'I didn't walk out that day feeling "fixed" or free from my pain, but I did walk out with more wisdom and perspective'
On 13 October 2107, my 30-year-old brother David died peacefully in his sleep. He went to bed the night before and just never woke up. It was a complete shock and so very painful.
As soon as I arrived at my parents' house and my dad blurted out what had happened, I saw him in a way that I had never seen him before - so broken and vulnerable. At that point, I instinctively told myself that my parents had to come first, my emotions came second: I needed to do whatever was needed for them.
As you can imagine, the following days, weeks and months were very difficult. I was at my parents' house every single day for the first month, doing whatever was needed. For the most part, I kept strong - on the outside at least. I made teas and coffees. I tidied up, I went shopping. Keeping busy meant I didn't have to stop and absorb what had happened.
At home, I tried to remain composed in front of my children but would crumple every night in my husband's arms. He was really good. He would always ask me if I wanted to talk about it, but I never did, so he just held me while I sobbed.
I've always found it difficult to verbally express how I feel, but after my brother died this only intensified. I didn't feel that anyone could understand my pain. Yes, we had all lost David, but no one else had lost their brother. No one else had to watch their mum and dad broken and in pain and know that there was nothing they could do. So, like many of us, I buried it deep.
As you can imagine, the pressure was building. I know this is a metaphor, but there were times that I swear it felt physical. My dad had been seeing a bereavement counsellor and kept suggesting that I do too. After months of declaring 'I'll be OK, I can deal with it myself'. I gave in. I put myself on the waiting list to speak to someone out loud, truthfully, about how I felt.
When my first session was booked, I vowed to be completely honest. There was no point doing this if I wasn't going to do it properly. I knew that speaking to someone external and impartial would be better. I just wanted to be heard. I didn't want to be interrupted or given the 'It'll get better with time' dismissal that essentially invalidated my emotions.
I went into that first session not knowing fully what I was going to speak about or where to start. I had an idea, of course, but the lady I saw was amazing. She let me lead the conversations but gave me prompts when I struggled. She also told me that I didn't have to fill the silences - that I could just sit with how I felt until I was ready to speak. She gave me permission to be honest without having to worry that I would be judged. She listened to how far I had come and the coping mechanisms that I was currently using and suggested ways to build on what was already working for me, as well as some new ideas. She helped me realise it was OK for me to speak to my loved ones about how I was feeling, and about my brother - silly things he said how he made us laugh, and how much I missed him. Because I was no longer struggling to push my emotions down, I felt lighter and liberated and had space in my own mind for new and exciting things.
I didn't walk out that day feeling 'fixed' or free from my pain, but I did walk out with more wisdom and perspective. That was my first and only counselling session, not because it wasn't helpful but because the counsellor made me realise that no one can 'fix me'. I realised that I didn't need a specific day and time to speak about how I felt. I realised I have the power and the tools to help myself.'
Extract from article published in Therapy Today, May 2019, Vol 30, Iss. 4. The author, Rhiannon Jones is a writer and trainee life coach. Her book 'The Web of Grief', is available on Amazon.
'There is no point in trying to force yourself to do something if you don't want to, or if you are doing it for the sake of other people. You have to want to do it for yourself.'
"Being 14 wasn't an easy year for me.. I got back in brief contact with my father through email, but it was exactly that - brief. He and my mum split not long after I was born and, by the time I was about five, he had completely cut himself out. I also found out that I had a rare, inherited condition that my mum had too, which is why she was in and out of hospital when I was growing up. I felt my family had kept this a secret from me for all these years, and my relationship with my mum, which had always been good before, took a turn and went toxic. When I wasn't at school, I spent most of my time in my room, to avoid any confrontation or hurt.
I was really struggling to decipher how I felt. I didn't know how to vent, or deal with the mix of emotions and feelings - the anger, sadness, fear, worry and even excitement and happiness. It all felt too much. Then, when I had just turned 15, my mum insisted I spoke to someone who could help. My guidance teacher at school, who had supported me through a lot before, referred me to a counsellor who came to the school each week.
I had no idea what a counselling session would be like, but the counsellor was lovely. She was so welcoming and down-to-earth and promised me that everything said in the room would be kept between us unless she thought I was in danger. Some days she would bring along her dog, a chocolate Labrador, and he would sit next to me through the session. Just his presence was so comforting.
When I first began counselling I didn't feel ready to begin 'the recovery process'. Talking to a counsellor felt like an admission of weakness. I didn't just spill my life story out to her. It took time to open up, to fully trust her and feel safe. Over the course of the sessions, she identified I had anxiety and depression, which I knew very little about then. I just thought it was who I am, part of being a shy, quiet person; that how I felt was normal for someone who had been through my experiences. I guess I wasn't completely honest with myself.
Even after I began counselling, I definitely relapsed. For the first eight months I had some terrible days - terrible weeks even - before I decided I was sick and tired of feeling the way I did. Only then did I manage to find the strength to open up. Through talking to the counsellor, I learnt that there's no point in trying to force yourself to do something if you don't want to, or if you are doing it for the sake of other people. You have to want to do it for yourself.
As time went on, the counsellor taught me techniques to help overcome negative thinking. What seemed like simple exercises have become tools for me to use whenever I feel down. She always reminded me to 'take control'. Those two words that will stick with me as I go through life. I wear a bracelet with 'Take Control' on it as a constant reminder.
It took a year of counselling for me to feel better again. It felt like I was emptied of the negativity that for years had dragged me down each day. I am better and stronger. Even though there have been bad times since when I've slipped back, or had overwhelming feelings, I remind myself that everyone has bad days and these are just some of mine.
If I hadn't spoken to the counsellor, I don't think I would have ever taken control. Counselling saved me. We can all benefit from a safe, confidential space to talk to someone who won't judge you. I hope my story will give other people out there the motivation to ask for help. It's important to know that everyone is deserving and you are strong enough to take control!"
Extract from article published in Therapy Today, April 2019. Vol. 30. Issue 3 by Kathleen Campbell who works at Bright Light, the Scottish Relationship counselling charity. This article is based on her blog on the Bright Light website at www.bright-light.org.uk.
'In a moment of frustration, I leant forward, locked eyes with her and said: Kate, I'm afraid I don't buy it"'
'It's a cold, bright, winter's day and I'm sitting on a tightly upholstered sofa, opposite my client, a diminutive 80-year-old lady, who is tightly clutching a tissue and staring at me, wide-eyed, from under her many layers of woolens. Silence. The clock is ticking on the mantelpiece and my heart is racing.
Kate had just been telling me how, following the death of her husband, she was struggling to cope with her lifelong agoraphobia and depression - all reported through the observations of others. "The doctor told me when she gave me the medication and the children tell me I'm depressed too, so I must be, mustn't I?"
Yet, as we talked, she had also revealed another narrative - one of extraordinary resilience and resourcefulness. In a moment of frustration, I lent forward, locked my eyes with her and said: "Kate, I'm afraid I don't buy it." A stare, a blink. "I think it is maybe only others who think you can't cope."
Needless to say, I took this moment to supervision. I am still not sure what prompted me to be so direct. As soon as the words left my mouth and she made her small "Oh" in response, I experienced a post-climatic rush of doubt. Was this too much? But I know that, in that exact moment, I was passionately committed to creating something new for Kate.
It can be hard as a caregiver, family member or professional to transcend the visible signs of frailty when we see them in others and to resist assuming the role of a rescuer. Freud ridiculously believed that older people were not able to make effective use of therapy: Erikson argued that the final stage of life is about integrating past, present and future to merely find acceptance of the life that has been lived. I would argue that, even in very old age, it is still possible, indeed crucial, to actively challenge long-held life narratives and dare to write new ones. This moment with Kate allowed me to see that apparent fragility does not mean that we avoid challenge, as long as it is held gently and appropriately.
I think we can find a balance between treading carefully and providing an environment where challenge and active discourse can happen. if we can only engage in surface-level, inauthentic talk, we are missing the magic of what happens when two people really meet. I could have said "Hmm, I know things are very hard for you at the moment", or even made a gentle reflection: "You feel unable to cope". But I certainly wouldn't have been authentic (I was frustrated as hell), and I'm not sure I would have been serving Kate terribly well, as this is what everyone else seemed to be telling her. We can value our clients' frailties while allowing them to depart from the norm of their experience.
Sadly, there is no happily-ever-after denouement. In our three remaining sessions, we had planned to reflect on the coping mechanisms Kate had devised many years before, which had worked for her, to try to find some confidence in her own abilities. The day before the next session, I had a voice message from her daughter: Kate was feeling unwell and wouldn't be up to our next session. The following week, another message: "The doctor feels the counselling isn't a good idea for her as it is bringing up things that are difficult. Thank you, but she doesn't want to have any more sessions."
My hope is that we had a least challenged together the construct that she 'couldn't cope' and re- imagined it as 'I can find my own ways of coping', but I can't know for sure. However, this moment serves as a constant guide and touchstone for me if I think I am retreating into 'tea and tissues' with clients who seem to be vulnerable, particularly those who are profoundly old and infirm. My plea is that we all consider when we might be filtering or making allowances based on our own perception of a client's weakness. it is, of course, and illusion, and the pull to rescue is powerful. Yet we all confront the realities of our own lives when we close the door on our counselling room - a poorly relative, a challenging child, a marriage in trouble. We all cross the boundary from "I'm ok" to "I'm not ok" in the blink of an eye.'
Extract from article by Helen Kewell a humanistic counsellor in private practice in Sussex and who also volunteers as a counsellor and supervisor for Cruse Bereavement Care. Her book, Living Well and dying Well: tales of counselling older people, will be published this month by PCCS Books. Article pub in Therapy Today: March 2019: Vol 30: Issue 2
'I went home knowing that I was no longer having to cope on my own'
"The doctors came across the cancer tumour in his lungs by chance. My husband has chronic obstructive pulmonary disease and we had taken him into hospital because of that. It was a moment of utter disbelief and total shock. We were told there was absolutely nothing that could be done, that we should go home, put everything in order and basically just wait.
Our minds were in turmoil, trying to come to terms with the news. I began to feel desperate for someone to talk to. Our families live quite some distance from us and I didn't want to burden them. I didn't feel I could speak to my husband as it only upset us both. So I bottled things up. My husband had nurtured and supported me throughout our marriage and, all of a sudden, our roles had changed.
It was as if my prayers were answered when I read in the local paper about an organisation offering places in group therapy for people affected by cancer.
Attending my first group session, I met five complete strangers, but, as the weeks went on, I went home knowing that I was no longer having to cope on my own. As the weeks progressed our friendships grew and we all felt confident enough to open up and discuss things that we could not talk about with anyone else. We found most of us were feeling/thinking similarly. We all felt we were being selfish in wanting to talk about how the cancer was affecting us, as carers. What is going to happen to me? How do I cope? It sounds selfish even now, but that's what I needed and I got reassurance from the group and the counsellors that it was OK to think of myself. I was scared -what would life be like without him? I wanted someone to help me through this, to wrap their arms around me and tell me it was going to be all right.
Our two counsellors were absolutely amazing: they were patient, understanding and had an ability to know what to discuss and how to get us to express our fears and concerns and put them into perspective.
Up until week nine of the sessions, I'd joined in all the discussions, but my reason for being there had never felt real. I hadn't accepted my husband's diagnosis and the ultimate consequences of it. That week we participated in a mindfulness session. Almost immediately I felt my whole body relax in a way I'd never felt before. I didn't want it to end; I wanted to stay in this happy, carefree place forever. As the therapist brought us out of it, all my pent-up emotions came out too. It was the first time I'd cried, and it was then that the reality of what was happening and why I was there hit home. And all of a sudden, it all made sense, I knew what I needed to do; my mind was no longer full of cotton wool. Everything I'd learned from the weeks of counselling and discussion clicked into place. This was my turning point.
The course went on for 12 weeks and it that time we laughed a lot, cried a lot, spoke honestly and reached our personal targets. For me, that was to be able to talk about the situation without getting emotional and to feel confident that I would be able to see this thing through to the bitter end, and beyond. We are all still strong friends, still supporting each other and there for each other when things get tough.
If I hadn't accessed this group, I really don't know what sort of state I would be in now. It changed me completely. People say that I am more confident; my husband says he knows now that I will be OK when he has gone. I think he is proud of me. I now say how I feel and I think I am more open, more caring, less critical and more honest - all because of counselling".
Extract from Therapy Today; February 219: Vol 30: Issue 1. The author of the article was a client with We Hear You (WHY), a charity in Somerset that provides free professional counselling to anyone who has been affected by cancer of any other life-threatening condition. For more information, visit www.wehearyou.org.uk.
The need to be like others
"The third need of the developing self Kohut called the twinship or alter ego need. He thought that children need to know that they share important characteristics with one or both of their parents, that they are not too different from the world into which they have been born. If this need is met, the growing person develops a sense of belonging, of communal status. If this need is not adequately met, children are in danger of feeling that in some basic way they are not like other people, that they are somehow strange and don't fit in.
For much of his career, Kohut had thought that the self could most usefully be understood as having only two components - the grandiose-exhibitionistic and the idealised parental imago. He added the twinship need late in his career and consequently wrote less about it. For our purposes, it is enough to note that it's part of the self. It will be helpful to us in our effort to understand certain transferences."
Extract from "Between Therapist and Client; The New Relationship by Michael Kahn. Pub . A.W.H. Freeman/Holt Paperback c 1991 and 1997
The need to idealise
"A second strong need of the developing self is the need for what Kohut called an idealised parental imago. It is important that the child can believe that at least one parent is powerful, calm, and confident. If this need is fulfilled, the child can count on help from that powerful, knowledgeable, and calm person in the face of an external world too complex for a youngster to comprehend and internal events too chaotic and frightening for an immature ego to deal with.
Here, too, parents must sometimes fail. No parent is omnipotent or omniscient, and from time to time that fact will reveal itself even to a young child. And the child who has had repeated opportunities to identify with power and knowledge will be able to discover, when the failures come, some power and knowledge of her own. Thus, bit by bit, through the process of transmuting internalisation, the child will come to see herself as powerful and to feel confident of her ability to cope both with the external world and with inevitable internal conflicts and pressures. This confidence is a key part of the self.
As this part of the self grows and matures through childhood into adolescence and beyond, it develops indispensable capacities. First, it is the repository of the ideals by which life is guided. Second, it exercises control over the impulses, enabling one to use them rather than to be overrun by them. Third, it develops the capacity for self-soothing in times of stress and pain.
We might pause here and note that all therapists know the importance of the capacity to soothe oneself. Many clients, perhaps most, lack this ability to a significant degree. Painful events happen to everyone. Everyone sometimes experiences anxiety and almost everyone sometimes experiences guilt or shame. The question is how a person responds to these experiences. According to Kohut, people who have successfully internalised a calm, parental figure will expeditiously and quietly soothe themselves, deal with the situation, and go on. Many of our clients (and many of us), however, suffer prolonged, sometimes very prolonged discomfort.
Finally, Kohut believed, the "higher" aspects of their personality - humour, empathy, creativity, and wisdom - come from a successfully internalised experience of an idealised parental imago.
Here the danger is that the child cannot idealise either parent. Perhaps the parents are locked into a pattern of denigrating each other before the child, or they may have such serious behavior problems that it is painfully obvious to the child that they simply are not candidates for idealisation. The child will then have no opportunity to develop this part of the self. Kohut taught that when we meet people who seem to take no joy in life, to have no capacity to be inspired and little vitality, we may be seeing evidence that a need for an idealised parental imago was not met".
Extract from "Between Therapist and Client - The New Relationship" by Michael Kahn. pub W.H. Freeman and Company c 1991 and 1997
The developmental theory of self psychology
'In Kohut's view, three strong needs must be fulfilled if the self is to develop fully: the need to be "mirrored", the need to idealise and the need to be like others.
The need to be mirrored
The first need to arise is what Kohut called the gandiose-exhibitionistic need. Children need to be shown by one or both parents that they are special, wonderful, and welcome, that it is a great pleasure to have them around. Kohut taught that children learn how their parents value them not through anything the parents specifically say or do but through the most subtle of cues: gesture, expression, tone of voice. And presumably the message can be conveyed in varying degrees. To the parental message of delight in the child Kohut gave the name mirroring. The child looks to the parent for the answer to "Mirror, mirror on the wall, who's the most wonderful of them all?" If, a reasonable percentage of the time, the mirror replies, "You are, my wonderful child," the grandiose-exhibitionistic need is met.
Now, no parent can possibly be the perfect mirror all the time, and Kohut says, that's a good thing for the child. Inevitably the parent will sometimes fail to provide adequate mirroring. If that failure doesn't happen too often or too traumatically, it provides the child with an opportunity. Children who have been well mirrored many, many times can draw on the memory of those experiences and thus discover an ability to get along without the mirror - at least for a brief time, at least once in a while. And when that happens, they discover that at least for a brief time, at least once in a while, they can be their own mirror. Kohut called this a "transmuting internalisaton, by which he meant that children seize the opportunity of the selves and, as a result, change something basic in their self. His way of describing that change was to say that bit by bit the child adds structures to the developing self. By structures Kohut referred to the adaptive and satisying functions of the self. Gradually, as the child grows and develops, these transmuting internalisations and the structures they create add up to one important aspect of a strong and cohesive self. Now the grandiose-exhibitionistic needs are no longer primitive. Children who have been well mirrored no longer ask or care if they are the most wonderful on of all. they know that they are attractive and likable people, no matter what messages they may get from the outside world. Their self-esteem is firmly rooted, presumably forever.
If the parents are too disturbed or too preoccupied with questions of their own self-esteem, however, the child never gets enough of those early positive messages. The grandiose-exhibitionistic needs are traumatically frustrated and then repressed because it is too painful to be in touch with them when the child has no hope that they will ever be gratified.
Psychoanalytic theory teaches that one of the costs of repressing an important need is that the need does not become integrated into the developing personality. The need is walled off from the ego, and because the ego is the part of the personality that orchestrates integration and appropriate maturation, the need remains in its primitive form. This is the fate of grandiose-exhibitionistic needs that are not gratified. The person, then, is likely to suffer from insecurity and feelings of worthlessness, interrupted on occasion by surges of unrealistic grandiosity and, in some cases, maladaptive boasting when these powerful needs for mirroring burst momentarily through the barrier of repression and futilely strive for some crumbs of gratification. Thus a necessary structure of the self in stunted.'
To be continued in December's blog
Extract from "Between Therapist and Client - The New Relationship" , by Michael Kahn. pub W. H. Freeman/Holt Paperback c 1991 & 1997.