Monthly Archives: May 2014

Two amazing women

By Richard Yep May 30, 2014

executive-director-headshot

Richard Yep, ACA CEO

This month, I am writing about two amazing women whose contributions to the American Counseling Association and the counseling profession are worth noting and appreciating. As many of you know, June is the conclusion of our fiscal year at ACA. In addition to “closing the books,” we also begin the transition to a new group of leaders at all levels of the organization. As of July 1, it is time to start anew, but also to strategically carry on with the plans that fulfill the mission of the association.

June is a bittersweet month for me. After working for the past 12 months with our national president, it means I will soon see that person move into the role of immediate past president. ACA has been fortunate to have Cirecie West-Olatunji serve as our top elected officer this year. She was tireless in her efforts to bring the various facets of the profession together, to encourage meaningful dialogue among those from within as well as those external to the counseling profession, and to reach beyond our geographic borders to share ACA’s content and knowledge with those outside of the United States.

During our year together, Cirecie demonstrated her commitment to being a leader. She traveled extensively to connect to, consult with and support members who were at various stages of their careers in the counseling profession. She helped many of these members focus on their career aspirations, and she was always encouraging to those who would be phenomenal ACA leaders. Given her background as a counselor educator, Cirecie did a wonderful job mentoring students far and wide this year, and she was also determined to ensure that ACA was represented in discussions regarding research that is critical to the continued development of the profession.

Cirecie planted a number of “project seeds” during her time in office. While some of those seeds bloomed this year, there are a number of projects and issues that will see the light of day in future years. Her mark on the profession will continue to be realized, so rather than saying “goodbye,” the staff and I look forward to her continued involvement in ACA on various levels.

At the beginning of this column, I said I would be writing about two amazing women. At the end of this month, ACA will gather to bid farewell to someone I have known for my entire tenure at the association. After three decades as part of the ACA staff family, our deputy executive director, Carol Neiman, has decided to retire.

During a tribute to Carol at the ACA Conference in March, I said, “Each year, I come before you and ask you to join me in honoring an individual or a group who has had an impact on the profession, our members or even sometimes just me. This year, I want you to help me honor someone who has impacted all three of those categories.

“For more than 20 years, I have come to work at ACA, and there is one individual whom I have worked with every day, through good times and some not so good times. This person has been a font of knowledge, a wisdom keeper and someone who has helped to guide me in doing what is right. She is one of the most dedicated and hardworking people I have ever known in my life.”

Carol really cannot be replaced. We will move on, of course, and however we structure things after her departure, I know that our subsequent successes can in part be attributed to her many efforts. She has instilled in all of us the need to take care of our members, respond to their concerns and develop the products and services that they value. We are a better organization because of her innumerable contributions to ACA, its members, its leaders and the entire counseling profession.

So there you have it — my thoughts on two amazing women who have helped to shape who we are as ACA and whose dedication and efforts will continue to shape our development for years to come.

On behalf of the entire staff, I want to also thank all of you who chose to serve in a volunteer role this year. Whether you are a graduate student, practicing counselor, counselor educator or retired member, we very much appreciate your connection to ACA and your efforts to serve the profession.

As always, I look forward to your comments, questions and thoughts. Feel free to call me at 800.347.6647 ext. 231 or via email at ryep@counseling.org. You can also follow me on Twitter: @RichYep.

Be well.

 

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Accountability, credibility and verisimilitude

By Cirecie West-Olatunji

Cericie

Cirecie West-Olatunji, Ph.D.
President, ACA (2013-2014)

As I prepare to step down from my role as ACA president at the end of the month, I am reflecting on my initial goals while in office. When I wrote my statement as a candidate for president, subsequently published in Counseling Today in December 2011, I asserted three priorities: a) leadership development, b) international counseling connections and (c) social action and outreach. Over this past year, I have attempted to demonstrate concrete movement in each of these areas and thus contribute to the work started by my predecessors. So, in the spirit of assessment, let’s see how the year went.

Leadership development: I either launched or strengthened several leadership initiatives this year. First, I established an additional leadership task force focused on the role of seasoned leaders and asked it to collaborate with two previously existing task forces working on expanding the pipeline to leadership and developing training resources for leaders. Second, I asked the Research and Knowledge Committee to explore the concept of leadership in counseling to determine if our vision of leadership is unique in any way and might thus require our own set of pedagogical tools. The members and chairs of the leadership task force and the Research and Knowledge Committee presented their progress reports as a panel at the annual ACA Conference in Honolulu this past spring. Third, the Governing Council representatives received leadership training at both their meetings this year to move toward becoming a more effective board. The meeting at the annual conference reflected significant improvement in board functioning as evidenced by their visionary thinking, improved communication and decision-making, and use of meeting time. Fourth, I met with our CEO, Richard Yep, to help him formulate a self-assessment framework that is dynamic, reflective and forward thinking, and based upon effective nonprofit association leadership practices. Fifth, I worked with staff to ensure that this summer’s ACA Institute for Leadership Training would include a leadership track and that efforts were being made to reintroduce the Leadership Academy within a digital environment.

International counseling connections: Over the past three years, agreement has been reached that internationalization efforts are desired. However, only in the past year did we commit funds to expand our global presence. As president, my goal was to solidify connections with our sister organizations outside of the United States. To that end, I have engaged in dialogue with my counterparts in other countries. My hope is that by the time this column is printed, we will have signed memorandums of agreement with a few international associations. Additionally, existing partnerships allowed me to represent ACA at the British Association for Counselling and Psychotherapy research conference (which ACA co-sponsored) in London and the International Association for Counselling annual conference in Victoria, British Columbia, in May. My visit to Victoria afforded me the opportunity to meet with leaders from the Canadian Counselling and Psychotherapy Association (CCPA) in preparation for ACA’s 2016 conference in Montréal, which will be held in partnership with CCPA’s annual conference that year.

Social action and outreach in counseling: My contributions to social action consisted of a presidential session at the ACA Conference. Additionally, I was able to visit Capitol Hill on several occasions to support national advocacy efforts related to education and vulnerable student populations. I also attended the Rosalynn Carter Symposium on Mental Health Policy this past fall to confer with other behavioral health care leaders on the Affordable Care Act. Lastly, I sanctioned ACA’s co-sponsorship of the inaugural Time to Thrive conference that brought together advocates for lesbian, gay, bisexual and transgender youth.

It has been a distinct pleasure to serve the association. I have come to further appreciate the work of branch and division leaders as well as rank-and-file practitioners who are in the trenches helping people on a daily basis. And none of my work could have been done without the creative brilliance of the ACA staff. Thank you for this opportunity to serve.

 

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Follow Cirecie on Twitter: @Dr_CWO

The stigma of mental illness and the noble savage myth

By Jonathan Schildbach and Jeffrey T. Guterman May 29, 2014

Branding-AvatarDespite the seemingly widespread understanding that mental illness is a disease that can be effectively treated, prejudice toward individuals with mental health issues still pervades our society. People with such conditions are often depicted as undesirable and incapable of maintaining meaningful personal relationships or holding positions of authority. Organizations such as the National Alliance on Mental Illness and the National Institute of Mental Health have led efforts to overcome the stigma of mental illness. In addition, anti-stigma campaigns have been developed to end discrimination surrounding mental illness. The American Counseling Association has also encouraged its membership to play an active role in the fight against mental health stigma. It is clear that the stigma surrounding mental illness is both a social justice issue and a public health issue.

Stigma compounds the already challenging problem of mental illness. Just as oppressive as its symptoms is the effect of the dominant story in our culture about mental illness that tends to marginalize, subjugate and pathologize individuals with such conditions. Actress and activist Glenn Close, who co-created the anti-stigma campaign Bring Change 2 Mind, suggests that the stigma is worse than the mental illness itself. Stigma affects all sectors of society. For example, the U.S. military has developed programs to combat stigma associated with mental illness and improve quality of care for soldiers who are increasingly dealing with posttraumatic stress disorder and other conditions.

An international study by researchers at Indiana University in 2013 found that stereotyping is a main source of stigma surrounding mental illness. Although notable efforts have taken place to create accurate portrayals of mental illness in the entertainment industry and media, many depictions continue to disseminate stereotypes and other information that is just plain wrong. But rejection of negative stigma may also lead to positive stigmatization: attaching stigmas that are intended to grant a kind of protected or special status to clients with mental illness. The problem with stereotyping of any kind — even if there are positive intentions behind such views — is that it categorizes the objects of the stereotyping as people who are somehow “other.”

In this article, we present the concept of the “noble savage” as a metaphor for understanding how the general public and, in particular, counselors may stigmatize people with mental illness. The noble savage is a fictional archetype based on a common social stereotype. The noble savage describes an idealized indigenous person, outsider or “other” who has not been corrupted by modern civilization, therefore symbolizing the innate goodness of humanity. The noble savage concept suggests that indigenous, native people are somehow closer to nature and therefore possess a heightened spirituality compared with “civilized” people who do little more than corrupt or destroy the natural world.

The phrase noble savage first appeared in the 1672 play The Conquest of Granada by John Dryden. In his play, Dryden differentiates between a world of laws, which includes civilized people, and a world of nature before such laws were brought to bear. The former consists of controlled, debased humans separated from God by modern societal constructs; the latter is a free, natural, wild world populated by noble savages — humans in their pure state.

Examples of the noble savage are replete in contemporary films, including Avatar, Dances with Wolves, The Last of the Mohicans and The Last Samurai, tales in which invaders, corrupted by their desire for wealth and conquest, are contrasted with more primitive cultures. Most of these narratives involve a member of the invading culture turning against one’s own kind to champion the cause of the noble savage. For example, Avatar is about tall, striped blue beings living in trees — the noble savage Na’vi — who are rescued by a white male who comes from a technologically advanced planet that is attempting to plunder Na’vi resources.

Films based on actual events have also depicted the noble savage concept. Mississippi Burning casts the struggle of African Americans in terms of how members of the dominant white culture become involved with resolving the other’s situation. Those who are not part of the dominant culture take a back seat in their own struggle to be recognized as equals and treated with dignity.

Viewing clients as noble savages

It is easy for counselors to metaphorically transform clients into noble savages. From this perspective, mental illness provides some measure of immunity from the modern world and the maladies that make those who do not struggle with such conditions somehow more corrupt. It follows that mental illness takes a person out of the normal flow and function of modern life; it comes to be seen as a purifying agent, something that makes people with mental illness “good.” Yet such a view contributes to the belief that those with mental illness are ultimately uncivilized and less than human. Hence, viewing people with mental illness as “noble savages” creates and perpetuates stigma.

The concept of heroism associated with entering into the world of the noble savage is particularly relevant for counselors. Perhaps some counselors see themselves as “champions” for clients, not only because counselors have the means to bring about positive change, but also as a result of assigning clients a special status as people incapable of helping themselves. Effective counseling requires an ability to guide clients to identify their own strengths and problem-solving skills. If a counselor falls into the trap of viewing clients as noble savages, then he or she may see clients as “good” but also ultimately incapable of making their way in the same world that so-called “normal” people occupy. In such cases, the counselor becomes primary, a member of the dominant culture, while the client becomes secondary, a representative of the “other.” The counselor becomes the hero, the client someone to be saved.

It is important for counselors to recognize the precise meanings of their descriptions of clients. Although counselors may use the Diagnostic and Statistical Manual of Mental Disorders, such diagnoses should serve as limited guidelines for treatment, not labels that confine clients to roles as limited persons. Any label connected to mental illness must be approached with clear self-reflection. If counselors place themselves in the role of hero, then clients may not be afforded an opportunity to be empowered during the change process. Therefore, it is critical for counselors to consider if they are viewing clients with mental illness as essentially different from themselves.

Challenging the noble savage myth

Viewing clients with mental illness through the noble savage lens amounts to a fundamental denial of human nature and, in turn, contributes to stigma. Cognitive psychologist Steven Pinker has suggested that humans are not born as blank slates but, rather, have predetermined faculties for various traits, including language, memory and perception. Similar to the blank slate, the noble savage continues to be an influential concept in modern society. It has contributed to the development of ecological movements that distrust all things man-made and synthetic. The noble savage has also occasioned the emergence of the recent utopian view of bullying as a phenomenon to be eliminated rather than a fact of life that has always been and which is inevitably tied to aggressive and competitive tendencies in humans.

Research in various disciplines suggests that mental illness is deeply rooted biologically and can be explained in terms of evolutionary development. Advances in genetics have shown that personality traits are heritable. Neuroscience has identified brain mechanisms associated with aggression. And evolutionary psychology has taught us that the pervasiveness of human violence is related to Darwinian processes. Although there are cross-cultural differences between people, human universals suggest we are more alike than different. It is a misconception then to think of human beings in terms of “us” who are free from mental illness versus “them” who are uniquely plagued by such conditions.

Viewing clients as noble savages in need of rescue and counselors as their saviors ignores the ubiquitous nature of mental illness and the complex ways that mental illness can arise. According to the Centers for Disease Control and Prevention, 25 percent of U.S. adults have a mental illness. Mental illness is a complex phenomenon related to genetic, psychological and social factors. We are all prone to mental illness. For counselors to reduce themselves and their clients to archetypes is to deny that each of us encompasses a wide range of assets and deficits. We do not exist as simplified characterizations of virtue and vice.

What now?

Counselors serve an important function in combating stigma because of their relevant education, training and experience, as well as their direct contact with clients, educators, health care providers and policymakers. A major part of the effort to address stigma involves calling attention to the underlying attitudes that reinforce stigma and then working to change those attitudes. Like the culture at large, counselors often view people with mental illness in terms of established cultural narratives, such as that of the noble savage, which casts individuals in terms of stereotypes. Counselors need to examine their own beliefs and practices to ensure they do not perpetuate such stigmas.

Sometimes counselors buy into stereotypes about mental illness using the same inaccurate language and biases as social institutions, the media and the general public. For example, some counselors may refer to a client as “a borderline” rather than a client who has been diagnosed with borderline personality disorder. Becoming aware of expressions of stigma is an important role for counselors, and learning how to challenge these expressions is a critical skill. Counselors can reinforce their own anti-stigmatizing efforts by helping colleagues, friends and family members identify instances when they use diagnostic terms as insults or pejoratives. In addition, counselors can involve themselves in the efforts of organizations to fight stigma and call attention to inaccurate portrayals of people with mental illness in the media.

Perhaps most important, counselors have unique opportunities to help fight stigma in their clinical relationships with clients. Counselors can promote social justice in the fight against stigma one case at a time. This can be achieved by viewing clients as individuals with their own resources, strengths and skills. Clients must not be confined to roles as noble savages — good, but incapable. Instead they should be viewed as complete human beings who have struggles that we all share as part of the human family.

 

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Jonathan Schildbach is a licensed mental health counselor in Seattle. Follow his blog at respecttheblankie.com, and contact him at jcschildbach@gmail.com.

 

Jeffrey T. Guterman is a licensed mental health counselor in Fort Lauderdale, Florida. Visit his website at JeffreyGuterman.com, and contact him at jguterman@gmail.com.

 

Letters to the editor: ct@counseling.org

EMDR for the co-occurring population

By Jeanne L. Meyer

In my work with clients with co-occurring mental health and substance use disorders, it became clear to me early on that most have experienced trauma in their lives — trauma that they must resolve to achieve and maintain a healthy recovery.

These traumas are sometimes categorized as little “t” or big “T” traumas. Big “T” traumas include childhood sexual, physical or emotional abuse, natural disasters, war experiences, severe car accidents and rape. Little “t” traumas can be just as damaging, especially because they tend to occur over time and build on each other. This complicates the overall effects of the trauma as well as the trauma treatment. Some examples of little “t” traumas include ongoing emotional abuse or neglect, experiences of shame, being humiliated and being bullied. Incidents involving racism, sexism or homophobia could be classified as either big “T” or little “t” traumas depending on the severity. These traumas might involve one or two distinct incidents, or be more complex, ongoing experiences. The result is a primary belief that the world is not safe. In some cases, individuals who are traumatized learn to expect pain, dishonesty and betrayal from the people they love the most.

In the case of clients with addiction, even if they have not experienced trauma prior to the onset of their disease, they most likely have experienced violence, rage, betrayal, abuse (sexual, physical or emotional), incarceration, homelessness or a whole host of other negative experiences while using alcohol or other drugs.

There are two clinically appropriate strategies for treating posttraumatic stress disorder (PTSD) with people in substance abuse recovery. One strategy is to address the trauma or abuse immediately as the client enters the beginning stages of recovery. The other is to wait until the client’s ability to achieve and maintain abstinence has stabilized.

How do we know which strategy will be successful? Ultimately, the client is the one who knows. If the ability to maintain abstinence from alcohol or other drugs is precarious or impaired due to memories, suicidal ideation or self-harm, it is essential to treat the cause of these symptoms from the beginning. For these clients, recovery will likely remain elusive until their trauma is addressed. If the client is relatively stable, however, waiting until the later stages of recovery is indicated. Clients who are pressured into addressing their trauma issues before they are ready are likely to relapse into active addiction.

According to recent brain research described in Uri Bergmann’s 2012 book Neurobiological Foundations for EMDR Practice, when someone experiences an event or multiple events that cause intense fear, it can change the neural pathways, or maps, in the brain. Whenever something is experienced as a reminder of the trauma, clients can relive that trauma, making them afraid of certain places, tones of voice, objects or even other people with certain body types. Smells can also trigger intense anxiety and fear. The repetitive experience of anxiety and fear can result in panic attacks, health problems, chronic pain, sleeping difficulties and eating difficulties. The individual eventually becomes self-centered, focusing so much on self-protection that there is little objectivity or ability to have empathy for others. This makes every relationship unstable.

eyeThe good news is that several proven therapeutic techniques, including eye movement desensitization and reprocessing (EMDR), can alleviate symptoms stemming from past traumas. EMDR uses the mechanism by which information from frightening and horrifying events is processed into memory and stored in the brain. By manipulating the brain’s intrinsic information processing scheme, a practitioner can help clients release themselves from the intense hold those memories have on them. EMDR combines sensory bilateral stimulation (visual, auditory or physical sensations) with emotional memory and the underlying belief system to lessen the intensity of the experience. It does not erase the memory, but it can reduce or alleviate many of the associated symptoms.

The mystery of EMDR

It is not known precisely how EMDR works, but various research studies have verified its effectiveness in the treatment of trauma. Twenty-four randomized controlled (and 12 nonrandomized) studies have been conducted on EMDR. Most of these studies address simple rather than complex trauma. For a list of these studies, visit the EMDR Institute website at emdr.com and click on the “Research Overview” link under the General Information tab.

In developing EMDR, Francine Shapiro postulated that PTSD is caused by a disruption in the adaptive information processing system. Because the fear and helplessness experienced by clients stays attached to the memory of the traumatic event, it creates havoc in their lives. It is as if the trauma is continuing to happen to them. Because it is still occurring neurologically, it cannot be processed as a memory.

EMDR changes the configuration of the neural connections or map of that event, detaching the dysfunctional physiological and emotional components so that it becomes a more manageable memory. This helps the client “let go” of the past because the neurons are literally letting go of some connections and replacing them with new ones.

In my experience, EMDR is the fastest, most effective and least intrusive way to help clients release trauma, regardless of whether it stems from childhood abuse, sexual abuse or assault, accidents, disasters or combat, and regardless of whether it is the result of a single event or multiple experiences. I have also seen EMDR reduce or eliminate chronic pain, headaches, fibromyalgia and cravings for alcohol and other drugs. One of the best things about EMDR is that it doesn’t require clients to retell their horror stories. In my view, when people don’t have words to describe what they are experiencing, don’t remember the original incident, have somaticized their pain or are too emotionally raw to put the experience into words, it is essential to offer treatment that does not require verbalization.

 

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[Click on the image to see the chart in full size]

The eight phases

To practice EMDR, a clinician must have a master’s degree, counseling experience and the proper EMDR training. Although the process may seem simple to an outside observer, it requires both an understanding of how the brain and emotions work with trauma and a specific protocol. As shown in the table below, there are eight phases of treatment.

We’ll use “Carrie” to highlight how each phase of the EMDR treatment protocol might be carried out with a client.

  • History taking and treatment planning (Phase 1): This is used in most counseling therapies. The therapist and client review biopsychosocial history and trauma history, assess client resources and strengths and determine the frequency and level of any dissociation symptoms. The therapist will suggest different targets and strength-building skills depending on the overall emotional stability of the individual.

“Carrie” comes to the clinic requesting help with night terrors and anxiety. While obtaining her background history, it becomes clear she has survived many traumatic events, has few financial or social resources and is currently separated from her abusive husband. She smokes cigarettes, uses marijuana, uses some mindfulness tools and practices breathing techniques to manage her distress and anxiety. The therapist determines it is essential to improve her emotion regulation and distress tolerance skills, along with targeting various symptoms such as her recurring nightmare.

  • Preparation (Phase 2): The therapist explains the adaptive information processing system and how trauma disrupts it. The mechanics of treatment are reviewed. Emphasis is placed on clients nonjudgmentally observing their reactions and awareness, and communicating those observations to the therapist. Rapport is established. Relaxation and self-soothing techniques are taught and practiced.

In Carrie’s case, she is able to best understand the adaptive information processing system with the help of a simple illustration the therapist draws to engage her in the therapeutic relationship. The therapist says, “I will show you exactly what the technique looks like. We can use eye movements, sounds using headphones, or I can tap the back of your hands. Which feels most comfortable to you?” When Carrie chooses eye movements, they arrange the chairs so Carrie and the therapist are facing each other. The therapist holds a pen in front of Carrie and asks, “Is that comfortable? Do I need to change the distance or the pen I’m using? What I will do is wave my pen back and forth, and you follow it with just your eyes.” The therapist does this, and Carrie follows the pen easily.

  • Assessment (Phase 3): The client and the therapist determine exactly what the target is, including any images, physical sensations or memories that are associated with the emotionally loaded material. They rate the intensity of the feelings that are attached using the Subjective Units of Distress Scale (SUDS). An “irrational belief” (as defined by Albert Ellis) is identified by the client as the negative cognition. The client chooses a more reasonable belief to use as the positive cognition and rates the perceived validity of this statement.

In Carrie’s case, she remembers parts of her dream: She is in a dangerous situation with people looking for her; she crawls through a hole in a wall to discover she is in a bunker with gunfire all around her. She rates the fear she feels as she recalls the nightmare at a SUDS score of 9. She identifies her belief when these feelings come up as, “I am never safe.” The therapist asks her what she would rather believe.

Carrie responds, “That I am safe, I guess.”

“Are you safe?” the therapist asks.

“No, not always,” Carrie says.

“But sometimes you are safe.”

“Yes, sometimes I am safe.”

The positive cognition becomes “I can be safe.”

The therapist asks, “How true does that statement feel right now?”

Carrie rates it on a Validity of Cognition (VOC) scale as a 1, indicating it feels “like a lie.”

  • Desensitization (Phase 4): The cognition, the emotion and body awareness are combined with bilateral stimulation. The therapist changes the bilateral stimulation speed with eye movement, tapping and sounds throughout and between sets. A set is composed of a series of bilateral stimulations. For example, moving the eyes back and forth 10 times would represent a set. The therapist varies the length of a set depending on the intensity of the material the client is experiencing. In between sets, the therapist determines that the process should continue by asking the client if he or she is noticing any changes. This pattern continues until the client reports no change between sets and the SUDS score has been reduced to a 0 or 1.

For example, the therapist tells Carrie, “Bring up that memory, crawling through the hole and being in the bunker. Remember the sounds and smells. Notice how your body feels. Allow the thought, ‘I am never safe,’ to float in your mind. Do not try to direct your thoughts. Let your mind wander. Wherever it goes is where it’s supposed to go.”

Carrie watches the therapist move the pen back and forth, causing her eyes to move from left to right rhythmically. After a set of 10 eye movements, the therapist stops and says, “Take a deep breath. Tell me what you are noticing right now.”

The therapist makes a note of Carrie’s response and starts another series of bilateral stimulations. The process continues until Carrie reports several times that she feels “nothing.” When recalling her nightmare, her SUDS score is 0.

  • Installation (Phase 5): The positive cognition is strengthened for the client. The bilateral stimulation is used as the client thinks of the positive cognition. The sets are shorter and slower to allow the positive experience to establish itself. The VOC is measured again until a score of 6 or 7 (“completely true”) results.
  • Body scan (Phase 6): The therapist asks the client to pay attention to the way her body feels from head to toe (or vice versa) and report it.

Carrie notices some trembling in her hands. The therapist uses more sets of eye movements until the trembling ceases.

  • Closure (Phase 7): The therapist ensures clients are safe to leave the session and navigate their way to their next destination. They are guided through self-calming rituals. The therapist explains that the client may feel spacey or very tired for anywhere from one hour up to a few days. Clients are given an assignment to journal their experiences, emotions, thoughts and dreams until the next session.
  • Reassessment (Phase 8): This phase occurs at the beginning of the following session. The targeted material is recalled and the client’s SUDS score is determined. The VOC of the positive cognition is also reevaluated. Any residual processing that occurred between sessions is discussed. If there is a change in either the SUDS or VOC score, it indicates there are more aspects of the target to process.

At Carrie’s next session, she reports the nightmare has not returned. When she remembers it, her SUDS score is 1. The positive cognition, “I can be safe,” is rated at a VOC of 7 (“completely true”).

Conclusion

When I work with a client, I keep meticulous notes about the intensity of the individual’s negative emotions and the perceived validity of the positive cognitions before and after a treatment. I keep this record partly so that I can review it with the client in the future. Many times, the client possesses no memory of having the original problems and emotions. The client still remembers the traumatic incident and has feelings about it, but the incident does not haunt the client any longer.

My experience of utilizing EMDR with clients has been no less than amazing. I continue to be surprised at its effectiveness addressing a number of concerns. It works relatively quickly, and its results are maintained. After the initial setup, it relies on clients’ own processing and therefore validates their experience completely. With EMDR, there is also a shorter period of intense unpleasant emotion that clients experience than with other talk or exposure therapies. It engages the parasympathetic nervous system, leading to relaxation or drowsiness when the process is complete.

Whether EMDR is used at the beginning of addiction recovery or after a period of abstinence, clients are able to manage their recovery more easily and more successfully when PTSD symptoms are alleviated.

 

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Jeanne L. Meyer, a licensed mental health counselor, licensed professional counselor and master addictions counselor, is a co-occurring therapist with Choices Counseling in Vancouver, Washington. She is also a member of the American Counseling Association Trauma Interest Network. Contact her at jmeyer@ChoicesCounseling.org.

 

Letters to the editor: ct@counseling.org

Maya Angelou remembered as advocate, inspiration to counselors

By Bethany Bray May 28, 2014

Maya Angelou, noted poet, author and inspiration to many counselors, passed away today at age 86.

Angelou, a longtime professor at Wake Forest University, gave the 1997 keynote address at the American Counseling Association’s annual conference in Orlando, Florida.

Maya_branding-box

Maya Angelou, American poet and author. Image via Wikimedia Commons.

“I still remember her ACA conference keynote more than 17 years later,” says ACA Chief Professional Officer David Kaplan, a past president of the association. “Her poetry was enthralling and her passion made you feel as if you were the only one in the room – even though you were surrounded by thousands. It was the most memorable ACA keynote I have ever witnessed and her passing makes me sad that others will not have the opportunity to hear her speak in person.”

An article in the May 1997 issue of Counseling Today describes Angelou’s keynote address at the ACA conference as “brilliant and moving.”

More than 5,000 people attended. She concluded the hourlong speech by reciting her poem “A Brave and Startling Truth,” which was met with a standing ovation. (The poem is included at the bottom of this article.)

“Angelou lifted the spirits of all who were lucky enough to attend,” states the article. “… [She] lauded the exquisite power of counselors, saying ‘you are the best we are, and the best we can hope to be.’”

All people must support each other and teach love, and that is what counselors do, Angelou told the audience.

Angelou grew up in Jim Crow-era Arkansas, which she chronicled in her landmark 1969 book I Know Why the Caged Bird Sings.

Angelou wrote more than 30 books during her lifetime and won three Grammy awards for spoken-word albums. She also directed, wrote and acted in movies, plays and television programs and was a lecturer, dancer, singer and civil rights activist.

Rebecca Daniel-Burke, a counselor and ACA’s director of professional development, said Angelou has been an inspiration to her and she, in turn, has used Angelou’s writings to inspire her counseling clients.

“When I was 25 years old, I lived in Manhattan. I went to the New York Public Library and made a decision to read all of the autobiographies written by women,” Daniel-Burke says. “When I got to I Know Why the Caged Bird Sings, I was in for a treat. Later in life I became a counselor and started giving my clients inspiring poems. One I have given to many women is ‘Still I Rise.’ [Angelou] has provided inspiration to me, my clients and infinite numbers of women.”

Angelou died quietly May 28 at her home in Winston-Salem, North Carolina, said her literary agent, Helen Brann.

In her last tweet on May 23, Angelou said, “Listen to yourself and in that quietude, you might hear the voice of God.”

 

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A remembrance of Maya Angelou, from American Counseling Association CEO Richard Yep

“I have two very distinct memories of Maya Angelou. The first is when I was in high school and was assigned to read I Know Why the Caged Bird Sings. Even at that young age, I was moved and still remember the impact that her biography had on me. She was a woman of such inner strength and fortitude.

The other memory I have was in 1997 when Dr. Angelou accepted ACA’s invitation to be our keynote speaker at the annual conference. The contract from the speaker’s bureau was very clear that we were to meet her plane when it arrived and that staff was to follow her in a separate car to the hotel.

We made sure she got into the limo and headed to the other car when she asked what we were doing. When told that we would be in a different car, she said that was nonsense and that we were to ride with her! On the ride to the hotel, she was engaging, asked about our life and our careers, and made us feel so comfortable. When she went to the stage to present her keynote, she even referred to those of us who met her at the airport by name. Gracious, welcoming and a very unique woman.”

 

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Counselors, how have Maya Angelou’s life and writings inspired you?

Scroll down to post your thoughts and memories of her legacy and impact on the counseling profession.

 

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Bethany Bray is a staff writer for Counseling Today. Contact her at bbray@counseling.org

Follow Counseling Today on Twitter @ACA_CTonline and on Facebook: facebook.com/CounselingToday

 

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A Brave and Startling Truth

By Maya Angelou (recited by the author at the American Counseling Association’s 1997 annual conference)

We, this people, on a small and lonely planet
Traveling through casual space
Past aloof stars, across the way of indifferent suns
To a destination where all signs tell us
It is possible and imperative that we learn
A brave and startling truth

And when we come to it
To the day of peacemaking
When we release our fingers
From fists of hostility
And allow the pure air to cool our palms

When we come to it
When the curtain falls on the minstrel show of hate
And faces sooted with scorn are scrubbed clean
When battlefields and coliseum
No longer rake our unique and particular sons and daughters
Up with the bruised and bloody grass
To lie in identical plots in foreign soil

When the rapacious storming of the churches
The screaming racket in the temples have ceased
When the pennants are waving gaily
When the banners of the world tremble
Stoutly in the good, clean breeze

When we come to it
When we let the rifles fall from our shoulders
And children dress their dolls in flags of truce
When land mines of death have been removed
And the aged can walk into evenings of peace
When religious ritual is not perfumed
By the incense of burning flesh
And childhood dreams are not kicked awake
By nightmares of abuse

When we come to it
Then we will confess that not the Pyramids
With their stones set in mysterious perfection
Nor the Gardens of Babylon
Hanging as eternal beauty
In our collective memory
Not the Grand Canyon
Kindled into delicious color
By Western sunsets

Nor the Danube, flowing its blue soul into Europe
Not the sacred peak of Mount Fuji
Stretching to the Rising Sun
Neither Father Amazon nor Mother Mississippi who, without favor,
Nurture all creatures in the depths and on the shores
These are not the only wonders of the world

When we come to it
We, this people, on this minuscule and kithless globe
Who reach daily for the bomb, the blade and the dagger
Yet who petition in the dark for tokens of peace
We, this people on this mote of matter
In whose mouths abide cankerous words
Which challenge our very existence
Yet out of those same mouths
Come songs of such exquisite sweetness
That the heart falters in its labor
And the body is quieted into awe

We, this people, on this small and drifting planet
Whose hands can strike with such abandon
That in a twinkling, life is sapped from the living
Yet those same hands can touch with such healing, irresistible tenderness
That the haughty neck is happy to bow
And the proud back is glad to bend
Out of such chaos, of such contradiction
We learn that we are neither devils nor divines

When we come to it
We, this people, on this wayward, floating body
Created on this earth, of this earth
Have the power to fashion for this earth
A climate where every man and every woman
Can live freely without sanctimonious piety
Without crippling fear

When we come to it
We must confess that we are the possible
We are the miraculous, the true wonder of this world
That is when, and only when
We come to it.

 

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