Crystalisation of Identity

From Person Centred Counselling to an Integrative Approach: One Client Inviting Change

Pier and Bridge

A Beginning – Morley College

I started officially training to be a counsellor in 2006. The introduction to counselling course was at Morley College in London and taught me what Counselling entails. Iain Mendelberg was the tutor and was able to offer a model for the type of counselling professional I wanted to be for clients: patient, wise, honest and courageous.

As a group of trainee counsellors, we were introduced to Carl Rogers and his passage into counselling and psychotherapy. Rogers was closely followed by Fritz Perls and Gerard Egan which gave us a thorough grounding of person centred and humanistic perspectives of counselling.

Freud’s scientific method was often referenced as a starting point that was used to frame our learning. What I gained insight to was from Mr Mendelberg’s calm humorous approach to teaching. His generosity as an educator gave me an indication of what lay ahead for me as I trained – I too could become for those that I worked with a reflective, calm and person centred mental health practitioner. Or so I thought.

On completing the Morley course I took a year out of study. My first son Coltrane, was born shortly after the course ended in June 2007. 1 year later September 2008 I began at Greenwich University on the MSc Therapeutic Counselling an integrative counselling course.

What Does Integrative Mean?

I had little understanding of what integrative meant in the 1st year. Some of the information that was covered in the first term refreshed my awareness of counselling theory from my time at Morley college. The main difference of the Greenwich course, was apart from the workload was the amount of reading material to be digested on a weekly basis and the depth the writing therein went to.

Each article was intricately written, often with intimate insights that frequently altered my perspective of counselling. There was also a general understanding that the reader would grasp some, if not all of the concepts discussed. The first year of the course I found to be a struggle but I worked hard at attempting to meet the requirements the course asked of me including; Placement and application of counselling theory, Skills, Experiential group, Theory, and Personal logs. The requirements life asked of me were a frequent source if inspiration, tension and fatigue and these included; my marriage, fatherhood, work, coaching basketball, amongst a few other responsibilities…

Integration of Perspectives

For the 2nd year of the course at Greenwich in Oct 2010, I was fortunate in securing a 2nd placement at a prison. My first placement was at a Doctor’s surgery in SE London which I was fortunate to be awarded in Aug 2009. My learning as a trainee counsellor I feel was enhanced by both placements as I was able to witness how mental illness is supported in the community and in a prison setting. The significant differences noted were the efforts made by the mental health team in prison collaboratively working together to reduce risk – efficiently.

In the community, fast access to mental health support is desirable but not always achievable. Due to the volume of people in GP’s wards. The range of services and referrals to and from specialist support is difficult to meet. Providing treatment for mild to moderate cases of mental illness can take 6 weeks – 8 months to be received. With the advent of IAPT (Increased Access to Psychological Therapy), the idea was to drastically reduce waiting times and be able to support more people in the UK, that experienced depression and anxiety.

Laos – Understanding Integration

I met Laos (not his real name) in January 2011. Laos was a tall, well-built Asian man in his 30’s who repeatedly offended. He was held in custody for charges related to attempting to rob with a bladed article. Laos shared with me the incident in question and much of his life history. Which is to follow.

I worked with Laos for 5 sessions in total and throughout that short time my counselling approach changed. During the 2nd and 3rd appointments an idea formed that person centred counselling did not appear to be touching the core of this man’s particular set of difficulties. I took it upon myself to investigate and develop a psychological perspective to gain an understanding of his formative life experiences and how I could support him more effectively as a counsellor.

Reflecting on my counselling journey it was this choice that changed my perspective on how I practice as a therapist. As an aside I have enjoyed the Kung-Fu Panda series of movies. The 3rd Kung-Fu Panda stood out as a perfect collaboration of contextual realities, concluding with a seminal experience and eventual crystalisation of identity for Po. My light-bulb moment wasn’t as spectacular but had elements of the clarity Po achieved in this movie clip.

Drug Use – An Escape?

Laos reported that he had many change experiences including moving home a number of times across much of Asia, the far east, Australia, Canada and to U.A.E. Laos had begun using various substances in his teens starting with Marijuana, Heroin, Cocaine and Crack. He mentioned that he had also used amphetamines but stated that he preferred cocaine. With other drugs he reported that it was always a gamble.

Schooling

He described himself as a bright student and that he found G.C.S.E’s easy. Laos said that he started smoking marijuana to celebrate with friends on completing his exams. Initially it was purely recreational. A levels, Laos said were more difficult and he changed to the International Baccalaureate. These qualifications he said suited his learning style more. Laos was introduced to harder drugs at AS level and began selling and distributing to supplement his own use.

Laos shared that he and his father didn’t really get on. His father was the main reason that the family moved as much as they did. Laos described his father as strict and the one who dealt with his indiscretions severely.

Life Events

Laos described his mum as kinder and nurturing towards him. His mother died when Laos was in his late teens and he mentioned that for the family it was a difficult time. Laos experienced his 1st Jail term in a Malaysian prison shortly after his mother’s death. He was convicted as a minor of selling and distributing cocaine to fellow students at his school. He reported being in jail for a period of 9 months. He was released early as a result of his father’s connections. Laos described this period as hell on earth. He was away from family for the first time and his mother had passed away. Laos mentioned that his father had practically disowned him for the sense of shame he had brought on the family. His siblings were angry and upset with him. All that he had known was irrevocably changed.

Recognising the inter-relatedness of attachment theory, Object relations, Transactional Analysis, maladaptive coping mechanisms which can support a person in functioning into adulthood. Coping mechanisms unfortunately breakdown in moments of crisis. For Laos these moments of crises were experienced when he was faced with; the mundane and monotonous, significant moments of change or stress.

He had experience of supporting himself by using alcohol and various substances including marijuana cocaine and heroin. Laos described himself as a binger (someone who used lots of a substance all at once for a few days and then stopping). It was on a binge that he lost track of the amount of cocaine he had left. Laos told me he had finished his supply and quickly needed to make a withdrawal to go and buy more. Laos was between jobs and had low cash flow to buy more drugs. He decided to go to an off license to pick up some more alcohol as his supply was low. This decision and following events lead to Laos’ 4th jail term.

Case Formulation – Speculative Coalescence

My formulation and how I started to identify that I was thinking and behaving as an integrative therapist was informed by some of the reading I was completing at the time. Petruska Clarkson’s 5 Relationship Model offered me a useful framework to recognise where I was – in my journey as a counsellor. A research project titled ‘A Son’s Journey’ written in my 3rd year of the MSc course, found points of Laos experience reminiscent of my journey to adulthood. (I will look to pick relevant points from my research in a later blog post)

Adapting to Change

Laos early attachment to his parents and to his place of birth were affected by a number of significant changes with and to his environment. Moving from one country to another may have affected his realisation of who he was. This sense of recognition would be in relation to having to repeatedly start again from the beginning in a new and different environment. He would have had to form new routines with new classmates, peers, learn new social cues and with each move be socially adapt to the new country. Laos mentioned that he had been moving home and country since he was 3 years old. The moves were a result of his father and the work he was involved with. If the family home was not a wholly warm and nurturing environment Laos could have begun developing ways to look after himself outside of his parents or family’s awareness.

It is possible that Laos did not come forward and share the difficulties he encountered with his family. Any challenges he had overcome at school or whilst playing with peers he may have kept to himself. Perhaps major achievements and triumphs he may have experienced may also have gone unnoticed as well. I wondered if he shared much with anyone. (Self dependency, self reliance)

Growing Pains

As he entered early adolescence he may have found certain peers more appealing and started to associate with their way of viewing the world. Exciting, dangerous, rule bending/breaking, becoming argumentative/aggressive with siblings, parents, teachers and authority figures. Leading him to take ever greater risks, enjoying self-injurious actions and activities i.e. smoking or self-harming, drinking alcohol, tattooing, piercings etc. The difficulty for me as a counsellor is in recognising the difference between the actions Laos reported of his experiences during his adolescence and usual teenage behaviour.

The purpose of the actions as listed could be to give him a chance to gain a sense of belonging or to fit in with others or create a new identity. It could also have offered Laos an attempt to make the feeling of disillusionment of parental let down dissipate or not be as painful. Another consideration would be in relation to Laos’ attachments to others. If we were to observe his relationship to his mum and then her death could his spiralling drug use be in relation to having difficulty admitting to or acknowledge his feelings of loss? The realisation for Laos could be that self-injurious acts may become habitual and destructive.

The interesting thing for me as I sketched through some of these hypothetical realisations was how Laos had attempted to rescue himself or bring about an end to his behaviour. He had not gone to rehab or completed 12-step programmes. Laos being caught, found selling or incapacitated through use of drugs and going to prison put in place a semi-permanent stop to his self-destructive pattern of behaviour. This is not to say that drugs could not be found in prison. But Laos was able to recognise that through his actions he was again locked away for a period of time. It is possible that prison acted like both a punitive and supportive parent at the same time. What Laos was appeared to do by being arrested by incarceration was to learn how to find another way to live without both of his parents. It is possible he had not an internal representation of both parents and sought external controls to manage his behaviour.

Re-evaluating – Re-inventing

Within a longer piece of work from 1 year – 2 years it is possible Laos may have been able to recognise what he had lost as a result of his earlier experiences. The losses could include his sense of identity, self esteem, parental guidance, maternal attachment figure (after his mum passed away), emotional self regulation and self-protective mechanisms i.e. speaking to others and finding emotional support. A therapist could have been able to support him in identifying his current patterns of behaviour and look to establish life affirming behaviours that looked at his dependency on alcohol and drugs to alleviate boredom, anxiety and depression.

Idea-Seeds

My work with Laos was informative for a number of reasons. I learned that I had been able to graduate my thoughts to appreciate a psychodynamic profile of a person’s past. What I was able to offer Laos as a counsellor was a robust level of emotional support and an awareness that there were topics from his past that with the right support he would be able to heal in time. I was able to plant an idea-seed. With good support that idea-seed could grow and I imagine bring about significant change for Laos.

Moving forward this level of reflection has supported me in all aspects of my life, noticing patterns of behaviour with those I support. Identifying personal scripts that clients operate with that limit themselves from engaging in new and exciting ways with themselves and others. My hope for Laos is that he recognises his pattern and with support from family, a partner or a trained professional can find other ways of being that are healthy and life enriching.

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Belonging v Fitting In

Confusion 2015-05-25 15.32.10

There are many reasons that I have wanted to write a regular blog. Mostly to share a perspective on things I experience from bewildering and conflicting perspectives. These perspectives include myself as a thinker, a past time of mine since I was a young man.

  • A black male psychotherapist, three words that cause me to pause and reflect on the meanings that are associated with each and how these three words interact with each other and with the social fields I come into contact with on a daily basis. I suspect a blog about being a black male psychotherapist is to be written in time.
  • Being a father of 2 young black boys the responsibility I am presented is to support their development in being able to simply just be. With Janelle Monáe’s Hell you Talmbout I recognise that my involvement with my sons’ lives is of primary importance and one in which I am invited to be an educator, coach, listener, artist, co conspirator, chef, journey planner and Doctor. Ta Nehesi Coates speaks and writes well on this subject in his book Between the World and Me.
  • Some of the other roles I engage with are; as a member of a mental health organisation working alongside probation and with service users, as a husband, as a lover of jazz, a reader, a former interior designer, youth worker, comic book reader, movie goer, longboard rider, podcast listener, basketballer and coach, friend, walker, facilitator and multiple sclerosis sufferer. This list is not exhaustive and there are probably at least 5 or more subjects I could add.

Fitting in, Belonging

For this blog I wanted to discuss an awareness I sensed but hadn’t fully brought into full consciousness until I came across it whilst reading Brené Brown’s ‘Daring Greatly’. One of the concepts she was able to describe was a simple concept of either fitting in or belonging. At the time of reading ‘Daring Greatly’ in Oct – Nov 2015 I was experiencing what it meant to either ‘belong’ or to fit in.

2014 into 2015

Working for a large organisation with a group of people one knows vaguely who each have slightly differing roles and responsibilities to yours, there can be points when you are offered a chance to either fit in, or if lucky to choose to belong. When I joined the organisation I attempted to go with the flow and fit in.

Fitting in often does not cause great offence to others ‘no boats are rocking’. Perhaps in oneself the effect is of losing grip on what is important – oneself and one’s reality. Losing sense of oneself can be unsettling and what could be worse is not realising that your way is lost until you are saying and doing things that you don’t recognise.

In December 2014, I left an experience of belonging to a staff team in a high security prison and joined the organisation I currently work with in January 2015. The mental health team I left consisted of Psychiatrists, Social Workers, Nurses, Counselling Psychologists, counsellors , an EMDR counsellor who was also my line manager and supervisor, Occupational  Therapists, and counsellors on placement.

HMP Belmarsh’s mental health team was a robust co-operative, co-ordinated group of professionals that met every week to discuss mental health referrals. It took me 2 years to get used to the quick fired nature of the referral process and dissemination of potential clients to departments within the mental health team. In the last 2 years of working at Belmarsh I gained a sense of how valuable these differences amongst the mental health team were as Social workers would have a different perspective to Psychiatrists or CPNs another opinion to Occupational Therapists and counsellors to counselling psychologists.

With these differing opinions in relation to treatment options, barriers for individuals seeking treatment were overcome and mostly resolved. The experience I had was of belonging to a staff team who were willing to work together for the greater good of those seeking mental health support. I was able to recognise that differing viewpoints can be supportive rather than only negative, that can appear to slow or block progress.

A reminder

Whilst training as a counsellor 2008-2011 I had experiences that were of not being able to neither fit in nor belong. I was one of a few minority ethnic people on the course and one of only 3 males that completed year 1. Struggling alongside 18 other students on a bewildering counselling MSc course, I would have thought would generate a sense of belonging or camaraderie. My experience was that of being outside of a group of people who were able to exist in a quasi-understanding of fitting in with each other.

I made a choice in October 2015, which was supported by Daring Greatly, that fitting in was not going to be how I operate whilst working with others. Belonging was a better coat to wear. I had been in a number of previous working experiences pre Belmarsh were belonging was a part of the fabric of the organisation.

Currently I find myself reminded of my training to be a counsellor and the discomfort of attempting to fit in amongst a student populace that I was to belong to, but was different from.  The knowledge of being an outsider from a group is not a new one and has the possibility of offering me an internal conflict which can lead to personal growth.

Reality

The reality is that the experience of belonging or fitting in will repeat in whatever work context I find myself involved with. The interesting thing for me is that I will attempt to gain a sense of belonging wherever I work. The cost of attempting to fit in I find too great. It’s the experience of not sharing your perspective on subjects you care about, of fearing that you will be ostracized by people you work with, finding that you stand out and being uncomfortable with this.

Belonging

Being amongst a group of others I would find it important to relate and talk about any number of subjects on a number of different levels and not be judged or ridiculed in my sharing. Depending on a person’s background and family of origin the aim could be to gain a sense of belonging similar to that of a family system. Perhaps without some of the negative aspects of a family group. For me it’s about the feelings that come with the experience of recognising that one belongs. Which feels very different to fitting in.

I would liken belonging to hearing a favourite song by chance whilst out doing something innocuous. The song I would be happy to hear would be Ooh Child by the Five Fairsteps and something like love spreads throughout your system like you’re in a hot bath.

My experiences of belonging are many-fold, for example attending my first BAATN mens group and mentioning that unlike Ralph Ellison’s Invisible Man I WAS being seen and heard by the group, and that I also belonged. Coaching basketball in a number of settings was the epitome of gaining a sense of containment attachment and belonging for every team I coached and for all that attended. My sense of the Experiential Group even though I was the facilitator, I felt part of the group not apart from it, lastly, when my family get together we express our love in volume but each member receives that warm bath feeling…

Belonging.

A Short Story of Change

I am wondering about another way of extending my counselling practice.

Short Focused work

I read a short story over 10 years ago of a psychologist who had worked with a client for a short number of weeks. The setting appeared to be in one of the North Eastern States of America as there was mention of Coney Island.

Assessment and direction

The story was about a man in his mid 30’s – 40’s who went to see a psychologist due to feeling low and not knowing the reason for his low mood. (I should note that no ethnicity culture or race was mentioned which for me as an African Caribbean male could mean he could be African American, Asian American, Native American, Latin American or European American). After a short assessment the psychologist was able to offer the man treatment for his low mood in the form of writing a to do list of activities and to return in exactly 1 month and pay the significant bill.

The client took the sheet of paper and scoffed at the advice. Joking aside he was aware of his plight. If he did not follow the psychologist’s requests things would remain the same. In the four weeks the man was able to complete the 6 things on that list. He returned to the psychologist at the 2nd appointment and told of his accomplishments and how he had noted his mood appeared better. The psychologist asked as to what was different between the two appointments? The man told him of the changes he had put in place and as a result many things in his life were different.

One of the 1st requests on the list was to take a 2 week break from work and make a concerted effort on the list as it was going to be hard to complete whilst at work.

The man spoke of revisiting Coney Island as a man, but remembering what it had been like when he had visited with his parents. Back then Coney Island had been filled with colour, noise of people having fun, the sea crashing on to the beach and gulls calling. For the psychologist had invited the man to revisit a place from his youth. As the man spoke a smile brightened his face as he remembered what returning to this place had been like for him.

There were a number of other tasks the list contained including:

  • Settling debts,
  • Ridding his home of debris he had collected over the years that he no longer needed,
  • Accepting the wrongs he had caused himself and suffered by others and making a resolve to wipe the slate clean. Making himself aware of the lessons and deciding to move on.
  • The last thing on the list was to write a letter to the one person he had wanted to say sorry to for a long time.

He reported to the psychologist that this last request had been the hardest to complete. He had written the letter the previous night before coming to the appointment with the psychologist. The man told of who he had written the letter to and of his deep sorrow at not having done a few things he had said he would, and as a result what life had become – dull uninteresting flat and uneventful.

The man spoke of the past four weeks as if they had been an adventure. As if he had discovered what living was about again and stated that he wanted more of it. He told the psychologist that he had written the letter for himself and was to send it to his parents apologizing for what he had not achieved even though he had had dreams when he was a boy.

On completing the letter and signing it he made a discovery before he sent it to his parents. The man reported to the Psychologist that his life was not over and that the four weeks away had taught him a valuable lesson. He only had himself to look at for how his life was. He had decided that he was not going to make excuses for not achieving his dreams any longer! He told the psychologist that on the 1st week after his staycation he had returned to work and had handed in his notice and had found another role in a different type of work that had awoken in him a sense of adventure. The four weeks he had taken to rediscover himself had been the best investment he could ever remember making and that he would be happy to pay the fee he was being charged as the 6 short requests had brought him back to himself and to his life.

I can remember that I had a smile on my face as I read that story. It may have been in Chicken Soup for the soul 3rd edition. What springs to my mind is the huge capacity of therapy and the individuals, groups, and children that work with us to create change in their lives. I am wondering if I shape my business in a similar way, what could happen in 2 sessions; a crash course in creating manifesting and managing change.

Inside Space

Inside Space

Walking and Talking Therapy Begins

Thursday, 30 May 2013

It’s evening on May the 16th. I’ve had a busy day, leafletting my local neighbourhood about Walk and Talk therapy. It’s in the quiet time of the day I can reflect how far I have journeyed. An estimate of the round trip, I have probably travelled 4 miles, Lee-Blackheath-Hither Green. Through my walks I am starting to develop a deeper understanding of the area.

Freud’s Dangerous Method

I want to use this space to enlighten the journey of walking therapy. It started I believe with Freud – one of the forefathers of Counselling and Psychotherapy. It has been well documented that Freud used alternative methods to interact with clients. He would use hypnotism to relieve clients of their distress and on occasion go for walks with clients. The development of having clients lie on a couch was something Freud found useful when working with clients related to clients being immersed in something other than the room. Disassociation became something he found useful for clients to fully open up and drop guards and defences.

Collaboration whilst walking

Walking Therapy I believe does something similar, as a client starts to pick their way with a guide, the relationship established due to the motion and the action of walking becomes one of collaboration. Traditionally clients and their counsellors sit at a distance to one another. Their chairs are either faced in just off oppositional positions to each other. The room will usually be furnished in a low key non threatening manner. There may be a picture or 2 on the walls. Perhaps framed certificates on the wall or stand somewhere in the room and a hidden time device. (To keep sessions to time)

Looking for some creativity to my own practice I imagined another way I could work that might inject something new to the counselling process. Walk and Talk Therapy was born. I haven’t looked back since. Excuse the pun (humour and Analogy another way to be creative in therapy examined in On Being a Therapist Jeffrey Kottler).

Feedback

I have run 2 successful trials with 2 different individuals over the past 2 months and their response has been hugely positive.

“Walking and talking is a tranquil activity as it combines movement with introspection” another useful comment was

“You can’t help but be in the moment! Each step you have to be aware of, and that keeps you in the now”.

I have enjoyed how the environment has enabled conversation and inspiration to bubble up and be accessed. Even when in a quiet lull in conversation, the effect of walking in beautiful areas around Lee and Blackheath has meant that something ‘other’ is being accessed and it is when this is brought back into the conversation the reflective quiet’s findings are always surprising and useful.

M

Basketball Therapy Anyone

Basketball Therapy

I have been a Basketball coach for 14 years and know first hand the beneficial effects basketball and playing team sports in general can have on people. While most people assume the positive effects have to do with being physically fit, as a therapist, I’m interested in the emotional benefits of playing sports as well as the obvious physical ones.

Working with boys and girls in the 11-18 age range, one of the things I observed over the years was how the sport equipped them with life skills they could apply off of the court. For example through turning up to early morning practice on time, packing a kit bag, working hard during practice and persevering with learning new skills, players acquired a range of skills including commitment, sacrifice, organisation, accountability to one self and the team, responsibility, confidence and ultimately leadership.

Therapy in Play

As well as what happened on the court, there was often a therapeutic effect at play in the period after sessions. Many players would speak to me after sessions about some of the difficulties they were experiencing including homework, relationships, concerns with family and worrying about their future. I was often surprised by what was shared and equally what I was prepared to share about some of the challenges I experienced whilst growing up.

Basketball and Therapy

Both the experience of playing basketball and the informal sharing which took place afterwards enabled some players to address feelings associated with depression and anxiety. In many instances I watched players transform from people with low aspirations to people with ambition and hope about their future. I attribute their transformation in part to both the success they achieved on the court and the informal mentoring they received away from the court.

Some of the reasons I have become a counsellor stem from these conversations which sparked something in me to want to support people who were experiencing some degree of emotional/mental difficulty. Looking back on this now from the vantage point of being a trained counsellor, I’m interested in how sports develops positive relationships between players and coaches which is a fantastic starting point for therapeutic conversations.

Mentoring

As a learning mentor in a boys secondary school in London, Basketball again proved an effective tool to enable young men who were experiencing difficulties to talk. Talking whilst engaged in basketball allowed young men to look at some of their challenging behaviour and seek ways to adapt so as to get the best out of their school experience. Games like P.I.G. and H.O.R.S.E were great, as whilst the young men were focusing on making their shot I would be able to offer some useful insight to help their situation. Working this way helped me to establish a good working alliance with the young men that were on my case-load.

Walking and Talking

Much of what I have learnt about using basketball to support people to talk has influenced my decision to launch a walk and talk therapy service. Whether using basketball or the act of walking, both approaches involve using an activity to enable sharing and reflection. Clients often report that when walking and talking, they are surprised at how naturally the sharing occurs. To date I have observed that being in parks and open spaces invites the client to open up in the environment and begin identifying processes for change.

Recently I had a conversation with a friend about wanting to develop an idea I have of incorporating Basketball and Therapy. Given my love for the game, this seems like the obvious next step for me.

But first of all I better dust off my basketball trainers hit those courts and brush up on my skills.

Watch this space….