changes that may be far beyond what the therapist has done. I feel that being entirely person-centred and going with them, it could be entirely safe for us to explore an understanding and level of self-awareness that I clearly do not feel I have. I would have admired
To go back to the ending with R I found him quite difficult. I was somewhat relieved to see the back of him actually as he didn’t really want to engage with me in the last session, it was a formality in some respects I felt. That made any special treatment of the ending quite false and overkill. He’s going to be ok I thought and good for him that he is having these contemplations now so that he can begin to come to terms with who he really is. This he must do in his own way, not mine.
Reflecting on how useful my interventions have been with R, I would have to say that the fact that we have six sessions as a maximum is something that drives a focus to the work. We have travelled between us through several issues and come to begin to explore him, as a person. The goal of the university counselling team is, rather particularly, to keep the cash cows grazing. That’s an underlying conflict to me,no matter how the staff re-present it. While I feel that by helping this client stay aware and in control by being listened to, this goal has been maintained. Is it a satisfactory process for me as a therapist, no. However, I have succeeded in my job of keeping the cash cow at Uni.
Another client, NV came to me some 5 sessions ago with the issue of anxiety over a speech impediment. She was having serious anxiety attacks when going into certain lecture rooms and was extremely worried about her impending presentations. We have spent 5 sessions getting to know her in more depth. I have been able to use that time very well with her I feel as yes, we’ve validated the anxiety and taken her feelings very seriously. She has been grateful to receive this authentic validation I feel. To evaluate how far we have come is tricky for me. We have not had the environment nor I the training that could actually help her speech impediment in any way. This is not really something that she came for anyway, just the anxiety. At times this has become higher and the very day before her last session this week she had another attack. In that sense I am not assisting with the management of her anxiety attacks. What I have been able to do is make her experience very real, not dimished and further, asked her about her. The person behind the anxiety, who is she?
I sensed that it has been extremely liberating to share space and time with me to talk about ho she feels, what she wants in life and her wider interests,. She is so much more to me than a girl with a stutter. I would like her to know this for herself. This is my goal for our sessions.
Another boy, OK has now finished with my sessions. He had shared with me and the counselling team how helpful he had found the sessions as I ‘got him’. He was able to open up about many issues in such a way that surprised me a great deal. He was another reason I had looked to Yalom’s book to reassure myself that I could support someone who was going through things that I doubt I would have the courage to share. If a client goes further than we have, is it safe to support them? Is it possible to support someone who is going through such emotional vulnerability in front of another person, when I myself am likely not ready for that exposure. Well, to evaluate ones practice by realising that such things have been achieved is a gratifying thing to do, but also something that needs to be taken with caution. This one went well. This client moved forward, felt heard, felt listened to and not judged. Ben, you’re doing it. But how come that client went well? What did I do that made those sessions ‘work’ for the client in this agency setting?
Surely there’s something about me in a University setting. It’s a very exciting place to work and I am enthused to support this client group. Also I have taken on board the 6 session limit and been mindful of the need to focus and mark the passing of sessions and the need to prepare a client for the ending. But it’s a little more than that. When I am with clients here I am very caring and interested and I have noticed I truly validate there experiences. I sense that in such a young client group that may have lacked external validation through much of their lives to this point, this attribute of mine must be a useful addition to see in a man.



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