Tag Archives: Voice of Experience

Voice of Experience: Diversity and third-culture kids

By Gregory K. Moffatt September 21, 2022

Pita Design/Shutterstock.com

My client was a 19-year-old female presenting with anxiety. She had just started college, and her anxieties had led to trouble concentrating and making friends, and they sometimes kept her awake at night. She was also troubled by the fact that until recently, she had been easygoing and didn’t get ruffled quickly.

The client was a child of a missionary family, and for over a decade, she had lived in South America. But she was born in the United States and had spent nearly all her grade school years in a rural community on the east coast where she now attended college. She and her family also made regular visits back to the United States during those ten years when she was living abroad.

One would have thought that returning to the United States for college after spending the last 10 years in South America would have been an easy transition for her. After all, she was already an easygoing individual, she functioned well in her adoptive culture, and she never had any issues on her sabbaticals home to the United States. But it wasn’t easy, and she couldn’t understand why.

But I had an idea.

When she left the United States, she was only nine years old. The world she knew was long gone because of the passage of time and her own development from child to adult. On top of that, in her visits back to the United States, she spent most of her time looking up old friends or enjoying the company of relatives until her trip was up and she had to go “home” in South America.

As a white girl with blond hair, she was an anomaly in Ecuador. She lived in a community where English wasn’t spoken. Although she spoke Spanish without much of an accent, it was still not her first language. She was not a true Ecuadorian.

But when she returned to the United States, she also discovered that she was not a true American either. Being gone most of her adolescence, she had missed 10 years of acculturation. TV shows, movies, music and cultural events were just some of the things she couldn’t relate to. It was like she walked into a very long movie just at the end; she didn’t know what was going on around her.

My client was what is referred to as a third-culture kid — people whose identity is influenced by their parents’ culture and the culture(s) in which they are raised. Third-culture kids are often the children of missionaries, nongovernmental organization workers or military families. My client obviously didn’t totally belong to the guest culture (Ecuador), but she didn’t belong to her home culture anymore either. Not every third-culture kid’s experience, of course, is as stressful as my client’s. Most of her stress stemmed from the fact that she was not prepared for feeling like an outsider in her home culture.

Transitions from one culture to the next are easiest when the cultures are similar, when the visit is short, and — as is often true for Americans — when they take U.S. culture with them. When I hear about someone from the United States traveling abroad and I learn that they stayed in American hotels, ate American food and spoke nothing but English, then I know they took America with them.

But for missionaries and NGO families, living on the economy almost necessitates diversity of culture, longer stays, and an inability or lack of desire to take America with them. The “American” stands out and may take years to be thought of as an insider.

At the same time, attempting to gain acceptance in the chosen culture by default also means leaving one’s home culture behind. Third-culture individuals are like ships without a flag.

In our never-ending attempts to improve our understanding of diversity, it would be easy to overlook third-culture kids. Based simply on appearance, people may not realize someone is a third-culture kid. I could have easily missed the significance of my client’s third-culture status and focused only on her anxiety. That would have, at best, slowed down her healing.

Recognizing that she was really neither American nor Ecuadorian helped her understand why she didn’t seem to fit in a culture where she looked like everyone else. This realization was the beginning of her developing coping strategies that worked quickly and helped her symptoms of anxiety abate.

Large international agencies often employ mental health workers to assist their personnel when they transition to a new culture as well as when they are ready to transition back to the United States. But smaller agencies such as the one my client was associated with may leave navigating this transition up to the individual, which is what happened to my client.

When I was a graduate student in the 1980s, “diversity” generally focused on issues of race. Fortunately, our thoughts on diversity have evolved since the 1980s, but we still have a long way to go. And we can start by recognizing overlooked areas of diversity, such as third-culture kids, and developing strategies to help them.

 

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Read more on the nuances of counseling third-culture kids in a recent article from Counseling Today: “Growing up between cultures

 

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Gregory K. Moffatt is a veteran counselor of more than 30 years and the dean of the College of Social and Behavioral Sciences at Point University. His monthly Voice of Experience column for CT Online seeks to share theory, ethics and practice lessons learned from his diverse career, as well as inspiration for today’s counseling professionals, whether they are just starting out or have been practicing for many years. His experience includes three decades of work with children, trauma and abuse, as well as a variety of other experiences, including work with schools, businesses and law enforcement. Contact him at Greg.Moffatt@point.edu.

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

Voice of Experience: The search for intimacy

By Gregory K. Moffatt August 17, 2022

Humans are social creatures, no doubt. But we run the spectrum from the intensely introverted (like I am) all the way to the expressly extroverted (like the rest of my family). Isolation is often a necessity for introverts who need to recover from the energy-draining, crowded workdays.

But for extroverts, being immersed in their work and sitting at a desk all day, even if they are surrounded by people, requires them to seek out social time. All three of my adult children are like that. After a long day at work, they still want to go out to museums, clubs and parties. It exhausts me to think about it.

But what we all have in common isn’t just our social nature, varied as it is. Intimacy — a component of our social nature — is what we really seek.

Erik Erikson brought the term “intimacy” into our clinical vocabulary in the first half of the 20th century with his eight stages of psychosocial development. The sixth stage of his theory teaches us that we reach a critical juncture in our 20s: We either learn to be intimate or we find ourselves feeling isolated until we do. Some people, according to Erikson, remain stuck in this stage, doomed to live out their days feeling empty.

A shallow reading of his theory might lead one to suppose he only meant romantic relationships. I am sure that was a part of what he had in mind, but intimacy is so much more than that. Intimate relationships encompass both platonic and romantic relationships, and they are ones where individuals are free to bare their souls and to know that their secrets will be safe and understood.

The most satisfying marriages are intimate marriages, but intimacy isn’t just physical. In fact, any sex therapist could tell you that people often substitute sex for intimacy. But sex can be safer than intimacy because it doesn’t allow one to be as easily hurt or betrayed.

Robert Sternberg, an American psychologist, helps us understand the difference between intimacy and sex even better in his triangular theory of love. This theory teaches us that the most loving relationships are those that balance intimacy, passion and commitment. Intimacy is the sharing of self, whereas passion is the physical attraction of a relationship.

A relationship can have a passionate physical life yet be devoid of intimacy. Clients often say, “My spouse never talks to me.” When I want to test for intimacy, one of my quick go-to questions is, “What is your spouse most afraid of?” If the client can answer that question, they have at least some level of intimacy.

Think about the many ways we demonstrate our need for intimacy. We take pictures, not just to remember the moment but to share them with others. We are saying, “Look at what is important to me. Do you understand me?”

We touch. Holding hands, a pat on the arm or a high five are all ways of being intimate. We are allowing others into our space or moving into other peoples’ space for the sole purpose of letting them know, “I see and understand you.”

We tell stories and jokes. With this exchange, we are trying to illicit a response from the other person. We want them to notice what we enjoy or find funny.

If you don’t believe me, think about the last socially awkward moment you had where someone didn’t care about a picture you shared, didn’t appreciate your touch or didn’t laugh at your joke. I bet it left you feeling empty — just as Erikson said it would.

Navigating intimacy is a lifelong task. Our biggest fear is being rejected — having someone betray our risk of intimacy. Dysfunction occurs when we don’t know how to be appropriately intimate or we stop trying.

So many clients have passed through my door struggling to repair damaged relationships or contemplating divorce. “I’ll never marry again,” they often say, and I know in that moment, they believe it.

But I also know that feeling may pass because being completely isolated will not fulfill their need for intimacy. People don’t have to remarry or even date for that matter. But when one is hurt so deeply, it is easy to generalize pain and avoid intimacy with anyone. And that, my friends, is the antithesis of being human.

As counselors we often need to help our clients discover intimacy in healthy ways. Pornography addiction, affairs, substance use and careers can be substitutes for intimacy. People with calloused hearts who are afraid of being hurt may pretend they don’t need anyone else, but we know better. That kind of self-protection is understandable, but it robs one of their humanness.

Everton Vila/Unsplash.com

 

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Gregory K. Moffatt is a veteran counselor of more than 30 years and the dean of the College of Social and Behavioral Sciences at Point University. His monthly Voice of Experience column for CT Online seeks to share theory, ethics and practice lessons learned from his diverse career, as well as inspiration for today’s counseling professionals, whether they are just starting out or have been practicing for many years. His experience includes three decades of work with children, trauma and abuse, as well as a variety of other experiences, including work with schools, businesses and law enforcement. Contact him at Greg.Moffatt@point.edu.

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

Voice of Experience: Our new world

By Gregory K. Moffatt July 18, 2022

I’d like to say we are in a post-pandemic world, but I know that isn’t exactly true yet. Even so, I can’t believe how much our world has changed in the past three years.

The lockdowns, mask requirements and financial issues of the COVID-19 pandemic, to name a few, added stressors to our world that I have never seen in my lifetime.

I am a college professor and some of my students finished their third year of college never having seen a classroom without masks, screenings, quarantines and other precautions brought on by the pandemic. My wife teaches 4-year-old prekindergarten, and some of her former students from three years ago, who are now going to the second grade, have never seen their teachers’ faces unmasked.

The pandemic also magnified mental health and social problems that were already present, including addictions, anxiety, depression, marital discord and a host of other issues. The last thing my clients struggling with addictions or depression needed was to be locked down at home for weeks on end with nothing to do. That doesn’t even begin to touch the magnitude of clients with obsessive-compulsive disorder who struggle with the fear of germs or autistic spectrum clients who need routines.

A few months ago, I wrote in my column that burnout could be managed, at least sometimes, by reframing. One reader criticized that statement by noting that the pandemic has been so overwhelming that reframing isn’t a panacea. I can’t argue with that criticism. This situation is just so different, I suppose.

For over a year, I didn’t eat out and I found myself anxious every time I wanted to go to a store. I’d wonder if it was open, if they had the items I needed and what restrictions they might have. I found it easier to just stay home.

Like all of you, I’ve shared the stress of relatives who worked in jobs that couldn’t easily be done remotely, especially in the retail and the restaurant industry. I saw some of them lose their financial stability and some even lost their jobs, which only added stress to the other preexisting stressors.

Most of us have been affected by this pandemic in one way or another. So many of us have been sick. Nearly all my family has had it, including me, despite vaccinations. And then, of course, there is death. Like others, I lost a close friend to this virus.

This doesn’t even include the political and social divisiveness surrounding issues related to this pandemic. Families have been divided — maybe even permanently — over the question of vaccines and boosters.

People are seeking help from counselors in numbers I’ve never seen before. I don’t know a single counselor who isn’t operating on a full schedule right now, and it has been that way for months.

But the pandemic has caused us to grow as well. Three or more years ago, most counselors didn’t do telemental health. Even though I had the credentials for telehealth as well as telesupervision, I rarely used it before the pandemic. But now, I don’t even accept an intern who hasn’t had telehealth training. It wasn’t even on my radar three years ago to require telehealth training for an intern, and I don’t know of any graduate programs that required or even offered it.

I’ve also grown to appreciate telehealth as a client. Because I live in a rural area, I’ve always had a hard time finding my own therapist who wasn’t 50 miles away in Atlanta. Now, I can manage my self-care in a one-hour telehealth session rather than spending three or four hours driving to and from my therapist’s office in Atlanta.

We’ve seen changes in continuing education requirements as well. In my state, prior to the pandemic, only 12 hours of distance learning could be counted for recertification. Now nearly all of them can be as long as they are synchronous — a term that few of us even knew three years ago.

In addition, telesupervision hours now count toward license requirements in Georgia. This gives clinicians in remote areas options for training far beyond what they could have accessed three years ago.

I often wonder why I wasn’t offering my clients the option of telehealth before the pandemic. I had clients who drove two to three hours one way to see me. Why hadn’t I thought to help them by offering distance work? Today, although my caseload with children is still largely in person, I use distance counseling with nearly all my other clients and supervisees.

As we come out of these troubling pandemic years, it is clear we will never be the same. But telehealth has been a positive change for the counseling field and offers a silver lining in the new post-pandemic world.

Syuzann/Shutterstock.com

 

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Gregory K. Moffatt is a veteran counselor of more than 30 years and the dean of the College of Social and Behavioral Sciences at Point University. His monthly Voice of Experience column for CT Online seeks to share theory, ethics and practice lessons learned from his diverse career, as well as inspiration for today’s counseling professionals, whether they are just starting out or have been practicing for many years. His experience includes three decades of work with children, trauma and abuse, as well as a variety of other experiences, including work with schools, businesses and law enforcement. Contact him at Greg.Moffatt@point.edu.

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

Voice of Experience: The mean dog

By Gregory K. Moffatt May 25, 2022

“When will this go away?” my client asked me.

So many times, I’ve seen the same desperate look in the eyes of clients. With this 45-year-old man, the look was caused by grief at the sudden loss of his closest friend — his father. Every morning after a restless night, he woke only to be greeted by the ever-present hole in his heart created by his loss.

“This kind of pain doesn’t go away,” I said softly. “It fades, but unfortunately, it will always be there.”

And then I shared a metaphor with him that I’ve used a thousand times.

“Suppose you live next door to someone who has a mean dog. Let’s also suppose that you will never move and your neighbor will never move. Wishing for your pain to go away is like wishing for the neighbor with the mean dog to move. It won’t happen.

“But instead of wishing that the dog would go away, we can confront our fear of the mean dog. If we pretend that it isn’t there, it very likely might hurt us if we carelessly stray too close to the property line. But if we are aware of the mean dog and the length of its chain, then it can never hurt us no matter how much it growls or how loud it barks.”

This metaphor works for addictions — the mean dog is the lust for chemicals. Pretending the mean dog isn’t there (or hoping it has gone away) can trick the person to stray too close to the party with alcohol or the reception where former methamphetamine acquaintances are likely to be congregating.

The metaphor works for trauma — the mean dog is the event or the perpetrator. Pretending “I’m OK” can allow the mean dog to slip closer and closer, maybe over years, as the client represses fear, hurt and pain. Then, one day without warning, the mean dog can bite.

The metaphor works for sexual addictions. So many men and women have been drawn into this secretive and shame-laden world under the illusion that “I’ve got this under control.” In the privacy of their homes, they swim in their addictions, sometimes straying too close to the property line. The dog bites in the form of spouses or children who catch them or in the form of illegal activities that land them in jail, forever branded as sexual offenders.

Recognizing the mean dog isn’t novel. The idea has been around in other forms for many years. Alcoholics Anonymous got us started in 1935 with the concept of 12-step programs. The very first step is admitting your powerlessness over the addiction. By admitting one’s powerlessness, in a sense one is admitting that the mean dog will be around for a while — probably forever. I just added the metaphor.

But even before Step 1, we admit who we are. “Hello, I’m Greg, and I’m an alcoholic.” In a way, I’m saying, “Hello, I’m Greg, and I see that mean dog over there. I respect it and know its dangers, but I also know its limitations.”

One last truth about the mean dog: It will never be our friend, but we can co-exist with it. So, in addition to the above, we can vocalize, “Even though I know the dangers of the mean dog, I won’t allow it to cause me to live in fear, shame or pain. I am well aware of my limits and the things that compromise my safety.”

Whether used with a 7-year-old child who has been sexually abused, a 40-year-old man struggling with grief or a middle-aged woman challenged with addictions, this metaphor has been a regular and helpful tool for me.

And one last way to utilize this metaphor: Sometimes we can move away. When we hold on to our resentments and anger and we wallow in our hurts, we are electing to live next to the mean dog when we don’t have to. In such cases, maybe it is within our power to find a quieter place to live.

As for me personally, as may also be true for you, I know the mean dogs in my history, and I practice this myself. I have moved away from the mean dog a few times, but there are other mean dogs that will always be with me. As much as I’d love for the guy with the mean dog to move, I know that in some cases, we are neighbors forever. But as time moves on, the hedges grow taller and the barking gets quieter.

That, my friends, makes for much more peaceful nights and restful days.

Don Agnello/Unsplash.com

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Gregory K. Moffatt is a veteran counselor of more than 30 years and the dean of the College of Social and Behavioral Sciences at Point University. His monthly Voice of Experience column for CT Online seeks to share theory, ethics and practice lessons learned from his diverse career, as well as inspiration for today’s counseling professionals, whether they are just starting out or have been practicing for many years. His experience includes three decades of work with children, trauma and abuse, as well as a variety of other experiences, including work with schools, businesses and law enforcement. Contact him at Greg.Moffatt@point.edu.

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

Voice of Experience: How do you know?

By Gregory K. Moffatt April 27, 2022

My supervisee (we’ll call her Tasha) sat back in her chair and, with a look of confidence that I love to see in a first-year supervisee, told me that she had a successful session with one of her clients.

“I feel really good about it,” Tasha said.

I love watching the tentative and fearful looks that I see during the first few months of supervision gradually transition over to those first glimmers of “I’ve got this.” But that evolution also makes me nervous.

“Tell me about your feelings of confidence, Tasha. What happened that makes you confident you did a good job?”

Tasha reported that the client had made progress the week before after several weeks of stagnation in their work together. That is a good sign of course. But then Tasha said something that always raises a red flag in my supervisor’s brain.

“I don’t know, but I was explaining … and it just felt right. I think I got through to my client.”

I don’t know whether Tasha got through to her client or not, but the fact that she couldn’t operationalize it, along with the fact that she was “explaining” something to the client, made me nervous.

We’ve all been there as counselors. Everything just seems to click, and we close a session feeling good. But we also know that, in general, our feelings are not always trustworthy.

I suspect Tasha’s good feelings were reflective of her “explaining” things rather than anything the client did or said. Nothing is wrong with a little psychoeducation, but explaining well doesn’t mean that Tasha’s client “got it.” In fact, confidence based on her own feelings could even increase the probability that Tasha would miss it if her client didn’t get it.

Most veteran therapists at one time or another have felt good about a session only to find out later that their client didn’t share that feeling. The opposite is also true. Sometimes when we aren’t certain that we have connected well, we find out later that the session was a breakthrough moment.

I’ve made this error myself. I once worked with a young man who was strong, energetic, mature for his age and very verbal. He was one of those easy clients we all enjoy seeing on our calendars.

I thought we had hit it off pretty well in our first session and looked forward to each week with him. But after four or five sessions, he stopped coming. After he missed two sessions, the receptionist in the agency where I was working reached out to see if he wanted to reschedule.

Clint Adair/Unsplash.com

As you can easily predict, he didn’t reschedule. What was more disheartening to me was his reason. He told the receptionist that he just didn’t feel like I was the right fit and that he had decided to go elsewhere. He shared no details beyond that, but I’ve never forgotten about what happened.

My mistake was errantly assigning the cause of my feelings. I supposed that I felt good because he was connecting with me when, in fact, I most likely was feeling good because of things about me. Yikes. It is never about us.

I’m always happy when new clinicians experience successes. It would be a miserable career if we never had those positive experiences and interactions, so I celebrate their successes. But I don’t stop there. I always ask why they think it went so well.

If the answers have to do with “gut feelings” or something about the clinician, I suggest caution. The session might have been amazing, but I don’t trust feelings that I can’t operationalize.

Feelings are unstable things on which to base decisions. Most of us have had an experience where we were positive that a relationship in our personal lives was right, only to be equally convinced sometime later that it wasn’t. Our initial feelings about relationships are often based on newness, first impressions, expectations, appearances, sex or other shallow pieces of data. As the relationship progresses, the more important data points eventually become evident and are much more reliable than our initial feelings.

It is the latter data set that tells us if we should continue the relationship, adjust it or terminate it. And that same type of data analysis should be part of assessing our feelings about our sessions.

Feeling good about a session is fine; just ask yourself why you feel good. If it is because of something that your client did, said or presented, great! But if you can’t nail that answer down, be cautious.

 

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Gregory K. Moffatt is a veteran counselor of more than 30 years and the dean of the College of Social and Behavioral Sciences at Point University. His monthly Voice of Experience column for CT Online seeks to share theory, ethics and practice lessons learned from his diverse career, as well as inspiration for today’s counseling professionals, whether they are just starting out or have been practicing for many years. His experience includes three decades of work with children, trauma and abuse, as well as a variety of other experiences, including work with schools, businesses and law enforcement. Contact him at Greg.Moffatt@point.edu.

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