Be the change you wish to see

i think I am probably going to do a couple of weeks on my experiences at the bapca conference. This one will be less about my personal experience and more about BAPCA.

Going back to ADPCA last year, I listened to some people say they didn’t feel safe with ‘some people’ at the conference. It seemed to be a long-standing thing and I had no idea who or what it referenced. As the ‘outsider’ (it was my first time) it engendered a feeling of unsafety for me, and also of rules that I didn’t know if I was breaking. I didn’t know if I was talking to the ‘wrong’ person, and I am concerned about my own safety with regards to who is safe or not to become close to.

At the BAPCA conference this year, someone was named in group as having had several inappropriate relationships where you might reasonably expect those not to happen (for example, as a counsellor, tutor, trainer, etc).  I have to be honest. My first two responses were a) relief that *something* was out in the open and b) a thought about whether that was (one of) who was being talked about last year. I don’t know the answer to that.

I saw the community rocked by this. It became clear that some people were on one side and some were on another. My question was about whether there was evidence- my concern was that as a ‘newbie’ I was listening to a narrative by one person about another person (who had chosen not to be present) involving other people (also not present) that I’d never met. It becomes difficult to make a judgement although I tend towards thinking that ‘a string’ of allegations leads to some important questions. I was told a statement was made by one person and that originally the BACP were approached with that. That’s enough for me. At that point, I have to say ‘I believe her’.

A different community I am part of had a similar conversation last year. A consent violation was alleged, and initially denied. Then, much like the Saville case (and seemingly every high profile case since), more and more people came out to say ‘me too’, over years, even (in my case) as the original victim was still being vilified publicly and privately. I know that because when I contacted them privately to say simply ‘I believe you’ that’s what I was told in return. Those consent violations had been happening for years. I had not known and I had been at very personal potential risk.

For me there is no fence to sit on. I must be on one side or the other, and it is unthinkable to me that I should be against a potential victim. It comes from personal experience. Seven years ago I experienced my own consent violation. Dealing with the aftermath literally nearly killed me- I was spiralling into suicide attempts, an eating disorder, a lot. I came out of it thanks to my family. My mum literally saved my life. But a few months later I started to hear rumours about myself from friends across the country (From Suffolk to Northamptonshire to the Midlands) that I was accusing the person of X and that I was lying. On finding the original source of the rumours, it was someone I had briefly met once and who after the fact had met him and they had become friends. And the reason I say ‘there is no fence’ is because the people who said to me ‘I wasn’t there, I don’t know what happened, so I can’t say for sure’ essentially felt like they were saying ‘I don’t believe your experience is true’. For them, my aftermath meant nothing (I gave up my job, my home, my life and moved across the country to escape).

I cannot be that person. All the consent violations I have mentioned are different- I’m not equating any of them. But they are all deeply personal and involve a misuse of personal and structural power.

So, I was glad that the ‘rumour’ had names and dates. But it meant that BAPCA was now falling apart. I went to the ‘what’s next for BAPCA?’ meeting and also spoke to a few people and it was clear to me that there was some unease around the CG and processes. At the meeting, I was trying to decide whether or not to stand for the CG, when my friend spoke to stand. At that point I decided that I could too. I had not wanted to be the lone voice, but felt sure then, that on a lot of things I would not be the lone voice. So I have been co-opted on to the CG. I also know of one other person who definitely wants to be co-opted, and one who is saying she does (but I’ve had less specific conversation with her), and I think that the four of us are a) very different people to each other, but also b) very different people to many of the CG and I hope that it will provide a balance in processes.

I don’t know if this will be a long-term ‘staying’ for me or not. I am undecided on many things, but I also know that I do have a chance to change things- so I will take that opportunity up.

The growth of my counselling service (creating your own placement)

I wanted to talk some about growing this counselling service. Except I’m not really sure how it happened. But what I do know is that I went from starting with one client a week in September 2013, and gradually moving up to two (My average was 1.5 clients a week for the first year), I was able to approach a counsellor I knew who also wanted to work in the areas of gender and sexual diversity and ask if she wanted to join me. I don’t actually know what her numbers were for that year, but I think from conversations, that they were much like mine. My supervisor spent much of my first year telling me that I should get a second placement, and eventually, in October of 2014, I moved my own placement down to one evening a week, and started working elsewhere one evening a week.

 

That seems to have mushroomed my service. From about November I’ve had an average of just under 4 clients a night here. My fellow counsellor averages about the same, and we have just taken on a new trainee who has started with two clients (and may move to more). From never having a waiting list, our waiting list hasn’t dropped under 5 in 6 months. I live in constant fear that it will.

 

Now we have left the umbrella of the service we were with and are applying to become our own charity. The paperwork is in, we have moved offices (to a much smaller room that feels much more cosy), and I feel like I’ve spent a LOT of money on chairs, room rent and electronic systems for us (some of these I have not yet spent – they are upcoming). There was clearly a need for this service in my local area given the wait – currently at four months, and the fact that in the last week I’ve had more than one person tell me they wish this service had been around for them when they needed it.

 

Not all institutions allow students to create placements. I’m lucky that mine did, otherwise I would probably not have been able to complete my course (I did not anticipate this complete lack of evening availability when I signed up), and I guess that this week what I’m saying is – if your course allows you to do it, and you have a specific area you want to work in that isn’t already covered locally, go for it! It helps if you have some marketing experience and the like, but my service has gone from non-existent to having seen well over 50 clients in two years (my numbers add up to just under 50 and I guess my co-counsellor’s will add up to less than that) and my average number of client sessions has gone up, from about 4, to about 10. I think that says something a) about my improving skills as a therapist and b) about the types of things that my clients feel able to bring. They certainly bring very different things now to what they were bringing a year ago. Maybe it’s just a standard thing – I don’t know yet, I’ve only been in practice two years. I saw my first client on the 24^th Sep 2013, so just short of two years. And tonight, as my first night as ‘my own’ (there are four trustees; it is no longer ‘my’ counselling service, but it will always have been ‘my baby’) service in some way evokes all of that original process –How will it be? Will it work out?

 

I’m going with a ‘yes’!

Group process revisited

 

In the trainee facebook group I manage (but will be handing over soon as a ‘no longer trainee’), a conversation has arisen recently about process groups and acceptance. Coming out of that, and not directly relating to any one question I’ve been thinking through process groups.

 

All too often it seems to me, people in process groups are so keen to present themselves as ‘accepting’ that they do not question things. And when your tutor is in the room, of course – you don’t want to be perceived as judgmental or stereotyping etc. So when someone presents something challenging to us, there is a big temptation to say ‘yes – that makes sense’, even when it.. doesn’t. Even when we don’t get it; when we have questions.

 

I think about my own experience, part of what caused me to leave, where something about my life is on the surface accepted and no questions have ever been asked, but when I talked about the possibility of doing some training for the year below (as part of my make-up for missing two days when my dad collapsed and later died), a majority of the group seemed very interested in attending that.

 

It is a liberalist discourse, that says ‘everyone is equal’. And yes they are, individually. I am as equal as anyone else, but I identify with a lot of the ‘protected characteristics’ (disability, gender identity, sexuality) that mean that structurally, I’m actually NOT equal (by which I mean that there are more things stacked against me than the person who is straight and cisgender and has no disabilities – for a very quick one: people in civil partnerships are not AUTOMATICALLY entitled to the same pension rights as people in marriages). And the problem with a liberalist discourse is that because everyone wants to be perceived as being liberal, ‘acceptance’ is the name of the day. No questions are asked, thus, unless I (for example) keep putting myself out in to a void where no-one asks questions, and continually explain things for everyone, it is possible to make a lot of assumptions.

 

Of course, there will be some people in the group who get it and who are not asking questions because they will get it, but Dominic Davies’ (1998) paper echoes my sentiment:

 

“However, this avoidance of difference and denial of cultural variables can be very damaging for the therapeutic relationship. Clients may spend a lot of time trying to work out the therapist’s real frame of reference, and look for subtler signals of genuineness or incongruence. This detracts from the pre-condition of psychological contact (Singh and Tudor, 1997)”.

 

This I think, is similar for group process. It certainly rings true for me in my experience of the group.

 

Dominic (I did start by saying ‘Davies’, but I know Dominic, so this felt weird!) goes on to quote Tudor and Worrall:

 

“It is likely that if as therapists we consistently ignore or deny some of our feelings and experiences we will, out of awareness, communicate such unassimilated, or partially accommodated material to our clients”

 

And Rogers himself: “Rogers makes it clear that maintaining congruence isn’t always easy or comfortable and “includes being himself even in ways which are not regarded as ideal for psychotherapy.””

 

This suggests that it is healthier for all (especially when we will go our and see clients with similar histories), if a step can be taken by individuals in group process to say ‘actually – I don’t get it. I’d like to. Can you tell me about X’.

 

As one of my group once said to me (I paraphrase): ‘assume kindness’. It’s a mantra that has worked. I know that in group, I am working from a place of kindness and trying to understand, and assuming that others are (until otherwise told) helped a lot. Here – if you don’t get something or need more understanding, you can commit to doing some research (and nothing made me happier than when people said to me ‘I was reading this thing on gender’) and at the same time, you can express that you don’t get it. You will probably be much better accepted than if you supress that and the person at the side of you can see it, despite utterances to the contrary.

 

In short – it’s DIFFICULT to say in group that you don’t get something. It’s hard to stand out and be that person. But you will make a much better experience for the person who was brave enough to speak, to KNOW that they have been heard and that you want to engage with them, than if they speak and are met with a wall of what can feel like placation with no attempt at understanding. And – if you DO get it, say so. Say why. Let the person know you’re with them, don’t let them sit alone.

 

Reference:

Davies, D. (1998) ‘The Six Necessary and Sufficient Conditions Applied to Working with Lesbian Gay and Bisexual Clients.’ The person-centered journal [online] 5 (2), 111–120

Feeling the pressure of using ‘skills’


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I remember how metaphorically naked I felt. That first session. My face (which has a tendency to betray me, colour-wise) feeling somewhat scarlet in a building not overly warm. I should probably go back and look at that blog post for the first hour – see what I said. But one of my biggest thoughts was that i HAD NO TOOLS! JUST ME! and those tools were a potential armour. The stereotypical ‘tell me how you feel’ not quite seeming to cut it as a protection in the same way that a CBT worksheet might.

 

It was just me.  Alone. With nothing. REALLY SCARY! However, I should say that my tenth hour was with a client who went on to stay with me for over a year. They recently came back to help them through an unexpected situation for a couple of sessions, and somehow the topic of them first coming, came up, and in the conversation I mentioned that it was fairly soon (although I didn’t say exactly when) into my seeing clients that they came. They were surprised, not having registered that i was SO new. All my clients know that I am a trainee, but no-one has ever questioned my statements so I have never had to say more than I am comfortable with. But it was lovely to hear that I had not been seen as ‘rubbish’, even though I had nothing to ‘hide behind’, as it were.

 

But recently I spoke to a new client about the possibility of doing some focusing, because that feels appropriate for what has come to therapy. I’ve had training, I’ve USED focusing, but I don’t use it as part of my therapy, so to speak. I do it separately, and don’t use much of it in sessions. The discussion of, and desire of the client to try focusing sent me rapidly scrambling for books (noticing that one has gone AWOL and i haven’t the slightest clue where it is!), ready for the most recent session. And before the session, desperately trying to remember ‘these things are important. DO THESE THINGS!’. As it happened, we didn’t do focusing, as it didn’t feel the right time.

 

It’s a marker of how far I’ve come, that I was absolutely happy with just seeing a client, vs lots of panic! It was the application of tools that made the difference to me and has gone from being a ‘good thing’ (to hide behind) to something additive to my normal therapy. It’s also a reminder to keep myself up with the things that are important to me. I love the PCA, but focusing also speaks to me. And life – that has a habit of getting in the way. Must make/take time.

Messing up

 

 

We all mess up when we see clients. And to prove it, I’ve asked around a couple of trainee friends and acquaintances to share some of their experiences with you. I’m naming no names, and I’ve changed details if people are possibly identifiable, but you’ll see from the list that the mess ups go from ‘inconsequential’ to ‘something that was talked about in supervision’. Some of them are mine, some aren’t. I’m not sharing which are which. But this is for students not yet in (or just starting) training – we mess up! It’s usually not the end of all things!

 

1: when getting up to show out a client, I stood up and immediately fell over. My foot had gone to sleep and I hadn’t noticed.

 

2: I wore my top inside out for the whole evening, only noticing on my third client.

 

3: I once didn’t turn the handle to the waiting room properly and as a result, walked into the door, and then the waiting room with a very red face.

 

4: Checking my phone between clients I realised I’d not put it on silent. Lucky for me, no calls came in!

 

5: I got in to my client room to discover the clock had been taken away and I wasn’t wearing a watch. I managed to time it JUST right

 

6: On an evening placement, I became aware the cleaners were cleaning as I was seeing my client and I had forgotten to flip the ‘counselling’ sign to ‘in use’. I felt my heart pounding as I tried to decide what was best to do. It seems daft now.

 

7: I asked for some fairly low-key advice on a client thinking they had left, but they hadn’t. It wasn’t anything that broke confidentiality, but I feel mortified.

 

8: Seeing a client for their second session I went in whilst they were getting a hot drink and started to say hi but they ignored me. As they turned around I realised it was a friend of the client’s and the client was there waiting for me.

 

9: One of my clients always has squash. All the others have water (squash is an option if asked for but they are the only person to ask for it). Last week I was flustered with the client before and I forgot and put water out. I felt terrible when they asked why they had water.

 

10: My files are anonymised. I had two new clients lined up to start in two weeks. When I went in to start, I didn’t have a record of what their names were. Luckily for me, they were recorded on an old version of the spreadsheet for the placement. It took me about half an hour to find the names. (They both DNAed).

 

So there you go. Random things trainees have done and had it work out ok.

 

What things have readers done?

 

 

Endings

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Someone asked me to write about endings, so here it is.

 

There are several types of endings I’ve been through since I started seeing clients:

 

The ones where clients stop coming without notice and don’t respond to any contact

The ones where clients call (or text) and tell you they aren’t coming

The ones where clients come and ‘out of the blue’ tell you in session that this is their last session

The ones where you and the client plan for an ending together.

 

Putting aside the ones where you don’t see a client to plan, this is how I have experienced endings in the past.

 

When a client reaches a point where either they express a desire to end (or spread out sessions), or I notice that they seem to be heading towards this, I tend to point out that something has changed, and ask them how they feel about lessening or ending sessions. I often find that clients are surprised when I suggest that they can move to fortnightly (and then monthly) sessions rather than just ‘leaving’ and so far, I haven’t had a client say they would rather just stop – there is a certain safety net in ending more slowly and seeing how it feels to extend time without seeing your counsellor. I recognise that not all placements allow this however (I believe that my formal placement – as opposed to my own service – runs in this manner, although I’ve never tested it).

 

In that last session, it can feel odd – what do you do? How do you keep it person centered?

 

For me, I let the client run the session where I can. If I am at one placement I have to go through some paperwork. I get that completed at the start of the session, and then I let it go pretty much as a normal session in all honesty. I might ask a client how they are feeling about ending and explore that with them, but it’s unlikely to be the first time it’s come up – I would probably feeling a bit remiss I’ve got to an end session with a client and HAVEN’T talked about endings.Once my clients understand what is available from me in future if needed I am happy for them to direct the session as normal. As however they want to have the session. Is there something specific? No. For me it’s about making sure the client is ok in the last 50 minutes. I’ve had clients come in their last hour who obviously didn’t feel they *needed* to come, but wanted to. I’ve had clients come and say ‘I haven’t mentioned this BIG thing before, but I just want someone to know it: (XYZ)’, and then once I’m told, I become almost the ‘holder’ of that thing, and they feel they have achieved what they need. In my own placement, I let clients know that if they want to come back, they just need to contact me and I will put them on the waiting list (or offer them a space if there is one), and in my other placement, I explain what the procedure is (there is a period of time clients must wait before they can go back on the waiting list, but in that time the associated helpline is accessible).

 

There’s no real ‘one way’ to do it, and it’s more about staying true to each of my client relationships, than any particular ‘person-centered’ process. Do what feels right 🙂

You’re voting for whom?!


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A client recently told me who they were intending to vote for. It was a shot out of the blue for me; I would not have expected it and had to work quickly to move the surprise from my face and maintain a clear face – the party wasn’t the important thing at that point, so I was able to put it to one side. But I guess it’s just another one of those times where a client surprises you with a thought or a word about a group of people, (positive or negative). It’s happened to me before – I’ve lost count of the times I’ve heard from varying clients ‘I’m not racist, but..’, or a homophobic, biphobic or transphobic comment, or an anti-religious comment, or an ableist one. It’s a conversation hotly debated amongst trainees; do you challenge, or do you let it go? Is it important to the working relationship? Does allowing the comment to pass unchallenged somehow make my practice (as in my overall place of work, as well as individually) in some way oppressive? Does it challenge UPR? Is it un-person-centered?

 

I haven’t come to a conclusion as of yet. So far I seem to be in a place where I gently challenge an outright prejudiced comment, to see if the client genuinely means what they said, or if it is just a throw-away, IF the context of the conversation allows for it. I don’t stop the client’s process and offer ‘whoa! wind back a minute! you said…’, but I might point someone back to it and check my understanding was correct. If it is, and the work allows for it, I might unpack it.

 

The problem with this is that the only things that get picked up are those in the client’s awareness. I’m willing to get that in counselling rooms across the country, clients are saying some things that are shocking, and counsellors do not see them as problematic. In my other life, I read a paper recently about the teaching of ‘homosexuality’ in schools in sex and relationship education. In the paper, 60% of teachers who took part said that they were comfortable teaching about being LGB (T is rarely mentioned), but 60% of the teachers who were observed teaching about LGB identities we rated as being in some way ‘problematic’ in their teaching, either through their lack of addressing prejudiced comments from students (or joining in with prejudiced jokes) or simply because they just ignored the fact that LGB identities existed. All of those things are problematic – whilst ‘other’ identities remain othered, there is a danger that they remain ‘easy targets’. By bringing those identities into the counselling room we make them less available for negative comment – by usualising them.

 

Political identity however? I hope it’s something that changes over time, and for the ‘better’ (I’m joking here….)

Dual roles and ethics

 

 

The thing my counselling course is so hot on (understandably!) is.. ‘ethics’. Speaking as a student who was unable to get permission to do a piece of work with their cohort on the training experience because of the issue of ‘dual roles’, I have come ‘up close and personal’ to this issue a number of times.

 

As a person counselling in a small community, I have (inevitably perhaps) bumped into ex-clients at events. As a (trainee) counsellor with some minority interests, I have met other counselling professionals unexpectedly in some quite intimate venues. Both of these things are things you often can’t (or don’t) legislate for in advance. As much as I might talk to a client about the fact we might bump into each other at an event, I don’t always hold in mind that I could bump into ANY client at ANY event (although when I put the bins out in my PJs the other day it was definitely top of my list of thoughts).

 

But something that is rarely talked about and (by my institution at least) is something that I know has been an issue for at least one other trainee, and that is when your supervisor is also your placement co-ordinator. How do you manage that? It is probably fine when all is going well, but what if you have an issue with your placement outside of supervision (say you have a particular area of expertise and your placement is less than expert on the matter and you want to raise it)? What if your placement has an issue with you? Normally this would not be necessarily dealt with in external supervision – procedural issues would be addressed in placement, and if YOU felt it was an issue, you could decide to take it to supervision. When your co-ordinator is your supervisor this separation may not be possible.

 

It’s something that’s recently become more relevant for me because for the first 15 months of seeing clients I was running my own placement. Now I am in a second placement where my supervisor is the placement co-ordinator and I am having to negotiate where something is one thing and where it is another. My advice would be to have something concrete set up: we’ll have supervision X times a month, but it may be that I need to talk to you about procedural things outside of that and we will do that outside of supervision. Or: we’ll mix the two. It doesn’t have to be one way or the other, but until I was in this position it never occurred to me that without those boundaries I would suddenly be experiencing contact with my supervisor that did not feel like supervision, but was perhaps, billed as that.

 

From all I can see, we hit dual roles all over the place. A friend recently asked me if I could recommend a counsellor for them. And i can. But only because I know the counsellor. If i didn’t know them, I wouldn’t be able to recommend them. So now my friend may be seeing my friend who is a counsellor (I haven’t, and won’t ask. But if they say they are, I will negotiate that. But it’s still a dual role: friendship/professional relationship). I co-run a person-centered group locally. Trainees and trained counsellors come. Some of whom I am aware of from other services. Some of whom I know from my life before. It’s a dual relationship. I work with someone who is related to a friend. These are all dual relationships that we are expected to manage, without even really a passing word. Whilst I could not get ethics approval to write a paper about the student experience (because it was a dual role), I will be allowed (or at least, in the past others have ben allowed) to interview potentially people from my cohort for my dissertation. It’s a dual relationship. As are all the others. But in the others, it is a given that I will be expected to manage that.

 

Being non-binary in binary places

 

 

Non-binary. What’s that then?

 

“Non-Binary Genders are gender identities that don’t fit within the accepted binary of male and female. People can feel they are both, neither, or some mixture thereof. It might be easier to view gender as a 1-dimensional spectrum with male on one end, female on the other, and androgyne in the middle- but the reality is that gender is more complex, and 3-dimensional models with axes for male, female, and how strongly you feel attached to that gender identity have been suggested.” from the gender wiki

 

That, in a nutshell, is me. I have never really identified as ‘female’ and in fact, I’m quoted in a book that I’m not going to link to here that was published in 2006, saying that ‘I do not know what ‘woman’ feels like. I only know what *i* feel like’. At that point, I didn’t know that non-binary existed. I remember as a small child, thinking that I must be a boy. But that feeling faded a bit. I don’t feel female. I don’t feel male. And sometimes I feel like both together, or neither at once. Or – that’s not quite true. There are days when I am comfortable performing gender in one way, and some in another. Today I am wearing a skirt and presenting as you’d expect ‘a woman’ to present. There are other days when I am in jeans and a button-down shirt and presenting in a way you’d expect ‘a man’ to present. And days when I mix that up. Most of the time, my identity is stable. As non-binary. As genderqueer. As me.

 

But I am perceived (coded) as female. In mixed-gender places where people know my pronouns (they/them/theirs) they use ‘she’ unapologetically and without conscious thought (I hope). I hope, because everyone does it. Counsellors, trainees, workplacements, university, loved ones (at least my loved ones correct themselves. This helps), everyone.

 

I had a much more personal story written; the story of what’s happening with my placement. But I am choosing not to share it here, and instead, will share something I read on facebook the other day:

 

“When trans people say “respect our pronouns” we are not just asking you to shift your language, we are asking you to shift an entire paradigm around sex, gender, and race. It’s not enough to change one word when we are asking for the end of an entire worldview.

What we are saying is not just “this word makes me feel good,” but rather I demand the right to narrate my body and my history on my own terms in a system that is predicated on categorizing, containing, and criminalizing me.

When we say “respect” what we mean is fight like hell for me. What we mean is I wasn’t just assigned this gender at birth, I am non-consensually gendered every day and what are you going to do about that?

This is not an opportunity to be politically correct, this is an opportunity to stop being incorrect.” Darkmatter

I do not (yet) call myself trans. But I also recognise that strictly speaking, I am not cisgender; My gender identity is not congruent with the sex I was assigned at birth. But the lines above, they speak to me.

 

Never assume that you know someone’s pronoun. How we perform our gender does not necessarily have anything to do with our gender identities. You would pretty much always look at me and code me as female. sometimes I wear skirts. Sometimes I wear jeans. I’m still ‘they’.

I post this today, with trepidation. But why should I not be me? Anyone else with me (please feel free to comment and say it’s private and I won’t undo it – unless you’re a person who has automatic approval!)

Clinical formulations and the person-centered approach


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Following on from last week’s post:

 

The second part of this for me was about clinical formations and how I think they have something to teach us as person-centered practitioners. For a long time I have had issue with the ‘processes’ that we have a tendency to use in the person-centered world- ‘fragile process’; ‘dissociative process’ ‘psychotic process’ (other processes incoming) and my issue is as to whether it’s inherently any better to say someone has ‘autistic process’ than it is to say they have ‘autism’, or ‘dissociative process’ rather than that they dissociate, or whether ‘dissociative process’ is a better way of describing than a client’s own potential label of ‘I’m a multiple’.

 

In all the process definitions I have most often seen them referred to as something someone has, rather than a way in which we do something. That for me feels as stigmatising as sticking with the diagnostic codes in the DSM. When people start saying they have ‘fragile process’ in the same way that they might have said they have ‘borderline personality disorder’ or ’emotionally unstable personality disorder’, are we missing a point? Are we in some way finding a new way to diagnose someone? As a trainee, I hear these as absolutes a lot, rather than any kind of ‘in process’ thing. It’s labelled as ‘difficult process’ in the person-centered world, and I have to wonder: ‘difficult for whom?’ Undoubtedly society is set up so that these processes probably often ARE difficult to the client, but is it also that they are difficult for ‘us’?

 

Clinical psychology with its use of formulations (as explained in the book) seem like a good way to get to ‘why’ things happen, and I would suggest that for the most part, things don’t happen because someone has ‘fragile process’, they happen because someone experienced some early trauma that contributed to the resulting action that we now see. What would be more helpful to the client:

 

You have dissociative process?

Why?

Because you dissociate.

Why do I dissociate?

Because you have dissociative process

 

(The above by the way, is the example Lucy gives, only using standard DSM diagnoses, in the book). Or

You dissociate

Why?

What has happened to you in your life?

Well…..

 

I wonder if we have become too keen to label our clients as having some ‘processes’ and whether that actually gets in the way of relating to our clients, and whether it would be better to put those aside also.