Tag Archives: Voice of Experience

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.

Voice of Experience: If it were easy

By Gregory K. Moffatt March 23, 2022

A few years ago, I managed the most complicated case of my professional career. I was serving as an adviser to an agency, and this case required me to manage HIPAA, ethics, confidentiality, supervision, competency in practice, dual relationships, intrusive intervention, the law, risk assessment and a host of other issues that would have been a challenge by themselves. Dealing with all of them at the same time was nearly overwhelming. I couldn’t have managed that case 20 years ago. Most likely, I wouldn’t even have known where to start.

The case wore me out physically and mentally. For more than two weeks, there was something to do every single day — a phone call with the agency, the client, the care providers, colleagues for consultation, and attorneys. Some days I drained my cell phone battery searching through the ACA Code of Ethics, which I always have available to me on my phone.

I worried about the client, potential lawsuits, ethics and my license. I second-guessed myself often, not in a bad way, but just double- and triple-checking my decisions to make sure I hadn’t missed anything. At times I dreaded answering the phone or checking my email. But in the midst of it all, I remembered my own words to my students and supervisees: “If it were easy, anyone could do it.”

I’m closing in on the end of my career, and retirement is never far from my mind. Challenges like the case I just mentioned could easily be the catalyst that drives some people to hang up their hat and retire, but the effect on me is just the opposite. I love what I do, and these types of challenges keep me in the game. With confidence I can say, “I got this!”

I’ve written in the past that I don’t believe burnout exists. In brief, people burn out when they either never had the passion for the job to begin with or when they let the challenges of the job smother the passion they had in the beginning. The former can’t be burnout since there was no flame to start with. The latter can be repaired by reframing or adjusting one’s job to limit the clutter and renewing that passion.

We all face challenges in our career, but when the job gets hard, that is when I am most energized. A newly licensed clinician can manage the easy stuff in the profession. The older and more experienced I get, the better I am at my work, and without challenges, I wouldn’t be doing anything that I couldn’t have done 20 years ago. That is when boredom sets in.

I was a soccer referee for many years and retired from the game as a professional referee doing national and international games. At some point in my career as a referee, I decided I didn’t want to be just another average referee, so I began my journey into the big leagues. I marveled as I watched the very best referees in the game manage exceedingly challenging matches.

I didn’t know if I could ever do that. But as I developed and trained, and as I learned and improved, I made it. I often had butterflies in my stomach as I prepared to blow the kickoff whistle, knowing there were young referees in the stands watching me, just as I had done with other referees many years earlier. There is great energy in professionalism.

As a retired referee, I sometimes reminisce with friends about tough games, mistakes I made, and challenges I faced well. That brings me happiness, and I suppose that is some of what Erikson meant when he taught us about the last two stages in psychosocial theory — generativity versus stagnation and integrity versus despair. I “generated” something valuable, and that brought me to a place of integrity.

The point here is to encourage young clinicians to seek challenges that force you to grow. Don’t be just another average referee — so to speak. And for those of you in the middle or later stages of your career, don’t let challenges drive you prematurely into retirement or out of the profession altogether. You have arrived, and new clinicians need to watch and learn from you.

We get to a place like this by seeking challenges rather than avoiding them. We master our craft by working with the hardest clients, facing the most difficult ethical problems and pushing ourselves professionally in every area.

As the old saying goes, “steel sharpens steel.” You will never sharpen a knife with a soft piece of wood, and you will never sharpen your skills by taking the path of least resistance. You got this!

sydney Rae/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: A frightening truth in the profession

By Gregory K. Moffatt February 23, 2022

I never get through a single supervision session without addressing ethical issues. Ethical behavior must be at the center of every thought we have and every action we take with our clients, from first contact to closure. As counselors, we are schooled on the importance of ethics from the opening hours of our graduate programs, and in my home state at least, ethics appear prominently in the licensure requirements as one of nine areas of focus.

But there is a frightening truth in our profession. After we leave our graduate programs and finish supervision, nobody is there to tell us what to do. It is up to us to focus on ethics and, sadly, this is where things start slipping.

Over my many decades in the profession, I have heard story after story about lapses in ethical conduct. I have also witnessed firsthand the questionable behavior of some professionals in the counseling field. These behaviors range from individual blind spots related to confidentiality, diversity or boundaries to systemic issues within agencies.

Here are a few examples (details have been changed slightly to, well, remain ethical). After a workshop that I presented on ethics, a counselor with many years in the field asked me if it would be acceptable for him to sell his beach condo to a current client. Um … no. He was stunned at my answer. Really?

A counselor stopped me in the hallway at a break during a conference to thank me for the referral of a client — whose name she said out loud. She then proceeded to tell me about the client’s backstory. I couldn’t believe my ears, and it took me a minute to compose myself and stop her from going further.

A former student expressed concern about the agency where she was working. The agency was encouraging its counselors to “push continued therapy” with full-pay clients, even when similar sliding-scale clients were quickly made ready for termination. It appeared that the focus on the bottom line in this agency was taking priority over clients’ best interests. Even more troubling, none of the many fully licensed clinicians in the agency had protested.

These examples are just the tip of the iceberg of the things I have seen or heard. How many more scenarios are out there that we don’t even know about? That, dear colleagues, should make us all shudder.

r.kathesi/Shutterstock.com

Dishonest people exist in every profession, including ours. But let’s set those dishonest few aside for a moment. The majority (by far) of questionable ethical behaviors that I’ve encountered in our profession have not been committed by dishonest people. Instead, most have been committed by reasonable counselors doing good work who have strayed over time from the course they set out on in the early part of their training.

I propose three reasons (beyond blatant dishonesty) that get at the root of these ethical lapses. First, is blind trust. In graduate school, counseling students can discuss ethics in the sanitized setting of the classroom, without the complications of real clients or supervisors sitting across from them.

When they start practice, they have the same blind trust in their supervisors or agencies that they had in their graduate school. Yet this is where they most need to put their ethics training into practice. But how realistic is it to expect a clinician-in-training to question a fully licensed and experienced supervisor? Even more intimidating, how likely is it that a clinician-in-training would challenge an entire agency?

“This is how it is done, I guess,” is an easy, and understandable, result in such a context. Those mistakes are then repeated and perpetuated.

Second is the termite analogy. Termites, despite their horrible reputation, are not that damaging if caught early. They work slowly, and all it takes to protect a home is to have regular inspections and to intervene if termites appear. No major damage will be done. But the nibbling away at the foundations of a home can eventually lead to its collapse, or at the very least some expensive repairs.

The same thing happens with ethical breaches. Most clinicians who sit before a state ethics panel have not committed egregious breaches all of a sudden. Their behaviors have slipped a little at a time until the metaphorical structure of their ethical life is badly damaged.

And, finally, these breaches happen because of a simple loss of focus. I don’t get angry easily, but I lose it if I hear clinicians talk about “having to do” their ethics hours. If clinicians see these hours as “obligations,” they are already traveling the wrong road.

These clinical trainings are imperative to ensure that ethical standards are, as with my supervisees, always at the center of everything we do. We should welcome ongoing training in ethics, even if it wasn’t required.

 

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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: Freud may have been right

By Gregory K. Moffatt January 25, 2022

As a young graduate student in a very person-centered program, most of my professors had little to say about Sigmund Freud that was positive, if they even said anything at all. Indeed, psychoanalytic theory is complicated and time-consuming, and much of it was based, at least originally, on Freud’s observations, experiences and speculations rather than on evidence-based study.

But I love Freud. On my office desk, I have a Freud finger puppet, bobblehead and action figure. Not because his theory and its components are correct, but because Freud got us started.

I think of Freud in much the same way that I think of the earliest pioneers in the automobile industry — Daimler and Benz, Maybach, and Ford, to name a few. Nobody would think of driving any of those early models farther than the grocery store or a local car show today. After all, many of them were open cockpit and didn’t have a fuel pump (they had to go uphill backward to ensure a continuous flow of fuel) or electric starter. They didn’t have heat, radios or safety equipment. Even into the 1900s, the windshield wiper, if it existed, was operated by hand.

But the general mechanics of the automobile haven’t changed much since those days. The early pioneers — in automobiles as well as in psychology — got us started hypothesizing. That is why I love Freud.

I can’t deny two major contributions that Freud made to the world of mental health. I’ve used the following line a thousand times in my career: “All behaviors that are dysfunctional, that are not physiological, are defensive.” If I can figure out what people are afraid of, I have a pretty good idea of where to focus my clinical energies. Freud was the first to give us the concept of defense mechanisms, and on this one point at least, I think he was exactly right.

The second of Freud’s major contributions involves our unconscious behaviors. A psychologist who sat in on one of my homicide profiling lectures at the FBI Academy said to me afterward, “This is all so Freudian!” Indeed it was. The idea that we speak through our behaviors is fundamental in profiling, but it is also fundamental in play therapy, which is my clinical area of focus.

We must assume that one’s behavior has meaning that is often outside of the conscious thinking of the individual. That is why profiling works. The perpetrator can’t not do the thing that tells me something about him. He does it intentionally, but not with conscious thought.

To demonstrate this, I often seek a volunteer from a live audience. “Why did you wear that shirt/blouse today?” I ask. I get a variety of answers, and those answers aren’t untrue, but they aren’t the whole story.

“It was all I had clean,” a man might in answering my question.

“Oh, really?” I respond. “So, if it was pink and had pictures of unicorns on it, would you still have worn it?”

Nearly always, the subject laughs. Of course not. The reason he thinks he wore that shirt was in his consciousness, but a deeper reason for why he wore it was outside of his consciousness.

Children do the same thing in my playroom. The toys they select for the sandbox, their arrangement of the toys, and the interaction between those figures is something they must do. Psychiatrist and author Lenore Terr calls this “abreaction.”

Children must tell the story of their abuse, trauma or experiences over and over until they find resolution. Imagine you are driving to work and, on the way, you see a graphic and horrifying car accident happen right in front of you. For days you will tell the story, over and over, as you try to find a place for it and make sense of it. Like the children in my playroom, you are intentionally telling the story but not consciously intending to repeat it over and over. You must tell it.

Over time, as you find a place for that event, you have less and less need to tell the story. Finally, it becomes just a story you tell rather than a story that you must tell.

Regardless of your theoretical orientation and whether you accept the premises that I’ve proposed here, one can’t deny that Freud gave us a lot to think about. Many of his ideas have been shown to be baseless. Interpretations of dreams, for example, even if they do have meaning, have no scientific evidence to support them.

At the same time, maybe Freud was right on a few things. And maybe, just like with the benefits we enjoy because of the basic mechanics of automobiles, all of us are in some way indebted to him.

bilha golan/Shutterstock.com

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Related reading, from the Counseling Today archives: “The value of contemporary psychoanalysis in conceptualizing clients

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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.