Never ask a Client to do Something you Wouldn’t do Yourself

When training as a Counsellor/Psychotherapist, most programs expect students to attend personal therapy themselves.  In my case we were expected to complete 60 hours of personal therapy, which took almost 1.5 years, attending weekly (and having the odd holiday!).

The reasons for this are:

  1. You work out all your own baggage, to ensure you are not bringing it into your sessions with clients.  When clients ‘use’ a therapist to work out issues, it is called transference.   When a Therapist uses a client to work out their problems, it is called countertransference, and in this sense it is clearly not appropriate.
  2. You experience what it feels like to sit in the client’s chair, and get a very thorough understanding of how clients experience being in therapy.  This is really important, because unless you’ve sat there yourself, you really have no business expecting clients to sit in front of you, as you have no real concept of the structure and impact of a therapeutic relationship.  A therapeutic relationship is different to a normal relationship and the therapist has an obligation to observe and maintain that boundary, within creating and developing a deep and meaningful relationship with clients.

However, once you finish your training, you do not stop learning.  You continue to read, study, attend conferences and workshops and generally continue to ‘upskill’.  I believe there is an obligation then to continue doing your own work too.

So what have I asked clients to do?

–       Exert willpower, particularly around food and breaking patterns of eating;

–       Read books – common recommendations are Sunny Sea Gold’s “Food: The Good Girl’s Drug” and David Staffords “Children of Alcoholics” (now out of print but still available second hand);

–       Communicate differently with family/partners – for example speaking from “I” instead of “you”;

–       Writing therapeutic letters to help express feelings better;

–       Complete certain exercises for example the “if…then” exercise, or the Cost/Benefit exercise; (a short note about each of these follows this blog, just scroll down to view it).

….to name but a few.

Not only have I read every book I recommend, but I also try to challenge myself in all the interventions I recommend for clients.  Sometimes I have to consciously have a stiff conversation with myself – for example if I know I’m avoiding having a difficult conversation with a family member, yet at the same time discussing with a client the possibility of them doing the same thing – and essentially remind myself of the title of this blog. 

Sometimes a client will bring a situation or event to therapy that I realise is mirroring something going on in my life too, and when that happens, I have a responsibility to work out my own issue before being able to objectively help the client.  In these cases I might sometimes have to return to my own therapy, and I do this both for myself, and for the continuing ethical delivery of support to clients.  It’s part of my responsibility as an ethical therapist.

So, if you are attending therapy and you feel your therapist is suggesting or recommending a course of action that you are not comfortable with, perhaps ask them if they’ve ever tried the intervention themselves.  They may not directly answer the question, but how they answer will tell you something about them.  If you feel you are working with someone who is better at ‘telling’ than ‘doing’, you might want to think about that and see how it makes you feel. As a service that you pay for, you are entitled to ensure you are getting the best possible service from your therapist, and you are entitled as a client to question the quality of that service if you are not happy (some practice in assertiveness there too!).

Exercise 1

If…Then

Many clients struggle with decision making and fear making the wrong decision each time there is a choice to be made.  This can paralyse clients and result in them doing nothing, and therefore staying stuck.

The If…then exercise is like a flow chart, and it allows clients to explore all their options safely, giving them a degree of confidence and some understanding that no matter what happens as a result of a decision, they will know what to do.

Example:

IF I speak to my boss about my heavy workload and ask for some support, THEN:

She/he could assign someone else to help me;

She/he could ignore my request and blame me for not being able to cope.

IF I get the help I ask for, THEN:

I will hand over the forecasting project to the other person and that will leave me free to focus on the sales training project so I complete it on time.

I may be able to prove the need for another person to be assigned to my team permanently.

If my request is ignored THEN:

I will go to HR/Department Head/Company EAP/Medical Officer to discuss the stress I’m under (a therapist would work through all these options with a client)

I will apply for a transfer to another department

I will start looking for another job, my salary does NOT reflect the stress I’m under with this job.  (NB People generally don’t leave Companies, they leave Managers).

So you can see how you can safely explore any and all options before deciding what the best course of action is, and what you can do in every circumstance.  I’ve just typed this out as a short example, but lots of clients find it helpful to do this exercise as a flow chart or a mind map – which can help you to be more creative and brainstorm all aspects of each situation.

 

Exercise 2

Cost/Benefit Exercise

A common issue I use this for is around maintaining or beginning to let go of an eating disorder.  Again, a therapist will work through all of this with you, but you can do it for yourself.  Draw out this grid on an A4 sheet of paper to give you plenty of space for all your responses to each of the four headings.  You can use it for any issue you want to explore, including the previous example, eg.:

Cost of going to my boss/Benefit of going to my boss:

Cost of not going to my boss/Benefit of not going to my boss:

COSTS ofHolding On to my Eating Disorder  BENEFITS of Holding On to my Eating Disorder
COSTS ofLetting Go of my Eating Disorder  BENEFITS of Letting Go of my Eating Disorder