The Frame and Role of the Therapist - Essay Example

Reflective Skill Essay Introduction In this short paper, I will concentrate in one of the sessions in which I was given a written feedback by the course leader and my colleagues. The course leader and my colleagues provided me with some very important insights in the way I can manage setting up boundaries, and also the use of my therapeutic skills. They also guided me on other aspects that may have taken place during my therapeutic encounter. I will also provide an account of my emotions and feelings that I experienced during the therapeutic encounter. The paper will also include a discussion of the feedbacks that I received and an analysis of solutions or actions I could have taken in order to enhance the client’s understanding of her world and the world we both shared. Generally, the essay is about my experience with a client during a therapeutic session and the challenges that I encountered during the session. The Frame and ‘Role’ of the Therapist The existential approach of the past trimester was in itself a challenge, as I felt it provided a less structured frame compared to the previous psychodynamic oriented skill practice. The sense of floating and moving in ‘grey’ and variable areas defined by the feeling that we represent in the room during the skills was for me a constant challenge. This is because it did not provide an anchor where one would place the emotions that were experienced during the therapeutic process. The latter however, gave me some more insight into my inner self and to experiment my own way of being in a therapeutic relationship. Additionally, the session encouraged to be true to myself as much as possible by expressing the feelings that I experienced in the room during the session. The expressions of feelings include my personal feelings and those feelings that I shared with the client. Rather than an exercise of techniques or to strive for solutions, I felt more free and relaxed when in the company of the client. I had to let the process take its course just like Cohn points out “Under the pressure of anxiety therapist slide from time to time to technique. It is the avoidance of that openness to the phenomena, which Heidegger sees as a denial of a very distinctly human capacity. It is inevitable but reversible.” (Cohs, 2002 p. 116). The existential approach as I understood from Spinelli’s work Tales of Un ­knowing’ of 1997 and which resonate in me, is the one in which the role of the therapist is to support and allow the client to reflect and clarify the way he or she feels during a therapeutic encounter. In addition, I felt also comfortable with Emmy van Deurzen’s attitude and function of the existential practitioner in which she says: “the practitioner functions as a fellow ­‐investigator, maintains the focus on the investigation into the client’s living style and enables her to broaden her perspective and increase her sense of mastery over her own destiny” (van Deurze, 2002 p.26). The session and its process I had worked with this client in a previous session and I had some insight about her life. My former session provided a strong foundation for this session. However, I had been learning each therapeutic session as a new journey and as such had taken each session as special and unique. I have tried to embrace this attitude during all my sessions and at times it has been very successful while others it has been unsuccessful. Despite the mixed results, I have been able to acquire more materials and stimulation from my successful therapeutic sessions. The lesson that I have acquired from my previous sessions is that I will always be open and avoid dwelling on my preconceptions about culture, sex or society. The client was a twenty‐four year old girl from a cultural background that was totally different from mine. She was able to bring into the sessions some very challenging topics. The narratives that the client was concerned with were at times confusing, although some recurrent themes were mentioned. Some of the topics brought about by the client include the sense of guilt, respect towards older people also seen as the authority and a constant concern about her young age. While there was a general positive consensus in the feedback that I received both from the tutor and my colleagues with regards to my boundary management (where a sense of care and attentiveness as well as a natural presence were pointed out), I also developed some level of anxiety during the sessions. There was the anxiety of being observed by the tutor and peers. This generated in me a sense of being more conscious about the way I was conducting myself as a therapist. Moreover, I also had the anxiety to deliver positive feedbacks. Although I was aware of not to fall into a role (in this case of the therapist) it was however, hard for me to free myself completely from that role. Learning to be true to yourself while reaching an equal alliance with the client was a difficult task during this session. Things became more difficult given the fact that there was a significant gap in our age differences, something that the client continuously pointed out in her narratives. The respect that the client associated with age was a great topic to explore during the session. That exploration however felt at times demanding to balance, as it created in me a sense of being respected due to our differences in age. The way in which the client was given great emphasis in the equation age equal respect was something I was struggling with as I was striving to bring our therapeutic relationship to an equal level. I asked the client to define her meaning of age as I was hoping to clarify where her equation came from, as well as to clarify what our age differences also meant to her. Later on, I reflected on whether in that question there was also something for me to think about, because during some parts of the session I wanted to provide some sense of reassurance and guidance to the client. This may have possibly reinforced in the latter the age gap that I so much wanted no to be in the session. The flood of words that the client was inundating the session with was another of my struggle during this session. The continuous talking required great attention as many narratives were brought to life. I had difficulties with stopping that from happening. I even wondered why and where that difficulty came from. In retrospect and through some of the feedbacks received the space that I did not manage to also be part of, was possibly something to do with me wanting the client feel free to explore her world without any directive from my part. However, I did not consider that the session was also my space, our space, was the one to explore the feelings of the client as much as my own, and by choice what was happening in the room. I wish I could have brought back also myself into the session. My physical presence as much as comforting, professional or attentive it may have seemed from the observers it needed also to be able to operate and voice to the client the reason of that uninterrupted talking. If we had addressing it and explored the reasons, we would have gained a much deeper insight into our worlds and our relationship. As different narratives were surfacing, respect came about once again; this time round it was associated with guilt. The client was guilty of something she felt she should not have done. For instance, she felt a sense of guilt when she was interested and looked at different religions to find an alternative to the one she has been taught by her grandmother. I too sensed some guilt in me that it made some sense in my own world. The source of the guilt is that I felt indebted to my grandmother and was also guilty of she had done for me. By bringing this part of my own world into the session, I was aware not to expose part of me. However, I embraced the challenge of which I felt comfortable to do and as a reflection encouraged the client to bring her contribution to the session. The simple question “what does guilt mean to you?” opened a myriad of lesions, associations and a self-reflection which ended up with a silence, a silence that felt therapeutic. The client and I stayed in maintained silence in the room for a little while. However much therapeutic the silence seemed, there was also in me an anxious feeling that the silence would be prolonged and move to an uncomfortable space. I almost forebode what already had happened in one previous session when that space felt my responsibility. That time I felt accountable for leaving the client in that uncomfortable void, and lonely. However, after some insightful feedbacks from my colleagues I realized that the responsibility was not given to me by the client but was initiated by me, and that the lonely space was something that we possibly both created in that encounter. This time round I inquired the nature of that prolonged silence, and not only to myself but to the client. Although I did not feel I had a clear response of what that unvoiced space felt for her, I was challenged to move on from my subjective stance to reach out and understand the impact that the client’s world and my world had during the silence. Ernesto Spinelli summarizes quite well what I am trying to describe above, "Viewed from an existential standpoint, questions of choice, freedom and responsibility cannot be isolated or contained within some separate being (such as self or other). In the inescapable interrelationship that exists between a being and the world, each impacts upon and implicates the other, each is defined through the other and, indeed, each is through the existence of the other. Viewed in this context, no choice can be mine or yours alone, no experienced impact of choice can be separated in terms of my responsibility versus your responsibility, no sense of personal freedom can truly avoid its interpersonal dimensions." (Spinelli, 2001 p. 16). The cultural differences between me and the client were also something that we shared during our thirty minutes session. While the client was trying to explain some of the issues that her culture and the highly religious background had on her life, and the way she was adjusting to the Western values the latter brought in me some considerations and thoughts. This is because I was also a foreigner and had been in this land. I also had to struggle with a new world that sometimes saw me battling with cultural cliché’ and preconceptions. I felt that although we were both from different cultural backgrounds, the client saw on those cultural differences a common ground from which she was able to reconnect with me after that prolonged silence. I also felt the need of ‘leaping in’ and wanting to rescue our struggle that the silence had brought about. I was not realizing that by sharing with the client my experience as a foreigner but I was validating the unity that she was looking for in the therapeutic relationship while fulfilling the role of the rescuer that I so much wanted to move away from. The result was a clumsy reparatory intervention, in which I tried to convey my own ideas that although we were both foreigners our values and perceptions of the world were unique and that as such those differences should have been respected and celebrated by ourselves. It was highly unnecessary for us to change in order to feel accepted by the mainstream or to feel part of that social system. On the contrary, I would have liked to clarify with the client about her foreign world by asking if she felt misunderstood, lonely or isolated. I wondered if our cultural and social dilemmas were an expression of something more than that feeling of wanting to be rescued and find a common denominator. Conclusion Although the session ended with a positive feedback from the client, I felt that I could have done much more. It felt like it had been a hard session and a very demanding one, where confusion took over clarity and vice versa. Whereas I was learning to be in a position of complete openness and putting aside any preconceptions of cultural, sexual or social nature, it was at times difficult. However, the challenge presented an opportunity where I felt that I had a challenge to overcome. The grey area that I spoke at the beginning of this essay had followed me during this session and the struggle of ‘painting’ the session in my own style and in my own time and my own world was a challenge that I would continue to carry on in the next trimester. Read More