Monthly Archives: October 2013

Divorce can take a devastating toll on male clients. How can counselors help?

Heather Rudow October 30, 2013

450px-Man_and_divorce

(Photo: Wikimedia Commons)

Going through a divorce is a difficult process for all parties involved, but according to a recent study, it might take a greater emotional and mental toll on men than previously thought. According to the case study, found in the Journal of Men’s Health, divorced men were shown to have higher rates of mortality, substance abuse and depression—and less social support to fall back on than women.

But what can counselors do for male clients who may have trouble expressing the true depth of the pain from their divorce? Brian Canfield, past-president of the American Counseling Association and the International Association of Marriage and Family Counselors, talked to Counseling Today about why understanding and supporting the needs of couples is more critical now than ever for counselors. 

What are your thoughts on the study?

 I found the study interesting in that it provided support for what many have recognized anecdotally regarding the impact of divorce upon many men. However, I would be cautious in generalizing the conclusions to all men.  Statistical data applies to aggregates and not individuals, so the findings may or may not be applicable to a particular man going through a divorce.

Have you noticed a gender bias when it comes to coping with divorce?

In my practice I have noticed that women tend to express emotions of “sadness,” while men tend to be more likely to express feelings of  “anger.”  However, I’ve observed a range of emotions among both men and women. So while there may be some differences, I suspect the emotional response range among groups of men and groups of women is broader than any mean difference between gender groups.

  What coping mechanisms have you suggested for male clients going through a divorce?

I support my clients in recognizing that divorce is a transitional period. The typical narrative is one of “loss” and “failure.”  I encourage clients to use the divorce experience to learn what they wish to have different in the future, particularly in relationships. Though things will be different after divorce, depending upon the client’s willingness to learn from the experience, things can and will be better in the future.

 Have you found that male clients going through a divorce are less ready to talk about how they’re feeling?
I find that most men have no difficulty in expressing feelings associated with “anger.”  However, that is only part of the emotional spectrum and often there are some underlying feelings with which men are less comfortable. I encourage men to recognize that feelings and expressions of “anger” sometimes serve a temporary useful purpose in masking underlying uncomfortable feelings of  “guilt,” “sadness” and “loss.”  This realization is often a useful step for men in recognizing and accepting their role in the failure of their marriage.

Do you believe that it has gotten easier or worse for men going through or coping with a divorce? Why?

Divorce remains a very difficult experience for all concerned. However, increased access to qualified counselors with specialized skills for helping couples, families, and individuals dealing with the impact of divorce is a vast improvement over past decades.  Help is available, provided a person in need seeks help.

How can counselors help a male client going through a divorce?

As counselors, we can help our clients by providing a supportive, caring, non-judgmental, genuine and safe environment for the client to explore their feelings, behaviors, and life-choice options. Working in a collaborative partnership with the client as a caring and objective professional with no personal agenda is the best way to support a client in their efforts to bring about desired changes.

What signs should counselors be on the look out for in male divorced clients?

Always assess for symptoms of depression and address ways the client can better attend to their physical and emotional needs (e.g. diet, exercise, etc.)  Although only about 10 percent of clients with symptoms of depression have suicidal thoughts, when depressed symptoms are evident always assess for suicidal ideation and follow appropriate protocols to safeguard the client as may be warranted. In my experience, this is rare – but essential.

 Additional thoughts:

 For the vast majority of people, marriage is difficult.  Since approximately 45 percent of marriages end in divorce, it is often helpful for clients to reconsider basic assumptions and expectations about marriage and divorce. I regularly see “reasonable” and “sane” people struggling to change an unhappy marriage. Many of us recognize that the institution of marriage is essential to a stable society. As such, the role of counselors in better understanding and supporting the needs of individuals and couples is more critical than ever.

 Heather Rudow is a staff writer for Counseling Today. Contact her at hrudow@counseling.org.

What was your ‘turning point’ as a counselor?

October 29, 2013

(Photo by Paul Sakuma Photography)

(Photo by Paul Sakuma Photography)

Counseling Today is compiling information for an article about different “turning points” in counselors’ careers — experiences or revelations that fundamentally changed how they approach their life’s work. Have you had such a turning point, perhaps because of working with a certain client or population, learning a new technique or approach, overcoming a particularly difficult challenge or even discovering something new about yourself? If so, Counseling Today would be interested in hearing about it and possibly sharing the experience with other ACA members, either in the monthly magazine or at CT Online. If you are interested in participating, send the following information to CT editor-in-chief Jonathan Rollins at jrollins@counseling.org: Your name, number of years in the counseling profession, current work position and location, how you approached counseling before your turning point, how you have approached counseling since that turning point, and the major “lesson” or bit of wisdom you would pass on to others. 

German counselor uses art and music to promote resilience in New Orleans

Heather Rudow October 25, 2013

arttherapyClick here to listen to a song by counselor Klaus Lumma and jazz harpist Patrice Fisher.

Klaus Lumma may be from Germany, but the city of New Orleans has become a second home to him.

Lumma is a counselor in private practice, a certified art therapist and a senior adviser to the Institute for Humanistic Psychology and the Akademie Faber-Castell, a youth art school in Germany. He has been teaching counseling and humanistic psychology at the Gestalt Institute of New Orleans since 1996.

Since 2000, Lumma has also been offering a six-day intensive program for European counseling students interested in adding fine arts interventions to their counseling practice. The program culminates with the students taking a trip to New Orleans’ Einstein Charter School to experience its art counseling program.

The longtime musician and composer is also a regular guest performer at the New Orleans French Quarter Festival.

Lumma, who plays both the trumpet and the saxophone, first became interested in music at age 13. But in 2004, he combined his love for music with his passion for mental health.

“I had the idea to compose songs according to each cycle in Pamela Levin’s theory of human development,” explains Lumma, an international member of the American Counseling Association.

He uses the songs as interventions for his clients.

“I ask them which developmental power needs to be enhanced in respect to their personal topic or problem,” Lumma says. “They [then] listen to the specific song which was written for this part of Pamela Levin’s cycle of power, and at the same time they are invited to express their ideas about it by painting with oil pastels, colored pencils or similar material.”

His method has resulted in overwhelmingly positive responses from his clients. In addition, Lumma’s former counseling students started to use the songs in their private practice work and as counselor educators.

But in August 2005, Lumma’s yearly plan to return to the vibrant, musical city he loved changed: Hurricane Katrina flooded 80 percent of the city, resulting in nearly 1,500 fatalities and $105 billion in damage. Residents were reeling over the intense losses the storm left, and so was Lumma.

Looking to help in any way he could, Lumma eagerly accepted a proposal from local counselors to offer post-traumatic counseling to flood victims.

He provided art and music therapy to both children and adults. With music playing, Lumma invited clients, in groups of four to eight people, to draw pictures.

“I then gave them topics related to their personal situations,” Lumma says. “For example, ‘What do you think enabled you [to] survive in spite of the terrible circumstances after the hurricane?’ In this way, I asked them to share their power of resilience with one another, thus creating an opportunity for the sharing of experiences to begin. The effect has always been very successful in getting the discussions started.”

In the years since Katrina, he has found the drawings from hurricane survivors being recognized as effective tools for other people in distress, “whether it be from personal or professional experiences or both. Any client who is ready to re-decide his way of life, who feels that he or she needs support for special situations in his or her life, finds resilience from the Hurricane Katrina drawings, which we’ve been collecting in New Orleans since 2006. The drawings apparently have enhanced the resilience of those who produced them, thus achieving our goal of assisting victims to overcome their trauma and become more optimistic and productive in their future lives.”

Eventually, jazz harpist and New Orleans resident Patrice Fisher heard about Lumma’s efforts and asked him to collaborate  — both musically and therapeutically.

“Since 2007, we’ve been involved in combining post-trauma counseling with her music in my portable studio of art therapy, in the United States as well as in Germany,” Lumma says.

The pair created an album called Resilience, which provides music therapy to the sounds of Latin jazz that Lumma and Fisher play together.

Lumma explains the cognitive reasons behind the success of art therapy, music therapy and other creative interventions in trauma counseling. “Artwork activates the right hemisphere of the human brain,” the side of the brain responsible for spatial abilities, facial recognition, visual imagery and music. “When adding music [and] painting to the counseling process, we can be sure to reach the person in a holistic way. This is effective in both normal counseling as well as with trauma clients. Giving topics to be painted — not only to be spoken about — reactivates subconscious recovery resources. The addition of our specially designed music with the harp, trumpet, guitar, bass and percussion gently rearranges the emotions and skills which were blocked by the traumatic experiences.”

Lumma suggests that counselors interested in using these kinds of interventions start by looking at the resilience drawings he has posted on the Institute for Humanistic Psychology’s website to see which one “gets through to your emotions.”

Counselors could then personally practice the intervention to get a better understanding of how it affects the human body, he says.  “Only reading about how something might affect the client is not enough,” Lumma adds.

Use crayons and copy either part of or the entire selected image, Lumma says, “and enlarge it and add your very own colors to it. A logical next step to test the method would be to have [the counselor’s] colleagues do the same, and then compare their own experiences with the material.”

German publisher Windmühle Publishers of Hamburg is printing Lumma’s new book on resilience coaching. The cover of the book shows one of the pictures drawn by a group of four Hurricane Katrina victims.

Lumma believes that art and musical interventions should be further incorporated into the counseling profession and should also be included in counselor training and education.

“Adding nondigital interventions like music, art and artwork most certainly has a positive effect on the healing process,” Lumma says, “just as playing music and singing songs has a positive effect on the education of young children.”

He believes the focus on right brain activity is a big factor in why these nondigital interventions have had such a positive effect on healing in trauma survivors.

“If we regard our body as a whole, we are to realize that thinking only — or making decisions with the digital side of our brain, the left side, alone — has little healing effect,” Lumma says, “but including the right hemisphere makes our body understand that we are dealing with the given issue in a holistic manner, and that has a positive effect on healing.”

 Heather Rudow is a staff writer for Counseling Today. Contact her at hrudow@counseling.org. 

Processing personal grief as a professional counselor

October 18, 2013

brokenheartExperiencing loss is an inevitable part of life, and counselors are trained to help others overcome these emotionally difficult events. But what do counselors do to process their own personal grief — and how can they ensure that their grieving does not impede on the therapeutic process of clients?
Eric W Cowan, a counseling professor at James Madison University and author of Ariadne’s Thread: Case Studies in the Therapeutic Relationship, says self-care is key. Cowan, a member of the American Counseling Association as well as the Virginia Counselors Association, told Counseling Today that counselors must constantly manage their emotional well-being, especially when suffering a personal loss, to ensure that they can successfully provide therapy to clients.

Do you believe counselor self-care has become more important within the profession over the years? If so, how?

My impression is that there has been a growing awareness that counselor self-care is central to providing effective counseling — at least we seem to talk about it more. The real question is, does this awareness translate into counselors creating for themselves the kind of balance in life that enables them to tend to their own mental health needs, especially in times of personal challenge or crisis? Are counselors being mindful that they must provide for themselves the kinds of self-enhancing experiences that they wish for their clients?

This takes a kind of discipline because counselors are subject to the same barrage of impersonal demands of a complex culture as everyone else. At the same time, counselors are subject to a whole set of very personal demands inherent in the intimate counseling process. Learning what it is you need to stay balanced and self-aware becomes very important.

 Why is counselor self-care important?

Counselors have a unique challenge compared with other professions because the counselor functions as the very instrument through which he or she strives to be helpful and effective. Conceivably, a surgeon, an accountant or a car mechanic can be effective regardless of what is going on in his or her inner world or outer life — it is an easier job to partition that out from the task at hand. The counselor’s inner world of thoughts, emotions and interpersonal sensitivity are, however, the very tools he or she must utilize to be effective.

The counselor whose inner life is in turmoil or greatly out of balance is not only in danger of being less useful to the client, but also of importing his or her unmet emotional or spiritual needs into the relationship with the client. These countertransference enactments hinder the client’s ability to use the counselor to foster therapeutic growth. More insidiously, for some clients this dynamic with the counselor may reenact old traumas in which the client’s own developmental needs became subservient to an implicit demand to prioritize the needs of caregivers in crisis.

As counselors, we can also tend to build up a kind of psychic charge that has to do with this deep involvement in others’ emotional turmoil. This has to be discharged or expressed in some way, or you carry around all this tension and wonder why you are yelling at the dog.

When a counselor is suffering a loss in their family, what self-care steps should they take?

Robert Haas has a poem that begins with something like, “All the new thinking is about loss. In this it resembles all the old thinking.” I love that line because it reminds us that the experience of loss and the challenge of responding to great loss is inherent to loving others. We need to learn to live alongside loss because it is the rule and not the exception.

Counselors, especially, must learn to live with this idea because so much of what we do is to help clients move through great loss and attending grief. Of course, counselors do this by helping clients make room for grief in their inner life — to honor its place and give it a voice. Only then can a profound loss be taken in, accepted and ultimately incorporated.

When grief and loss come to the counselor, it challenges the counselor to this heightened level of attention and self-acceptance. The process may take up more space in the counselor’s thoughts and feelings than they would like, especially because counselors often imagine that they always have to “keep it together” and be a model of perfect mental health. The paradox is that by failing to fully honor a personal loss, the counselor’s grief may not move and transform, and transformation from a loss of something “outer” to something that you are able to hold within is where it’s at. That’s what you are after.

Being “out of balance” because one is not attending to pressing demands from within is different from the temporary imbalance and dislocation of attending to and honoring one’s profound feelings of loss.

How can counselors tell if their grief is hindering their ability to practice?

When counselors carry unresolved grief from old losses or when they are in a process of mourning from a recent loss, they are especially susceptible to problematic enactments with their clients. Most often this would show up as a loss of optimal therapeutic stance.

For instance, imagine that the client’s tears or expressions of grief elicit from the counselor not only a disciplined empathic resonance but also the counselor’s tears or expressions of grief in response. The client may begin to attenuate or even to hide his or her emotional responses. In other words, the client begins to adjust his or her expression of affect to accommodate the counselor’s ability to stay emotionally intact. This loss of the counselor’s ability to provide an adequate “holding environment” for the client’s affect is a sure sign that the counselor needs to attend to pressing emotional needs.

Less obvious is when counselors find they are compromised in their ability to be fully present with the client in the here and now because of distractions from upwelling emotions not related to the therapeutic session. At that point, it is a disservice to the client to try to tough it out, and you’ve got to do something to attend to yourself.

Is the way that counselors handle grief different, or do we all mourn the same way?

For counselors, it is tough to have to go through life always having to cultivate one’s self-reflective awareness. Garrison Keillor remarked that sometimes “you just have to stand up to reality and deny it,” but as appealing as this sometimes sounds, this is not really an option for someone who has committed to the counseling profession.

If counselors handle their grief differently, it is because they have come to the realization that each developmental task, each loss or transformation, involves a kind of death to an old self and the birth of a new and expanded self. Whether this death and reconstitution is in response to a loss of some person or a letting go and birth of something new from within, a new phase of personal development, it always involves some level of acceptance of loss and pain.

Perhaps it’s this letting go and not grasping to hold onto something familiar that ultimately fosters greater awareness. It’s that whole idea in Eastern philosophy that everything is in a state of flux, of passing, of impermanence and transformation. The counselor does not feel less pain in loss but is, perhaps, more likely to accept it as direct experience, less likely to turn that pain into neurotic suffering. That’s the attending part, I think. Not the frantic effort to avoid inevitable pain, but more an enhanced ability to carry it willingly and mindfully.

Should counselors use past experiences to help clients get through their own grief?

It is tempting for counselors, in an effort to create rapport with clients who are experiencing a profound loss, to reference their own losses and grief experiences, especially if they resemble the circumstances of the client’s loss. The intent is to communicate that “you can get through this as I have,” and “I have been there so you can relate to me.”

The danger in the counselor’s referencing his or her personal experiences of loss and grief is that it tends to take up emotional space that rightly belongs to the client. The client is temporarily obligated to understand the counselor’s profound experience of loss. The client may begin to wonder if his or her own expression of loss is hurtful or damaging to the counselor. In the worst-case scenario, the client may find that his or her loss cannot compete with the counselor’s or that the client feels a need to make the counselor feel better.

Counselors do use their past experiences to help clients get through their grief but not ordinarily by relating to the client the specific incidences or content of the counselor’s experiences. Rather the counselor’s experiences of loss inform the process and pathos of his or her empathy for the client’s specific losses.

What can counselors learn from experiencing a deep loss?

This experience of a deep loss strips us of trivialities. For a period we seem consumed in pain but also have a deeper sense of the profound and important. If the loss is tragic, as the death of someone we love by accident or suicide, then the loss may be shattering and it will take much attention and effort to directly grieve rather than become depressed.

But, sometimes, the experience of loss can awaken us to an enhanced and deeper awareness, what Martin Buber called the “infinite ethos of the moment.” Then we are more fully present to our existence and its potentialities, even though, or perhaps because, we see how fragile it is. Ideally, the loss allows us to participate more deeply in our relations with others. Or perhaps we experience what Buddhists refer to as impermanence, leading to a new openness to the flow of our existence, to letting go. The process of saying “Yes!” to life, open armed, even in the face of great pain or loss.

That’s the thing — you want to toss in the towel, but you still have to find a way to say “yes” to counter that nihilistic or fear-based impulse. This is what most of our clients are struggling to regain, and if the counselor can do it, then he or she can help others to do it as well.

For more on this subject, read Counseling Today’s September Feature, Attending to countertransference.

 

ACA Participates in National Dialogue on Mental Health

October 15, 2013

acaLogo3012On October 12, ACA participated in the Creating Community Solutions discussion on mental health.  Convened by Washington DC Mayor Vincent Gray, the town hall event was part of a national dialogue to promote solutions to the challenges faced by those with mental health issues. Over 400 invited individuals convened at the Walter E. Washington Convention Center in Washington DC, with participants ranging from middle school students to consumers to mental health professionals to mental health associations and facilities.

Presenters included Mayor Gray, Steven Brigham, the President of American Speaks; Dr. Joseph Wright from the Washington DC Children’s Medical Center; Councilwoman Yvette Alexander, the Chair of the Washington DC committee on Health; Stephen Baron from the Washington DC Department of Behavioral Health; and Dr. Dr. Paramjit Joshi from the George Washington University School of Medicine.  The focus was on highlighting the importance of mental health, key challenges for mental health, supporting the mental health of our youth and young adults, and action planning for solutions.

Participants focused on the need to reach those in need as early as possible and to fight stigma; particularly the misconception that those with mental health issues are violent.  The importance of bullying prevention was also addressed.  Some key statistics presented included:

  • One in five in the United States experience a mental health problem every year but only 40% of these individuals receive services.
  • Only three to five percent of violent acts are committed by people with mental illness.  However,  24% of Americans believe that people with mental illness are dangerous and 39% believe that they are unpredictable. Individuals with mental health problems are more likely to be victims than perpetrators.
  • Only 44 percent of Americans believe those with mental health problems can be successful in the workplace.  However, studies show no difference in productivity.
  • Only 30 percent believe a person with mental illness issues can recover when, in fact, mental illness is eminently treatable.
  • Because of stigma, cultural issues, and language barriers, up to 50 percent of those with mental health issues do not seek treatment.

ACA’s input focused on the need for early assessment in schools through the funding of school counselors and the need to fund professional counselors in mental health settings to address the chronic under treatment of those with mental health issues.

For additional information on the Creating Community Solutions national dialogue on mental health, please contact David Kaplan, ACA Chief Professional Officer, at dkaplan@counseling.org