Monday, January 26, 2009

The Helping Environment

A Helping Relationship


For those who haven't heard of Carl Rogers, here's a summary of what research has found to be of the most help in counseling: That the client feels that his/her therapist is trustworthy, that the therapist tries to understand them, and that the therapist is being genuine with them.

Techniques and teaching methods alone do not bring about improvement. It's hard to trust the process, if you don't have faith in the person putting you through it. This is true for most relationships, even those that you may not consider personal. Take calling up customer service for help, for instance. If the representative doesn't seem to care about your problem or doesn't seem to understand, you're not likely to have much faith in what they tell you--especially, if like me, you normally find that this type of customer service representative is far more likely to tell you something that causes more harm than good. Not getting enough data will give diagnoses that may be very wrong and don't fit in with the other things the client is experiencing. It's hard to give sensitive information to someone whom you don't trust, even if you know intellectually you should. It's a matter of self-preservation.

But if one has the knowledge, they can tell you what's wrong. And knowing what's wrong is half the battle, right? To such a question, I answer, "Only if the diagnosis makes sense to the one it's being applied to." Though to be honest, I still believe that a diagnostician who doesn't have the client's trust is working under a handicap. Anyway, no diagnosis will help a client to make any significant change to their lifestyle if they don't comprehend it. I can't find my book right now, but I believe it is in John Bradshaw's Healing the Shame that Binds You where the author gives the example of a preschooler being reprimanded for riding their tricycle beyond the corner, after being told several times not to. While the parent was engage in rage, the terrified child looked up and asked, "What is a corner?" No one can follow instructions they can't understand.

Another situation that many people are probably more familiar with: someone is in a very abusive relationship, who really should leave, but doesn't--or if they do leave, they return to it after a while. Most people who have been on the outside looking in, often give up on the person, saying things like, "They want the abuse." "They're idiots." "They're just hopeless." However, what often happens is these people don't leave because they really cannot comprehend how to live differently. Sometimes financial or cultural issues keep them there. Sometimes they don't understand the help they can receive. However, some of them stay because of beliefs that the relationship will change if they just work hard enough at it, or love the person more, or that they are the ones at fault. These people can be pressured into leaving their abusive significant other, but they do it to please those pressuring them, not because they themselves believe the abuser is horrible. In fact, being insulting about the abuser is more than likely to bring out the protective response in them. As long as they see some hope in the relationship, they won't give it up easily. Only they can make that decision and make it stick. After all, if you are demanding them to get out of the relationship, you might appear just as bad as the abuser they are dealing with. That's not to say that you shouldn't tell them that there is something wrong, if they appear open to it. Nor am I saying that you shouldn't interfere if it becomes a matter of life and death. However, when all is said and done, only the person can finally cut those ties.

What has worked the best for me when in such a situation is to emotionally support the person in their decisions and let them know that I am there for them, even though I don't agree with them. Usually when they no longer feel pressured to defend the abuser or the relationship, they are able to make the decisions necessary for their own happiness and there are no "What if I had tried this or that?" regrets to contend with. When all is said and done, they need the support more than they need the problem labelled, though the label can help them to address the problem.

Grossly simplified: diagnosis is not the same as therapy. This is a particularly sore spot for me because as someone who intends to become certified as an art therapist, one of the greatest frustrations I have is getting people to understand that when I speak of doing art therapy, I am not talking about using the client's art to see what's wrong with them--I'm talking about the client using their art, especially the process of making it, as a means towards self-understanding and growth. Yes, it is possible to diagnose certain conditions through artwork. Studies have shown that schizophrenics often draw in a certain manner and that sexually abused children will often exaggerate certain body parts when drawing people. However, studies have also shown that it is what an individual personally attaches to an image that matters when it comes to a therapuetic art process. And non-directive therapuetic artmaking works better in most cases than telling the client what to draw, even though directive artmaking is not without some benefit.

The research on Carl Rogers' person-center therapy has been so convincing and thorough that almost all schools of therapy promote using it in addition to their methods and philosophies. But how does one foster this trusting and safe environment with a client? Not without a lot of soul searching on the part of therapist. To be able to provide a safe environment to allow the client to explore the dark and scary parts of their own psyche, the therapist has to be able to not only deal calmly with the client's fears and anger, but their own. We are never truly as good about hiding things as we often belief we are. Things slip out at times and if we do not handle those feelings with genuiness, then we give our clients very good reasons to feel at least a little unsafe around us. They will hold back telling us about certain feelings and thoughts to keep the therapist from reacting badly. However, if the therapist also has shown that they believe in the client's abilities to grow and be stronger, then the relationship has another mooring to keep it in place. Likewise, an understanding of the problem as the client experiences it creates yet another mooring.

In a way, the therapuetic relationship is like scaling a cliff with the therapist as a guide and safety line. Both therapist and client has some treacherous terrain and loose rocks to look out for, but a skilled therapist, like a mountain guide, makes sure the safety lines are in place and knows not only how to handle the situation when the client slips, but what to do in the hopefully uncommon situations when both do.


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