Counseling Today, Online Exclusives

From counselor of clients to midwife of hope

By Christine M. Browning December 17, 2015

In preparation for teaching a graduate introductory theories course, I read back through some applicable articles. Arthur J. Clark published an article in the Journal of Counseling & Development in 2010 that described a counseling model based on Carl Rogers’ phenomenological framework.

Clark’s model is composed of three interpersonal ways of knowing:

1) Subjective empathy

2) Interpersonal empathy

3) Objective empathy

As I read through the article, I was reminded of the wealth of application that Rogers’ three tenets — genuineness, empathy and unconditional positive regard — unconsciously contribute to my profession and how effortlessly they align with my personal and spiritual worldviews. Clark’s article also reminded me of a recent counseling session in which a seemingly typical client’s response to a standard interview question solidified my propensity for Rogers’ theory, gave figure to Clark’s form of three separately distinguishable “ways of knowing” and brought a new awareness to the very real and meaningful spiritual moments in a counselor’s profession.

The interview process for a state agency is fairly standardized, but the details are as varied as the people who need to be heard. The process isn’t at all like an initial interview session conducted for the purpose of developing counselor-client rapport in which a treatment plan is proposed, discussed SunnyPathand adopted. Rather, it is a one-time meeting after which a report is written and sent to the state. The counselor’s “job” is to clearly and concisely provide a narrative picture of the client for review.

The information-gathering aspect of the client evaluation is always interesting but typically uneventful. The counseling scenario recorded herein serves as a case study for the application of Clark’s model. The counseling session served to bring my individual inclinations for person-centered therapy, my fund of professional training and my spiritual sensitivity into a keen, insightful focus. Permission has been granted for reproduction of the session particulars reported here.

 

Sympathetic empathy

It was only 10:30 a.m., but it had already been a very long day. As I lumbered to the waiting room to retrieve my third client of the morning, the visible depth of her sadness struck me and shook me out of my self-engrossed Monday stupor.

The two friends who accompanied the disheveled woman rose anxiously in concert with her. I introduced myself and informed the friends that it was not necessary for them to join the woman during the interview session; they would be consulted if and when necessary. The pair reluctantly and simultaneously sat in perched-on-the-edge-of-their-seats fashion. Their concern for their friend was clear.

During this brief exchange, my client never raised her gaze from the spot on the floor directly in front of her feet. Once in my office, she didn’t look up but sat where instructed and answered what was asked with bulleted spurts of information.

I quickly jotted down these words on my notepad: “Low voice tone and rate, poor eye contact, flat affect, despondent, hopeless.” I silently breathed a prayer that God would grant me a sense of His presence and help me identify the onset of the spiral of defeat into which this client seemed to have fallen.

Clark refers to this interchange between counselor and client as subjective empathy, or what Rogers referred to as unconditional positive regard. It is the moment of imagined identification with a client’s plight that consists not of pity or an inclination to “fix” but rather the genuine heartfelt, unspoken tug of humanity between counselor and client.

 

Interpersonal empathy

A few moments into the session, I asked, “Have you ever been married?”

“No,” the client sighed, her gaze still fixed downward.

“Do you have any children?” This is a standard question in the necessary interview process, but the woman’s response was gripping. She looked up briefly and locked her eyes with mine as tears streamed down her cheeks and onto her shirt. Then she lowered her head as her body began to heave with muffled sobs.

I waited for the wave of emotion to pass and felt the atmosphere of the room change. The question I had posed had inserted a key into my client’s private hell. Why did that simple question evoke a torrential response?

With a hushed, respectful tone, I asked if the client could tell me about her tears. As I moved the tissue box closer to her groping hand, she stated in a pointed and harsh tone, “I am not a mother. I had a stillborn baby…” Her carefully worded statement trailed off into a second torrent of tears.

I sat in awe of her bravery and her ability to communicate the depth of her pain with such simply stated words. Words brimming with brokenness and love — a mother’s love.

“I am so sorry for your loss,” I whispered. “How long ago?” I asked.

“Two … years,” was her broken, tearful response.

Her sobbing quieted as we sat together in the palpable sorrow. Somewhere in our brief exchange we had stepped away from the counselor-client relationship and into the territory of two women together shouldering the burden of life and loss.

“I know you told me you do not have any children, that you are not a mother,” I offered, “but you do have a child. You are a mother!”

Her eyes flashed with a spark of light as she settled them onto mine.

“You are a mother,” I repeated. “You birthed a child.”

Clark refers to this second way of knowing between counselor and client as interpersonal empathy — empathy experienced with the client in the here and now from an “extended empathic perspective.” This concept represents Rogers’ genuineness, although less in the sense of counselor identification with the client.

 

Objective empathy

I wrote down the name of a group for women just like her — mothers whose babies drifted into eternal sleep before drawing their first earth-bound breath. These stillborn sons and daughters are beloved children.

My client had never heard of such an oasis. A room full of women with similar experience and understanding — empathy. She readjusted her position in the chair as her bowed shoulders widened and her poorly postured spine straightened. She was incredulous and full of questions about the group.

Clark refers to this tapping into referential data as objective empathy. It is the reflexive skill that develops as a counselor steps away from the classroom and into the lives of real people. Objective empathy brings a synthesis to the broad scope of information obtained during a counselor’s education, practical training and professional credentialing. It is the empathy component of Rogers’ ways of knowing.

“What did you name your child?” I probed, extending the realm of interpersonal empathy we had ventured into together.

As she answered, her tears slowly ebbed and her voice grew confident with the sound of her child’s name in the air. She repeated it. I repeated it. Her countenance brightened. Her eyes cleared. She reached for another tissue with decisive intention, and the interview concluded with the fragrance of hope surrounding us.

About 15 minutes after the she left my office, the woman called to talk to me. I was already with another client, but my secretary took this message: “I got into the group! I start this week!” Her voice was reportedly bright with excitement.

 

Conclusion

Psalm 56:13, written long before my interaction with this client, aptly describes the experience from my perspective: “For you have delivered me from death and my feet from stumbling, that I may walk before God in the light of life.”

The interaction also appropriately answered Gordon Paul’s (1967) quintessential question of best practices in counseling (paraphrased): “What will work best for this particular client with this particular concern at this particular time with this particular counselor?”

In the brief measure of a 55-minute session, I witnessed the beauty of renewal as God’s Spirit hovered and birthed the mother of a stillborn child into life again. In the process, my profession was also altered — from mere counselor of clients to midwife of hope. It was more than theoretical positioning, clinical skill or the demonstration of a new design. It was an amalgam of individuality, knowledge, professional posture and an intentional spiritual sensitivity.

What Clark’s work demonstrates for the counseling community, as viewed through the lens of an actual counseling session, is a framework born of Rogers’ time-honored theory upon which three clearly identifiable elements of empathy are constructed. As demonstrated in the counseling scenario recounted, these three elements can be utilized to facilitate a person-centered approach to therapy.

It is my goal as I train future counselors to introduce them to the expanding wealth of clinical intervention and teach them to assimilate new knowledge into the rich pool of training, closely observe for keys to unlock clients’ stories and remain spiritually sensitive to the potential of client encounters.

As these encounters transpire, we will experience increasing opportunities to function as midwives of hope in this ever-varied, extremely challenging and uniquely rewarding field.

 

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Christine M. Browning is an associate professor and director of the master’s in counseling program at Milligan College in Tennessee. She is a licensed professional counselor, a nationally certified counselor and a senior psychological examiner. In addition to her teaching and administrative duties at Milligan, she maintains a small private practice. Contact her at CMBrowning@milligan.edu.

 

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Related reading

For more on working with clients who are going through a miscarriage loss or infertility, see Counseling Today‘s October cover story, “Empty crib, broken heart

For more on strengthening the counselor-client therapeutic alliance, see our 2014 article “Connecting with clients

 

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