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Counselors Audience

Where East meets West

Lynne Shallcross October 1, 2012

Cliff Hamrick was meditating long before he became a counselor, having found the practice useful for treating the depression he had experienced some years before. Now a private practitioner in Austin, Texas, Hamrick integrates Eastern and Western approaches to counseling because he believes it benefits his clients.

Partway across the country in Connecticut, counselor Deb Del Vecchio-Scully also combines Eastern and Western approaches when working with clients. She discovered guided imagery and meditation almost three decades ago while seeking ways to manage her pain after multiple back surgeries.

As technology continues to “shrink” the world and as the counseling profession steadily expands its global presence, it is not hard to predict that an increasing number of counselors will join Hamrick and Del Vecchio-Scully in further breaking down barriers and intermingling Eastern and Western approaches to counseling.

Isabel Thompson, an assistant professor with the Center for Psychological Studies at Nova Southeastern University, has researched and presented on this topic. She has also integrated Eastern contemplative approaches into her work with clients and says Eastern and Western counseling approaches have similarities in that they both focus on relieving human suffering and helping people feel better. But they also differ, she points out. Generally, Western approaches place more focus on psychopathology and rely on a medical model of alleviating symptoms, Thompson says. Although Eastern approaches can also be applied to psychopathology and the alleviation of symptoms, their primary focus tends to be on flourishing and achieving optimal human development through leading an ethical life, says Thompson, a member of the American Counseling Association.

Fred Hanna, a professor in the Department of Counselor Education at the University of Northern Colorado, says Western approaches place more emphasis on correction and on mitigating feelings and symptoms. Eastern approaches, on the other hand, are more aimed at liberation and “setting [people] truly free so they can be in charge of their feeling states and so they can control their thoughts,” Hanna says. “This can be done through Eastern meditation techniques as well as direct Eastern-derived psychological techniques.”

In traditional Western thought, emotional problems aren’t viewed as affecting the body, Del Vecchio-Scully says, whereas in traditional Eastern thought, it is all interactive. “Everything that happens in the body affects the mind and emotions, and vice versa,” says Del Vecchio-Scully, a certified yoga therapist and Reiki master who is also the executive director of the Connecticut Counseling Association, a branch of ACA. Del Vecchio-Scully often sees that mind-body interaction play out among her clients, who are referred to her through the neurology group for which she works, Associated Neurologists of Southern Connecticut.

“I find that Eastern thought is rooted more in the integration of mind-body and energy,” says Serena Wadhwa, an ACA member who works in a hospital outpatient group practice and runs a private practice in Chicago. “Western thought tends to separate body and mind, although there is much progress [being made] in this area. We see the approaches of yoga, tai chi, Ayurveda and Chinese medicine, to name a few, that also focus on utilizing the body’s natural healing systems and restoring balance. Western thought usually involves a ‘quick fix’ medicinal approach.”

In a broad sense, there’s also a difference in the locus of control, says Hamrick, a member of ACA. With many Eastern approaches, it is assumed that people will fix themselves, often by paying close attention to themselves and their surroundings, he says. In the West, that control tends to be externally located, he says, with the expectation being that the “right” technique or intervention will fix the client. Hamrick says those differing ideas likely took root in the respective cultures. Buddhist and Hindu traditions teach that each individual person has a soul or god residing within them, whereas Western European thought suggests that individuals should rely on an external, all-knowing God or someone else to help them and guide them along the way. In the West, that often translates to the counselor being viewed as the “expert” and outcome success hinging on the counselor’s advice and interventions,
he says.

Hamrick believes there is room for both views. He likes for his clients to feel that they possess the power within to handle and solve their mental and emotional issues, which is based more in Eastern thought. But on the Western side, he says, an abundance of good scholarly work is being done that he can pass along as knowledge to his clients, such as new research in neuroscience and positive psychology.

Although Eastern and Western counseling techniques traditionally come from different vantage points, Wadhwa says it is important for counselors to recognize that the underlying concepts are often the same. For example, the idea that our thoughts have an impact on us is fairly universal, says Wadhwa, who is originally from India and has presented on Eastern treatment considerations in working with Asian populations. “So I use both cognitive restructuring and mindfulness in my work, and depending on how I introduce these techniques, the individual I am working with may be more open to exploring how it may work for them.”

Wadhwa says she discusses with clients how thoughts may cause suffering and explains the idea behind both approaches. “I explain how cognitive restructuring works by providing strategies to cope with the thoughts and how mindfulness practice works at detaching from the thoughts and focusing back on the present moment. I also explore how coping with the thoughts may be initially more relieving than mindfulness, as mindfulness takes practice. Most clients are open to learning how to cope with their thoughts and then how to detach from them.”

Taking control

In a counseling session that he supervised, Hanna remembers a client diagnosed with borderline personality disorder who had cut herself habitually and reported that she had attempted suicide 160 times. Hanna and his doctoral student asked the client to bring to mind the feeling she would have just before she started to cut or attempt suicide. “Then what we did was have her go directly into that feeling,” says Hanna, a member of ACA. “It was sort of a therapy-assisted meditation of exploring those feelings.”

Hanna and the counselor-in-training asked the client to imagine she was in an elevator made of thick, clear glass that she could take straight down into her feelings. They told her she couldn’t feel the pain or anxiety inside the elevator but that she could see what was deep down inside those feelings. In her mind, the client took the elevator, little by little, all the way to the bottom. She reported that it was like a lake, and at the bottom of it all, there was really nothing to be afraid of. After reaching the bottom and thoroughly exploring her feelings, the client filled the lake with earth and put a house on top of it in her mind. “After those sessions, the client reported a marked decrease in her borderline symptoms,” Hanna says.

Hanna created the approach that he and his doctoral student used with the client. He calls the approach “internal control therapy,” which he describes as a blend of yoga psychology, Buddhism and a few Taoist ideas. “Using that object-oriented approach, [the client] was literally taking control over those feelings … that were before in control of her,” Hanna says. Internal control therapy makes use of a client’s powers of creativity to generate positive feeling states and unbuild negative ones, he says.

From a yoga psychology perspective, the mind is an object that can be manipulated, akin to an ordinary physical object, Hanna says. His internal control therapy taps into that perspective. “If [clients have] a strong image in their mind of someone who hurt them and they carry that image around — I wouldn’t want their image hanging in my living room, would I? But we carry those images around in our minds. … If you treat [that image] as an object, you take it down and throw it away.”

Although yoga psychology is a traditionally Eastern approach, Hanna thinks its application can benefit Western psychology by offering an alternate view of psychopathology. Whereas the Diagnostic and Statistical Manual of Mental Disorders (DSM) presents classifications for disorders in an attempt to explain and treat mental illness, Hanna says yoga psychology offers the idea that there are five points that lead to suffering and dissatisfaction with life: ego and self-centeredness; cravings beyond what we need; resisting something; ignorance; and fear of death. In this view, when people get overly bogged down with any of the five points, it can result in suffering and psychological problems.

Hamrick gravitates toward a different Eastern-based approach — mindfulness meditation — introducing it to almost every client with whom he works. “Usually in the first session, I will spend about five minutes walking a new client through a sitting meditation just to show them how the technique works and demonstrate its usefulness,” he says. “My clients with anger, depression and anxiety find it particularly helpful [as a technique] to … control their emotions, stop ruminating on the past and prevent worrying about the future. Clients learn that racing thoughts can be stopped or slowed down with practice.”

Mindfulness-based therapy is akin to mental training, Hamrick says. “My clients learn how to train their mind so they can think about what they want to think about, when they want to think about it and how they want to think about it,” he says. “[Clients] wouldn’t tolerate their right arm suddenly going off and flailing around without their control. So why would they tolerate their brain doing the same thing? Mindfulness teaches clients to focus on the here and now rather than on the there and then and on what they can control rather than on what they cannot control.”

Hamrick also uses the Buddhist concept of impermanence, especially with clients dealing with depression, anxiety or substance abuse. “This concept emphasizes that nothing lasts forever,” he says. “It gives hope to the hopeless. There is no reason to believe that the client will always be in the same situation [he or she is] in now. Depression can be treated and overcome. A panic attack never lasts forever. And plenty of people have overcome addictions of all kinds. Once we’ve established that the situation can be overcome, then I find using solution-focused techniques will help clients develop a plan to overcome what’s facing them.”

Counseling and contemplation

Thompson has long nurtured an interest in contemplative practices, a broad term, she says, that includes both formal seated meditation practices and practices such as walking meditation and yoga. She says contemplative practices are “activities that are used to cultivate the mind and the heart.”

According to Thompson, the act of contemplation helps shift us out of a current mode of thinking to a broader, more open mode of thinking that increases our ability to understand issues. “When we are stressed out, or if a family system is under extreme stress, [our] brains are firing for survival,” she says. “Contemplation helps one relax so that the brain reorients to a more reflective and calmer place — a place where problems can be solved more easily because there are more resources available to draw from. The foundation of any contemplative technique is to focus on relaxation first, then gain stability of concentration and then advance to vividness/intensity. The West tends to focus on intensity first without understanding that … intensity is unstable” unless relaxation is also emphasized.

Both Eastern and Western mental health approaches use a form of contemplation, Thompson says, but the East has a longer history of developing those techniques. “This stems from the two different modes of inquiry that the East and West have emphasized,” she says. “The West and its modes of inquiry have generally relied on exploring reality from a ‘God’s-eye view’ or an objective standpoint through science, while the East’s more contemplative approach starts with subjective experience and phenomena, then moves out from there. This approach still asks empirical questions, but the answers are more rooted in subjective experience.”

Both the counseling profession and Eastern philosophy share a respect and appreciation for the client’s subjective, internal experiences, Thompson says, which makes them a good match for the integration of contemplative approaches. Contemplative approaches are typically present-focused, Thompson says, adding that studies have linked a contemplative mind to lower cortisol levels, lower rates of depression, fewer heart attacks and lower rates of cancer.

For clients presenting with a concrete situation that they need assistance changing, a Western approach might work best, Thompson says. For example, a Western-based counseling approach might be a better fit for a family seeking help with a child’s school-related issue, such as bullying or poor academic performance. “A contemplative approach may be more useful for issues related to the long term, more related to lifestyle or a chronic condition — for example, working with habits, chronic anger or chronic pain,” she says.

A benefit often exists to blending Eastern and Western approaches as well, Thompson says, such as when working with a client with severe depression. “I have found that addressing the depression first using a more Western counseling approach is beneficial,” she says. “For example, I might start with a person-centered approach to build a therapeutic relationship with clients and then integrate elements of cognitive behavior therapy (CBT) to help clients see the connection between their thinking patterns, behaviors and moods. I also might include psychoeducational components to help clients understand their symptoms and realize that they are not alone in healing from depression. When someone is suffering from severe depression, many things, even contemplative practices, can become tools of self-recrimination. Therefore, helping a client to break the downward spiral of depression characterized by guilt, regret and self-blame is a starting point. Then, a foundation for a positive spiral, characterized by acceptance, gentleness and self-compassion, can be laid.”

In cases such as these, Thompson says, she would gently integrate Eastern approaches at a pace that is right for each client. This gives her time to ensure she is being sensitive to the needs of the client and allows her to gain a solid understanding of the client’s worldview and beliefs. “For me, Eastern approaches emphasize returning to gentleness and self-compassion as foundations for future change,” she says. “Sometimes clients suffering from depression have a greater sense of compassion for others than they do for themselves. Helping them to see their own worth and recognize that they deserve compassion as much as others begins the process of cultivating self-compassion and acceptance.”

Treating trauma and pain

Many of the clients Del Vecchio-Scully sees are dealing with posttraumatic stress disorder (PTSD) and chronic pain. A blended approach of Eastern and Western techniques tends to yield the best results for these clients, says Del Vecchio-Scully, who is certified in integrative yoga therapy, a specialized form of yoga that can be used with clients with medical conditions.

For chronic and acute pain, Del Vecchio-Scully says relaxation and meditation techniques are key. From the Western side, she says, that can include CBT, guided imagery and dialectical behavior therapy (DBT). From the Eastern side, her chosen approaches include mindfulness, yoga breathing, Buddhist meditation, Tibetan chants and mantra. The aim of these techniques is to reduce clients’ anxiety, which can frequently accompany pain and the human tendency to guard against the pain, Del Vecchio-Scully says. “For example, if I have a sprained ankle, I will avoid putting weight on it for fear of pain,” she says. “This phenomenon actually creates more pain by creating additional tension in the muscles and tissues. When a person in pain can release this tension through relaxation, their pain decreases.”

As it relates to PTSD, Del Vecchio-Scully says counselors must have a toolbox of coping skills to help clients effectively manage and heal their trauma. Clients with PTSD often experience a cluster of arousal symptoms, she says, including insomnia, nightmares, irritability, anger outbursts, hypervigilance and an exaggerated startle reaction. These clients are often experiencing a stress response that is stuck on “on,” she says.

“The most effective approach to arousal is calming and soothing,” Del Vecchio-Scully says. “How this is accomplished is where a blend of East-West skills can be applied. Each of these symptoms taken on its own could have its own treatment approach. Insomnia, with difficulty falling asleep, could be treated with CBT and sleep hygiene as well as sleep meditation [and] self-hypnosis. Many times, trauma survivors have insomnia because they are afraid to go to sleep. In this case, identifying ways to foster safety — guided imagery, visualization, hypnosis, expressive therapies and art therapy, which can be either Eastern or Western in how they are applied — can be helpful. It truly is individualized to address each person’s unique presentation.”

Clients who have experienced trauma might present with hypervigilance and dissociation, which together can form a vicious cycle, Del Vecchio-Scully says. But teaching these clients to be present to their feelings can help them feel less afraid and threatened, she says. A Western approach of psychoeducation can be useful in addressing hypervigilance because it teaches clients about the nature of trauma, she says. Del Vecchio-Scully might then follow that up with Eastern techniques that provide restorative, calming experiences, including yogic practice and breathing, mantra meditation, affirmations and safety totems, such as hope stones that clients can carry with them.

“Another way of blending [Eastern and Western] approaches,” she adds, “is through the use of trauma-informed art therapy, which utilizes expressive arts therapies [including] yoga, art-making [and] mindfulness to stabilize mood and dysregulation often experienced by trauma survivors.”

Del Vecchio-Scully again blends East and West in addressing the dissociative piece of trauma, using Western-based progressive muscle relaxation and Eastern-based basic centering/grounding and additional yogic techniques.

One client who came to see Del Vecchio-Scully was dealing with a history of PTSD and bullying, while also struggling with fibromyalgia and chronic fatigue. Once again, Del Vecchio-Scully found a blended approach worked best. “She benefited from medication to improve her sleep and reduce pain; meditation — guided imagery, visualization and mantra — to calm and soothe herself; and psychoeducation regarding the nature of PTSD and the many ways it can present — for example, anxiety and hypervigilance, chronic pain, insomnia. In this case, medication alone would have helped her sleep without changing the cause of her pain syndrome and anxiety. She has found the meditation particularly useful in reducing her anxiety, improving mental clarity and fatigue.”

Del Vecchio-Scully also uses Reiki, a healing tradition that originated in Japan, with some of her counseling clients. The idea is that every living thing has an energetic vibration, and Reiki is one way of experiencing that life-force energy. “There are many ways to share Reiki with another,” Del Vecchio-Scully says. “It can be given through a light touch or by placing your hands close to a person’s body. It can also be shared through intention. For example, in my counseling session, I activate my Reiki vibration, which can help the client feel calmer and settled. Reiki and other energetic-based techniques help clients to assess their own well-being [and] can reduce anxiety and chronic pain. I use psychoeducation to identify [clients’] own energies and teach them methods to do so [themselves].”

Finding the client’s comfort zone

Although Eastern and Western approaches tend to come from different perspectives, these counselors say there are benefits to be gained in session by blending them according to each client’s needs. “The blending of Eastern and Western healing work is a philosophy of how I, as a therapist, approach counseling,” Del Vecchio-Scully says. “My counseling training taught me how to identify psychopathology, which is invaluable in identifying a client’s symptoms and classifying them. It gives me the starting-off point for therapy. However, the healing process begins with normalizing their behaviors, feelings and experiences as often normal reactions to abnormal situations. This clearly doesn’t include psychosis, delusions, hallucinations, intention for self-harm or harm to others. My philosophy is holistic, incorporating the mind and body, emotions and spirit using the best of the traditional Western approaches and perhaps nontraditional — though I believe this is changing — Eastern approaches. Both have value when
used with clinical skill for the client’s greater good.”

For example, Del Vecchio-Scully says, if she is using basic CBT techniques such as cognitive restructuring, cognitive reframing and challenging limited beliefs with a client, at the same time, she will ask that client to take a moment to stop and breathe. Teaching people how to be in the here and now is a basic Gestalt concept, but yoga and mindfulness practice are also steeped in that philosophy, so a lot of overlap is present, she says. “I weave mindfulness into any intervention I am doing,” she says. “It’s always about, ‘Take a breath. Let’s see if we can slow down the pace of what’s going on inside.’”

Wadhwa, who is also the program coordinator for an addictions counseling concentration at Governors State University in University Park, Ill., often allows the client to choose the best route. “I will usually introduce Eastern approaches [by saying], ‘One approach that exists is …’ This seems to work well for my clients. They ask questions, and we discuss the topic.”

For example, Wadhwa has seen clients who were dealing with transgenerational issues. “When clients recognize some pattern from generation to generation, I’ll offer the transgenerational thought of how things may be passed down,” she says. “I’ll introduce the approach of karma and how one approach believes that one generation works out the karma of the previous generation and that maybe what my client is experiencing is the cumulative effect of that karma. If this is something that resonates with the client, then I’ll offer some options on assignments geared toward this. If not, we’ll explore what elements of these different approaches fit better for the client and what [he or she] thinks may be helpful in resolving or healing this particular issue.”

These counselors acknowledge that some clients are hesitant to try techniques that incorporate elements of a traditionally Eastern approach. If Hamrick encounters a client who is unsure about meditation, he raises the point that meditation is a form of mental training. “I explain how meditation has been shown in scientific research to be beneficial in the treatment of depression and anxiety, and [how] scans of the brains of people who have practiced meditation, even for short periods of time, have shown real changes in the structure of the brain that allow for better emotional control,” he says. “When put in these concrete terms, clients typically want to try meditation.”

Thompson looks for approaches that are relatable to the client. For example, she has worked with individuals who were turned off by the idea of meditation because they thought it ran counter to their closely held religious beliefs. “It [didn’t] connect with their experience of the sacred,” Thompson says. “I want to be helpful to them in the worldview that makes sense to them, so I might ask them instead about what Scriptures provide them a sense of peace [or] what brings them calm.”

Radical acceptance, which also has Eastern themes, is another approach Thompson sometimes uses, particularly with clients struggling with perfectionism and self-judgment. At times, however, these clients resist the idea of acceptance because they have come to counseling with the idea of “fixing” themselves, she says. At that point, Thompson might switch to the technique of motivational interviewing. “Have you achieved your goals with self-criticism?” Thompson asks clients. “What would it be like to accept that this is where you’re at?”

Regardless of where counselors fall on the spectrum of Eastern versus Western approaches, Thompson believes meeting clients where they are and using techniques they are comfortable with is most important. “In order for a transaction to occur, the therapist must meet the client in his or her worldview and understanding of change and contemplation,” she says. “It takes so much courage to come to a counselor, and I want to demonstrate to my clients that I honor their courage. I want to help them alleviate the suffering that spurred them to come into counseling. Therefore, gathering information about clients, their cultural backgrounds, their family backgrounds, their worldviews and spiritual and/or religious beliefs is essential. The question ‘How would you like to try … X?’ is helpful. If the client is not interested, then I do not pursue it.”

“Most clients agree that relaxation in one form or another is helpful, so I like to start from there,” Thompson continues. “It can easily move to progressive relaxation, full body awareness or simply cultivating the wish for happiness and to alleviate suffering. A useful question related to mindfulness is, ‘What do I need to do and what do I need to stop doing in order to be happy?’ What is surprising is that answer can frequently range from mundane tasks such as doing more laundry to completely changing how one engages with reality. Contemplative approaches have something for everyone.”

Although not a common occurrence, Del Vecchio-Scully recalls one client who was concerned that yoga might run counter to her Christian faith. “I talked it through with her and supported her decision,” Del Vecchio-Scully says. “The only path is to honor and respect their feelings toward something and move on in another direction.”

Del Vecchio-Scully says she doesn’t present approaches as being Eastern versus Western with clients. “We discuss what may be helpful to them and then try to identify the right interventions for them based on personality, openness and willingness to try,” she says. “I reinforce that if one thing doesn’t work for them, there are always many options.”

Maintaining counselor identity

As more counselors begin promoting the benefits of Eastern-based approaches such as meditation, mindfulness and yoga, the public may question what counseling has to offer that meditation centers or yoga retreats don’t.

“In a meditation center, the only focus is on meditation,” Hamrick says. “In counseling, the focus is on the client feeling better. In counseling, I might use meditation as a tool to help my client, but I have many more tools in my toolbox. I think the biggest benefit that clients can get from counseling that they can’t get at a meditation center is the opportunity to talk about painful and possibly embarrassing topics with an unbiased and confidential professional.”

Counseling remains more clinically oriented as well, adds Del Vecchio-Scully. “I’ve made a diagnosis and formulated a treatment plan that includes multiple interventions based on the diagnosis,” she says. “There are different types and styles of meditation and yoga that garner different outcomes. This is where the blend of my clinical training and Eastern specialties is a distinct advantage. Within the guided imagery field alone, there are many approaches for clinical issues, and [they] are based on the written script. A nonclinician isn’t going to have this expertise. Also, [counseling clients] are getting one-to-one attention to their issues, and techniques can be modified based on their needs. This isn’t going to happen in a group setting [led] by a nonclinician.”

With the influence of globalization, Del Vecchio-Scully predicts the counseling profession will continue to experience a shift toward eclectic practice, including the incorporation of Eastern-rooted approaches. The complementary nature of Eastern and Western approaches will further facilitate that movement, Thompson adds. “Both Eastern and Western approaches share the common goal of helping people,” she says. “Eastern approaches can provide tools to help clients work with their minds and emotions to build on the changes they have made through Western approaches.”

Thompson, who has pursued trainings focused specifically on integrating contemplative practices into counseling, says many training options are available to counselors who want to blend Eastern approaches into their work. However, she says, there is no one “best” training, just as there is no one best approach to counseling.

Regardless, it is imperative that counselors have personal experience in whatever practice they might ask their clients to engage in, she says. “Do your own yoga, seek out meditation on your own,” Thompson says. “Personal exploration and practice are essential. If you want to share meditation with your clients, pursue contemplative training and practice it first. If you want to integrate mindfulness attitudes and practices into your work with clients, again, find ways to integrate them into your own life through training, retreats and personal practice. In addition, finding a community of counselors who incorporate Eastern/contemplative approaches is extremely helpful. There is a community of counselors in my area who incorporate Eastern approaches — specifically mindfulness — into clinical practice. This has been a wonderful resource and inspiration for me. Also, for clinicians working on licensure, finding a supervisor who incorporates Eastern approaches would be an excellent means of getting support.”

Hamrick agrees that personal experience is the best starting point. “Eastern philosophy is based on the individual experience,” he says. “You can read a pile of books and have a beginning understanding of Buddhism, Hinduism or Taoism. You can learn the steps of meditation and teach them to others. But if you really want to incorporate Eastern approaches into your counseling, you need to start practicing them first. Once you’ve really experienced the changes they can bring to your life, then you’ll really be ready to present them to your clients.”

“The first thing to do is put down this magazine and look around the room,” he says. “Really look without thought and without judgment and without analysis. Simply sit, look and be. That’s a good start.”

 To contact the individuals interviewed for this article, email:

 Lynne Shallcross is the associate editor and senior writer for Counseling Today. Contact her at lshallcross@counseling.org.
Letters to the editor: ct@counseling.org

ACA keynote speakers view counseling process from different angles

Heather Rudow

The keynote speakers for the American Counseling Association 2013 Conference & Expo in Cincinnati (March 20-24) are well known in their respective fields. The circles in which they are famous and the perspectives from which they view the counseling process are quite different, however.

Actor, humanitarian and mental health advocate Ashley Judd will present the conference’s opening keynote on March 22. Allen Ivey and Mary Bradford Ivey, counselors with a strong background in neuroscience, will follow on March 23 with a keynote titled “What Counselors Need to Know About the Intersection of Neuroscience and Counseling.”

Brain-based counseling

The Iveys have been researching neuroscience and its implications for the counseling profession since the 1970s. Allen is distinguished university professor emeritus at the University of Massachusetts, Amherst and courtesy professor at the University of South Florida (USF). He is a life member and fellow of ACA and the originator of the influential microcounseling framework and developmental counseling and therapy. He has authored or co-authored more than 40 books and 200 articles, and his work has been translated into 20 languages.

Mary is a national certified counselor, a licensed mental health counselor and courtesy professor at USF. Her areas of expertise include writing, independent consulting, school guidance and applying her consultation skills to school and management environments. Mary was one of the first 13 individuals honored with ACA fellow status.

“We feel honored and excited that we will present a keynote in Cincinnati on the relevance of neuroscience to counseling,” Allen says. “The basis for our presentation is the scientific finding that counseling changes the brain and that virtually all that we are doing [as counselors] is now backed up by neuroscience research. Neurogenesis, the development of new neurons and neural connections, occurs throughout the life span, even among the most aged. This possibility for human growth never ends.”

“Counseling has always been on the right track with its emphasis on wellness and client strengths,” he says. Attendees of the Iveys’ keynote can expect to hear the phrase brain-based counseling, which, Allen says, “means that all our efforts are making distinctive differences in the client’s brain.”

The topic of neuroscience has gained much momentum in the counseling profession since the Iveys first presented on it at the 2008 ACA Conference in Honolulu. “We had a moderate response in Hawaii, but interest in neuroscience has multiplied extensively, and we feel lucky that many more counselors are now seeing its potential,” Allen says. “A lot has happened since that early presentation, and we have seen many new breakthroughs that increase our understanding of the counseling process and how we can help clients more effectively. We are eager to share some of our discoveries of the past few years. At issue is using this knowledge so that we can more effectively reach clients and help them achieve their goals.”

The Iveys will highlight empathy in their presentation as an example that counselors’ methods have been on the right track from the early stages. Says Mary, “Empathy has long been basic and central to our profession and to our personal identity as counselors. Carl Rogers has shown us the importance of empathy and seeing the client’s world as he or she experiences it. Counseling could be described as the empathic profession. Now, empathy can be identified through observation of brain activation through functional magnetic imaging. One of the more interesting studies [investigated] brain patterns of a client and a counselor in a real interview. Moments of highly rated empathic communication between the two showed in parallel brain processes.”

The Iveys emphasize that ACA members already understand the importance of working with their clients’ strengths and focusing on wellness in their practices. However, Allen adds, “knowing the power and influence of the limbic emotional system enables us to become even more aware of the need to facilitate positive emotions and effective decision-making.”

He cites strategies such as cognitive behavior therapy and stress management as “key part[s] of our practice, for we are indeed seeking to help our clients manage their thoughts, feelings and behaviors more effectively.”

Another part of the Iveys’ presentation will explain how using Therapeutic Lifestyle Changes (TLC) as a treatment option can help clients manage their thoughts and behaviors effectively.

“TLCs are all oriented toward a positive wellness approach to body, mind and human development,” Allen explains. “We have spent far too much time on repair, when a reorientation to building on existing and future strengths will move us to health and wellness.”

In their keynote, the Iveys will cover the “big six” TLCs, which include the improvement of social relationships. Allen points out that this is what much of counseling has traditionally been about. All six TLCs strengthen client cognitions and emotions, he says, leading to better mental and physical health.

Mary states that prevention activities and social justice action are also strongly supported by neuroscience research and writing. “Evidence is clear that poverty, hunger, trauma — for example, neighborhood shootings — and abuse can actually slow or even destroy brain growth,” she says. “On the other hand, children and adolescents are resilient, and counselors can facilitate normal growth, and we do much to prevent these problems in the community.”

“Thus,” Allen says, “one of our central messages is that counselors have a responsibility for neurogenesis and neural growth in our clients and in their communities. We can only do this with a positive wellness approach to human change. Through TLCs, stress management and social action, our profession can and will make a significant difference for our clients.”

The Iveys will discuss these and other topics in more detail during their keynote in Cincinnati.

The other side of the coin

Ashley Judd can speak to that “significant difference” from a different perspective. In 2006, Judd, who has starred in 30 films and multiple TV shows in her career, spent time at an intensive inpatient treatment program at Shades of Hope, an addictions center in Buffalo Gap, Texas, to help her cope with a long-standing struggle with depression.

At the time Judd checked in to Shades of Hope, her sister, country music star Wynonna Judd, was being treated for an eating disorder at the same center. Ashley told Esperanza that after the counselors witnessed her acting out symptoms of a compulsive disorder, such as constantly tidying up her sister’s room, they suggested that she check into the center herself. She agreed.

“What I said was, ‘I’m so tired of holding up all this pain. I’m so glad to come to treatment,’” Judd told Nightline in an interview about her time in treatment. “God saved me from being angry, and it impairs my ability to be of service to another human being.”

Judd wrote in her memoir, All That Is Bitter & Sweet, that her depression, which began at age 8, stemmed from a childhood filled with abuse and loneliness, as her mother and sister, the famed country music duo, The Judds, would leave her at home when touring across the country.

Esperanza reports that Judd went to 12 schools in 13 years, and this insecurity, coupled with feelings of loneliness, fed into her depression as well as a fear of the unknown. “I remember what it was like for me … when I was living in a perpetual state of anxiety,” she told the magazine. “It feels like you can’t breathe properly. Every thought you have brings more stress, and for me, the most frustrating part was that I felt powerless to change it. The really frustrating part is that a part of you recognizes that you are doing it to yourself. But there’s this inexorable force pushing you down, and what’s really [messed] up is that you end up hurting your own feelings. I’m good at creating these dead ends for friends and loved ones where it makes it impossible for them to help.”

Judd acknowledges acting out through fits of rage and cleaning frenzies in an attempt to cope with her feelings of depression and anxiety.

But according to Judd, her treatment experience at Shades of Hope was both successful and life changing. Following her positive experience, she became an advocate for the therapeutic process. She will be speaking about that experience during her keynote at the ACA Conference.

In 2010, Judd graduated from Harvard University with a degree in public administration and has found new meaning through charity work and spending time as a political activist and humanitarian focusing on issues such as AIDS, poverty and women’s issues.

She is a global ambassador for YouthAIDS, a global health organization targeting malaria, HIV and reproductive health, and has been a member of its board of directors since 2004. Judd has traveled with the organization to places affected by illness and poverty such as Cambodia, Kenya and Rwanda.

In 2011, Judd joined the Leadership Council of the International Center for Research on Women and is involved with other organizations such as Women for Women International and Equality Now.

In April, Judd wrote a piece for The Daily Beast slamming the media for speculating over what they called her “puffy” appearance and incessantly commenting on the appearance of women and girls everywhere. “The assault on our body image, the hypersexualization of girls and women and subsequent degradation of our sexuality as we walk through the decades, and the general incessant objectification is what this conversation allegedly about my face is really about,” she wrote.

Judd also advocates for more public acceptance of mental health issues in society. “Unfortunately, there’s still a huge stigma around all kinds of mental illness, and depression in particular,” Judd told Esperanza. “It’s odd. We don’t stigmatize people with epilepsy, which is another debilitating disease. I think the disease element of depression needs more traction. People need to understand that depression isn’t just a matter of being sad. It’s a condition and a real illness. It’s actually a full-blown public health issue. But right now … talking about depression is like coming out. And … I don’t mind being one of the first to talk about my so-called little secret.”

For more information on the ACA 2013 Conference & Expo, visit counseling.org/conference.

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

Letters to the editor: ct@counseling.org

Q & A with a counselor: Teri Nehring

Heather Rudow September 28, 2012

Teri Nehring is an American Counseling Association member who works with individuals from all walks of life — from trauma victims to the Oneida Tribe of American Indians. As reiki master, certified breathworker and shamanic practitioner, Nehring says what she has found to work best with all of her counseling clients is an infusion of both Eastern and Western counseling approaches. Nehring says she truly believes that the utilization of both of these practices combined with energy work is the new wave of contemporary therapy. For more on Eastern and Western approaches to counseling, read Counseling Today’s October cover story, “Where East meets West.”

What techniques do you specialize in?

I specialize in mental health/drug and alcohol issues with an emphasis in trauma work and empowerment training. I have been able to blend reiki, breathwork, chakra clearing meditation, mindfulness and shamanic energy-based work in conjunction with traditional strength-based and talk therapy. I have developed my own model of working with clients using all of these tools called Luminous Energy Therapy — “luminous” meaning working with our energetic light or medicine body.

 How did you first get involved in Eastern techniques?

I became very interested in Eastern and shamanic energy healing seven years ago when I started to see an influx of clients who were trying to work through chronic pain, fatigue, trauma issues, depression and anxiety, to name a few. Traditional talk therapy combined with constant pain medications was not working to benefit the clients.

Describe a typical session with your clients.

A typical session starts with a dialogue about what the client would like to have more of in their life, and then energetically, I track with the client where the blockage around the core issue is in their energy body. I am looking for the chakra that is nearest to where they identify feeling the issue in their body. When we desire more of something in our life, we have to find the energetic block and identify the core issue or negative messages that we give ourselves. If the client wishes to give detail about the situation they can, but it is not necessary. I then ask the client to close their eyes and to hear and visualize the negative message and where do they feel it in their body. I work with the client to simplify the message.

For example, a client may say, “I never seem to feel confident in myself,” or, “I am always worried that others will not like me.” A core issue statement usually starts with the words “I am not” and then we narrow down what resonates with the client. In the example I used, the core issue may be “I am not good enough” or “I am not enough.”

Sixty percent of the time, people will tell me they feel it in their belly because energetically the belly is where feelings and emotions are energetically held. The other chakra many people feel those negative core issues in is the chest or heart chakra.

I work with the client to begin a connected breath. I also breathe with the client until they have established a steady breathing pattern. The breath is our life force. It is the fuel that powers the body, the amazing vehicle that allows our spirit to live and move around in. Cells have memory and they remember and record every event in our lives that we experience, so when we breathe, we are able to release the negative energy and take a new message and positive energy into the cells through oxygen. Oxygen is the fuel for the cells and through the connected breath we can begin to create a new cellular memory and message.

I use the technique of journeying to help the client identify a place that they feel is safe and that they love being. The client is allowed to bring anything with them except another living being into the sacred and safe place they create for themselves. I often will journey or go with people to their sacred space to do the connected breath work. People feel more relaxed and are able to begin to get in touch the core issue and negative feelings that surround the message.

When the connected breathwork begins and the chakra is opened, energy automatically begins to move along with the emotions connected to it. I coach people to continue to breathe as the emotions begin to arise and move through and out of the body. It is important that people continue to breathe because often when we feel negative emotions, we stop breathing and then the body holds the negative energy. When the energy is held it usually finds the weakest area and our body and locks itself in. This often becomes the origin for chronic pain and fatigue along with a host of other physical ailments.

Once the client begins to release the energy, I continue to track with the client what are they feeling in their body and where. Energy can sometimes become stuck, so I work to open other chakras as the energy moves so it can be released through that chakra.

Once the energy is released, many times there is inner child work that needs to take place. I will again journey with the client to their sacred place or sanctuary to begin working with the child within through a dialogue that starts the process of nurturing and restoring what the inner child most needs to feel safe and loved.

If the inner child work needs to done, I work with the client to develop his or her own new positive core message starting again with “I am.” I have the client repeat the new positive message out loud three times while holding their hands on top of their heart. This helps them bring awareness and a new message in to the cells and is received on a soul level.

This is the spiritual piece of the work, which then unites and completes the integration of mind, body and spirit, which most traditional therapies cannot help our clients to do. All the chakras that were unwound and opened are then closed as they are now clear of any negative energy.

The client is given a notecard to record the new message or affirmation on and is directed to keep the notecard in a place where they will see it several times a day. Every time they see the card they are asked to say the affirmation out loud to themselves.

An assignment that creates action and meaning connected to the session work that has been completed is given to help the client nurture themselves. This allows the client to honor the sacred and powerful work they have completed and to continue to help integrate the new positive message on an energetic and cognitive level.

When we begin to understand that the body is more than just physical, that is has several subtle energetic fields that surround it, we can then begin the process of helping clients to heal and restore on all levels.

In this work, I find that I can help a client to resolve and to restore themselves on all levels 50 percent faster than traditional talk therapy. A typical client can create a meaningful and strengths-based resolution in three to five sessions. Clients also are given tools that allow them to practice the process outside of the therapy session.

What kinds of clients do you see?

I see clients [ranging from] teenagers to adults with mental health, alcohol and other drug abuse, and trauma issues. I also am a personal trainer and work [with] clients who want to take part in personal/business empowerment and transformation by understanding their authenticity, speaking their truth, owning it and stepping into themselves.

Why do you believe it is important it to integrate Eastern and Western approaches to counseling?

I believe that many of the Western modalities only address mind and body. When we begin to understand the principles of the Eastern practices, then we begin to come from a place of integrating the spiritual pieces that complete our healing on a soul level.

What kinds of misconceptions arise — if any — surrounding your techniques?

Fear is the biggest obstacle that stands in the way of understanding and progress. We are creatures of habit and this rings true even in the counseling field. We all have our favorite modalities that we are confident in working with. Sometimes it is difficult to allow oneself to get out of the box and experience something that may be outside of our comfort zone.

What sort of counselors do you recommend trying Eastern approaches?

I believe Eastern modalities should be encouraged for all types of counselors to look at the potential of how they can integrate these approaches and tools into their practice for the benefit of their clients.

Where should counselors look for more information about the subject?

Counselors can find information all over the Internet and in bookstores. Keywords are energy therapy, holistic approaches to healing, reiki, shamanism and breathwork.

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

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Get to know Will Stroble, director of ACA’s new Center for Counseling Practice, Policy and Research

Heather Rudow September 24, 2012

Will Stroble is the American Counseling Association’s newest employee and the first director of ACA’s new Center for Counseling Practice, Policy and Research. The Center’s goal is to produce products and research that will increase public awareness of the counseling field, as well as materials that will result in more professionals being able to practice. He is looking forward to using his decades of experience in the counseling and passion for the profession to advocate for and empower counselors nationwide.

Where did you work before coming to ACA?
Prior to joining ACA, I worked for the Department of Defense Education Activity (DoDEA) in Arlington, Va., as a school counselor. I worked with high school students in a virtual environment around the world, including Europe and countries in the Pacific such as Japan, Korea and Australia.

As a counselor, why did you want to work for ACA? What did you think of the organization?
I have always enjoyed working with people who reach out to help others. That’s what we, as counselors, do on a day-to-day basis. When I made the decision to join the ACA staff, I believed that I was making a wise decision because, through my work at ACA, I will be able to effect systemic, positive changes for all people and make changes on a broader scale that will empower people, thereby making this world a better place for everyone, regardless of the barriers and challenges that people face in their daily lives.

What does your position entail?
My position entails developing from the ground up the infrastructure for archiving, disseminating and promoting exemplary counseling practice information and resources for professional counselors, counselor educators, supervisors, students, legislators, the media and other consumers of applied counseling knowledge. My position also allows me to advocate for optimum counselor work and training conditions. My vision for the Center is that it will be seen as both the premier place to obtain information and resources that focus on cutting-edge counseling practices and will serve as the focus of the counseling profession’s advocacy efforts for high-quality workforce conditions.

What future goals do you have regarding your position?
I have many future goals, such as networking with other well-known colleagues in the counseling profession and leading the efforts on behalf of counselors to gather information and data on best practices in the profession, working with public policy staff to advocate for my colleagues and securing grants and funding for cutting-edge research in the counseling profession.

Other thoughts?
I am humbled and honored to have joined the staff at ACA as a counseling leader in the profession. After 33-plus years in the profession, having worked at the local, state, federal and now national levels, I am excited about this challenge and look forward, with great anticipation, to working alongside my professional counseling colleagues in the field. As we collaboratively and collectively work to make this world a better place for all people through our practice, I pledge humbly to accept the charge for the challenges, expectations and confidence that have been placed before — and in — me by ACA’s outstanding and most impressive leadership team, and all ACA members and constituents who have bestowed this sacred trust in me.

Heather Rudow is a staff writer for Counseling Today. Email her at hrudow@counseling.org.
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Fathers aim to change FMLA guidelines to include child bereavement

Heather Rudow September 19, 2012

(Photo:Wikimedia Commons)

The American Counseling Association has extended its support to an initiative that, if passed by Congress, would amend the benefits of the Family and Medical Leave Act (FMLA) to include bereavement and allow employees who have experienced the death of a child to take time off for the healing process.

The Farley-Kluger Initiative is the brainchild of Kelly Farley, author and founder of the Grieving Dads Project, and Barry Kluger, author and CEO of the MISS Foundation, a nonprofit organization providing immediate and long-term support to families after the death of a child.

The men first connected in 2010.

“I was looking on the Internet for other parents who had written books about grief,” says Kluger, “and [Farley] was running his Grieving Dads blog. We spoke on the phone, and as we discussed our common interests, the subject of taking time off for grieving parents came up and the initiative came from there.”

Kluger is the author of the book A Life Undone: A Father’s Journey Through Loss and Farley is the author of Grieving Dads: To the Brink and Back.

“Grief has no half-life,” says Kluger. “The Family and Medical Leave Act of 1993 provides up to 12 weeks’ unpaid leave if you have a child, adopt a child, care for a sick family member, or you yourself are ill or an injured service member. Yet, if you lose a child, most companies give two to three days of bereavement leave.”

Because current FMLA guidelines provide 12 weeks of unpaid leave, the men believe that leaving the current statute as is would be the easiest way to modify the bill. However, Kluger says, they are open to a lesser six-week period if suggested.

In January 2011, Farley and Kluger decided to turn their efforts into an online petition and invite others from across the country to support the cause. Currently, 40,463 people have signed the petition, which then sends emails to lawmakers on Capitol Hill.

The petition garnered more traction in August 2011 when Sen. Jon Tester (D-Mont.) decided to support Kluger and Farley’s cause. He introduced the Parental Bereavement Act of 2011, which is currently sitting in the Senate Committee on Health, Education, Labor and Pensions with five co-sponsors. Kluger and Farley have met with more than 50 members of Congress to get a similar bill introduced in the House of Representatives. They hope to see this happen in 2013.

While they wait for Congress, Farley and Kluger have scheduled a rally on the steps of the U.S. Capitol for Feb. 5, the 20th anniversary of the passing of FMLA.

In addition to ACA, the Farley-Kluger Initiative has received support from the National Association of Social Workers, Parents of Murdered Children, The MISS Foundation, The JED Foundation, BlueStar Families and Gold Star Support Network, among others.

Grief is not only hard on parents and families, says Kluger, it is also costly. According to the Grief Recovery Institute, bereavement costs U.S. businesses more than $75 billion annually due to lost productivity.

Kluger describes grappling with the death of his daughter, who died in a car accident in April 2001, while also trying to keep up the pace at his job in an editorial he wrote for USA Today:

“Although the workplace provided me the distraction I needed, a foundation, I would sink into the blackest of depressions in a matter of seconds, without warning. It was then that I’d head for the door and go home.”

“We just want the healing process to begin and to be a suitable amount of time to adjust to the new ‘normal,’” Kluger says.

Additionally, he says, “We think the definition of child should be up to age 26 to include causes such as military deaths, victims of violent crime [and] suicides, which statistics show are greater in the over-18 [age] group, keeping it in line with the Affordable Care Act, which covers children in insurance up to 26 years old.”

Kluger and Farley know from experience the importance of taking time to grieve properly before attempting to re-enter “normal life.”

As a man, Farley adds, it can be especially difficult to come to terms with these feelings. “One of the things I noticed after I lost my children is the difficulty I had as a dad [and as a] guy to actually go to a counselor,” says Farley. “I felt it was a sign of weakness that I couldn’t do this on my own.  I learned the hard way that it’s OK to ask for help.”

After going through the experience of losing his two children, Farley is now in the process of obtaining his master’s in counseling from Northern Illinois University.

He says grieving parents can often experience trauma as a result of losing their child. “I interviewed hundreds of grieving dads for my book,” Farley says, “and the one thing most of them mentioned were symptoms of PTSD (posttraumatic stress disorder). Many parents were with their child [when they died] or received the news in ways that impacted them. Many deal with [symptoms such as] nightmares, flashbacks, anxiety attacks [and] suicidal thoughts that are not often present in other losses. Having the 12 weeks to start the process of healing and comprehending what they have gone through is crucial to recovery. Not everyone will need it up front, but they may as a few months go by and the reality of what they went through has hit them.”

The American Counseling Association is proud to lend its backing to this initiative because it keeps with its long-standing mission of supporting counselor and client needs.

“ACA and its members have long been advocates for sensible policies impacting families, parents, children, adolescents and others,” says ACA Executive Director and CEO Richard Yep. “Those families impacted by the horrific loss of a child need time to deal with their grief and how best to move forward. The work of the Farley-Kluger initiative is clearly supportive of that need. ACA is proud to be a partner in this coalition of helping professionals and consumers.”

 For more information, visit farleykluger.com, grievingdads.com, missfoundation.org and alifeundone.com.

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