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Mom--Did the psychiatrist act like it was all your fault?
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<blockquote data-quote="Marguerite" data-source="post: 338758" data-attributes="member: 1991"><p>Oh, Farmwife, I'm on your wavelength!</p><p></p><p>difficult child 3 is in therapy of sorts at the moment and it does seem to be helping. I'm all for CBT - I spent some time as a subject of this before difficult child 3 was born as part of a research project. I must have driven the researchers mad - after each week's group session (conducted by an inept amateur) I critiqued it and sent the critique to the head researcher. I remember at one session we were asked to count how many breaths per minutes - I counted 6 for me. The expectation of the therapist had been that we were all over-breathing. And we clearly weren't. Of course, merely being asked to count your own breaths will skew the results because it makes you conscious of your own breathing. But my medical condition (and that of the others in the room - similar condition) "rewards" your body for inactivity. I was at a conference some years before that, when a speaker looked around the room and said, "I've never seen a room full of people so interested - and yet so still." So when sitting quietly, we did more than just sit, we would go almost into instant meditative state and slow ALL activity, including breathing.</p><p></p><p>Also as part of my experience in working with people with a similar disability, I did a formal telephone counselling course. I had been counselling people over the phone for several years before that and was horrified to find some of my best techniques being denounced as bad or ineffective. I made the conscious decision to keep breaking the rules. Over time I recognised that some of my methods were not good across the board; I used to divulge a little about myself, for example, (the "me, too", seemed to help people who had been feeling extremely isolated) which I know did help at times. However, there were other times when I had given out enough information for a client to track me down, and I was finding myself getting approached in public by clients who shouldn't have known how to find me.</p><p></p><p>Star, I remember absolutely LOATHING the "and how do you feel about this?" But even more than that, I really hated the "reflection" method of communicating. I have myself rung counselling services (trained under the same system) and when I begin to experience them reflecting, I call them on it and say, "Stop. Do not use that on me. It breeds resentment, it seems patronising, it is ineffective and hurtful. Cut it out."</p><p></p><p>Reflection is where the therapist merely repeats the gist of what the person has said. It's supposed to make the client feel "heard".</p><p>It goes like this - </p><p></p><p>Client: My husband comes home drunk and beats me.</p><p>Therapist: Your husband comes home and beats you.</p><p></p><p>What (according to the textbook) is supposed to happen, is the client at some point says, "Wow, you seem to really be hearing me and understand what I'm telling you!"</p><p></p><p>What I found happens in reality, is the client eventually says in frustration, "Will you stop flamin' well repeating everything I say!"</p><p></p><p>The day we had to study this, I spent a lot of time in the corner (metaphorically). The trainer knew I was breaking the rules; but she also knew I was helping people, I got good feedback.</p><p></p><p>I think the reason they think this works is because clients don't hang around to put up with it. They end up saying, "I feel a lot better now. Goodbye!" and hanging up. </p><p></p><p>That was another thing - I hated referring to people as "clients" in this situation. They were callers. Period.</p><p></p><p>And the "how do you feel about that?" does have its uses, but the therapist needs to really THINK before saying it, not to simply trot it out when they can't think of anything else to say.</p><p></p><p>Doing the course taught me a great deal about why therapists do/say what they do. We were told we were not to tell people what to do, not even advise them what to do. People had to work it out for themselves. I remember saying, "If people could work it out for themselves, why would they need to call us?"</p><p></p><p>I developed my own method - I would listen to the problem, I would then try to listen deeper to what might lie behind the problem. I would then (sometimes) ask the person what they would like to see come out of the situation. Sometimes (often) the person couldn't see the wood for the trees (which is why they had rung) and needed some suggestions, posed as "How would you feel about...?" I made sure I laid out a range of suggestions and as far as possible I tried to elicit responses from the caller too, so they had ownership of at least some of the ideas. I then pointed out that choices needed to be made and it didn't matter where the ideas had come from - I was a tool, like a screwdriver in the tool kit. The person using the screwdriver was the person doing the work. They had to choose a course of action and follow it. Not choosing was itself making a choice for inaction and still needed to be owned. Generally, though, people were happy to have some sense of direction. Before terminating the call we were recommended to get the caller to self-assess how they felt at that point, compared to when they had rung. Did they now feel that they were back in the driver's seat? "Are you OK with things now?" was the fairly universal question we were encouraged to ask. I would often just listen to hear it. Sometimes if I felt the person wasn't fully aware of their own emotions, then I might touch base and confirm. </p><p>An interesting aspect of this, was how to deal with suicidal callers. By the time we studied this I had already had several of these and had developed my own techniques which I shared with the class. I did learn a few more things in this, but it was a challenging area - this condition does cause depression, plus people who are chronically ill get very lonely and just want it all to stop. We were taught that to avoid talking about suicide was NOT the way to go; and we found this ourselves. Talking about it did NOT put the idea in people's heads. It often allowed them to talk, where previously they had been quietly planning an exit and could well have gone on to make an attempt after the call, if we hadn't mentioned it and thereby allowed them to talk.</p><p></p><p>Sometimes answering "How do you feel about this?" can be helpful. But too many therapists just toss this out without thinking about it, it has become too automatic. And a client with a fraction of functioning brain can recognise this and frankly, it smacks of carelessness, of not giving a hoot really for the client because therapist is on automatic pilot. Therefore over-use is disrespectful and unprofessional.</p><p></p><p>But don't react negatively every time you hear it. It does serve a purpose, if used appropriately. We do need to be able to own how we feel about something, and too often we've pushed aside our awareness of our own feelings.</p><p></p><p>But beyond that - let's just get on with solving the problem, hey?</p><p></p><p>Marg</p></blockquote><p></p>
[QUOTE="Marguerite, post: 338758, member: 1991"] Oh, Farmwife, I'm on your wavelength! difficult child 3 is in therapy of sorts at the moment and it does seem to be helping. I'm all for CBT - I spent some time as a subject of this before difficult child 3 was born as part of a research project. I must have driven the researchers mad - after each week's group session (conducted by an inept amateur) I critiqued it and sent the critique to the head researcher. I remember at one session we were asked to count how many breaths per minutes - I counted 6 for me. The expectation of the therapist had been that we were all over-breathing. And we clearly weren't. Of course, merely being asked to count your own breaths will skew the results because it makes you conscious of your own breathing. But my medical condition (and that of the others in the room - similar condition) "rewards" your body for inactivity. I was at a conference some years before that, when a speaker looked around the room and said, "I've never seen a room full of people so interested - and yet so still." So when sitting quietly, we did more than just sit, we would go almost into instant meditative state and slow ALL activity, including breathing. Also as part of my experience in working with people with a similar disability, I did a formal telephone counselling course. I had been counselling people over the phone for several years before that and was horrified to find some of my best techniques being denounced as bad or ineffective. I made the conscious decision to keep breaking the rules. Over time I recognised that some of my methods were not good across the board; I used to divulge a little about myself, for example, (the "me, too", seemed to help people who had been feeling extremely isolated) which I know did help at times. However, there were other times when I had given out enough information for a client to track me down, and I was finding myself getting approached in public by clients who shouldn't have known how to find me. Star, I remember absolutely LOATHING the "and how do you feel about this?" But even more than that, I really hated the "reflection" method of communicating. I have myself rung counselling services (trained under the same system) and when I begin to experience them reflecting, I call them on it and say, "Stop. Do not use that on me. It breeds resentment, it seems patronising, it is ineffective and hurtful. Cut it out." Reflection is where the therapist merely repeats the gist of what the person has said. It's supposed to make the client feel "heard". It goes like this - Client: My husband comes home drunk and beats me. Therapist: Your husband comes home and beats you. What (according to the textbook) is supposed to happen, is the client at some point says, "Wow, you seem to really be hearing me and understand what I'm telling you!" What I found happens in reality, is the client eventually says in frustration, "Will you stop flamin' well repeating everything I say!" The day we had to study this, I spent a lot of time in the corner (metaphorically). The trainer knew I was breaking the rules; but she also knew I was helping people, I got good feedback. I think the reason they think this works is because clients don't hang around to put up with it. They end up saying, "I feel a lot better now. Goodbye!" and hanging up. That was another thing - I hated referring to people as "clients" in this situation. They were callers. Period. And the "how do you feel about that?" does have its uses, but the therapist needs to really THINK before saying it, not to simply trot it out when they can't think of anything else to say. Doing the course taught me a great deal about why therapists do/say what they do. We were told we were not to tell people what to do, not even advise them what to do. People had to work it out for themselves. I remember saying, "If people could work it out for themselves, why would they need to call us?" I developed my own method - I would listen to the problem, I would then try to listen deeper to what might lie behind the problem. I would then (sometimes) ask the person what they would like to see come out of the situation. Sometimes (often) the person couldn't see the wood for the trees (which is why they had rung) and needed some suggestions, posed as "How would you feel about...?" I made sure I laid out a range of suggestions and as far as possible I tried to elicit responses from the caller too, so they had ownership of at least some of the ideas. I then pointed out that choices needed to be made and it didn't matter where the ideas had come from - I was a tool, like a screwdriver in the tool kit. The person using the screwdriver was the person doing the work. They had to choose a course of action and follow it. Not choosing was itself making a choice for inaction and still needed to be owned. Generally, though, people were happy to have some sense of direction. Before terminating the call we were recommended to get the caller to self-assess how they felt at that point, compared to when they had rung. Did they now feel that they were back in the driver's seat? "Are you OK with things now?" was the fairly universal question we were encouraged to ask. I would often just listen to hear it. Sometimes if I felt the person wasn't fully aware of their own emotions, then I might touch base and confirm. An interesting aspect of this, was how to deal with suicidal callers. By the time we studied this I had already had several of these and had developed my own techniques which I shared with the class. I did learn a few more things in this, but it was a challenging area - this condition does cause depression, plus people who are chronically ill get very lonely and just want it all to stop. We were taught that to avoid talking about suicide was NOT the way to go; and we found this ourselves. Talking about it did NOT put the idea in people's heads. It often allowed them to talk, where previously they had been quietly planning an exit and could well have gone on to make an attempt after the call, if we hadn't mentioned it and thereby allowed them to talk. Sometimes answering "How do you feel about this?" can be helpful. But too many therapists just toss this out without thinking about it, it has become too automatic. And a client with a fraction of functioning brain can recognise this and frankly, it smacks of carelessness, of not giving a hoot really for the client because therapist is on automatic pilot. Therefore over-use is disrespectful and unprofessional. But don't react negatively every time you hear it. It does serve a purpose, if used appropriately. We do need to be able to own how we feel about something, and too often we've pushed aside our awareness of our own feelings. But beyond that - let's just get on with solving the problem, hey? Marg [/QUOTE]
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