Monthly Archives: April 2018

Behind the Book: Counselor Self-Care

By Bethany Bray April 23, 2018

There is no perfect plan when it comes to self-care. The important thing is to have a plan and make self-care a career-long focus. Not only will the methods that counselors find effective vary from practitioner to practitioner, but a self-care routine will also need to evolve to meet changing needs throughout a counselor’s career.

“No one person has the ideal formula for optimal self-care; We are unique individuals with varied life experiences,” write the co-authors of Counselor Self-Care. The book, recently published by the American Counseling Association, compiles the insights and personal self-care journeys of more than 50 counselors from across the profession in various stages of their careers.

Counseling Today sent the co-authors some questions, via email, to learn more. Gerald Corey is an ACA fellow and professor emeritus of human services and counseling at California State University, Fullerton; Michelle Muratori is a senior counselor at the Center for Talented Youth at Johns Hopkins University in Baltimore; Jude T. Austin II is an assistant professor in the Counseling and Human Services Department at Old Dominion University; and Julius A. Austin is an assistant professor in the Marriage and Family Therapy and Counseling Studies program at the University of Louisiana at Monroe.

 

 

Q+A: Counselor Self-Care

Responses co-written by Gerald Corey, Michelle Muratori, Jude T. Austin II and Julius A. Austin

 

Why, in your opinions, is self-care considered an ethical mandate?

Simply put, we can place our clients in danger when we do not take care of ourselves as counselors. It is hard for us to believe that counselors can make sound decisions regarding their clients’ welfare when they are struggling to make sound decisions about their own welfare.

Self-care as an ethical mandate involves taking active steps to acquire and maintain wellness in all aspects of living. The concept of wellness is a lifelong journey that has implications for us both personally and professionally. We sometimes hear that self-love and self-care are signs of selfishness. As co-authors of this book, we believe that it is not a matter of self-care versus caring for others. It is surely possible to be invested in both. We may feel invested in promoting a good life for others and be instrumental in improving conditions in our communities. But to be genuinely involved in social action and bettering society, we need to begin with ourselves. Taking time to reflect on the quality of our lives is a good beginning for making changes in our behavior that will lead to increased wellness.

If we neglect caring for ourselves on a regular basis, our professional work suffers, so self-care is a basic tenet of ethical practice. If we are drained and depleted, we will not have much to give to those who need our time and presence. The prevention of burnout and the commitment to monitoring ourselves is a cardinal ethical principle. The 2014 ACA Code of Ethics includes the statement that “counselors engage in self-care activities to maintain and promote their own emotional, physical, mental, and spiritual wellbeing to best meet their professional responsibilities” (Introduction to Section C, Professional Responsibilities). Meeting this ethical standard is not a final event, but instead it is a call for counselors to reflect daily on what they are doing and the degree to which their behavior is working. Self-care can be thought of as a set of practices that prevent emotional depletion and burnout.

Books and chapters, as well as articles in the professional journals are being written on counselors focusing on prevention of burnout, as well as learning to manage personal and professional stress. One example of this is Counseling Today’s recent article “The Battle Against Burnout” (the cover story of the April issue).

 

In general, do you feel that new counselors emerge from graduate and training programs with an adequate understanding and focus on self-care?

We have not conducted any surveys on self-care in graduate programs, so we cannot answer this question with supporting empirical evidence. It is our assumption that counselor preparation programs do their best to give this topic some degree of attention. In fact, some programs may do a fine job of educating their trainees about the hazards of burnout and the necessity for self-care. However, understanding the concepts intellectually and experiencing the demands of the profession firsthand are two different things.

Each of us has heard from trainees during their practicums and internships that they are surprised by the intensity of the work and the stress that it produces. Too often students graduate and enter the early phase of their career with idealism and optimism, only to encounter barriers to achieving their professional goals and maintaining wellness. The amount of paperwork, responsibility, emotional energy, and strain on personal relationships are just a few things our students said they wish they would have known about before graduation. At times, their optimism wanes and their hopes to see changes are dashed, which leads to disillusionment, exhaustion, and early stages of burnout.

While we cannot speak with authority about programs in general, we can speak about what we do to encourage our students to develop self-care practices that will bode them well in graduate school and strategies that can enable them to prevent burnout. As co-authors of this book, the four of us take the ethical imperative of self-care very seriously and do our best to incorporate self-care activities and practices in the courses we teach and in our role as mentors with the many students with whom we work.

We think it is of paramount importance that faculty model attitudes and practices of self-care. Our students will be more impressed by who we are and how we interact with them than by our lectures on self-care. In our respective programs, many of our colleagues introduce a variety of self-care activities in their classes, including mindfulness exercises. Some of us encourage students to develop a self-care action plan, and to think of ways to make learning a personal journey rather than a strictly academic pursuit.

 

What resources would you suggest for a “veteran” counselor who has been working in the field for a while and is looking for ways to boost or update/refresh their self-care routine?

To update/refresh their self-care routine, experienced counselors need to endorse the value of lifelong learning, realizing that their education and development do not stop at graduation. One of the best ways to revitalize their self-care routine is to find new ways to connect to valued colleagues who share their passion for this work. Colleagues can serve as mentors long after we are into the professional field. Personally, we find attending professional conferences, workshops, learning institutes and other forms of continuing education to be valuable resources and networking opportunities. The four of us attend the ACA conference every year in addition to other professional meetings. We always come away feeling inspired, with new ways of thinking about topics that matter to us. We typically present education sessions and participate in learning institutes, and this affords us opportunities to work with students and counselors from various parts of the country. This is energizing for all of us! We also try to carve out time to enjoy lunch or dinner with colleagues, former students and friends in the area. We also intentionally make time to rest, sightsee and enjoy what the conference’s host city has to offer. These activities recharge our batteries and equip us with new tools to bring back to our students, clients and supervisees.

Besides keeping professionally updated, we are convinced that counselors who have worked in the field for a while can bring more vitality to their work if they are attending to their personal lives. Thus, engaging in various forms of recreation and hobbies are ways to refresh our self-care routine. Participating in travel can be taxing, but it can also broaden our perspectives and help to keep us interested and interesting. Another strategy is to try something new that has nothing to do with professional development. We might try a new sport, plant a garden, play a new video game, read a book purely for pleasure, learn a musical instrument or implement a new exercise routine. We must find ways to boost our routine when it starts to feel stale. What is critical is that each of us must find our own path for retaining our vitality, both personally and professionally.

 

Self-care that a counselor finds helpful will differ and evolve throughout their career. What would you want counselors to know about the need to change and adapt their self-care routine as they grow as a professional?

We would want counselors to know that self-care is a delicate process that is unique to each counselor. What works from some may not work for others. Moreover, a self-care plan that meets one’s needs at a certain point in one’s career may no longer serve us at a later time. There are likely to be many twists and turns in the evolution of our career; thus, we may need to be prepared to adapt our self-care practices accordingly. Being patient with this process and with ourselves as we navigate new personal and professional experiences is of the utmost importance.

As alluded to, even if we have been successful in establishing self-care practices as we begin our career, we are likely to find that we need to make changes as we take on new responsibilities. These stages include (1) graduate school; (2) early career; (3) mid-career; and (4) late career. Since each of the co-authors is presently in a different stage of professional development, we each describe challenges we face and how we do our best to thrive personally and professionally. In our book, Counselor-Self Care, we devote a chapter to self-care across the seasons of our career, in which we address this question in some depth.

Self-care involves unique challenges at each developmental stage in a career. For example, how we meet these tasks during graduate school has implications for how well we will be able to address them throughout our career. Transitions in life can be stressful, even when they bring about positive change. One such transition is leaving the safety net of a graduate program and launching a career as a new professional. Entering this next season of their life and career as early professionals can indeed be very exciting. However, it is a period when many changes occur and major life decisions are made.

As clinicians and counselor educators gain more experience in their professional roles and enter into the mid-career phase, it is likely that they will be expected to take on greater professional responsibilities, which are inherently stressful. For instance, clinicians may be promoted to positions that require them to supervise others and manage budgets while those pursuing positions in higher education may have to weather the challenges associated with going up for tenure. At the same time, they may be experiencing developmental stressors in their personal lives such as dealing with aging parents or children leaving the nest to go away to college or to enter the workforce. For mid-career mental health practitioners, the challenge involves becoming aware of developmental stressors, finding ways to maintain competence and assuming an active role in engaging in lifelong learning. This is a time for practitioners to continue to become aware of common risks for burnout and to monitor how well they are managing stress, especially with the increasing demands associated with a mid-career. It is important to adopt an active role in collaborating with colleagues and to avoid professional isolation and burnout.

The late-career professionals often are faced with adapting their lifestyle and self-care routines. Retirement is a part of this phase of one’s career. Retirement is an opportunity to redesign our life and to tap unused potentials; it is not an end to all work. There are many choices open to us as we embark on the path toward retirement. We can get involved with the projects we might have put aside due to the demands of our job. We can discover that retirement is not an end, but rather a new beginning. Retirement is a major transition in life that brings a variety of choices and transitions. A major developmental task we face as we retire is deciding which path we will take to continue to find meaning in life.

 

What prompted you to collaborate and create the book? Why do you feel it’s a relevant/needed topic to cover now?

A combination of factors prompted us to collaborate and create this book. Primarily, our relationships with one another as a collaborative team on various other projects sparked our excitement to work together again. While attending professional conferences, we had observed a large number of attendees at self-care presentations and had noted that self-care for mental health professionals was being given more attention in the literature. In addition, we noticed a number of our own students, supervisees and colleagues asking for more information about self-care and talking about how spread thin they were with all of their demands. When we initially brainstormed ideas, we realized that the book would have more depth if we brought our combined life experiences and perspectives to the project.

We aimed to write a book that presented diverse perspectives on self-care with the objective of encouraging counselors and counselor trainees to evaluate their present level of self-care and consider specific changes they want to make in attending to all aspects of wellness in their personal life. The book gives readers a chance to look into the lives of many different helping professionals as they wrestle with taking care of themselves.

The four of us are engaged in professional work in different settings and are at different stages in our careers. Two of us are early-career professionals, one of us is a mid-career person, and one of us is a person in his late career. Individually and collectively our aim was to offer a balance of challenge and support as our readers consider ways to enhance their personal and professional life through self-care.

Early on we decided to invite guest contributors to share their experiences in meeting the ethical mandate of self-care. We exchanged ideas on how we could reach our audience with the message “Counselor, take care of thyself!” Our many discussions led to our decision to include a wide range of students, counselor practitioners, and counselor educators to share their self-care stories. We were impressed with their levels of honesty and courage in disclosing their struggles and sharing the action plans they devised to treat themselves with increased kindness and compassion. Despite the obstacles our guest contributors encountered, their stories are filled with their hopes and visions for the future. Many themes were explored, including not demanding perfection in taking care of themselves, continuing to strive to do better despite occasional setbacks, asking for the help they needed, recognizing that consistency in self-care practice is essential to competently serving others and that self-care is a process.

 

What do you hope readers will take away from the book?

Our hope is that readers will be motivated to engage in honest self-reflection of where they are now and where they would like to be in their self-care program. After reading the narratives of 52 guest contributors about their experiences with self-care, along with our thoughts and experiences related to this topic in each chapter, readers can continue to implement a personal action plan that will lead to wellness in all aspects of their lives.

There is no perfect plan that will motivate us to achieve our self-care goals, yet if we have no plan it will be difficult for us to survive the demands of our professional work, let alone thrive in our lives and careers. It is our hope that students and counselors who complete this book will make a comprehensive assessment of their current behavior and determine what changes they want to make to better meet their needs — physically, emotionally, mentally, socially and spiritually.

As counselors, we have the responsibility to do whatever it takes to be as present and effective with our first client of the day through to our last. We need to remind ourselves that self-care is not a project that is completed once and for all, but rather it is a process of taking care of ourselves. We need to put ourselves in our schedule so that we will have the stamina to fulfill the many demands of our professional work. It is our expectation that readers will see that burnout and impairment are not inevitable. If we make self-care a priority, not only can we stave off burnout, but we can engage in daily practices leading to wellness.

 

 

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Counselor Self-Care is available both in print and as an e-book from the American Counseling Association bookstore at counseling.org/publications/bookstore or by calling 800-347-6647 x222

 

Attending the ACA 2018 Conference & Expo in Atlanta this month? Check out these events with the authors of Counselor Self-Care:

  • Wednesday, April 25, 9 a.m. to 4:30 p.m.: Learning Institute “Taking Care of Yourself: A Luxury or an Ethical Mandate?”
  • Friday, April 27, 11 a.m. to noon: Counselor Self-Care author content session
  • Thursday, April 26 from 4:30 to 5:30 p.m. and Friday, April 27 from noon to 1 p.m.: Counselor Self-Care author book signings

See counseling.org/conference for more details

 

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

 

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Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.

 

 

 

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@TechCounselor: Streamlining repeat emails

By Adria S. Dunbar April 16, 2018

No matter my professional role, there always seems to exist the need to send out the same email over and over again. Either I write the same email monthly or annually, or I write the same email and send it to multiple people.

When I was in private practice, it was a “New Client” email. As a school counselor, it was usually an introductory email to parents and students. Now, as a counselor educator, my repeat emails are related to admissions and advising. Regardless of the content, I can help you streamline this process to save yourself a lot of time.

The first step is to embrace Google Sheets. Even if you don’t enjoy Sheets (or similar software programs such as Excel or Numbers), I can promise you that Sheets is one of the best tools to help you manage your email. Create a sheet, or multiple sheets, with the following columns:

  • First Name
  • Last Name
  • Email Address

Those three columns are the basic necessities to make this work, but feel free to add others. Oh, and capitalization matters.

Once you have your columns set up on the first row of your spreadsheet and have input all of your data, click on “Add-ons” and then “Get Add-ons.” Search for “Yet Another Mail Merge (YAMM)” and download the software. Get ready to be amazed at how easy this is!

Compose an email to all of your recipients. You might want to include some personalization, such as “Good morning, {{First Name}},” or “Hello, Dr. {{Last Name}}.” Your spreadsheet might also include a column titled, “Appointment Date,” in which case you could include that in the body of your email. For example, “We are excited that you will be visiting us on {{Appointment Date}} and look forward to working with you.” Once your email is complete and saved (Google autosaves for you), you’re ready to use YAMM.

Go back to your Google Sheets. Click Add-ons > Yet Another Mail Merge > Start Mail Merge. Choose the Sender Name and the Email Template you’d like to use. YAMM gives you a list of your most recently composed emails. You can also choose to track emails to see if and when recipients receive or open your message. Finally, you can also delay your email to send at a specific date and time. This is great for those of us who tend to be working late at night or over the weekends. However, you can also send right away. In either case, you may want to use the “Send Test Email” feature just to be sure your email sends in the way you intended.

For even more advanced options, check out how to convert Google Docs to Emails using a Chrome Extension. This will help you create branded or creative email messages that will really impress your recipients.

 

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Adria S. Dunbar is an assistant professor in the Department of Educational Leadership, Policy and Human Development at North Carolina State University in Raleigh. She has more than 15 years of experience with both efficient and inefficient technology in school settings, private practice and counselor education. Contact her at adria.dunbar@ncsu.edu.

 

@TechCounselor’s Instagram is @techncounselor.

 

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Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.

Counseling people who stutter

By Chad M. Yates, Karissa Colbrunn and Dan Hudock April 11, 2018

Kyle hears the drone of the elevator music playing behind the bland voice that states, “All calls are important to us. Thank you for your patience. A customer service representative will be with you in just a moment.” Kyle knows the message well because he has been on hold for nearly 15 minutes. While waiting, Kyle practices in his head the message he needs to state: “Hello, my name is Kyle, and I need to schedule a shuttle ride to and from the airport.”

Suddenly, a crackling voice replaces the music. “Hello, thank you for calling OK Shuttle. How can I assist you?”

Kyle feels his throat tighten and his chest begin to seize. “Hello, my name is Kyyyyyy, my name is Kyyyyyyy, Kyyyy.”

“Sir, are you there? Sir, are you there?” insists the customer service rep.

Kyle continues: “Hello, my name is Kyyyyle. I need to schedddddd … I need to schedddddd, scheddddd.”

“Sorry, sir,” the voice on the other line says. “We have a poor connection. Please call back again when your service is more reliable.”

The sound of the click thunders in Kyle’s ear as a tight-pitched squeal replaces the silence. Kyle looks down at his feet, too afraid to pick them up and move. He feels frozen in anger, disgust and helplessness. Fear precludes the idea of calling back again.

This experience is all too common for people who stutter (PWS). For these individuals, the experience of communication, which many of us take for granted, becomes a blockade that stands between connection, understanding and the navigation of one’s world.

Experts in the field of speech-language pathology define stuttering as a communication disorder involving disruptions, or disfluencies, in an individual’s speech. The cause of stuttering is typically thought to be a neurological condition that interferes with the production of speech. Although many children spontaneously recover from stuttering, for approximately 3 million U.S. adults (about 1 percent of the population), stuttering is chronic and has no cure. Despite this, there are ways to manage stuttering in both the behavioral sense (how much the person stutters) and the psychological sense (how much stuttering impacts the person’s life).

Situations such as the one that Kyle experienced can happen almost daily for PWS. The pain of these experiences often leads these individuals to isolate themselves from the things they love to do because the risk of communicating can feel as if it outweighs the benefits of living the life they want to live. Peer reactions to unusual speaking patterns can begin as early as age 4. These reactions persist and increase throughout adolescence, which can negatively affect many facets of life, including social relationships, emotional well-being and academic performance, for PWS. Adults who stutter have scored significantly lower in questionnaires regarding quality of life, specifically in regard to vitality, social functioning, emotional role functioning and mental health. Although various studies show that counseling is indicated with this population, many speech-language pathologists are not trained in counseling or do not feel comfortable with their counseling skills and abilities.

Interprofessional collaborations between speech-language pathologists and counselors can be considered best practice for helping PWS and other individuals with common communication disorders. Idaho State University’s counseling and speech-language pathology departments are involved in a unique relationship in which they are training both speech-pathology interns and counseling interns to work side by side to treat PWS. This treatment is provided through the university’s Northwest Center for Fluency Disorders Interprofessional Intensive Stuttering Clinic (NWCFD-IISC), which offers a two-week clinic for adolescents and adults who stutter.

The clinic is the first of its kind in which speech-language pathologists and counseling interns work together to treat the holistic needs of clients who stutter through acceptance and commitment therapy (ACT), a mindfulness-based mental health approach. We (the authors of this article) have conducted the clinic over four consecutive years. Through this experience, we feel that we can share recommendations for counselors working with PWS and with other clients who present with communication disorders. Additionally, we have observed key ingredients for interprofessional collaboration and can speak to strategies to build effective interprofessional teams.

Recommendations for counselors

To be effective working with PWS, counselors need to address the misconceptions they have about stuttering. Consulting resources, such as the National Stuttering Association and the Stuttering Foundation, that are supported by PWS can help counselors to debunk common myths associated with this population.

One common myth is that stress causes a person to stutter. Another myth is that taking deep breaths before one speaks can eliminate stuttering. We have heard countless “cures” for stuttering from the general public. These include placing spices under one’s tongue, receiving acupuncture and sitting or standing with the correct posture. These erroneous cures can be insulting and demeaning to PWS. At best, it is frustrating for PWS to hear these ideas repeated over and over again. Counselors should be knowledgeable about the lack of support for these types of cures while being able to point out to clients resources on effective treatments.

For PWS, reactions from listeners often can be painful. As PWS become more aware of their stuttering and encounter negative listener reactions to their disfluencies, they may develop negative emotions toward communication situations and begin to avoid speaking. The shame and guilt that PWS often feel for stuttering can lead to fear, anxiety and tension in relation to communication, as well as decreased self-confidence. PWS may develop secondary behaviors that they employ in hopes of alleviating their stuttering. These secondary behaviors might include avoiding eye contact, avoiding speaking to people in positions of authority and avoiding certain words that they anticipate stuttering. Being aware of this, it is important for counselors to understand the role that positive regard, expressed behaviorally through continuous eye contact or not averting their glance when PWS speak, can have on these individuals.

Working effectively with PWS also involves using positive and respectful communication practices. During conversations, time pressure can be present when PWS take longer to communicate. This can sometimes lead to one party attempting to finish the other’s sentences. To PWS, this behavior can suggest that their communication of ideas may not be as important as the other speaker’s time.

Finishing a person’s sentences is often done in reaction to uncomfortable feelings associated with the time pressure of communication. Counselors should be aware of when they are experiencing these feelings. They should continue to allow their clients who stutter to finish what they wish to say regardless of time pressure and regardless of whether these clients are having blocks (when sound or air is stopped in the lungs, throat or mouth/lips/tongue), breaking off speech or having repetitions (repeating a sound, syllable or word more than once or twice).

The final recommendation involves the use of person-first language. Often, PWS call themselves “stutterers.” Reframing the language to say a “person who stutters” can reduce the stigma that surrounds the word “stutterer.” This action also treats the person as an individual. During the NWCFD-IISC, we empower PWS and work to mitigate stigma by reinforcing the idea that what a person says is more valuable and important than the way he or she says it. We also affirm that all individuals deserve to communicate their thoughts and ideas.

Recommendations for interprofessional teams

Interprofessional teams can be difficult to start and maintain in practice. Professional training often maintains solo practice as its modality, adding topics related to interprofessional collaboration as elective practice. We have used the stuttering clinic as a way to train counseling and speech-language interns in interprofessional practice and application.

We have observed that to effectively build these teams, it is essential to train our interns on the respective scopes of clinical practice, professional roles and clinical responsibilities of each other’s professions. We also train our students on how to work in teams, how to build relationships based on open communication and respect, and how to understand and use team dynamics that occur during practice. Finally, we reinforce the shared values of both professions — that the well-being of the client is paramount to the purpose of the team.

We have observed that interns typically begin collaborations with thicker boundaries of professional practice and rigid time sharing when interacting with clients. However, after the pair begin to find comfort and understanding of each other’s professional roles, these boundaries begin to wane. Time sharing becomes much more dynamic and less rigid. When intern pairings are working effectively, we see the pair begin to assist each other in their roles and to plan out how they can work together to assist the client during the next session.

To facilitate the interns working together, we teach them specific strategies that are unique to each profession. For example, the speech-language interns learn how to use basic listening skills and practice these skills with the help of their counseling partners. Speech-language interns also learn the foundations of counseling interventions. Specific to the NWCFD-IISC, the interns learn the foundations of ACT. All interns are also taught the practice of meditation and mindful practice, and the principles of acceptance, thought defusion and emotional expansion. Counseling interns learn the foundations of speech-language pathology interventions. Specific to the NWCFD-IISC, they learn about how stuttering occurs, how to assess for stuttering and the social and emotional impacts of stuttering.

All interns in the clinic engage in pseudo-stuttering (fake stuttering) in public and use speech-modification techniques with all clinic participants and the public. Pseudo-stuttering can be used as a therapeutic strategy for PWS to increase acceptance and openness with their stuttering and to increase self-confidence. When the clinic interns pseudo-stuttered and used speech-modification techniques with NWCFD-IISC clients in public, the clients reported that these experiences strengthened the client-clinician relationship.

Our recommendation to counselors and speech-language pathologists who desire to develop collaborative teams is to be intentional about building a professional relationship on the grounds of respect and open communication. The team members should take time to learn about one another’s professions, roles and clinical responsibilities. We have observed during the training of our interns that speech-language pathologists are often focused on outcomes and data collection, whereas counselors are often more focused on process elements and the clinical relationship. It is essential to see both sides of the team as contributing to the overall impact in a unique way. The team members will work to support one another’s strengths and weaknesses.

Counseling interventions

The NWCFD-IISC uses an ACT framework. ACT was chosen because it provides a strengths- and skills-based approach grounded in mindfulness and psychological flexibility. ACT explores human suffering as it relates to psychological inflexibility. Using this framework, PWS learn to more fully focus on the present moment, become more accepting of their thoughts and feelings, and take steps toward acting in alliance with their personal values.

Several studies have supported positive results regarding the efficacy of ACT when applied to stuttering. In addition to this supported efficacy, we think that ACT closely aligns with the philosophy of the NWCFD-IISC. Our philosophy of treatment involves clients and students taking a team approach to understand, accept and effectively manage thoughts, emotions and behaviors related to stuttering. This is accomplished through generalized experiential activities, group education and discussion, and individual and group counseling.

ACT can be understood through the six guiding principles on the ACT hexaflex. These six principles are acceptance, thought defusion, mindfulness, self as context, values and committed action. Investigating how each principle applies, we can begin to understand the process of counseling PWS through an ACT lens.

1) Mindfulness: Clients who stutter often avoid the present moment by judgmentally reviewing the past or worrying about the future. Clinicians can help PWS to connect with the present moment through the use of meditation and mindfulness activities. Encouraging mindful practices can be a goal to incorporate in counseling.

2) Acceptance: PWS often feel like they have no control over their stuttering. Regardless of what they do, a stuttering moment may or may not arise. In these moments, PWS can choose to talk, choose to stutter openly and choose to acknowledge all the thoughts and emotions related to stuttering. Clinicians can help PWS explore acceptance of their thoughts and feelings. PWS do not need to like the thoughts or emotions they experience or enjoy stuttering. However, they can experience their thoughts or emotions as they surface without judgment.

3) Thought defusion: PWS have a tendency to overidentify with their thoughts or feelings, enabling these thoughts and feelings to become mental truths that cause inflexibility within the thought process. PWS may attempt to mentally avoid stuttering or become overwhelmed trying to control their speech. Additionally, PWS may feel certain that other people will reject or harshly criticize them, thus causing them to avoid social contact.

Clinicians can help PWS to explore and express all thoughts — helpful and unhelpful — about their stuttering. By unhooking from the thought or emotion, PWS can experience more psychological flexibility in relation to the context that the thought or emotion is occurring within.

4) Self as context: Individuals often associate with expressions in the form of labels, such as “I am smart” or “I am dumb.” These labels relate to content, not context. Individuals may define themselves in terms of content instead of context to fuse with thoughts and emotions that may be either known or unknown. PWS use self-as-content behaviors to avoid facing the reality of stuttering. PWS may think, “I stutter. That’s all I do. Because of my stuttering, I do poorly in school and never meet new people.”

Clinicians should explore with PWS how these thoughts about self are related either to content or context. Reinforcing flexibility in self-identity is key because it allows PWS to adapt more flexibly to novel situations.

5) Defining values: As described by Jason Luoma, Steven Hayes and Robyn Walser, in ACT, values are defined as “constructed, global, desired and chosen life directions” that can be expressed as adverbs or verbs. When exploring values with PWS, the notion of choice is important to discuss. Choice connotes the flexibility and autonomy they possess in defining what guides their behaviors or life direction.

A common values activity involves the “eulogy exercise.” During this activity, PWS visualize what a close friend would say at their funeral. Clinicians might even direct PWS to write down the values that were expressed during the eulogy: “He was a kind person” or “She was a caring friend” or “He was a compassionate individual.” Clinicians can then discuss these values with PWS and explore how these values are currently manifested and how they can become lost. Building awareness of what values are important in a person’s life can encourage these clients to persist through the difficult times they face.

6) Committed actions: ACT explores the concept of choice in alignment with values-based goals. When clients feel ready to initiate steps either within or outside of counseling, exploration of these committed actions in the counseling session is warranted. For PWS, committed actions could be used by encouraging challenging stuttering situations. For example, PWS may choose to take action directed at speaking situations during dating, during novel social interactions or within work settings. Committed action is the stage of counseling that encourages the synthesis of the tools within the complete hexaflex. PWS learn to engage in a way that is adaptive and flexible to their external and internal worlds.

Summary

Counseling PWS can be a rich and rewarding experience. Through our work in the NWCFD-IISC, we have built lasting connections with individuals in the stuttering community and learned how to form strong interprofessional teams that enhanced our understanding of two professions. In working with PWS, understanding the specific population concerns is key to effective treatment. Additionally, collaboration with professionals in the speech-pathology discipline can further enhance treatment experiences for PWS and for all professionals engaged in the collaboration.

 

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Chad M. Yates is a licensed professional counselor and an assistant professor in the Idaho State University (ISU) Department of Counseling. He has served as the mental health coordinator for the Northwest Center for Fluency Disorders at ISU for several years. He helped to develop the acceptance and commitment therapy (ACT) manuals and procedures for clients and clinicians at the clinic and supervises the counselors providing ACT. Contact him at yatechad@isu.edu.

Karissa Colbrunn is a school-based speech-language pathologist in Pocatello, Idaho. She is passionate about merging the values of the stuttering community with the field of speech-language pathology.

Dan Hudock is an associate professor at ISU. As a person who stutters, he is passionate about helping those with fluency disorders. One aspect of his research involves exploring effective collaborations between speech-language pathologists and mental health professionals for the treatment of people who stutter. He is the director of the Northwest Center for Fluency Disorders. For information about research, clinical or support opportunities, visit northwestfluency.org.

Letters to the editor: ct@counseling.org

Counseling Today reviews unsolicited articles written by American Counseling Association members. To access writing guidelines and tips for having an article accepted for publication, go to ct.counseling.org/feedback.

 

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Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.

Counseling people in the performing arts

By Bill Harrison April 10, 2018

Actors, dancers, musicians and other performers are vulnerable to a variety of challenges and clinical issues that are unique to those who choose to make their living using their creative talents and skills. Although artists are people just like the rest of our clients, I believe it is important for counselors to have a framework for conceptualizing the idiosyncratic personal, cultural and professional contexts in which many performers live. As Linda H. Hamilton says in her excellent book The Person Behind the Mask: A Guide to Performing Arts Psychology, “Catering to the special needs of performers is important because of the unique psychological, biological and social stressors related to this vocation.”

My knowledge about the performing arts community comes from many years of personal experience. I became a counselor after working as a professional musician and an occasional actor since the late 1970s. I have played, toured and recorded as a jazz and pop musician. I have also performed in theatrical pit orchestras for many national tours and local productions here in Chicago. I am trained in the acting methods of Sanford Meisner and have worked onstage and appeared in independent films and commercials.

As a counselor, I have been fortunate to work with a diverse cross section of artists, combining my counseling training with my intimate knowledge of the music and theater business. Even so, my clients have been my best teachers. In my view, performers are an underserved clinical population worthy of serious consideration by more counselors. There are, after all, many more actors, dancers and musicians who need counseling than there are clinicians who used to be performers.

Life onstage is analogous in many ways to life as an athlete. The performing arts and sports are inherently stressful professions because of the high expectations of both the audience and the people who have the power to hire and fire. Success in both fields depends on a lifetime of training and constant vigilance, both in maintaining awareness of one’s self in relation to the work and in maintaining one’s skills. Although a great deal of research and attention have been focused on sports physiology and psychology, relatively little clinical attention has been paid to performing artists. The few books available on the subject are largely outdated, and the scholarly literature is scant. Hopefully, this situation will improve in the near future.

What are the life factors that distinguish performers from other individuals who make their way to our counseling offices? It is useful to discuss this population using several contexts: developmental, career, performance-related and societal. Each context has both case conceptualization and treatment factors.

Developmental considerations

Many performers began their training as young children. Some can barely remember when they began to exhibit signs of talent. They may have been singled out as “special” among their siblings or classmates if they showed an aptitude for singing, playing an instrument or dancing.

Counselors should pay particular attention to these clients’ attachment issues with both parents and teachers. Were caregivers supportive or resistant to their child’s talent? Did the client feel encouraged, pushed or dismissed in relation to his or her natural abilities? Was the child considered a prodigy? Did the parental emphasis on performing distract from focusing on social and emotional development?

Many artistically gifted children display a poise that is easily mistaken for emotional maturity. As a result, the normal childhood needs often are either ignored or derided as “childish.” The prodigy label often comes with potentially unhealthy complications, given that 3- and 4-year-olds are incapable of making life-altering decisions for themselves.

Early teachers of these children may have been supportive and loving or harsh and critical. For many young performers, competition for coveted positions can be intense. Children are keenly aware of the talent/skill hierarchies. Were they chosen for the best parts or overlooked? Did they land spots as lead actors in plays, prima donnas in the opera, first-chair players in the orchestra or principal dancers in the ballet? If they are relegated to secondary roles, some children feel that they have somehow failed. This can have repercussions when similar situations occur in their adult lives.

All of these factors play major roles in the personality development of performers. Young children who demonstrate a natural affinity for a certain area of performance are vulnerable to overidentifying with their talent. Counselors need to be aware that a client’s degree of healthy narcissism may be directly linked to his or her perceived level of artistic ability. Besides being treated as special and having to compete, young performers can become socially isolated and lead a very unbalanced life that consists almost exclusively of developing their artistic gifts at the expense of emotional and interpersonal growth. This can become problematic later in life, if and when the client realizes that there is more to life than performing. And in relationships, there is a risk that performance can substitute for genuine intimacy.

Career considerations

A performing artist’s career trajectory is often short and always unpredictable. Unlike in many other professions, there is no clear-cut path to professional success or advancement when you act, play, sing or dance for a living. No amount of natural talent or advanced training can predict success with any reliability. Talent or skill may not matter nearly as much as happenstance, luck or physical appearance (principally for actors and dancers).

Although things seem to be changing incrementally, considerable racial and gender bias still exist in casting. With the dearth of acting and dancing parts for women over 35, it is difficult for women performers to sustain a career much past that age. Issues related to stereotyping and appearance aren’t that much easier for men.

In addition, the ability to earn a living is quite limited for most performers. For example, in 2008, The New York Times reported that only 5 percent of Screen Actors Guild-American Federation of Television and Radio Artists members earned at least $75,000 annually. Actors’ Equity Association, the union representing the world of live theatrical performance, reported that during the 2013-2014 theater season, only 9 percent of its members earned more than $50,000. On average, just over 13 percent of unionized actors were working in any given week that year; their median annual income was $7,463. According to HuffPost, in 2012, the Future of Music Coalition estimated that full-time musicians earn an average of about $34,000 per year.

Low income is just one stressor in the life of most performing artists. A 2015 Australian study, “Working in the Entertainment Industry,” reported strong correlative evidence that underemployment, employment uncertainty, unregulated working conditions and the societal devaluation of artistic work often precede the onset of emotional and cognitive impairment. The large majority of actors, dancers and musicians have to secure secondary employment to make ends meet. The number of performers who continue working past age 30 declines precipitously. The researchers interpreted this to mean that as people begin to focus on their non-arts-related life (marriage, family, home ownership, financial stability), they are more likely to give up on their artistic ambitions and “get a real job.”

The authors of the study concluded “that there is ample evidence to support the assertion that the work environment of the creative person is … fraught with difficult and challenging circumstances. These include performance anxiety, work overload … career anxiety, a lack of career mobility, irregular working hours, high rates of injury, low financial rewards, [having to maintain] high standards of performance, financial insecurity and sporadic work.”

It is crucial for counselors to recognize these professional limitations for people in the performing arts and to keep them in mind as we would for any kind of cultural context.

Performance-related considerations

People in show business expose themselves to some of the most physically and psychologically stressful conditions on an everyday basis. Auditioning, rehearsing and performing require intense concentration, focused energy, strong self-confidence and years of preparatory work. Work hours can be extremely demanding. Knowing that a hundred people are waiting in line behind you to take your job if you falter is nerve-wracking. For these reasons, performers are at risk for anxiety, loss of motivation, difficulty concentrating, burnout, physical injuries, low self-esteem, poor emotional regulation, sleep disruption and crises of confidence and identity.

Because most performers work as members of an ensemble, there can be difficulties with group dynamics or conflicts with co-workers with whom they may be living or traveling. In addition, the “instant intimacy” that can develop between members of a cast can sometimes pose challenges to the stability of relationships outside of the ensemble.

Anxiety and depression are common complaints among performers, just as they are for the general population. However, recent research suggests that the prevalence of both mood disorders is much higher among artists. The Australian study found evidence that performers are 10 times more likely to suffer from anxiety and five times more prone to depression. Likewise, they are three times more likely to experience sleep disorders. Performing artists have higher rates of suicidal ideation, planning and attempts; their abuse of alcohol and other substances is also significantly greater when compared with the rest of the population.

One of the most ominous findings of the Australian researchers was pointed out to me in a personal communication from the lead author of the study, Julie van den Eynde. She wrote that the researchers found “a solid link with suicidal behavior … to depression, anxiety and lack of social support. There was no link to alcohol and drug use. There were no differences in gender or age. These findings run counter to the normal population, as suicide behaviour is different for age and gender and is linked to alcohol and drug use. This means that creative artists and performers are a different and separate group.”

In other words, this population is at higher risk for suicidal behaviors regardless of other factors such as age, gender and substance abuse.

Societal considerations

Despite the performing arts contributing so much to the enjoyment and enrichment of people’s lives, performers are often treated as if their work has remarkably little value (with the exception of the tiny subgroup of the most popular and famous individuals). Due to the nature and intensity of the commitment that a life in the arts requires, performers tend to identify very strongly with their work. If an artist’s work is subject to the uncertainty and devaluation described in the study, then that person’s identity is at risk.

As noted earlier, earning a living wage from performing is difficult for the majority of artists. As is the case for any client whose income is below average, artists are more vulnerable to the societal biases against people who aren’t comfortably middle class, don’t have health insurance or lack a high credit score.

Art often serves society by expressing cutting-edge ideas, including criticism of the status quo. This artistic purpose is often undertaken by people who are most impacted by racism, sexism, genderism, ableism, etc., and who make up a substantial portion of the artistic community. Societal marginalization can contribute significantly to myriad therapeutic issues. Although performing can serve as an emotional outlet for minority populations, the extent to which their ability to express themselves publicly improves their mental health will vary from person to person.

Clinical considerations

It almost goes without saying that performance anxiety (aka stage fright) is often the issue that brings people in show business into the counseling office. Many performers experience stage fright before every show. Famous sufferers include Laurence Olivier, Scarlett Johansson, Ella Fitzgerald, Adele, Pablo Casals, Mikhail Baryshnikov, Vladimir Horowitz and Renee Fleming.

But for many artists, auditions provoke the most anxiety. Auditions present a perfect storm of conditions almost guaranteed to induce performance anxiety in even the most seasoned artists. There is a saying among actors: “Auditioning is your vocation; working is your vacation.” Anxiety before and during auditions arises from the belief that a negative judgment of one’s performance equates with humiliation, embarrassment or personal rejection. Actors face this kind of scrutiny each time they read for a role; rejection is a normal facet of life for them.

Perfectionism is another anxiety-related malady that may surface in counseling sessions with performers. It may present in conjunction with excessive procrastination, practice or rehearsal avoidance, guilt, anger, self-criticism or blaming others, eating disorders and suicidal ideation. As pointed out in Robert H. Woody’s 2015 Psychology Today blog post titled “Perfectionism: Benefit or detriment to performers?” some performers exhibit narcissistic traits that may be associated with perfectionism.

Depression is precipitated in this population for many of the same reasons that anyone else might experience depression. However, some performance-related triggers for depression include:

  • Being overlooked for an audition
  • Despairing over not getting a coveted part
  • Sustaining a career-threatening injury
  • Being confronted with an inability to start (or finish) a long-dreamed-of creative project
  • Being forced to choose between one’s performing career and the demands of one’s romantic or familial life
  • Contemplating leaving a profession that has defined one’s identity

Although certain myths persist about the prevalence and glorification of drug use among performers, substance abuse is a real problem for many actors, dancers and musicians. The combination of high stress, employment uncertainty, low income, inaccessible health care and easy availability of alcohol and other mood-altering substances results in a higher-than-average probability that these clients may be affected by substance abuse and addiction. During intake, counselors should assess for drug and alcohol use, particularly with clients who present with anxiety or depression.

Social isolation, chiefly among musicians, is another common issue. Young people with musical talent, especially those singled out as prodigies, must spend many hours a day practicing their craft. In some cases, this single-minded approach, though perhaps necessary for achieving virtuosity, can lead to social anxiety, poorly developed social skills and difficulty forming intimate relationships. Adult performers who present with social anxiety may have long-established patterns of self-isolation resulting from intensive practice regimens begun in childhood. For a deeper understanding of these issues, I highly recommend Andrew Solomon’s chapter on prodigies in Far From the Tree: Parents, Children and the Search for Identity.

Many performers, and artists more generally, are what Elaine Aron calls “highly sensitive people” or HSPs. They tend to be aware of subtleties in their environment and are likely to have rich and complex inner lives. Although such sensitivity can be a real advantage in their chosen profession, our culture, unfortunately, has little tolerance for highly attuned or easily overwhelmed individuals. They are often thought to be overly fearful, inhibited or neurotic. Although some HSPs may exhibit these traits on occasion, they are not inherent characteristics of this personality type.

The majority of the people in the lives of HSPs may find them difficult to understand because of their sensitivity, their inability to relate to other people and so on. High sensitivity may open another pathway to the mood disorders and social isolation often seen in this population. Aron’s research on HSPs is invaluable with regard to performing artists.

Finally, it would be remiss not to mention the controversial relationship between mental illness and artistic talent. There are those who contend that a direct correlation exists between creativity and the prevalence of bipolar and schizoaffective disorders among artists. Kay Redfield Jamison makes a strong case for this link in her book Touched With Fire: Manic-Depressive Illness and the Artistic Temperament. Contemporary neuroscience has produced evidence both supporting and contradicting this point of view.

Performers are often perceived to be more narcissistic than are members of the general public, although no real evidence exists to suggest that narcissistic personality disorder is more common in this population. Counselors should be aware of their own biases in this regard while maintaining an open mind about the possible presence of mental illness and personality disorders in their artistic clients.

Challenges to counselors

Performers will challenge counselors in a variety of ways. Some may treat their therapy hour as a kind of performance. Actors are notably accustomed to impressing and entertaining strangers, so they may initially prefer to hide their vulnerabilities behind a veneer of cheerfulness (despite having perhaps complained of terrible anxiety when calling to make the appointment). Some members of this population may see you as an authority figure, akin to a “stage mom” or a demanding teacher or director. Monitoring these kinds of transference possibilities is essential to creating a strong therapeutic alliance and allowing your work to proceed productively. Likewise, it is crucial to pay attention to your own countertransference. How are the clients’ projections influencing you? Is their charm or likability getting in the way of accurately assessing their therapeutic needs?

Some performing artists have a difficult time expressing themselves verbally. This is where your creativity might come into play. If clients seem unable to put their feelings into words in session, you might suggest that they write something between sessions or perhaps bring in a monologue from a play that conveys what they lack the words for. I had a client who had trouble discussing her feelings directly but would write and perform her poetry as part of our work. Another client played his instrument in a session to express something that he couldn’t verbalize. Even if you are not trained as an art therapist, you can encourage artistic clients to find alternative ways to communicate emotionally.

Actors and dancers might ask you to attend one of their shows. Musicians may want you to come to a recital or a gig at a bar or club. They might bring in CDs or DVDs of their work and ask you for your assessment. These requests bring up thorny issues for counselors. Do you bend your boundaries to attend a performance? Do you accept a recording, and if so, do you agree to listen (or watch) and offer an opinion? I don’t think there are universal answers to these questions. As always, if you’re unclear on what’s best for your client (and your professional boundaries), seek consultation or supervision.

Counselors know that the “why now?” question is always important, but it could be useful to know that performers often seek help at certain predictable points in their lives. Psychiatrist Peter F. Ostwald, in his article “Psychotherapeutic strategies in the treatment of performing artists,” suggested a few such points: at turning points in their careers, when they seem to be faltering or failing professionally, after a career-threatening injury and when they feel overwhelmed by career-related loneliness.

One final set of challenges directly impacts your ability to work with this population. As previously mentioned, many artists don’t earn a lot of money and often lack health insurance. Scheduling also can be difficult because many performers work full- or part-time day jobs and have either rehearsals or performances during the evenings and on weekends. Counselors must be clear in their decision-making process regarding their desire and ability to be flexible with their fees, schedules or both. Adjusting your professional boundaries should be done carefully and deliberately to ensure that you are able to provide excellent care without resentment.

Concluding thoughts

Life in the performing arts has its rewards, but it is also a difficult and often frustrating way to make a living. The people who choose to pursue the arts professionally make many sacrifices to bring to life diverse forms of expression. There is exceptionally little glamour in show business, despite what you might see on an Academy Awards or Grammys broadcast. I am regularly amazed at the reactions I get when I tell people that I have played for Broadway shows, at a certain jazz festival or on a TV show. Invariably, folks will exclaim how much fun that must have been and how envious they are of these experiences. Yes, it can be thrilling to perform under certain rare circumstances, but most of the real work of artists is unseen, and most opportunities to perform occur under far-from-ideal conditions.

I have tried to provide a comprehensive overview of the psychological and cultural milieu of performers, and to suggest some new ways to think about the unique issues that counselors may encounter with this population. If you provide mental health services to people in the arts, know that you are serving a group of people who truly need you. Performers contribute so much of themselves to make our world a richer, more vibrant place. As counselors, we are called on to perform the related task of helping to create a healthier, more emotionally stable environment for all.

 

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Bill Harrison is a licensed professional counselor on staff at the Claret Center in Chicago, where he specializes in the treatment of performing artists. Contact him at counselorbill1@gmail.com.

Letters to the editor: ct@counseling.org

Counseling Today reviews unsolicited articles written by American Counseling Association members. To access writing guidelines and tips for having an article accepted for publication, go to ct.counseling.org/feedback.

 

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Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.

The wise support system in domestic violence rescue efforts

By David L. Prucha April 9, 2018

A lot has been written about domestic violence, the cycles that keep people in violent relationships and how to get out of them. The commentary focuses on the role of substance abuse, the role of personality disorders and a cycle of conflict that ends with the exchange of a “never again” promise. Wash, rinse, repeat.

Although I believe these are relevant factors in violent relationships, a dynamic often emerges between the victim and her concerned loved ones, and this dynamic might play a role in keeping the violent relationship intact. It is of course sensible to think about the relationship between the abuser and the victim, but what else can we learn by looking at the relationship between the victim and her potential safety net?

If you are a family member looking from the outside in on a violent relationship, things look pretty black and white. The abuser is a bad guy. In fact, it’s probably better to use the word “evil.” He is taking advantage of someone smaller than him, he’s probably done this in previous relationships, and his promise to change can’t be trusted. He is one-dimensional: bad. The hottest place in hell is reserved for men of his ilk.

For those on the outside looking in, this is terrifying. Their loved one is in danger, she is captive, and if that wasn’t bad enough, she seems ambivalent about her chains. This leads family and friends to express their hatred for the abuser, but in their desperation, they might also express their frustration with the victim: “You’re smarter than this. I can’t believe you got yourself into this.” For those in the victim’s support system, a life might be hanging in the balance, so this seems no time to mince words.

If you are on the inside of the relationship looking outward, however, the picture can appear very different. Although the victim can certainly recognize her partner’s shortcomings, she cannot quite see what her support system sees. She doesn’t see a one-dimensional evil man.

Instead, she sees someone who is conflicted, someone who hates himself, someone who can’t get a grip on his emotions. Because she knows the “inner him,” she struggles to reconcile the blunt feedback from her family with the person she loves. The two pictures just don’t add up.

Could her partner really be as manipulative and cold as they say? Surely not. His regret and anguish are sincere. She has witnessed him cry out of self-hatred, and evil men don’t do that. He is broken but not bad. He wants to change, and she can’t imagine leaving because she doesn’t want to be like everyone else who has left him in the past.

 

A disciplined rescue

Before people are open to receiving help, they have to trust that the complexity of their problem is well-understood. When families characterize their loved one’s abuser as pure evil, a demonic caricature with cloven hoof, it delegitimizes their feedback, because for the victim, this evil cartoon character is nowhere to be found. In fact, the blunt feedback often has the opposite effect — it reinforces for the victim that the goodness of her partner isn’t being taken into account. This hardens her conviction that she is alone in understanding the situation, and this has the unintended consequence of further isolating her.

Given that explanation, what can be done? One way to intervene is to help the victim understand that there is a difference between evil people and destructive people, but both types of people can do the same amount of damage. In making this distinction, it validates that her partner is not a one-dimensional monster without dismissing the fact that a destructive reality still exists that needs to be addressed. This approach doesn’t isolate the victim from her support system. It also helps her understand why her situation feels so gut-wrenching: She has to leave someone who is partly good.

But partly good is not good enough. When we offer the truth that people are never entirely good or entirely evil, we offer an alternative worldview that enables victims to refine their partner-selection process in the future.

No longer should they reassure themselves if a destructive person shows goodness, because displays of goodness are no longer sufficient criteria for choosing a partner. Instead, the criteria become more nuanced. Despite the display of goodness, is this person also destructive? Victims learn that the presence of goodness and vulnerability are not the only variables to consider.

A second way to help is to teach victims that empathy is a morally neutral disposition: It can lead to both health and destruction. After all, the best predators use empathy to scan for the psychological vulnerabilities of other people. This maximizes predators’ ability to exploit.

In the cases of victims of domestic violence, their empathy is doing them harm. They are spending too much time thinking about how leaving the relationship would impact their partner and not enough time thinking about how they are themselves being harmed. Their high capacity for empathy has led them to walk around in the mind of their abuser for far too long, thinking his thoughts and feeling his feelings. The victim is not in her situation because she is foolish but because she has not learned how to manage her empathic impulses. Learning how to power down her empathy is vital, and she can do this by learning how to reprioritize her own needs.

Reprioritizing her needs can lead to feelings of guilt, and this comes from a sense that she is being selfish. The victim is in the habit of giving 100 apples to her partner without taking one for herself, so now taking 50 apples feels incredibly wrong. However, with the right help, she can learn that meeting her own needs is not selfish but is instead necessary to be truly generous.

In fact, when we compulsively engage with something that damages our well-being, it is not generosity — it is addiction. The person with alcoholism no longer enjoys the drink, and the person addicted to empathy no longer enjoys giving. Instead, they both feel bound to their habits. It’s not that virtue motivates the victim to give away the 100 apples; it’s that she doesn’t know how to give less than 100 apples away.

When victims learn that empathy has become a force for harm in their lives and that true generosity can’t flow forth from inner compulsion, the sense of virtue that they previously associated with staying in the relationship is tarnished. It isn’t that the abuser is without a gradient of goodness; it’s that he is still profoundly dangerous. It’s not that she is motivated by virtue; it’s that her empathy has kept her from seeing that her needs for safety and love should be more important to her than his need to avoid anxiety or sadness.

The hope is that thinking about how support systems can unintentionally create defensiveness and isolation in victims of domestic violence will lead to better rescue strategies. Although it feels repugnant for support systems to acknowledge the goodness in the victimizer, in some cases this might allow the victim to see more clearly the destructiveness of her partner. If members of the support system are able to stop themselves from accusing the perpetrator of simply being evil, this might lead the victim to feel powerfully understood. Perhaps the intimacy of feeling understood will increase the victim’s trust in the bridge away from her relationship and into the arms of those who love her.

 

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David L. Prucha is an adjunct professor of psychology at Johnson and Wales University in Denver, Colorado. He is also a licensed professional counselor who maintains an independent practice that specializes in depressive disorders, anxiety disorders, and trauma and stressor-related disorders. Email him at contact@pruchacounseling.com.

 

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Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.