Monthly Archives: February 2014

The true lesson from Newtown: The need for trauma education

By Keith J. Myers February 28, 2014

(Photo: Wikimedia Commons)

Today is the day to learn the true lesson from Newtown. Today occurs a couple of months after the inaugural year of mourning, after the memorial services and after the “dust has settled” for those who are not personally connected to Newtown and its resilient community. Today epitomizes the “Now what?” question, and its answer may surprise you. If we fail to learn the lesson from this significant day, our meaning from this tragedy could be lost.

Most of you may be expecting me to launch into various social and political issues of the day. One expectation might include a discussion of gun control in America. We could talk about the need for increased security in our schools. We could reference the importance of mental health screening and increasing the support of community mental health resources. We could debate the possibility of arming teachers within the classroom. We could lobby our government leaders to pass legislation that would help protect the children of our great nation. We could even ask questions of a spiritual nature, such as “Where is God in all of this?” or further explore the problem of evil and how it sometimes raises its ugly head even in a town of 28,000 residents.

We could discuss those problems at length, but those problems will be covered in other writings at other times. The actual lesson involves so much more than politics or debates. The lesson we need to learn is about trauma and its impact on each other’s lives.

So, let me clear at this juncture and offer my full disclosure. I am a licensed professional counselor who specializes in working with clients who have experienced trauma and grief. Some of my clients are combat veterans who have served our country faithfully in Iraq, Afghanistan, Vietnam and other parts of the world. Some of my clients have suffered interpersonal violence. Some have experienced “unspeakable terror” as children, enduring both physical and sexual abuse from the people they trusted and loved. I have listened to my clients as they have told me unimaginable stories that will not be uttered here. However, I believe that knowing their stories has made me a better counselor, a better husband and a better member of my community.

And it seems the flipside is also true for my clients. There is incredible healing in clients telling their stories. They feel more “human” after being able to tell their story. For most of my clients, their stories were meant to be kept secret or existed only in the darkness. Therefore, telling someone else about their burden brings a measurable amount of light into their life as they expose the truth.

The December 2012 school shooting at Sandy Hook Elementary in Newtown, Conn., was a traumatic event to be sure, but it happened on a public scale, not in secret in the darkness. As defined by the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, trauma involves being “exposed to an event that involves actual or threatened death, serious injury or sexual violence by directly experiencing the traumatic event, witnessing it or learning that it happened to a close family member.”

Most of you reading this are already aware that the events of Newtown were considered traumatic for all involved. So, what now? The answer is realized in understanding that trauma is much more prevalent than most might believe. Much of the interpersonal trauma that people experience happens in secret; it is not aired on national television by media outlets. Being raped or molested as a child is not something that is tweeted about or announced as a status on someone’s Facebook page. That type of trauma does not go viral on YouTube. The truth is that trauma often happens on an interpersonal level within the shadows of our own families and relationships.

The National Center for PTSD cites lifetime prevalence for the exposure of trauma. The organization says that 51 percent of women and 61 percent of men have experienced at least one traumatic event in their lifetime. I may have lost some of you with that last statistic. You may still be in shock or denial. However, that statistic illustrates the need to learn the most important lesson from the recent anniversary of the school shooting in Newtown. It involves increasing both personal and public awareness of the prevalence and impact of trauma. By deciding to increase your knowledge of trauma and promote a greater awareness of its prevalence, you are honoring those who lost their lives at Sandy Hook.

You are now faced with a decision. Perhaps you need time to process what I’m writing. Perhaps it will take you some time to comprehend the real lesson of Newton and decide to learn more about trauma and its impact. If so, I understand. Take all the time you need, but realize that as each day passes, the opportunity may be slipping away because our memories tend to fade over time.

Assuming you have made the choice, here are four things you can do as professional counselors to promote an awareness of the universal impact of trauma:

1) Learn more about trauma. The National Center for PTSD website (ptsd.va.gov) is a good place to begin. Additionally, searching Counseling Today or the Journal of Counseling & Development for articles on trauma can provide a wealth of information. The annual American Counseling Association Conference & Expo (see counseling.org/conference/hawaii-aca-2014) features a “trauma academy” that offers several excellent presentations on numerous aspects of trauma. Local, state and regional conferences often reveal helpful learning opportunities as well.

2) Have conversations about trauma with your friends, family members and communities. The more you address the topic with people in your life, the more people will be encouraged to bring light to something that often happens in the dark.

3) Conduct a thorough trauma assessment with your clients. Research indicates that more of our clients have experienced unresolved trauma in their lives than is easily observed on the surface as the “presenting issue.”

4) Seek professional help for yourself if needed by talking to a professional counselor in your local area. Remember, healing exists in telling your story.

It is through these steps that you can help promote public awareness of trauma. If you decide to take this course of action, then you will learn the true lesson from Newtown and honor those who died.

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Keith J. Myers is a licensed professional counselor and doctoral student of counselor education and supervision at Mercer University. He is also an intensively trained eye movement desensitization and reprocessing therapist, and member of the ACA Trauma Interest Network. Contact him at keithm355@gmail.com.

Counselors and the clinical staging model

By Allen E. Ivey and Mary Bradford Ivey

Counseling is a preventive profession, typically working with issues and challenges that our clients face daily. However, client concerns often exist at deeper levels, and counseling process often shades into therapy. As counselors, you regularly encounter children and youth who may be at risk. Whether with a medicated child who has been deemed as having attention-deficit/hyperactivity disorder or a depressed teenager whose family is unable to afford private treatment, counselors often end up being the key mental health resource. Of necessity, we often work with clients who have no other realistic source of treatment. For example, a teenager may return to high school after a stay in a psychiatric or drug treatment facility. A child or adult may need specialized care, but no referral sources are available.

The impact and effect of your work is vital not only with the “normal” issues that young people face, but also with the issues posed by potentially more disturbed youth. The National Institute of Mental Health estimates that 26 percent of the U.S. population ages 18 and older has a diagnosable mental disorder during any given year, while 6 percent face diagnosis of serious mental illness. Sixty-five percent of serious mental conditions such as anxiety and affective disorders appear before age 21, thus emphasizing the importance of early counseling intervention. Children and adolescents are increasingly being diagnosed with mental disorders and prescribed medications that can sometimes be dangerous. In 2012, the website ScienceDaily reported a 62 percent increase in the use of antipsychotic drugs with publicly insured children, with two-thirds of these potentially dangerous drugs being off-label prescriptions. In 2010, the Archives of General Psychiatry reported evidence that these medications shrink the amount of gray matter in children.

Professor Patrick McGorry, an Australian psychiatrist and world expert on young people at risk for psychosis, is challenging the very concept of diagnosis for conditions such as borderline personality disorder, major depression and schizophrenia. He asserts that the diagnostic categories in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) are “endpoints” with little or no attention paid to etiology and developmental issues. For example, subclinical youth may show signs of decreased functioning. Although we may see affective dysregulation and other signs, clear diagnosis is usually impossible. “Persistence and severity are key dimensions setting the bar for care, irrespective of the specific set of features,” McGorry has said. He speaks of a “soft entry” to treatment rather than arbitrary categories that all too often lead to overmedication and overtreatment.

Table adapted from “Early intervention, clinical staging in youth mental health” as presented by Patrick McGorry (see youtube.com/watch?v=gYTX7lQU_Ag for a full presentation of the model in its most current form).

CLICK HERE TO VIEW PDF IN FULL SIZE: McGorry Clinical Staging Table

McGorry makes it clear that all “disorders” have early clinical features or prodromes — early symptoms that might indicate the onset of a disease. Prodrome is the term ascribed to at-risk youth whose functioning is decreasing significantly. It has been found that one-third or more of these youth will become psychotic within three years. However, it is important to separate those youth who have a true prodrome from those who may be suffering from grief or trauma, the major effects of which pass over time.

The research appendix of the DSM-5 names the prodrome as attenuated psychosis syndrome. There is evidence that preventive treatment programs can significantly reduce later reversion to psychosis. Rather than one-third of these youth becoming psychotic, a 2012 review written by McGorry and colleagues in the journal Clinical Practice found that early intervention preventive programs reduce that figure to 5 to 10 percent. Even if psychosis does not appear, however, those considered at risk continue to have significant life challenges, often requiring some form of counseling throughout the life span.

This is an important issue, and the question remains — how can we work effectively to prevent psychosis in young people? In hopes of finding the answer, we visited Australia to meet McGorry. There we saw programs in operation that make a significant difference in preventing serious disturbance in youth. Rather than applying the potentially damaging label of attenuated psychosis syndrome to these youth, McGorry uses the terms high risk and ultra high risk. His program focuses on early prevention and avoids medication as much as possible. He worries that the attenuated psychosis syndrome label being used in the United States will lead to overuse of unnecessary medications because psychiatry does not give much attention to prevention or early intervention. If the attenuated psychosis syndrome diagnosis as formulated in the DSM-5 is accepted in isolation, we can expect preventive research to be ignored, while seeing a vast increase in potentially dangerous medications for youth.

A practical framework

Counselors often are the first professionals to observe when a young person’s behaviors indicate high risk of continuing and future major behavioral and emotional issues. Thankfully, effective counseling and systematic programs can make a difference, and the need for further help, or even institutionalization, may be prevented.

Diagnostic risk factors include, first of all, a noticeable decrease in functioning. The endpoint features of attenuated psychosis syndrome in the DSM-5 include symptoms that may appear only occasionally; most of the time, these youth will function normally in society. The attenuated psychosis syndrome diagnosis looks for odd beliefs or magical thinking, perceptual disturbance or some paranoid ideation, along with occasional disconnections from reality. Depression, anxiety or explosive outbursts may increase. The youth’s appearance may change in terms of clothing, self-care or significant gain/loss of weight.

McGorry’s clinical staging model is designed to work for patients, clinicians, families and researchers. It is rooted in the model of normalization and prevention. Clinical staging is the method used in McGorry’s Early Psychosis Prevention and Intervention Centre (EPPIC), which focuses on youth at risk with specific recommendations for treatment at each clinical level (see the accompanying table). The diagnosis is for level of need and treatment, not for a specific category.

Clients are first placed in two general categories — those who appear to be working with “normal” difficulties and those who may be at risk, high risk or even ultra high risk for becoming constantly depressed, bipolar or schizophrenic. Typically, the first group represents Clinical Stages 0 and 1. This group is treated using concepts that are well known and integral to the counseling movement. It is here that we see the counseling profession overlapping with in-depth psychiatry. Furthermore, it is obvious that counselors have an important role in working with at-risk youth. While traditional diagnostic endpoints do not lead to treatment recommendations, clinical staging does. The scaling and normalization of youth concerns leads to a newly integrated form of counseling and therapy.

McGorry’s original research has been replicated in many settings, internationally and in the United States. There is clear short- and long-term evidence that the clinical staging framework (or variations on that theme) reduces the chances of youth reverting to psychosis. Those youth who may never revert to psychosis receive the benefit of quality treatment without being labeled as suffering from attenuated psychosis syndrome.

Why are counselors so important in this process? Take a look at the mental health workforce in the United States. The Occupational Outlook Handbook shows more than 1 million helping professionals but lists only 24,210 psychiatrists, although other estimates range as high as 36,000. Even if we take the larger figure, psychiatry represents approximately 3.6 percent of professionals able to meet the mental health needs of the nation. From these data, it is patently clear that members of the American Counseling Association will continue to play a major role. The primary and secondary treatment options listed in the accompanying table have long been considered major roles. Not only are counselors needed, but they have the skills and experience to work with these youth.

Coordination of mental health services is key to the EPPIC model — infants, children, adolescents and adults in individual, family, group, school and community contexts. Furthermore, all mental health issues, from typical daily concerns to serious issues such as autism and schizophrenia, fall within this framework. McGorry seeks to avoid the use of medications with clients as much as possible, while focusing on psychoeducation and cognitive behavior therapy. The model includes typical counseling interventions such as stress management, anger management, family counseling and job placement with support, all with an extensive emphasis on relapse prevention.

The clinical staging model in a high school

The counseling and guidance program at Massachusetts Wellesley High School illustrates how the clinical staging model is related to counseling practice. Under the leadership of principal Andrew Keough, Wellesley High School states that “schools are more like families than like business, and every member needs a voice.” To build that family community, students have brief daily meetings and a half-hour meeting once per month in advisory groups of eight to 10 members. This ensures that every teen has personal contact with a teacher, counselor or administrator. Groups are randomly chosen to enlarge the students’ circle of acquaintance in the large school. There is a daily check-in, typically followed by short discussions on topics such as “what was the highlight of the weekend” or a school issue. There is often enough time for brief trivia contests or discussion of personal issues as well.

Additional student contact is made twice weekly through small group guidance seminars taught by counseling staff. The small groups are limited to 12 to 15 students and take place for all four years of the students’ high school experience. Groups in the first year cover study skills and school adjustment issues. In ensuing years, the groups tackle decision-making skills, positive mental health and symptoms of anxiety and depression. These programs make it possible to know all of the school’s students, and they also encourage self-referrals to counseling staff. They are important components of the first two clinical stages of McGorry’s model. Counseling, of course, covers the full range of academic and personal issues, including the ability to support students who are more challenged.

A student support team meets weekly to discuss student issues, with special attention paid to Stages 2 and 3, but always with awareness of Stage 1. For students at Clinical Stage 3 who are more distressed and may have been released from a hospital or drug treatment program, small groups ranging from three to five people provide support, while the leader often works in concert with the treatment facility. These groups also serve as transition teams to gradually return these students to their regular classrooms.

Another preventive effort designed to further community is an after-school enrichment/recreation program that caters primarily (but not exclusively) to students who are not involved in the many formal school groups or athletic teams. Students are encouraged to define their own desires for a group experience, supported by an interested teacher. Examples include time in the gym or on the athletic field for those who did not make school teams, a computer group that is taught how to develop apps, karate and boxing groups, clay and art workshops, and many others.

Somewhat parallel to the Wellesley program, McGorry has originated the Headspace program, which seeks to work with youth when “things are not quite right.” These centers offer similar services to those provided by Wellesley, but in a separate setting. There are currently 45 Headspace centers throughout Australia, with 90 planned by 2015. They function as combination community centers with a counseling focus for young people. Supportive counseling is available, and a major effort is made to get parents involved. Headspace emphasizes positive mental health and therapeutic lifestyle changes such as exercise, socialization skills, meditation and relaxation, drug prevention, adequate sleep and nutrition as personally and multiculturally appropriate. Headspace also includes access to medical and psychotherapy services and interface with crisis teams (24/7 mental health teams). The central function of these programs is to enable at-risk youth to stay in the community, to prevent more serious issues and to provide counseling support as appropriate.

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Visit the EPPIC website at eppic.org.au or the Orygen Youth Health website at oyh.org.au for additional information, including the outpatient programs where methods, systems and practices can be downloaded. We also recommend EPPIC’s 2010 Cognitive-Behavioural Case Management in Early Psychosis: A Handbook (oyh.org.au/online-store/cognitive-behavioural-case-management-early-psychosis-handbook). Extensive information on Headspace can be found by conducting a Google search. In addition, many useful videos are available, often presenting real clients and counselors discussing matters such as bullying, depression and gay/lesbian issues. These can be found on youtube.com/playlist?list=PL8C639D508E0A4B3C or by searching Headspace Ambassadors on YouTube. Information on Wellesley High School is available at wellesley.k12.ma.us/wellesley-high-school.

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Allen E. Ivey is distinguished university professor emeritus at the University of Massachusetts, Amherst and courtesy professor at the University of South Florida. Contact him at allenivey@gmail.com.

Mary Bradford Ivey is a courtesy professor at the University of South Florida. Contact her at mary.b.ivey6@gmail.com.

Letters to the editor: ct@counseling.org

Multicultural counseling: The next frontier

By Cirecie West-Olatunji February 27, 2014

Cirecie West-Olatunji, ACA president

As we celebrate the accomplishments of the many multicultural counseling scholars who have given birth to and advanced the multicultural competences, it is our responsibility to continually contribute to this body of knowledge. In reviewing what we know, there are six areas representing the next frontier for multicultural counselors:

1) transnationalism, 2) moving from knowing that cultural differences exist to accessing culture-centered interventions, 3) the impact of oppression and marginalization on cultural identity, 4) understanding multiple identities (or the intersectionality of identity), 5) diverse White identities and 6) exploring the silenced voices of faculty of color as insider researchers.

Given ACA’s commitment to extending our reach globally, it becomes imperative that we engage in a dialogue about transnationalism. This includes a discussion of military clients, immigrant families, youths in American K-12 schools abroad, the training of international counseling students, outreach to vulnerable populations and disaster-affected communities. To truly participate, ACA members need to attend counseling conferences outside of the United States and participate in projects designed to initiate dialogue with counselor educators and practitioners globally. Such transnational engagement would promote a deeper understanding of multicultural competence.

We can be proud of our stance on multicultural counseling competence and demonstrate advances in our students’ awareness and knowledge of working with diverse clients. However, research outcomes continue to suggest that a large number of our students resist multicultural counseling training. And even among those who are receptive to increasing their awareness and knowledge of how their privilege serves as a barrier to clinical efficacy with diverse clients, not enough students report gaining these new skills during their counselor training. We need to target research that demonstrates effective culture-centered interventions. This is of particular interest when considering clients who are members of cultural groups that have historically experienced systemic oppression.

Additionally, counselors need to conduct more multicultural research that explores the impact of social marginalization on racial/cultural identity development at varying stages of human development for diverse populations. Pervasive oppression and bias have been shown to affect individuals’ physical, psychological and emotional well-being. It would be of interest to determine how oppression affects individuals’ cultural identity as well. Outcomes of such research could assist clinicians in their case conceptualizations, assessments, interventions and evaluations.

Moreover, we need to develop a more complex understanding of identity development to explore how individuals access multiple aspects of their identity, such as gender, class and sexual orientation. Scholars investigating issues relating to women of color (or womanists) have introduced the concept of intersectionality to explain simultaneous identity development issues for non-White women. We need a more sophisticated conceptualization of identity development to better meet the needs of diverse clients.

Unfortunately, little attention has been given to White identities. Although often viewed as a monolithic cultural group with a focus on Western values and middle-class, heterosexual, male privilege, the reality is that a significant portion of Whites live in impoverished communities and suffer from many of the economic, social and health disparities that are evident in other low-income areas. A lack of discourse about Whites’ lived experiences is a barrier to our clinical effectiveness.

Finally, advancing multicultural counseling necessitates a critical view of the experiences of faculty members of color. Upon entering academia, these faculty members often bring with them an interest in exploring the experiences of culturally diverse clients, frequently investigating clinical issues from an insider perspective. However, researchers have documented how White peers often serve as gatekeepers to culturally informed constructs, data analysis and interpretations of findings. In effect, we may be silencing the voices of researchers of color in counseling.

These six issues constitute the next frontier in multicultural counseling. I am proud to belong to ACA, an organization that has played a pivotal role in promoting multicultural counseling competencies, and I look forward to the development of equally groundbreaking multicultural counseling research that will offer a new vision for transformative counseling.

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Follow Cirecie on Twitter: @Dr_CWO

Keeping it in perspective

By Richard Yep

Richard Yep, ACA CEO

Thirsty? Go to the sink and fill your glass with water. Forgot something you need for a recipe? Get in the car and head to the supermarket. Not sure which clients you are seeing today? Click and swipe your finger on your iPhone. These simple tasks are part and parcel of everyday life and the conveniences that many of us routinely take for granted.

This month, I want to share the story of Ron Miller, a man for whom I possess the utmost respect. For Ron, simple daily tasks went from something he did to what he can now only remember doing before the onset of his illness. Ron, age 46, has advanced amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig’s disease, an insidious illness that over time robs the body of its ability to move, even while the person’s brain remains active. After 14 years with ALS, Ron is paralyzed from the nose down.

Ron is my hero due in part to his motto: “I may have ALS, but it does not have me.” Faced with the same circumstances, many of us might have given up and lain in bed as the disease took over. Ron decided to do what he could to fulfill a lifelong dream of returning to college to finish his degree. Thanks to eye gaze computer technology, Ron “types” by focusing on each letter or word that appears on his computer screen. In addition, Ron found an institution of higher education that would allow him to pursue his dream. Ron also has a “team” of professionals who support his academic, health and daily living needs — another group of my heroes who have helped him in his quest.

From left: John Ebersole (president, Excelsior College), Rep. Scott Rigell (R-Va.), Cathy Thomas (Ron’s sister), retired Brig. Gen. Jerry Neff (chair, Excelsior College Board of Trustees), Ron Miller, Thomas J. Orsini (president and CEO, Lake Taylor Transitional Care Hospital), Derrell Miller (Ron’s father) and Richard Yep (past chair, Excelsior College Board of Trustees) at Ron’s commencement ceremony in Norfolk, Va.

This past December, Ron completed the requirements to obtain his associate degree. It would have been virtually impossible for Ron to attend a traditional graduation ceremony, especially since he was earning his degree from Excelsior College, an institution chartered in Albany, N.Y., by the New York State Board of Regents. For more than 40 years, the college has been dedicated to helping the post-traditional adult student. Given its unique ability to help adults from all walks of life realize their academic goals, the college’s staff and leadership were committed to providing Ron with the graduation experience.

So, in early January, key staff of Excelsior, as well as its president and chair of its board of trustees, went to Norfolk, Va., where Ron is a resident at Lake Taylor Transitional Care Hospital. There, commencement was convened, and Ron was awarded his degree. As the immediate past chair of Excelsior’s board of trustees, I had the privilege of attending the ceremony. I had been following Ron’s academic progress for a number of years, and was so happy to learn he had overcome all the obstacles he faced to obtain his diploma. As I said in my remarks at the ceremony, he really did earn this degree (and, truth be told, probably worked harder and under much greater adversity than most people).

It is this type of human spirit and enduring will that leave me in awe. Perhaps you know of clients or students who have overcome serious hardship. Or, to paraphrase Thoreau, those who have advanced confidently in the direction of their dreams to live the life they imagined, to meet with a success unexpected in common hours.

Ron Miller has met with the success referred to by Thoreau. However, Ron is not one to rest on his “academic” laurels; he is now pursuing his bachelor’s degree. I look forward to Ron taking on this next challenge because I want to return to Norfolk, attend his next commencement and personally congratulate him for his accomplishment.

If you would like to learn more about ALS, visit alsa.org.

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

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The art and craft of psychobiography

By Joseph G. Ponterotto

“There is something a little mesmerizing about locating mysteries in people’s lives, then fleshing these mysteries out and, finally, shedding what intensity of light one can on them.”

The quote above is from William Todd Schultz, noted psychobiographer of Truman Capote (among others) and editor of theHandbook of Psychobiography, published in 2005 by Oxford University Press. To me, this quote highlights the draw of psychological biography to the mental health professional. Counselors, both by nature and professional training, are interested in the life stories of others. We are pulled to understand the inner psychology — the thoughts, feelings and behaviors — of our clients, and we are often curious about the personalities of significant figures in human history.

Psychobiography represents a specialty area that applies psychological theories and research tools to the intensive study of an individual person of historic significance. Most often, psychobiographies focus on recently deceased or long-deceased public figures who had a lasting impact on society. That impact may have been for the good of society, as shown in Erik Erikson’s profile of Mahatma Gandhi (1969), or it may represent the worst of human nature, as in Walter Langer’s portrait of Adolf Hitler (1972) or Theresa DeSantis’ psychobiography of still-living serial killer Joel Rifkin (2002).

Psychobiography as a cornerstone of the psychology profession is often traced back to Sigmund Freud’s psychoanalytic profile of Leonardo da Vinci in 1910. Freud ignited a strong interest in psychobiography among his analytic colleagues; applied psychoanalysts went on to author the majority of early 20th-century psychobiographies. By midcentury, however, and coinciding with the burgeoning influence of Harvard University’s Psychological Clinic, the theoretical anchors and research methods of psychobiography expanded significantly. Harvard psychologists Gordon Allport, Henry Murray and Erik Erikson all promoted the intensive study of the single person in holistic framework, and all produced important psychobiographical work. In the present century, interest in and production of psychobiography by psychologists continues, and the field is witnessing a flourishing of diverse theories and research methods used to anchor psychobiography.

It is interesting to note that psychologists still write the overwhelming majority of psychobiographies. This article is, in part, an invitation to professional counselors to apply their professional skill set to this fascinating research endeavor. I want to highlight why counselors are well-positioned to conduct psychobiography, the benefits of psychobiographical research to individual counselors and to the profession as a whole, and the specific steps to gaining competence and engaging in psychobiography.

Counselors make good psychobiographers

Professional counselors have the ideal skill set to conduct psychobiography. First, of course, counselors have a strong interest in understanding the inner psychological drives and motivations of others. Second, through their training and clinical supervision, counselors are highly self-aware and can objectively bracket out their biases in a comprehensive and objective study of a public or historic figure. Third, counselors are schooled in the practitioner-scientist model and are highly skilled at balancing a controlled empathy for their historic subject with the scientific search for truth and understanding of the individual. Fourth, counselors are expert in considering their subject of interest within a socio-cultural-historical context, and they are careful to interpret the experiences of others from the most relevant cultural and historical vantage points.

Finally, counselors’ specific academic training provides clusters of competence ideally suited to psychobiographical research. Among the core areas of competence for counselors as outlined by popular accrediting bodies and state licensing and certification boards are in-depth knowledge of the following:

Psychological theory and history
Human development over the life span
Neuropsychology (including behavioral genetics)
Assessment, measurement and testing
Group dynamics
Understanding the family
Qualitative and quantitative designs in case study research
Ethical issues and responsibilities in research
Multicultural considerations, including the historic influences of oppression and privilege on individual life stories

Collectively, these core training competencies equip counselors well for psychobiographical research, which most often demands accessing this entire cluster of competence.

Benefits of engaging in psychobiography

A number of clear benefits accrue to individual counselors, to the counseling profession at large, to counselors’ clients and students, and to the general public when professional counselors engage in psychobiographical research and writing.

First, for the profession at large, well-conducted and reported psychobiographies promote the visibility of counselors through exemplary research scholarship. Psychobiographies are widely read because they focus on historic figures who capture the fascination of the public over multiple generations. Interest in psychobiography extends across multiple professions, including history, journalism, sociology, political science, psychology and psychiatry, as well as to the lay public.

Second, exemplary psychobiography informs and educates the general public about historic figures who have helped shape society, for good or bad. Psychobiography teaches psychology to the public through its explanation of the often complex and layered factors that anchor humans in their beliefs, feelings and actions. Psychobiography is also the means through which each generation connects psychologically with generations past. It is motivating to consider that Erikson’s detailed psychobiography of Gandhi was used in the 1960s civil rights movement as a model for nonviolent resistance to oppression. Psychobiographies of both creative and ingenious individuals, as well as those at psychological risk, have also informed myriad early intervention programs in schools and communities.

Third, psychobiography engages the curiosity and skill set of the individual counselor, thus promoting our own personal and professional development. In addition, counselors who present and publish psychobiographies may receive national visibility and other opportunities.

Finally, engaging in psychobiography holds the potential of making counselors better clinicians. It leads us to more fully understand behavior in socio-cultural-historical context, encourages us to consider transgenerational influences of both trauma and resiliency, and promotes the use of mixed methods research (quantitative and qualitative) and a variety of assessment tools and procedures. These skills prepare us for more depth and breadth in conceptualizing our clients’ lived experiences, challenges and strengths.

Steps to engaging in psychobiography

Counselors interested in engaging in psychobiography as a research and writing endeavor can follow the seven steps outlined here.

1) Reflect on a historic figure who has long intrigued you and whose personality or impact on society has fascinated you. The figure can be deceased or living. Carefully research what has already been written about this historic figure and then identify any remaining mysteries about her or his life. One or more of these mysteries can form the focus of your research. Contemplate what you could bring to the psychological understanding of this individual given your long-term interest in the subject and your in-depth training and experience as a professional counselor.

2) Develop knowledge and competence in the field of psychobiography through your own study of the specialty area and a review of both flawed and exemplary psychobiographies. The box on page 56 lists the four methodological primers that were most helpful to me in my development as a psychobiographer. Each of these key sources is replete with examples (both good and bad) of methodology in psychobiographical research.

3) Take the time to read both classic and modern psychobiographies. Classic psychobiographies include the influential, though markedly flawed, psychoanalytic profiles of da Vinci by Freud and of President Woodrow Wilson by Freud and William Bullitt (first published in the United States in 1966). These studies were considered flawed, both on the basis of author bias and lack of rigorous research methods.

Psychobiographies considered exemplary, both in theoretical anchor and comprehensive coverage, include Erikson’s profiles of Martin Luther (1958) and Mahatma Gandhi (1969). Erikson’s work on Gandhi received the 1970 Pulitzer Prize for general nonfiction.

Modern psychobiographies tend to be multitheoretical and have included psychological profiles of Diane Arbus, Truman Capote, Bobby Fischer, John Lennon, Barack Obama and George W. Bush (see box on page 58). After reading a few recent psychobiographies, consider publishing a review of the book on Amazon.com, or reach out to a magazine or journal that welcomes such book reviews.

4) If time and availability permit, consider taking (or designing) a course in psychobiography. Working with an established psychobiographer will provide the structure and methods needed to begin your own venture into psychobiographical research and writing.

5) As you identify a subject of interest for your psychobiographical research, consider collaborating with others who hold a strong interest in the psychology and personality of this figure. Given the interdisciplinary nature of psychobiography, consider colleagues outside the field of counseling, perhaps in history, political science or journalism. Each profession brings an overlapping as well as a distinct set of skills for psychobiography research.

6) Consider a narrow focus for your first psychobiography. Developing a comprehensive life-span psychobiography of a historic figure, either living or deceased, can be a multiyear process. At times, psychobiographers instead focus on a single event, time period or unanswered question in the life of a historic figure. For example, William Todd Schultz focused his short biography of Truman Capote on the question of why the famed author never completed his book Answered Prayers. Dan McAdams, in his recent profile of George W. Bush, focused specifically on understanding why the president launched a military invasion of Iraq in the spring of 2003. Tim Kasser devoted his psychobiography of John Lennon to the question of what led to his writing of the influential song “Lucy in the Sky with Diamonds.” Psychobiographical profiles can be published as full-length books or as articles targeted for academic journals and popular magazines. Counselors have the research and writing skills to tap into any of these publication outlets.

7) Consider the ethical issues related to psychobiography (a topic not addressed much by the field). Because the majority of psychobiographies focus on individuals who are deceased, the majority of psychobiographers have not submitted their research ideas and proposals for formal review and approval by an institutional review board. Unfortunately, neither the American Counseling Association nor the American Psychological Association specifically addresses psychobiographical research in their ethical standards. The lack of professional association guidance on this matter led me to begin developing a set of rights and responsibilities for psychobiographers (see box above for a list of key references on ethics in psychobiography).

I believe it is important for counseling researchers to attend thoughtfully to ethical issues and challenges that are likely to arise in psychobiographical research. Ethical issues are less salient when the subject of the psychobiography has long been deceased and has no family members surviving. Ethical issues are more salient when the subject is recently deceased and survived by extended family, friends and associates who may read the psychobiography. The ethical issues are most paramount when writing about historic subjects who are still living because the final psychobiographical report could affect the subject’s reputation, legacy and career livelihood.

One counselor’s journey into psychobiography

This is my story of how psychobiography captured my imagination, reinvigorated my research program and enhanced my clinical skills.

I have always been interested in biography, psychobiography and cultural history. Since my teenage years in the early 1970s, I have also been a chess player and fascinated with the life of the first American-born world chess champion, Bobby Fischer. After more than three decades as a counselor educator, I decided to apply my counseling research skills to unveiling the answer to perhaps the biggest lingering mystery in the chess world — what had happened to Bobby Fischer. Millions of chess fans worldwide had become enamored with Fischer’s creative genius at the chessboard, only to be disappointed when he forfeited his world championship in 1975 and then disappeared from the chess world. They were ultimately horrified by the vitriolic anti-Semitic and anti-American sentiment that characterized his later years (Fischer was himself Jewish).

Soon after Fischer’s death in January 2008, I began my research into the mystery of his life. Initially my plan was to write a brief psychological assessment article with the goal of determining whether Fischer may have suffered from mental illness and, if so, which particular illness. The literature was already replete with hypothesized mental disorders that Fischer may have suffered from, and there was already a strictly Freudian psychoanalytic profile penned by Reuben Fine, who was both a psychoanalyst and a chess grandmaster. However, a thoughtful, modern and comprehensive forensic psychological profile, or psychological autopsy, on Fischer was lacking.

Eventually, my narrow plan of research for a psychological assessment of Fischer expanded into a full life-span psychobiography. Truly understanding Bobby Fischer required knowledge of his family and genetic history, the international chess world in the 1950s through the 1970s, and the socio-historical-cultural context of Fischer’s life (1943-2008). Initially, my research methods focused on archival document review, including previous biographies of Fischer, audio- and videotaped interviews with the chess champion and accounts by journalists.

In time, I began to contact Fischer’s friends, select family members, journalists who had covered his life for decades and Frank Brady, whose biographies of the world chess champion, Bobby Fischer: Profile of a Prodigy and Endgame: Bobby Fischer’s Remarkable Rise and Fall — From America’s Brightest Prodigy to the Edge of Madness, are considered definitive biographical works. I was very pleased, and even honored, when the overwhelming majority of individuals I contacted agreed to talk with me, either by phone, via email or in person. I believe my status as a faculty member and mental health professional gave me some credibility as a psychobiographer, thus facilitating the process of securing interviews.

As document reviews led to personal interviews — which then led back to new document and archival sources — the iterative process of psychobiographical research was in full motion. My research also led me to access FBI files on Bobby Fischer’s mother, Regina Fischer, which I acquired through the Freedom of Information Act. She had been under suspicion of being a spy for the Soviet Union because she had lived and studied in Moscow from 1933-1938 and was a member of the Communist Party in the United States for a number of years. I also acquired medical and death records and traveled both domestically and internationally to complete my research.

Ultimately, the research took roughly four years to complete and resulted in a book, A Psychobiography of Bobby Fischer: Understanding the Genius, Mystery and Psychological Decline of a World Chess Champion, published by Charles C Thomas Publisher Ltd. in 2012. Currently, I am continuing this research, now with the help of master’s and doctoral students in counseling who also are interested in psychobiography and the study of both prodigies and at-risk youths and adolescents.

The benefits of entering the world of psychobiography have been significant to me, both personally and professionally. On a professional level, it was very fulfilling to combine my interest in counseling, history, culture and biography with my lifelong passion for the game of chess. Becoming a psychobiographer markedly expanded my research and teaching skill set, given the interdisciplinary tools and theories used by psychobiographers. A good number of our counseling students are interested in psychobiography, and we are now working together to design an interdisciplinary psychobiography course with particular appeal to counseling, school, clinical and forensic psychology students.

An unexpected and exciting outcome of my research and writing was being presented with opportunities to consult for both a Hollywood movie production company and a theatrical rendition of Fischer’s life. I interacted with movie producers and a playwright, read screenplays and scripts, and wrote psychological character profiles of Bobby Fischer and select family members.

Importantly, as a practicing mental health counselor and psychologist, I believe my clinical stance has been strengthened through psychobiography. It has led me to attend more thoughtfully to the sociocultural context of my clients’ and their ancestors’ lived experiences. Furthermore, as a clinician, I now count as one of my specialty areas working with chess players of varying strengths to help ensure a healthy life balance socially, academically and vocationally, while also promoting continued chess development.

My research has also led to close acquaintances with individuals who knew Bobby Fischer very well. These associations have enriched my personal and professional life. Furthermore, my professional network has expanded markedly through my work on the Fischer story, and I now count as close colleagues professionals in journalism, biography, history and elite chess competition. I invite readers to email me and our psychobiography research team at Fordham University using the contact information below.

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Classic methodological primers on conducting psychobiography

I believe these four publications are must reads for any psychobiographer. All three authors continue to be active in psychobiographical research, and each is considered a pioneer in modern psychobiography (post Sigmund Freud and Erik Erikson).

Life Histories and Psychobiography: Explorations in Theory and Method by William McKinley Runyan, 1982, Oxford University Press
“Psychobiographical methodology: The case of William James” by James W. Anderson in Review of Personality and Social Psychology, edited by Ladd Wheeler, 1981, Sage Publications
“The methodology of psychological biography” by James W. Anderson, The Journal of Interdisciplinary History, Autumn 1981
Uncovering Lives: The Uneasy Alliance of Biography and Psychology by Alan C. Elms, 1994, Oxford University Press

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Select modern multitheoretical psychobiographies

A Psychobiography of Bobby Fischer: Understanding the Genius, Mystery and Psychological Decline of a World Chess Champion by Joseph G. Ponterotto, 2012, Charles C Thomas Publisher Ltd.
An Emergency in Slow Motion: The Inner Life of Diane Arbus by William Todd Schultz, 2011, Bloomsbury USA
Barack Obama in Hawai’i and Indonesia: The Making of a Global President by Dinesh Sharma, 2011, Praeger
George W. Bush and the Redemptive Dream: A Psychological Portrait by Dan P. McAdams, 2011, Oxford University Press
Lucy in the Mind of Lennon by Tim Kasser, 2013, Oxford University Press
“The ‘genius’ and ‘madness’ of Bobby Fischer: Understanding his life from three psychobiographical lenses” by Joseph G. Ponterotto and Jason D. Reynolds, Review of General Psychology, December 2013
Tiny Terror: Why Truman Capote (Almost) Wrote Answered Prayers by William Todd Schultz, 2011, Oxford University Press

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Key references on ethics in psychobiography

“Case study in psychobiographical ethics: Bobby Fischer, world chess champion” by Joseph G. Ponterotto, Journal of Empirical Research on Human Research Ethics, October 2013
Extended note on the history of ethics applied to psychobiographical research: Supplemental online material to “Case study in psychobiographical ethics: Bobby Fischer, world chess champion” by Joseph G. Ponterotto, Journal of Empirical Research on Human Research Ethics, October 2013
“Saddam Hussein is ‘dangerous to the extreme’: The ethics of professional commentary on public figures” by John D. Mayer and Michelle D. Leichtman, Psychology of Popular Media Culture, January 2012
“The APA’s ethics code and personality analysis at a distance” by John D. Mayer, posted June 27, 2010, “The Personality Analyst” blog at PsychologyToday.com
“What should biographers tell? The ethics of telling lives” by Jerome G. Manis, Biography, Fall 1994

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Joseph G. Ponterotto is a licensed mental health counselor and psychologist in New York state and coordinator of the mental health counseling program at Fordham University at Lincoln Center in New York City. He is the author of A Psychobiography of Bobby Fischer: Understanding the Genius, Mystery and Psychological Decline of a World Chess Champion, and maintains a small private practice in New York City. Contact him at Ponterotto@Fordham.edu.

Letters to the editor: ct@counseling.org