Tag Archives: Counselors Audience

Counselors Audience

Examining our assumptions about emerging adulthood

By Peter Allen June 12, 2017

For many counselors and educators, the term failure to launch is a familiar part of the American lexicon. Some have referred to this phenomenon as an “epidemic,” and a few prominent clinicians have even described it as a “syndrome.”

This classification is problematic for a number of reasons, including that it fails to consider the longer arc of human history and development. Referring to our clients as having “failed to launch” begins the relationship with judgments and disconnection rather than a sincere desire to understand and help. When we commence our helping relationships by adopting a judgmental and comparative stance, we start off on the wrong foot with our clients and communicate to them that we have little to learn. This is, in effect, very poor modeling of the skills and traits that we hope to instill in them.

The problem

What do we mean by failure to launch? Usually this language is used to describe young adults, typically between the ages of 18 to 25 or so, who have not met the traditional benchmarks of adulthood in some fashion. The stereotype usually depicts young 20-somethings who are living in their parents’ basements, playing video games and generally not contributing to the household in a meaningful way.

In general, we observe a lack of motivation and a delay in the acquisition of skills and traits that we typically associate with adulthood: financial autonomy, independence, stable relationships, responsibility and some sense of obligation to society or the collective. We want our adolescents to grow into mature, productive adults. Because numerous examples of these adults are readily available for view, the contrast between them and the so-called failure-to-launch crowd becomes striking.

The English word adolescence comes from the Latin word adolescere, which means “to ripen” or “to grow up.” This is important because young adults, despite some thinking to the contrary, are very much still in adolescence. They are in the period between childhood and adulthood, with a foot in both worlds, so they exhibit characteristics of both stages. This presents unique challenges for those of us who encounter them in this in-between stage.

Although we basically understand what adolescence is, when it ends depends on the culture in which we were raised. For example, in Mexican culture, the quinceañera is held for young women at age 15. This coming-of-age celebration marks the beginning of adulthood in that culture. The Jewish faith marks this moment at age 13 with the tradition of the bar mitzvah and the bat mitzvah. In Japan, an event called Seijin no Hi (Coming of Age Day) occurs at age 20 and marks the passage into adulthood. The Chambri people of Papua New Guinea, sometimes called the “Crocodile People,” use ritual scarification to mark the passage of young males from childhood to adulthood. This ceremony can take place anytime between the ages of 11 and 30.

It is interesting to note the difference in timing for these cultures. I am particularly struck by the range of ages in the Chambri custom. They have perhaps come closest to identifying the actual biological range within which adolescence occurs.

Taking a cognitive behavior approach

Young adults are sometimes just beginning to evaluate the power of their own thinking to positively or negatively shape their world experience. There can be some confusion about the difference between thoughts and beliefs. In my own evaluation, a belief is simply a persistent thought that has become true or seems real to the person. For instance, if I have the thought that God exists, and if I think this way for long enough, it becomes a belief.

I like to use a story that I call “A Tale of Two Apple Trees” to teach this concept. In this story, I have an apple tree on my property. I have a lot of thoughts and beliefs about this apple tree. This apple tree is my property. I bought it, I watered it and I fertilized it. So when a stranger walks by and picks one of my apples, how do I feel? I feel angry. What am I likely to do with my anger? I am likely to have a confrontation with this person. My beliefs led to my emotion, and my emotion led to a behavior.

My neighbor also has an apple tree in her yard. Like me, she has a number of thoughts and beliefs about the apple tree, but they are quite different from mine. She believes that everyone deserves to have food. She also thinks that because she has many dozens of apples on her tree, she can certainly spare a few for someone who wants them. So when someone walks by her property and picks an apple to eat, how does she feel? Most likely she feels happy. What is she likely to do? It is likely she will approach this person and have a positive interaction. Her thoughts led her to certain feelings, and those feelings precipitated specific behaviors.

The point here is not about determining the true nature of apples and apple trees in the world. The point is that, objectively, the same thing happened to both of us: Someone picked an apple off of a tree in our yard. But our respective experiences of that event were drastically different. Based on my beliefs, I experienced anger and then behaved in a confrontational manner. My neighbor experienced happiness and then behaved in a friendly manner. We all must choose what to believe based on our life experiences and what makes the most sense to each of us.

As clinicians and educators, I think we have collectively failed to monitor our own thinking about this population. We know that thoughts lead to feelings, and feelings can lead to actions. Are we applying this knowledge to ourselves in our work with young adults? We should acknowledge that we have chosen certain beliefs about young adults and, as such, these cognitive structures are negatively influencing our experience of working with this population. One of my goals is to bring those structures into our awareness so that we can nobly wrestle with them and make more assertive decisions regarding how we are going to show up in relationships with our clients.

When we use the term “failure to launch,” we clearly display our belief that the young adult has failed in some capacity. I have also heard this called prolonged adolescence; in other words, this particular period of adolescence is taking longer than normal. Who determines what is normal? Struggling is a word often used with this population. They are certainly not thriving and not succeeding like their counterparts, who have not been labeled as “struggling.” Even the term late bloomer, which on the surface seems gentler, indicates that these individuals are not on time in their development.

Let’s assume that you came to see me, a counselor, to help you work through some issue. Perhaps you and your partner come in for couples counseling to work on better communication. How would you feel if I said to you, “Sure, I can help you with your failure to communicate”? My guess is that you would experience an immediate disconnection from me because you may not perceive yourself in that way. I am starting out from the position that you have failed. Or maybe you want to become more assertive with your parent, and I respond by saying, “I would be happy to help you while you struggle to assert yourself with your parent.” Wanting to work on something is not the same thing as struggling with it. This language betrays my internal dialogue about you.

We know that we cannot think ill of our clients, even unintentionally, and then hope to show up with compassion and warmth for them in session. There is a discipline involved in thinking well of clients, actively, so that their best interests are always at the forefront of our efforts. If we begin our work with young adults from a judgmental place, then our feelings and behaviors will follow accordingly.

That is why I advocate for a term I encountered while researching this subject: emerging adulthood. I believe this is a judgment-free term and one that is actually more accurate. Then our primary cognitive framework can begin from an understanding that these people are emerging as adults, in their own individual way, and there may be some issues or difficulty for them during this period.

Around the world

Many factors contribute to the belief that emerging adults have failed in some capacity, but one factor in particular has a very powerful influence on our perceptions of how young adults are developing — whether they leave their parents’ homes within the “proper” time frame. According to the Pew Research Center, in 2014, 32 percent of young adults ages 18-34 were living at home with their parents in the United States. This number is likely higher than most readers might have guessed.

As I thought more about this, I wondered how the rest of the world views this issue. Fortunately, the Pew Research Center has collected extensive data about young adults living at home in Europe. According to this research, Denmark is at the lowest end of the spectrum in Europe, with about 19 percent of young adults ages 18-34 living at home. At the high end of the spectrum is Macedonia, where about 73 percent of young adults in the same age range live at home with their parents. Most of Eastern Europe is in the 50 to 60 percent range. Most of the Scandinavian countries are in the 20 to 30 percent range. Why is there no failure to launch “epidemic” there?

In much of Latin America, including Central and South America, it is common for young people to live at home with their parents until they have completed school, partnered with someone in a long-term romantic relationship or begun their career. In an article from 2007, psychologist and researcher Alicia Facio and her team found that 71 percent of Argentinean emerging adults lived with their parents or other relatives.

Let’s turn to Asia for a final example. A 2014 Huffington Post article titled “Here’s Why It’s Not Weird for Indian Men to Live at Home With Mom and Dad” stated: “Typically, in the Indian culture, returning home after high school or college is not only encouraged, but expected. Even living in America, parents who have migrated here from India have instilled in their children the idea that living with their parents is how Indian ‘joint-families’ work. Most children will stay with their parents up until marriage and some even after marriage, and the Indian ‘society’ accepts this as the norm. There is no taboo, no judgment, and there is no shame — from the male or female perspective. Children are meant to stay with their parents to be taken care of, and as the parents grow older, the children are expected to take care of their parents in their home.”

The key part of this passage for me is the part that states there is no taboo, no judgment and no shame. Unfortunately, the American approach has plenty of all three.

There are actually numerous benefits to young adults staying at home beyond the age of 18 or 19. These benefits are not discussed much in the United States but are well-known to many other cultures around the world.

One thing young adults can do with greater success when they stay at home longer is save money. And nothing helps someone “launch” like having some money saved. In addition, with some healthy boundaries in place, the increased contact between young adults and their parents can actually lead to better long-term familial relationships. As the example about Indian families shows us, young adults who live at home longer are more likely to take care of their parents down the road when the parents may need support. The stability of this living arrangement also reduces anxiety for the young adult, and that readily lends itself to healthier development.

My assertion is that the American cultural emphasis on independence and autonomy is the driving force behind the current so-called failure-to-launch phenomenon. We want our young folks to be independent, but when they are actually capable of this varies widely from a developmental perspective. It is clear that Indian culture places a greater value on family connectivity than on independence. Therefore, there is much less pressure to get young adults out of the home, and thus they have more time to develop in a more stable environment — and with less shame. If American cultural beliefs are in conflict with the biological reality of human development, then perhaps it is our culture that should change.

If a young man is 25 and living at home in Argentina, his family is most likely accepting of this. It is normal for them. They do not see it as a problem provided that this young man is contributing to the household in some way. But a 25-year-old young man living at home in the United States is very likely to be viewed as being delayed somehow or, worse yet, considered lazy. This may be true even if he is contributing to the household, like his Argentinean counterpart. The same exact thing is happening in both situations (just like in my story of the apple trees), but our opinions of these young men depend on our beliefs about what is normal and healthy.

Integration of knowledge

This phenomenon is partly because of a failure to integrate knowledge from a variety of sources and disciplines. Practitioners in our field often draw on knowledge from psychology, but by also integrating information from anthropology, biology and sociology, we can develop a more accurate picture of what healthy human development looks like.

By now I hope I have demonstrated that the accepted timing of the path to adulthood depends entirely upon the culture in which one is raised. Biology tells us that the adolescent brain finishes developing in a person’s mid-20s. This piece of information alone should cause us to rethink our expectations of the average American 18-year-old. This neuroscience is widely known but seldom applied in day-to-day interactions with young adults.

Anthropology demonstrates to us that it is normal human behavior to live at home with one’s parents into one’s 20s. This is happening at very high rates all over the world. This discredits the idea that these other countries are all raising their young adults incorrectly and have been for millennia. This is not an “epidemic”; it is well within the range of normal human behavior. Sociology tells us that societies organized around principles such as family connectivity are sustainable over long periods of time.

When we put the knowledge from all of these disciplines together, it is fairly easy to see where we are going astray in the United States. When I presented this information to a group of clinicians, it was suggested to me that perhaps American culture is itself in adolescence. If that is true, then we should view ourselves as developing rather than as having arrived.

The counterarguments 

The principal argument I have heard repeated in many circles is that by letting our young adults live at home for a longer period of time, we will be raising a generation of infantilized people who will then be ill-equipped to manage their own lives. This is a valid concern, but I would respond by saying that the countries I have mentioned don’t seem to be creating generation after generation of incapable young people.

These cultures have been operating for centuries, continuously, and despite some current economic challenges, they seem to be making it work. If they were raising such incapable young adults, we probably would have seen their societies collapse decades or even centuries ago.

Having pointed that out, I am not suggesting that all young adults should get a free pass until age 25. On the contrary, we run the risk of enabling them by assuming, without testing them, that they are incapable of certain things. At the same time, we should rethink our basic position that a “healthy” person leaves the home at age 18 or 19 and should sail into adulthood with minimal disruptions from that point. What is healthy in the vast majority of the world appears to be leaving the parents’ home closer to a person’s early to mid-20s.

Both maturity and ability fall on a spectrum, so what I advocate for is the middle path. Some 18-year-olds are going to be very responsible and autonomous, while some 30-year-olds are going to need extra supports. We do not serve our clients well as counselors by comparing them all to the high-performing 18-year-olds. I acknowledge that in many cases young adults are experiencing significant gaps in their skills, engagement or motivation and need intervention to create healthy lives for themselves. In those instances, clinical and educational interventions are indicated.

Part of what we need to do better as counselors is ascertain exactly what the problem is before we intervene. Learning disabilities can play a large role in difficulties related to healthy development. If learning differences are a main cause of a young adult client’s stresses and problems, then it is we who have failed to adequately assess those challenges and make reasonable accommodations.

It has been mentioned to me several times that the difference between the other countries I have named and the United States is that young adults who live at home in those other countries are expected to contribute to the household. All of the clinicians I have asked about this have told me that they have worked with so-called failure-to-launch cases in which they discovered that the primary intervention was actually to coach the parents to communicate their expectations more clearly and to establish better boundaries.

My experience of young adults is that they will take a good deal — every time. So if parents offer full financial support and a free place to live with few or no obligations attached, young adults will gladly accept. This does not indicate pathology in them, however. Instead it indicates intelligence and shrewd negotiating skills, both of which transfer quite well to the real world.

The parents of young adults are often used to parenting children. After all, they have done this for most of their parenting lives when we encounter them as counselors. It requires a deliberate and skillful shift for them to begin parenting their new young adults effectively. Our job as counselors is to help them facilitate a smooth and supportive transition, not to judge them for perceived mistakes that we likely would make were we in their shoes.

In addition, when we encounter young adults and their families in our work, we should take very thorough histories so that we can understand the family’s unique culture and context and what is normal for them. From there, we can more effectively intervene for everyone’s benefit. For example, if the parents need to establish better boundaries, why would we offer intensive therapy to the young adult? If the parents have wonderful communication and boundaries, why would we presume to “teach” them something when we could be offering the young adult coaching and therapy services? The intervention must always flow from a careful and proper assessment of the situation and presenting problems.

The one-size-fits-all approach dictates that if someone uses the term “failure to launch,” then we assume the young adult is to blame for whatever is going on. This is an incredibly simplistic model for an astonishingly complicated developmental process. In short, our task as counselors is to separate legitimate clinical issues from normal, developmental ones.

Conclusion

As clinicians and educators, we need to actively monitor our thinking about young adults and choose a set of cognitions aligned with biology and normal human development. Our schools, clinics and programs need to be free of judgment-laden language that disconnects us from our clients and students.

We need to also recognize the wisdom that comes from a variety of cultures, countries and research-based science. We should acknowledge that we might have some cultural beliefs that, although deeply held, are incongruent with healthy human development. When we encounter these beliefs, we need to work publicly and privately to change them. The result will be better education and treatment for our emerging adults — and a better society as a whole.

 

****

 

Peter Allen is a licensed professional counselor and the program director at College Excel (collegeexcel.com) in Bend, Oregon. The company helps college-bound young adults who have attention-deficit/hyperactivity disorder, depression, anxiety and executive functioning deficits to succeed academically. Contact him at petercallen@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.

 

 

****

 

Related reading on emerging adulthood from the Counseling Today archives: Validating the quarter-life crisis

 

 

****

 

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.

Key concepts from Gestalt therapy for non-Gestalt therapists

By Jon Frew June 7, 2017

Several years ago, I attended a reception for a faculty member whom we had recently hired in our department. She had just completed her doctoral degree, and this would be her first academic job. She had received her training in the Midwest in a program known for its emphasis on cognitive behavior therapy (CBT). In a one-on-one conversation, she inquired about my theoretical orientation. I said I was a Gestalt therapist. She paused, looked slightly confused, then said, “Gestalt therapy? Really! I didn’t think anyone did that anymore.”

It’s not easy being a Gestalt therapist, especially when you’re teaching and supervising in a doctoral psychology program in the United States. Sometimes I encounter individuals, like my former faculty colleague, who believe that Gestalt therapy is extinct. More often I encounter individuals who have an antiquated and unbalanced picture of what Gestalt is (or was). Fritz Perls, the co-founder of Gestalt therapy, can be credited for this inaccurate picture, which has been difficult to recalibrate 47 years after his death.

When I presented on this topic at the 2016 American Counseling Association Conference in Montréal, I began with a “free association” exercise: “I say Gestalt therapy, you say …?” As expected, I heard hot seat, here and now, empty chair, techniques and the Perls prayer. I was also pleased to hear field theory, dialogue and process oriented.

One common misconception is that Gestalt therapy is a tool bag of techniques that any therapist, regardless of orientation, can employ. In fact, a technique, such as having a client imagine, then address, another person in an empty chair, can be employed by any therapist, but that intervention is not Gestalt therapy. As with any counseling approach, achieving even an elementary level of competence as a Gestalt therapist takes years of education and training.

Another misconception is that Gestalt therapy can be coupled with other counseling orientations. Many years ago, I attended a one-day workshop led by Arnold Lazarus, the “founder” of multimodal therapy. Near the end of the morning session, he announced that he was going to show a video in which he would demonstrate how he could combine Gestalt therapy with his approach. In the video, he led a client through a “two-chair” exercise (in which a client moves back and forth between “facing” chairs, enacting a dialogue with two conflicting parts of the self). I approached him during the lunch break and respectfully suggested that he was not doing Gestalt therapy. I asked if he would make a clarifying comment in the afternoon session. My suggestion and request were not well-received to say the least.

Having said that, are there aspects of Gestalt therapy that can be incorporated by counselors who are not well-trained and grounded in this approach? I believe there are, and in the remainder of this article, I will outline several of those concepts.

1) Context, context, context. In our increasingly multicultural society, the importance of considering context is becoming more obvious, regardless of one’s theoretical orientation. Gestalt therapy adopted (from Kurt Lewin) the concept of “the field” as one of its underlying philosophical foundations. In Gestalt therapy, the individual is always considered in the context of past and present field conditions or environments. Conceptualizing our clients as both being influenced by and influencing their various environments is the starting point of any therapeutic relationship.

One of the mistaken perceptions about Gestalt therapists is that we are not interested in the past. In fact, a thorough history is usually taken so that we can find key parts of the trail that led clients to their current social and emotional location. “Context analysis” is critical to effective counseling, and given the demographic shifts taking place in the United States today, our clients’ contexts are far more heterogeneous than they were in past decades.

2) Curiosity competency. I just completed a one-year training program on intercultural communication. I had to smile when my trainer announced that the most important competency in intercultural communication is curiosity. I smiled because for the past several years, I have been featuring curiosity as the most essential competency for Gestalt therapists.

Our theoretical term for this competency is phenomenological inquiry. Sitting with our clients, we attempt (as much as possible) to bracket off preexisting experiences, which would compel us to rush to judgment, to objectify and to believe we have these clients figured out. This process is not easy. After all, our academic preparation encourages us to ask questions to help us determine what box to put our clients in (diagnosis) so that we can apply the most evidence-based intervention.

The goal of phenomenological inquiry is not to classify, however. Rather, we are using our “open mind” to understand the client’s subjectivity. Paradoxically, the more we are like our clients (in regard to age, gender, race, ethnicity, sexual orientation and so on), the more essential it is to lead with curiosity, especially given the natural tendency to take shortcuts and assume we know how the story ends without taking time to read all the chapters.

In our increasingly diverse and multicultural world, it is more common to be sitting with clients who are not like us. One caveat about using phenomenological inquiry with clients who are very different from us is that it is not the job of the client to educate the counselor. Unlike other competencies that must be learned or acquired to be a skilled clinician, curiosity is innate and for most of us must be “recovered.”

3) Play no favorites. Many psychotherapy orientations place more emphasis on one particular aspect of an individual’s experience. I vividly remember watching a video of a group therapy session led by Carl Rogers. In the early minutes of the group, members predictably were engaging in intellectual exchanges. Rogers was very quiet and looked half asleep. When a member eventually began to talk about her feelings, Rogers became animated and said some version of “Now we are getting somewhere.”

Whereas client-centered therapy holds that feelings are primary, CBT places a similar emphasis on cognitions or thoughts. Gestalt therapy plays no favorites. Our clients may present with distress related to their thoughts, feelings, behaviors, dreams, sexuality, spirituality or relationships. All of those “domains” are interconnected, and at any particular moment in therapy, one may be more salient to the client than the others. As a Gestalt therapist, I trust that my clients (not my theoretical orientation) will identify the aspect(s) of their experience that is primary at any moment.

Cultural considerations will also require that therapists do not adhere too strictly to the dictates of any counseling approach, the majority of which have been developed with Euro-American values and biases. For example, how would a counselor trained to encourage clients to express feelings accommodate a client from an emotionally restrained culture?

4) The power of process. One of the hallmarks of Gestalt therapy is the attention to process, not just content. A graduate student recently approached me to inquire about joining one of my supervision teams. I asked him how familiar he was with Gestalt therapy. He said that all he knew for sure was that Gestalt therapists focus exclusively on the present. I corrected that perception and gave him a number of books and articles to read.

I think about content and process in counseling relationships in several ways. Content is the currency of therapy, what is exchanged. Content is the vehicle that drives therapy, the stories that our clients share. Content encompasses the past and the future. Process exists only in the present moment. Process is the arena for change because change cannot happen in the past or the future.

In every counseling relationship there is a rich and vibrant process that the therapist can either incorporate or ignore. The majority of counseling orientations are “content heavy.” Gestalt therapists realize that content and process cannot be separated. We are trained to pay close attention to process and to “artfully” comment about it. For example, a counselor might say, “As you talk about your former lover (content) you are speaking louder and your fists are clenched (process).” I use the word artful because it takes time and experience to become skilled at process observation and commentary.

To comment on process is to invite your client to be “in the consulting room” with you. To comment on process is to create the opportunity for a kind of “intimacy” that many clients would be uncomfortable experiencing. And yet no matter your counseling approach, there is ample evidence that the so-called “relationship factors” account for much of the positive outcomes that our clients report. Laura Perls, the other co-founder of Gestalt therapy, adopted Martin Buber’s “I-Thou” relationship beliefs as a model for Gestalt therapy. Something such as our clients feeling truly understood and appreciated by us can, in some way quite simple, be healing in and of itself.

In my experience, these occasional and fleeting moments when clients feel extraordinarily connected to their therapist (and not alone) can occur only if counselors are able to incorporate attention to process into their approach.

5) Beyond empathy. It is widely recognized in the counseling field that empathy is a good thing. Carl Rogers’ contributions to the field are well-documented. Certainly the ability to be empathetic is a necessary competency in all counseling relationships. But I would like to introduce and define another lesser-known term. The term is inclusion, and it comes to us from Buber and Heinz Kohut.

The distinction between empathy and inclusion is not absolute. There is some intersection and crossover between the two, but for the sake of this article, I will define them this way: Empathy is what it would be like for me to be in my client’s shoes; inclusion is “getting” what it is like for my client to be in her shoes.

Empathy is very useful in counseling and operates using the mechanism of projection. The Golden Rule is related to projection and empathy. We do for others what we would want others to do for us. By gaining an awareness of what it would or might be like for me if I were in the midst of a divorce with kids at stake, I can refine how I provide support to my client. On the other hand, if I become too “married” to my own experience, I might miss key differences or make inaccurate assumptions about the client’s divorce experience.

The mechanism of inclusion is phenomenological inquiry, which I defined earlier. It is closely related to the Platinum Rule: We do for others what they want done.

There are two parts to inclusion. The first is the process of truly getting (Buber used the word apprehending) our client’s experience at a particular moment in the counseling session. The second part is conveying to the client that we do truly understand and have no judgment. If we can occasionally practice inclusion at this precise level, we have moved beyond empathy, and the result will be what Maurice Friedman called “healing through meeting.” He believed, and I agree, that these powerful moments of connection between counselor and client can occur in any psychotherapy approach.

6) The funny thing about change. The field of counseling is committed to helping clients change. Most counseling theories have some fundamental philosophy about how change occurs. The funny thing about change, however, is that it is always happening. The seasons change, our bodies change, the weather changes, technology marches on, etc.

Gestalt therapy’s view of change is called the paradoxical theory of change. Simply put, change occurs naturally and organically when sufficient attention, awareness and support exist around the “what is,” not when we are preoccupied with the “what isn’t.”

Inevitably, clients come to therapy of two minds. They are 1) seeking change and relief from struggle and 2) they do not want to change. The “do not want to change” agenda is typically less apparent. As a result, counselors can easily get swept into aligning with the “desire to change” side and miss its counterpart. When therapeutic progress is not being made and treatment goals are not being met, counselors often become frustrated and question their own effectiveness. In the worst-case scenario, the client is blamed and regarded as not ready to change or “resistant.”

In my supervision groups, there is an ongoing joke that if I hear my clinicians say, “I am trying to get my client to …”
I will push a hidden button and a red alert light will flash. Of course, it is absolutely normal, for new clinicians particularly, to be enthusiastic about helping our clients change. The critical question is how we as clinicians support the change process.

Returning to the paradoxical theory of change principle, sustained (not quick-fix) change occurs when clients are able to “stay with” present experience, not flee from it. I should point out that when clients report that they feel “X” and don’t want to feel “X” anymore, I would never say, “Well the only way to not feel ‘X’ anymore is to more fully experience and resolve the ‘X’ so you can move on.” Experienced Gestalt therapists realize that our change theory is not how most individuals in Western culture consider change.

One of the key contributions Laura Perls made to Gestalt therapy was emphasizing the importance of both individual and environmental support. Individual support is what the client brings to therapy. It is posture, the breath and all of the senses. Environmental support is provided by the client’s chair, the lighting in the office, but mostly by the therapist. I believe that one of the essential tasks of the counselor is to assess the client’s sources of individual support and, over time, to endeavor to determine the kind of support the client needs from the therapist.

This last task is complex because each client is different, and there is no one-size-fits-all kind of environmental support. Different clients — and even the same client at different moments — may need the counselor to take the lead, to self-disclose, to sit in silence and so on. This ongoing attention by the counselor to maximize the level of environmental support requires attention to process, which I addressed earlier. Connecting the concepts of change and support, if clients are going to examine the “what is” or stay with aspects of their present experience (say an uncomfortable feeling), both individual and environmental support will need to be enhanced, both in the therapy hour and in their lives.

7) Watch your language and your attributes. The “fundamental attribution error” comes to us from our friends the social and organizational psychologists. They point out our tendency to “blame” or attribute responsibility to the individual. For example, a client arrives late for a counseling session and the counselor assumes some version of the client lacking sufficient motivation, not taking therapy seriously enough or not being a punctual person by nature. This type of faulty attribution is related to the deep individualistic roots of U.S. culture.

I was drawn to Gestalt therapy because it is a theory of health, not pathology, and because context is always taken into consideration. Children learn quickly that certain emotions and behaviors are not OK to exhibit in the presence of their caregivers. Creative adjustments occur over time, become rigidified and carry into adulthood. Examples would be the inability to experience sadness or to ask for emotional support, or even a self-conception of being a worthless person. These adjustments, so critical for survival and safety in childhood, are typically no longer necessary in the adult context. These disconnects between the past and present create a disturbance that counselors and the medical model often classify as “symptoms.”

Gestalt therapists do not blame or pathologize clients. Just in the past week in the training clinic where I supervise doctoral students, I have heard the following: the client is resistant, avoidant, attention seeking and dependent. I suggest that we all, no matter our theoretical orientation, watch our language when referring to our clients. These types of judgments lack sensitivity, miss the bigger picture and do not inspire the formation of a compassionate therapeutic alliance. By regarding our clients as any of these terms, we fail to seek the purpose or meaning for their behavior in the greater context of their lives, present and past.

The scientist who is studying an iceberg knows that to truly comprehend “icebergness,” there is much to take into consideration, not just the tip visible on the water’s surface. There is the larger mass of ice below the surface, the water temperature and the entire ecosystem, past and present, that provide context for the iceberg. To label a client as “difficult” or “avoidant” is to form a judgment based only on the tip of the person.

8) Co-creation, not assimilation or adjustment. In a recently published article, I wrote, “Going forward into the 21st century, I would suggest that the term assimilation be replaced with the term co-creation. Our multicultural society will be an ongoing creation with no superordinate culture as the thickest thread.”

One of my first trainers and mentors told me that Gestalt therapy was the only counseling approach he could identify with as an African American because it is not an adjustment therapy. That comment has stayed with me many decades later. Although individuals must creatively adjust to their childhood circumstances, Gestalt therapists do not encourage their clients to adjust to the values and expectations of the dominant majority culture.

Assimilation has been used in the Gestalt literature to describe a process in which the individual selectively accepts the value of some aspects of the environment while rejecting others. The concept of assimilation is also problematic though because it suggests a process of “making like” or “causing to resemble.” In fact, there is another term, assimilationism, that is defined as “the policy of absorbing minority groups.”

At its essence, Gestalt therapy is about honoring the potential and unpredictable outcomes of the ongoing meetings that occur daily between individuals. Through those meetings, both parties are changed, and new experiences and realities are co-created. Given our current political context, I would assert that this concept of co-creation be embraced to counter a resurgence of xenophobia and “disinclusion” of non-like others.

Counselors have the privilege to participate in very special (dare I say sacred) kinds of meetings with their clients. I would urge all of us to be wary about becoming, wittingly or unwittingly, agents of systems or agendas that promote adjustment or assimilation to the “thickest thread.”

 

****

 

Knowledge Share articles are developed from sessions presented at American Counseling Association conferences.

Jon Frew is a professor in the School of Graduate Psychology at Pacific University. He is an associate editor of the Gestalt Review and a co-author and editor of the book Contemporary Psychotherapies for a Diverse World. He is a co-director of the Gestalt Therapy Training Center Northwest in Portland, Oregon, and has been involved with the training of Gestalt therapists in the U.S. and internationally for more than 30 years. Contact him at jfrew@pacificu.edu.

Letters to the editor: ct@counseling.org

 

****

 

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.

Helping clients build their life rafts

By Angela Frank June 5, 2017

How can you judge the value of a life raft if you can’t measure the impact of the waves, the harshness of the current or the depth of the water? For clients, being in the midst of chaos feels like being in the middle of the ocean with no vessel, flailing arms in hopes that someone might see and help.

It can be hard to determine where to start to get out of a bad situation. But with the help of professionals, clients learn how to slowly build their life rafts. Not all results are immediate. It can take years for a counselor’s impact to become apparent in a client.

When I was a client in counseling as a minor, I’m sure that the helping professionals in my life questioned whether they were making any impact on me. They would likely be surprised to find that not only did they have an impact, but that I have made it my mission to pass on what I learned from them.

I remember the first time a school counselor told me that I could not only graduate from high school but that I could also go on to college. I had assumed that opportunity was lost to me because I had previously dropped out of school. No one else had ever told me it was still a possibility. I still remember the way I felt when I heard this news. I was crying because, in that moment, I felt more hope than I had felt in a very long time.

I had been subjected to a life that was excessively chaotic. Between elementary and high school, I moved eight times, was interviewed by child protective services (CPS) social workers in two different states, had to stay with a stranger while my mother was in rehab and was fostered by two other families (being removed by court order from one of them).

Upon graduating from high school, I was floored to find out that children in similar situations do not often go to or finish college. After graduating with both my bachelor’s and master’s degrees and becoming licensed in counseling, I feel safe to say that I beat the odds and the expectations of many. I can’t stress enough that I could not have accomplished these goals if it wasn’t for the professionals in my life.

The list of coping skills presented in this article may be useful in working with adolescents and adults who have had childhood trauma, but they may not work as well for people who are still in the throes of chaos. This list is best used with clients who are at a place in their lives in which they are feeling safe and no longer feeling threatened by their attackers.

Many of the action points on this list are considered therapeutic techniques, but I used them before I knew they were taught as techniques to counselors. My hope is that this list will help other counselors who might feel lost in their practice or off course with a client to find direction once again.

The following skills constitute the foundation of my life raft.

 

1) Making a timeline

For someone who has had a chaotic childhood, time might seem like an abstract concept. Collecting documents can help these clients piece memories together, make past events feel more real and provide an outside, unbiased perspective into what was happening to and around them. Documents also can be used as a tool when confronting family members who deny or don’t want to face reality.

In Washington state, anyone can search online for court case files and request public records. I have been requesting my childhood records because I need help understanding what happened in my life. I collected as many records as I could find related to my past. These include court records, CPS records, police reports and mental health evaluations.

Obtaining records has been a struggle, but it has also been one of the most important steps in confronting my trauma. They serve as a concrete reminder that, as unbelievable as it all seems, what I remember from my childhood really happened. I was able to obtain one record from CPS but was informed a previous record had been destroyed before I even knew it existed. In many states, CPS doesn’t have to inform the subjects of records that the records exist before destroying them. The records told me about the abuse I remember and didn’t report when, as an adult, now I know I should have.

My mother let me know that anything left at her house from when I was a child is gone, so these records are all I have of my past. I haven’t talked to her in six years. I offered to show my younger sister the records because she was very young when the chaos ensued and doesn’t remember a lot. I believe this step has helped both of us.

2) Sharing my story

Listening is the most basic counseling technique any professional is taught, and talk therapy is the place where trauma victims really need to start. Listening is a tool that can be used to gain the trust of clients who normally keep their thoughts on lockdown. For me, having someone there literally just to listen — who didn’t know my family, wasn’t going to tell them what I was talking about and wasn’t going to judge me — was such a relief.

My counselor had to push me a little bit to get me to talk about the trauma. I brought my counselor a copy of my CPS records and let her look at them. It was easier than saying what had happened to me. I didn’t know how to bring it up myself. I had avoided telling her that I had a traumatic childhood because I had come to counseling (or so I thought) for a different reason. After she read my records, I felt she had a better understanding of why there were destructive patterns in my life.

3) Confronting the shame

After trust is gained, clients feel more comfortable talking about how they have treated others in response to what has happened to them. This is important because clients who come from dysfunctional families might fear backlash. Their family members may have tried to use these incidences against them for blackmail or as a “guilting” technique in the past. Just the thought of bringing this up and the potential resulting scrutiny can put clients on edge.

Talking about guilt in a therapeutic setting can help clients to see patterns of shaming and let go of their guilt little by little. Once clients can acknowledge that they have hurt others, it can open up conversation about how these clients are now different. They recognize that how they treated others was wrong and can reassure themselves that it won’t happen again.

This process gives clients back the power. Shame can no longer be used against them once they recognize that part of the reason they can talk about it now is because they have taken steps to change their destructive behaviors with others and are interested in constructive interactions.

It is really hard to acknowledge when you’ve wronged someone. I had memories of how I had wronged people that haunted me for years. When I finally was able to talk about these memories with my counselor, I never sensed that she judged me for what I had done. It was such a relief to finally be able to tell someone who wasn’t going to judge me for actions I had taken when I was a kid and was in a bad place.

4) Normalizing

As a counselor, normalizing is an essential technique, but there are appropriate and inappropriate ways to use it. It is appropriate to use normalizing to help clients recognize that they reacted harshly to a situation because that is how they grew up — as long as they are taught or have learned more constructive ways to handle tough situations. Children have little control, but adults are more responsible for their behavior. Discussing how destructive reactions are inappropriate as an adult is important.

After I told my counselor about what I was ashamed of and how I had treated people, she would normalize it for me, saying, “In this situation, it would be normal for you to have this reaction given your history.” When she told me that, it helped me put into perspective how the trauma affected me and why I would resort to taking certain actions instead of dealing with issues in a more functional manner. From this step, I have been able to deal with my anger, panic, and numbness in more constructive ways.

5) Practicing altruism

Clients may not always be in a position to help others financially, but there are plenty of other ways to help every day. Encourage clients to find those small but meaningful opportunities. It has been therapeutic for me to be there for my younger sister, both financially and emotionally, the way I would have liked someone to have been there for me. When I was removed by court order from a family member’s home, I didn’t get to see my sister for five years. Even though she doesn’t blame me and is understanding, this is how I am trying to make up for missing all that time watching her grow up.

6) Making amends

When clients tell their counselors about their guilt, they might feel depressed for a while after. Admitting that you hurt someone, even if it wasn’t on purpose, might not feel like enough. The next step might be apologizing in a way that feels fitting to the client. Not everyone gets a chance to face their victim and apologize, so writing a letter (which might be kept or sent to the victim, depending on whether the client feels the apology would benefit the other person) can be a very healing experience.

In dealing with my guilt, I apologized to family members because, in my agony, I hadn’t thought about their feelings or how I treated them. I offered that if they ever felt the need to confront me, I would be open to meeting with them. It has helped me to imagine these interactions beforehand. So far, none of my family members has felt the need to confront me. Instead they have told me either that I do not need to apologize or that they have forgiven me, which has brought me closure.

7) Discovering gratitude

For clients in the midst of depression or anxiety, it can be hard to elicit any positive feelings. It’s most important during these times to be grateful because the affect can snap a person out of the emotion. Making a list of what the clients have that they would be worse off without or the things they don’t want to change is a good place to start. This might also jog some really good memories, and clients might end up wanting to reach out to people. The internet is a useful tool for people searching and reaching out when the time comes.

Clients who haven’t been able to confront their past or who still feel guilt and shame might not be able to remember the people who helped them yet. Give it time — it’s a process.

I decided to use the internet to try to connect with people I remember showing me kindness when I was in despair. From becoming grateful, I was able to have more affectionate feelings toward my family and started recognizing the little things they had done to help me along the way.

Even though my mother was not in a position to care for me at times when I was a child, there are things she did that showed that she loved me and cared about me. When the time came, she gave me her tax information so I could fill out the Free Application for Federal Student Aid to finish college. She also told me I wasn’t crazy even when I was convinced I was. These actions don’t make me want to talk to her, but they do let me know that she wanted to keep me moving forward. I wasn’t able to be grateful for these little acts until I could fully accept all the trauma and stop trying to hide it from myself and everyone else.

8) Having faith

It’s well-known that possessing faith can literally keep someone alive. Being able to turn life circumstances over to a higher power can be a profoundly impactful internal resource. For me, this takes some of the pressure off regarding the goals I want to achieve. I keep working toward my goals, but it helps to have faith that forces are at work (even if I don’t understand them), giving me the power to push to get the things I want. When I’ve done all I can, that’s the time for me to just turn it over to the universe to let it take care of what I no longer have control over. I have stopped trying to maintain control of everything and have started to just let things happen.

It doesn’t matter if your faith is in a Christian God, Buddhism, Judaism, fate, Unitarian Universalism or some other system. Just having faith and truly believing that there is some bigger force out there that can’t be taken away can make a positive impact on an individual’s life.

9) Reconnecting with community

Everyone has days when he or she would rather just sit alone at home and watch TV or be on the computer. Over time, this can result in feeling disconnected and lonely. It can even be triggering, making clients feel more isolated than they actually are.

Tell clients that you understand that it can be hard to get out at times. But also remind them that simply being with others can provide a welcome distraction, result in meeting personal goals, and lead to positive feelings and new opportunities. For frugal clients, there are plenty of free events, but this might require some research.

For me, forcing myself to become part of a community and visit friends even when I didn’t feel like it made all the difference. I ended up being grateful I had made myself go. If clients tell you this same thing, talk extensively about what happened that made it a positive experience for them. This will encourage the new behavior.

10) Engaging in advocacy

There are plenty of marches going on in America right now as a way to advocate for what many believe in. Advocacy creates unity between people with similar goals, creates community, brings hope and empowers. Counselors can help by searching for groups or communities with a purpose that would help their clients move forward from their past.

I case manage children in foster care and get triggered at work sometimes because some of the stories I hear feel similar to mine. I can physically feel my heart hurt. To deal with this, I remember that there aren’t many professionals who can relate to what children in foster care go through the way I can, so I draw on my personal experience to advocate for and understand them.

11) Using a mantra

Having a reminder of what’s often forgotten or overlooked in the midst of chaos can be very comforting. This can help clients who feel stuck to keep going. When things are hard in my adult life, one thing that keeps me going is remembering that I survived much worse as a kid and have only grown stronger.

 

 

Conclusion

When people stop denying or minimizing their trauma and face their fears head-on, the resulting calm and insight are greater than the numbness brought on by burying the past. We all have our methods of coping; sometimes our coping strategies are so unique to us that we can’t even put a name to them.

Counselors have the ability to help clients find their strengths. The hard work results in feeling so empowered that clients may prefer to remember what they have already survived rather than trying to forget and feeling powerless over what they are experiencing now or will experience in the future.

Keep in mind that anyone who is sitting in front of you as a counselor has already survived a lot. Their arms are flailing for help, but they haven’t given up. There is still a chance for them. Using the techniques in this article, you have the power to help them build their life raft. You have the power to support them and be there for them as they look back on the chaos they survived, so that they can finally be free from it. Now that I have reevaluated my personal history, I want to help others recover from their own fears and trauma.

It took a long time to get to this place where I can finally face my past and not feel devastated. But now that I have, I would rather live in a cardboard box than ever deny myself again. When I tried to ignore my past, all it did was trigger me. It did not help me or those around me. I had so much anxiety that it was hard to function daily. I forgot why I was doing what I was doing and what my goals were in life. When I finally faced it head-on, I was able to reclaim myself, my confidence and my internal compass. Without the guidance I received from the helping professionals in my life, I would not be where I am today.

It might seem that some children are set up for failure, but counselors can help them find the strength within themselves to overcome. Take it from someone who knows. Anyone who is reading this possesses the power to change the course of someone’s life. Remember that.

 

*****

 

Angela Frank is a licensed mental health counselor in Washington state. She graduated from Washington State University with a Bachelor of Science in psychology and a Masters of Arts in education. She recently started a blog at highlymobilechildawareness.com and can be contacted at angela@highlymobilechildawareness.com.

 

****
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.

Preparing for the mental health impact of climate change

By Debbie C. Sturm and Lennis G. Echterling May 10, 2017

Around the globe, coastlines are encroaching on communities, summer days are sweltering and reports of weather catastrophes often dominate the news media. These examples represent only a few of the monumental and pervasive environmental effects of our changing planet.

Climate change may be the most crucial issue confronting the inhabitants of our world today. The dramatic consequences that scientists have been predicting, such as rising sea levels, record-setting high temperatures and an increase in devastating natural disasters, are no longer theoretical. Although some still argue the point, climate change is now a grim reality, not a vague possibility in the distant future.

As devastating as these consequences are on our physical world, climate change also poses enormous threats to our psychological well-being. In a report released in 2012 by the National Wildlife Federation’s climate education program, with support from the Robert Wood Johnson Foundation, researchers predicted a sharp rise in mental health issues resulting from events related to climate change in the coming years. These issues include depression and anxiety, posttraumatic stress disorder, substance abuse, suicide and outbreaks of violence. The elderly, the poor, children and members of the military (and their families) were identified as being among those who will be most psychologically vulnerable.

We believe the counseling profession, which has its conceptual roots in the promotion of human growth and development, must play a more active role in addressing the mental health impact of climate change. For many decades, counselors have worked closely with countless individuals to help them achieve fulfilling careers, realize self-actualization, strengthen personal resilience and seek social justice. Recently, counselors have gained greater acceptance as valuable members of crisis and disaster response teams.

Our extensive training and experience in enhancing well-being enable us to serve as effective catalysts for positive change. Now more than ever, counselors are in a position to shape messaging and lead the way in effective prevention and intervention related to the psychological implications of climate change. This includes promoting climate resilience, strengthening disaster response programs and advocating for vulnerable populations.

Climate resilience and climate refugees

In January 2016, the Department of Housing and Urban Development announced a $48 million grant to move an entire indigenous community from Isle de Jean Charles, Louisiana, before the land disappears into the Gulf of Mexico. This marks the first allocation of federal dollars to permanently move an entire community impacted by climate change. These displaced people are now known as climate refugees. The main purpose of the grant is to work closely with the inhabitants of this community through a process that will honor their choices. By empowering the people and giving voice to their preferences, choice builds resilience.

Although this tribe is the first to be formally identified as climate refugees within the United States, climate refugee status is not a new phenomenon. The crisis in Syria, for example, has become so complex and tragic that it often eclipses the fact that a climate-related drought was the catalyst for mass migration to the cities, instigating intense cultural and economic conflicts.

Climate change threatens to become a tipping point in more and more areas of the world. Between 50 million and 200 million people could be displaced by 2050, according to the United Nations University Institute for Environment and Human Security. Populations that are economically and culturally vulnerable, such as those whose livelihoods depend on farming and fishing, will feel the impact most especially.

Climate resilience is the notion that we should not wait until there is no choice and people are traumatically displaced by the effects of climate change. Instead, we can help create resilience plans so that those who are impacted have both choice and voice in the matter. The International Red Cross has embraced the notion of climate resilience as a necessary element of preparation for what is to come, and as an opportunity to anticipate the physical, psychological and cultural needs ahead. Climate resilience, which is an integral component of disaster response within the International Red Cross, places significant emphasis on trauma and mental health response.

Place attachment

Consider again the people of Isle de Jean Charles. Although efforts are in place to help with the transition, residents still feel a deep attachment to their home. This isle holds their cultural and spiritual history. Their identity is deeply rooted to the story of this place.

Just as we are connected to our early attachment figures, we also share a deep and abiding attachment to our early places, both individually and culturally. In a 2016 article in The New York Times, Chief Albert Naquin of the Biloxi-Chitimacha-Choctaw tribe, the ancestral residents of Isle de Jean Charles, observed sadly, “We’re going to lose all our heritage, all our culture.”

Place attachment is the powerful bond that links a person to a place. It develops throughout one’s lifetime and even evolves over centuries throughout the history of a culture. This sense of connection to a specific place provides a profound source of meaning, belonging and sustenance. Simply put, this place is one’s home. Place attachment and sense of place are often interchangeable. Place identity considers attachment in terms of emotional or symbolic meanings, as internalized and integrated into a person’s identity.

Much like other aspects of attachment that we explore with clients struggling with any number of issues, place attachment is seated in a deep part of ourselves that connects to ancestry, early recollections, sensory experiences and story. It relates to the larger question of Who am I? — a question that can be partly answered through place identity.

In North Dakota, the Standing Rock Sioux Tribe recently engaged in a battle of culture and human rights against the Dakota Access pipeline, the construction of which threatens tribal land and clean water. Many have called Standing Rock a new civil rights moment encompassing a convergence of environmental rights, human rights and cultural rights. Tribal representatives from all over North America joined the Standing Rock Sioux in an empathic and familiar stand to protect culture and identity.

Journalist Rebecca Solnit, writing for The Guardian, spent time in Standing Rock to cover the movement. She gave eloquent voice to the tribe’s heartfelt commitment and place attachment: “Victors like to forget how they got their spoils, but the despoiled have long memories.” With a growing sense of awe, Solnit observed how the tribe relied on peace and prayer, valued humility and revered their ancestors.

Place matters as an integral piece of cultural, historical, existential and personal identity. The stories of people and their places, whether in Louisiana or the Dakotas, are as important as any other attachment issues or identity concerns that we consider when we counsel our clients.

Environmental justice as social justice

Issues that impact the planet also directly impact the people who live on the planet. At times, it seems as though conversations around environmental justice and social justice are happening with equal intensity and depth of passion but are taking place in two separate silos.

As the climate changes, families, communities and lives are affected. And as is true with so many other aspects of change, our most vulnerable neighbors — individuals with low incomes, communities of color, immigrants, indigenous peoples, children, pregnant women, older adults, people with disabilities and people with chronic medical conditions — are most subject to the impact. Understanding the issue and engaging in advocacy on behalf of the climate is also advocating on behalf of the people whose lives depend on a healthy planet. The global climate is interconnected — environmentally, psychologically, socially, culturally
and spiritually.

In 2010, the Council on Social Work Education declared sustainability and climate issues to be the social justice issues of the new century. In 2011, the American Psychological Association released a report highlighting the broad contributions that psychology could make, with continued research and advocacy, to understanding the power of the human-environment relationship. It included a call to action for scholars to bridge the gap between the science of environmental issues and the study and practice of psychology.

Our moral obligation

In a 2016 article on the ecoAffect website, psychiatrist Lise Van Susteren posed a challenge to those in the helping professions. She noted that we work with people who are faced with fears, traumas, unexpected changes and crises. We help our clients navigate this difficult terrain even as we view larger societal issues through a social justice and advocacy lens. She wonders, then, if we can ethically turn a blind eye to the approaching crises that our changing planet will bring. Do we have a duty to warn, to protect, or, at a minimum, to acknowledge that the changing climate is a significant variable in mental health?

The American Counseling Association has a long-established relationship with the American Red Cross as a model for and partner in disaster response. In 2002, the International Federation of Red Cross and Red Crescent Societies established the Red Cross/Red Crescent Climate Centre. This organization supports national Red Cross and Red Crescent Societies in their work to reduce loss of life and damage to livelihoods from climate change and extreme weather events. Goals include implementing information and education activities about climate change and extreme weather events; supporting the development of climate-adaptation activities and disaster-risk-reduction programs; and bringing concerns about the impacts of climate change on vulnerable people to the broader public. Considering the global movement toward acknowledging climate change in disaster response and preparedness, we believe it is vitally important for ACA to expand its vision for the future of disaster response.

As professionals who believe that all individuals deserve basic human and civil rights, we need to challenge ourselves to see the climate crisis as an imminent threat. Counselors are positioned to bring a trauma-informed and resilience-based perspective to the front lines of crisis and disaster response. We must recognize that environmental injustices and environmental racism — such as what we have witnessed in Flint, Michigan; with Hurricane Katrina; with the 2016 Louisiana floods; and with the standoff in Standing Rock — are enormous social justice issues.

Given our knowledge and skills as counselors, we have both the responsibility and the potential to contribute to environmental advocacy, disaster response and preparedness for building resilient communities. It is our basic duty to promote and deepen human beings’ most fundamental attachment to our natural world.

 

****

 

Debbie C. Sturm is an associate professor at James Madison University in Virginia and a licensed professional counselor with more than 10 years’ experience in counseling survivors of trauma and community violence. She engages in research related to nature connectedness and mental health, sense of place, the psychology of sustainability and environmental justice as social justice. Contact her at sturmdc@jmu.edu.

Lennis G. Echterling is a professor at James Madison University with more than 30 years’ experience in crisis and disaster response, supporting first responders, and international stabilization and recovery in war-torn regions. As a doting grandfather to two young boys, he believes it is important that we give greater consideration to the health of our planet and our children.

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 your article accepted for publication, go to ct.counseling.org/feedback.

 

****

 

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 self ish act of forgiving

By Lindsey Phillips April 26, 2017

A rabbi, returning home on a train, sat near a group of salesmen who were playing cards. Absorbed as he was in meditation, the rabbi refused to join the card game. One of the salesmen, annoyed by the rabbi’s aloofness but unaware of who he was, pushed the rabbi out of the compartment.

Upon reaching their destination, the men discovered that their companion on the train was a revered rabbi. This revelation prompted the salesman to ask for the rabbi’s forgiveness, but the rabbi refused. People then questioned the rabbi about how he could be so unforgiving. The rabbi explained that because the salesman had assumed he was offending a “common man” on the train, only that man, not the rabbi, could grant forgiveness.

This parable by Rabbi Abraham Joshua Heschel illustrates the complexities and power of forgiving and teaches that only people who have been wronged have the power to forgive. It also reveals the way that people’s thoughts about forgiveness shape their view of its utility.

There is also one perspective of forgiveness that might surprise many people: Forgiving is not a kind, selfless act. Rather, it is about self-healing, self-empowerment and self-liberation. As Desmond Tutu, South Africa’s former Anglican archbishop and a recipient of the Nobel Peace Prize, said, “We don’t forgive to help the other person. We don’t forgive for others. We forgive for ourselves. Forgiveness, in other words, is the best form of self-interest.”

According to a survey by the Fetzer Institute, 62 percent of Americans think that they need more forgiveness in their personal lives.

“We spend a lot of negative energy ruminating on parts of our lives that have been harmful,” observes Richard Balkin, assistant chair in the Department of Counseling and Human Development at the University of Louisville. “We have nightmares over this, we have flashbacks, we have memories that disrupt our lives.” Many people hold on to these negative or hurtful memories for years, he says.

The pressing question for counselors is how they can help clients move past the anger or hurt that is tied to these past events. And that leads to examining the potential role that forgiveness can play in the process.

Defining forgiveness 

Susan Stuntzner, the director of disability support services and a retention specialist at Southwestern Oregon Community College, describes forgiveness as “the ability to uncover [and] address any hurt and pain that one has.”

Through the process of forgiving, people usually “find that they hold feelings such as anger, anxiety, depression, some sort of betrayal or hurt,” adds Stuntzner, a member of the American Counseling Association. “It’s a process where as people uncover how they are feeling and thinking, they realize that they no longer want … the hurt or pain to control their life.”

Jan Lemon, a professor of counseling at Mississippi College, views forgiveness as a transformational approach in which clients correct their attitudes, beliefs and energy. For her, forgiveness is “an unconscious attitude or release of a toxic emotion. … It’s both letting go of the resentment [and] replacing the resentment with mindful awareness and empathy.”

Balkin, editor of ACA’s Journal of Counseling & Development, notes two different types of forgiveness. Interpersonal forgiveness is a relational process that involves forgiveness and reconciliation between the aggrieved person and the perpetrator, Balkin explains. He points out, however, that forgiveness doesn’t have to be relational, and this is where the second type of forgiveness comes into play. Intrapersonal forgiveness is an independent process in which the aggrieved person forgives by letting go of the hurt or pain caused by the perpetrator, or the perpetrator forgives by granting self-forgiveness for the pain he or she has caused others, Balkin says.

For Bryce Hagedorn, program director of counselor education and school psychology at the University of Central Florida, forgiveness is “a personal choice to release anger, the right for revenge [and] retribution for a wrongdoing. It can be both releasing that toward others who have wronged you as well as releasing yourself.”

There is growing evidence that the act of forgiveness is both physically and mentally empowering. In 2005, Harvard Medical School published an e-newsletter citing research suggesting that forgiveness reduced stress, lowered the risk of heart disease, strengthened relationships, helped lessen pain and instances of chronic illness, and led to greater happiness. A decade later, the scientific research on the topic had increased so much that Loren Toussaint, Everett Worthington Jr. and David Williams edited a book, Forgiveness and Health, that focused specifically on the health and well-being benefits of forgiving.

According to Stuntzner, forgiving improves a person’s coping and adaptation, reduces negative feelings and creates an overall better quality of life. Part of the power of forgiveness is that “there are multiple directions in which forgiveness can be applied,” she says. Counselors can use forgiveness as a tool to help clients with different situations, such as working toward self-forgiveness or working to forgive an abusive partner, she says. By coming to a new understanding of the past and how it affects a situation in their present, clients “are freed up emotionally and mentally to focus on more positive things,” Stuntzner says.

Overcoming resistance

When giving presentations to counseling audiences, Hagedorn often asks how many attendees have clients whose anger, depression, substance use, anxiety, relational discord or other issues are grounded in resentment or regret. Typically, 90 to 100 percent of the audience members answer in the affirmative, he says. Even though these two areas are central to forgiveness work, not many counselors are doing anything systemically with resentment and regret, adds Hagedorn, an ACA member and past president of the Association for Spiritual, Ethical and Religious Values in Counseling.

Furthermore, counselors can actually be resistant to using forgiveness strategies in their practices, Hagedorn says. In fact, he argues that assessing client-based and clinician-based resistance is one area that doesn’t get enough attention. Counselors may be resistant because they do not feel competent and do not know where to start or because they have not done their own work and would feel hypocritical using forgiveness techniques in session with clients, he says.

Another reason that some counselors hesitate to engage in forgiveness work in session is because they consider it to be a religious intervention, Hagedorn says. Many people — clients and counselors alike — view the topic of forgiveness as something that falls under the auspices of religious leaders, not counselors.

Stuntzner says that people’s beliefs about forgiveness, or even their beliefs about religion and spirituality, may hinder their ability to forgive. Yet she finds that the concept of forgiveness can be incorporated into multiple beliefs. She often asks clients what forgiveness looks like to them as a means of connecting forgiveness to their belief systems.

Other clients are resistant to forgiving for reasons that have little to do with religion or spirituality. Because clients often believe that forgiveness is relational, they may assume that forgiving someone is equivalent to pardoning the offender or condoning the offense that injured them, Hagedorn says. In addition, they may not recognize the connection between these old wounds and the presenting concern that brought them to counseling, he notes.

Counselors may assume that this resistance signifies that a client does not want to forgive. Instead, Stuntzner advises, counselors should interpret resistance as meaning simply that more work needs to be done before the client is ready to forgive.

At the same time, counselors should take care not to push clients before they are ready. Clients must initiate the process of forgiving. Both Stuntzner and Balkin emphasize the importance of counselors asking questions to understand clients’ thoughts on forgiveness. For example, Balkin asks questions such as “In a perfect world, what would you like to see happen?” and “What do you believe should happen?”

Because forgiveness is not universally defined, counselors need to be open to clients’ values and beliefs surrounding the concept. Sometimes this means “letting them come up with their own terms,” Stuntzner notes.

Readiness to forgive 

Hagedorn says one area that is missing in the practice of forgiveness is the assessment of client readiness. “We [counselors] tend to throw action-oriented interventions at clients across the board because we assume that when they come in for help, they are ready to make an active change,” he says. But that is not always the case.

Unfortunately, Stuntzner points out, there is no scale or objective measure that says clients are ready to forgive. “It’s a … subjective process,” she says. “That’s where a counselor’s clinical skills come into play.”

Stuntzner looks for possible indications that a client might be ready to work on forgiving. For example, does a particular event or person seem to rule the client’s life? Does the client spend a significant amount of mental and emotional energy rehashing the offense? Is it getting in the way of the client’s present life? Is the client in enough pain that he or she no longer wants to feel that way?

Lemon, an ACA member who frequently works on forgiveness with her clients, also looks for signs. In terms of needing to be forgiven, clients will typically show remorse, a desire to make it right or a desire to move on, she says.

To better understand his clients’ readiness to forgive, Hagedorn, the former editor of the Journal of Addictions & Offender Counseling, applies the transtheoretical model, which assesses individuals’ readiness to change their behaviors on the basis of the following six stages:

  • Precontemplation (denying there is a problem and only wanting to change others’ behaviors)
  • Contemplation (acknowledging the problem and the need to change but only thinking about it)
  • Preparation (planning how to change)
  • Action (modifying one’s behavior and environment)
  • Maintenance (maintaining the action)
  • Termination (coping without fear of relapse)

Counselors can assess client readiness by looking at how their behaviors match those stages of change (e.g., engaging in “other” talk, blaming others for their pain), Hagedorn explains.

But, ultimately, the decision to forgive lies with the client. Balkin stresses the importance of forgiveness being initiated by the client. Clients need to say that they are struggling with a situation and that they want to change it. Counselors must be careful not to impose forgiveness on clients before they are ready to forgive because the clients’ beliefs about forgiveness may hinder the process, he adds.

Learning to forgive 

People often assume that forgiveness is something that just naturally happens in the counseling process, Stuntzner says. However, forgiveness is not necessarily an intrinsic process. Forgiveness scholars, including Frederic Luskin, director of the Stanford University Forgiveness Project, and Robert Enright, co-founder of the International Forgiveness Institute, argue that forgiveness is a teachable skill that requires practice.

Hagedorn, an addictions counselor in Orlando, Florida, points out that one-third of the steps in 12-step recovery programs deal with forgiveness. He refers to Step 4 and Step 5 as “practice forgiveness” because they involve individuals taking inventory of the harm they have caused others and themselves and then seeking forgiveness from someone whom they have not harmed (e.g., a higher power, a counselor, a sponsor). In Step 8 and Step 9, individuals make a list of everyone they have harmed and seek forgiveness from them. Hagedorn has found that practicing forgiveness is also a good therapeutic technique for clients who need to learn how to be forgiven by others.

Stuntzner agrees that practicing forgiveness is a helpful technique. If a client cannot forgive a hurt because it is too painful, she advises counselors to restructure the session and ask the client if there is someone else he or she can forgive. Forgiving someone else can help clients experience the benefits of forgiveness and build confidence in the process, Stuntzner says, which might encourage them to readdress the previous hurt they were initially resistant to or at least apply forgiveness to other situations in their lives.

Clients must continue to develop the skill of forgiving because, as with any skill, it can get rusty without practice. Therefore, Stuntzner suggests that it might be beneficial for counselors to check in or have booster sessions with clients to see how they are doing with applying forgiveness in their daily lives.

Another common misconception is that forgiveness is relational. “Often people believe that reconciliation [has to be] part of forgiveness … and that is simply not the case. Reconciliation may or may not be part of the process,” says Balkin, an ACA member and past president of the Association for Assessment and Research in Counseling. In fact, sometimes, reconciliation is not possible.

Balkin offers an example from his own practice: A client is processing pain from the emotional neglect she experienced from her father growing up. He becomes terminally ill after she is an adult. While taking care of him, she tells him that she loves him, but he dies without ever returning the gesture. In this case, reconciliation is not possible, and the client must come to terms with the fact that she will never get what she wanted. In situations such as these, intrapersonal forgiveness is key, Balkin says.

The Jewish conceptualization of mechila, which means to wipe away debt, can serve as a helpful tool for teaching intrapersonal forgiveness, says Balkin, who finds this concept of forgiveness particularly empowering. By acknowledging that the person who hurt them no longer owes them anything or that they don’t expect anything from the person, clients stop spending time or negative energy on the hurt, thereby regaining control of their lives, he explains.

Because intrapersonal forgiveness does not require reconciliation and can be done on a personal level, people may assume incorrectly that it is easier, Balkin says. Admittedly, interpersonal forgiveness is difficult because a client must set aside the hurt and work on trusting the other person again, but intrapersonal forgiveness comes with its own set of challenges.

“Abandoning resentment toward someone who has not demonstrated remorse or change is hard to do,” Balkin points out. However, he adds, “Abandoning resentment doesn’t mean trusting that person. Abandoning resentment simply means, ‘I don’t wish the person any ill will, and I’m not going to allow this person’s actions and behaviors toward me to impact my
life anymore.’”

Integrating other approaches 

When Stuntzner initially started out, she viewed forgiveness work as atheoretical, but she quickly realized that counseling journals often wanted it tied to a specific approach. Even though she still believes forgiveness is a process in and of itself, she finds that it also works well with other counseling approaches. In fact, she views resilience, self-compassion and forgiveness as “a three-legged stool” because one can lead to another. “As people learn to forgive, they can experience more compassion and self-compassion and vice versa,” Stuntzner says.

Lemon believes that forgiveness work can be integrated into any type of therapy. After all, she points out, clients typically do not come to counseling just to work on forgiveness, so adjunct therapies are required. For example, she thinks there is a cognitive behavioral aspect to forgiveness. “Any type of spiritual approach works well with CBT [cognitive behavior therapy] because it is about changing thought patterns,” Lemon says. She adds that Adlerian therapy and solution-focused brief therapy (because it is goal-oriented) also work well with forgiveness. In addition, forgiveness meshes well with acceptance and commitment therapy (ACT) because of the aspects of self-acceptance and commitment to change, Lemon says.

Even so, Hagedorn cautions counselors against using ACT initially unless they are already familiar with it. ACT is not a stage-based or linear theory, so it requires counselors to possess a significant amount of experience with clients and the change process, he explains. Instead, he suggests that counselors begin with mindfulness-based interventions, which are an easy entryway to forgiveness work because they focus on getting people grounded and in the moment.

“Forgiveness is one of those things that we want to do but sometimes we don’t know how to do,” says Lemon, who has presented on the mind-body approach to forgiveness. Clients often resist cognitive approaches to forgiveness, she adds, which is why mindful forgiveness is so important. Mind-body techniques allow clients to “bypass the cognitive thinking and go to the unconscious” so they don’t have to focus on questions such as if they need to let the hurt or betrayal go or if the other person deserves forgiveness, she explains.

Approaching forgiveness from an energetic standpoint, Lemon aims to help clients rid themselves of toxic emotions such as anger and resentment by using forgiveness meditation. This method combines mindful breathing, affirmations (e.g., “I forgive you for all wrongdoing”) and positive visualization (having clients visualize someone they care for and then applying those same feelings to the offender and themselves).

Hagedorn refers to a mindfulness technique he uses as “the breakaway.” In this technique, a client recounts the story of his or her trauma or hurt. Partway through, the counselor has the client stop (or break away) to notice five things in the room. Afterward, the client picks up where the story left off. Through this technique, clients learn to “go in and out of the story and thereby gain some control and power back,” Hagedorn explains.

Lemon recommends another helpful mindfulness technique connected to forgiveness work that asks clients to imagine their situation from four perspectives: their own, a bystander’s, the offender’s and the client’s highest spiritual self. The technique involves more than just asking clients how they think the other person would feel, which often creates resentment, Lemon says. Instead, clients role-play and step into that other person’s perspective.

Forgiveness inventories and models 

In 2014-2015, Stuntzner conducted two pilot studies on a 10-module resilience intervention that taught people with disabilities about resilience and how to cultivate resilience-based skills. Throughout these pilot studies, participants reported that the module on spirituality and forgiveness was helpful and meaningful, but because of the difficulty of being able to forgive, they indicated that it would be useful to have more time to work on forgiveness. This finding, coupled with the fact that there was not a specific forgiveness intervention tailored to meet the needs and unique experiences of people with disabilities, led her to develop a seven-module intervention: “Stuntzner’s Forgiveness Intervention: Learning to Forgive Yourself and Others.”

Balkin and other researchers have developed a Forgiveness Reconciliation Model (FRM) that contains four stages:

  • Collaborative exploration (the counselor helps the client identify what his or her beliefs are about forgiveness)
  • Processing the role of reconciliation
  • Evaluating remorse/change from the offender
  • Determining an outcome (interpersonal vs. intrapersonal forgiveness)

Balkin urges counselors not to assume that reconciliation is a necessary part of forgiveness just because the word is in the model’s title. “[The FRM] is a process-oriented model, not one that eventually leads to a single conclusion,” Balkin says. Therefore, the model is a way to process forgiveness and helps counselors and clients decide if clients should reconcile or take a more intrapersonal route, he explains.

To aid in the process of choosing between interpersonal and intrapersonal forgiveness, Balkin, along with other researchers, also created a Forgiveness Reconciliation Inventory (FRI). The inventory contains four scales that measure each stage in the FRM.

With this inventory, clients can “see the conflict illustrated on paper,” Balkin notes. For example, when working with women in a domestic abuse shelter, Balkin found that some of the women wanted to reconcile with their partners even though the partners had not shown any remorse or changed their behaviors. The FRI helped the clients visualize the process and realize that in their situations, reconciliation would do more harm than good.

Balkin warns counselors not to think of assessments such as the FRI as labeling or diagnostic tools. No model or inventory will allow counselors to label someone as a “forgiving person.” Rather than being generalized to all issues, these tools are unique to each experience, he explains. In fact, similar situations can have very different outcomes. Therefore, the FRI “is not a labeling instrument, not a diagnostic instrument. It is a process instrument. It is designed to be used to enrich the session with the client,” Balkin says.

Scattering seeds of forgiveness

Forgiveness is often discussed in terms of difference. We talk about how religious, spiritual and cultural views or gender differences affect forgiving. But Balkin points out that it is more helpful to look at the commonalities of forgiveness. For example, we have all been hurt and we all have to figure out how to release that pain and not remain in the victim role, he notes. In addition, we all seek ways to find strength from what we encounter.

Another commonality is that “forgiveness is a freely chosen act,” Balkin says. Regardless of cultural views on whether someone should or should not forgive, we all choose to give or not give forgiveness — just as the rabbi on the train chose not to forgive the salesman because the rabbi was not the one who had been truly wronged.

Rabbi Heschel’s parable also reminds us that forgiveness does not have to be relational and that there are multiple ways of thinking about it. In addition, counselors should keep in mind that the act of choosing to forgive — being ready to forgive — can be a long process. “A lot of people live their lives in unforgiveness,” Hagedorn observes.

This means counselors may encounter clients who never reach a stage when they are ready to begin the work of forgiveness, and that can be frustrating. “Sometimes I’m just scattering seeds, and I’m hoping that someone else will come along and water [them],” Hagedorn says.

Counselors can play an important role in demystifying the process of forgiving and helping clients turn their anger, pain and shame into something empowering. Even if counselors never hear their clients utter the difficult words “I forgive,” they will have planted the seeds that might one day bring new life.

 

****

 

Moral injury and forgiveness

In some cases, clients must learn to live with certain hurts and wounds rather than simply releasing them. Military service members often deal with moral injury, which results in shame and hurt, whereas people with addictions often can’t forget the pain they have caused others and themselves.

In such cases, Bryce Hagedorn of the University of Central Florida advises counselors to shift from cognitive behavior therapy to acceptance and commitment therapy (ACT), thus changing the emphasis from eradicating the hurt to learning to live with the hurt. These clients must learn to “live in the ‘and,’” he says. This means learning to live with what has happened and still be a productive member of society, explains Hagedorn, who has conducted webinar training on
self-forgiveness, ACT and moral injury for the National Board for Certified Counselors.

With moral injury and addictions, clients often need to forgive themselves. But self-forgiveness can be particularly challenging. Susan Stuntzner of Southwestern Oregon Community College has found that “it’s easier for people to express and feel compassion toward others than [it is] to give themselves permission to be self-compassionate.”

 

****

 

Disability and forgiveness

Individuals with disabilities must often learn how to manage a whole range of factors, including changes in their life and relationships, unemployment or underemployment, bias, stigma and negative attitudes from society, says Susan Stuntzner, a counseling professional who has presented on disability and forgiveness interventions. In fact, she says, “Only one piece of forgiveness may be tied to the disability itself.”

There are other life experiences and new hurts or offenses that typically happen after the fact, and often people are not prepared to deal with them, Stuntzner explains. For example, these clients may be faced with a partner who is having a hard time adjusting to the person’s disability or has even decided to leave the relationship, or they might encounter barriers to finding a job, all of which can increase their anxiety or fear.

Stuntzner has found that forgiveness work offers an effective way to help these clients cope. For individuals with disabilities, rehabilitation is often thought of as physical, but there is an emotional component as well, especially for people with a traumatic injury that suddenly changes their lives, such as a spinal injury or stroke, says Stuntzner, a member of the American Counseling Association and the American Rehabilitation Counseling Association. Forgiveness provides these clients with an alternative to letting other people or situations control their view of themselves or their lives, she explains. The process helps them let go of their negative feelings and allows them to find a way to move forward toward a better quality of life, she says.

 

****

 

Lindsey Phillips is a freelance writer and content developer living in Northern Virginia. She has 10 years of experience writing on topics of race, immigration and health. Contact her at lindseynphillips@gmail.com or through her website lindseynphillips.com.

Letters to the editor: ct@counseling.org

 

****

 

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.