Last week I had my annual physical. I went to a doctor I hadn’t seen before. He was one of the best doctors I have ever encountered. Two aspects of his manner are especially relevant to counselors: 1. He listened to me and took me seriously, but 2. He was not interested in ‘archeology’ but present conditions and concerns. Both of these were so surprising to me, so helpful and so ‘on target’ that I trusted the feedback and recommendations he gave me. I felt he understood me; not some medical model of a typical patient. So when he suggested I might follow-up on this or that condition, I took him seriously and will follow-up.
It occurred to me that my counseling clients might respond to me the same way if I listen to what they are actually saying and how they are saying it and not filtering them through some theory or standard set of questions. As I understand him, Milton Erickson never developed a ‘theory of personality’ because he considered each client a unique example of their own personality. He believed that communication was the critical element in every counseling situation. And every time a client communicated with him or he to them, there was always an indicative and an injunctive element. That is, every statement a client makes to us, they are trying to impact us, to change us; and every statement we make to a client is intended to change them. The content is often irrelevant; the command element is what brings about change.
One example of how he listened to me when other doctors didn’t might be helpful to let you know what I am talking about. I have been in atrial fibrillation for several years. Although it increases my risk of a stroke slightly, the side effects of medication pose an even greater risk and both the American and European heart associations in their latest 2005 report recommend no treatment for someone with my condition. I know this because I have been involved in cardiovascular research, including atrial fibrillation, for over 10 years.
Other doctors would always want to put me on blood thinners. When I offered my perspective, they objected and gave me a lecture—it sounded like a standard response they might have learned in their residency.
This doctor, surprisingly, with his computer in front of him, quietly looked up the 2005 reference, found the appropriate recommendation and said “That’s new to me. I’ve learned something.” Then discussed some things that would be helpful for ME and my situation; not some generic patient. Because he listened carefully to what I had to say and followed up on it, I listened very carefully to what he had to say.
As counselors, since communication is our primary medicine, we must listen carefully to what our clients are saying to us and how they are saying it and not impose on it interpretations we have carefully studied and learned in our training.
A second surprise to me was his lack of interest in doing physical ‘archaeology’. When I was a pre-teen, I probably had a mild case of undiagnosed polio affecting my left side. Throughout my years I have noted 20-25 bodily symptoms that probably resulted from that early ‘insult’. When I mentioned this to the doctor, he was not interested in all that history. Rather he asked me about what was going on now. Was there anything with my present body that concerned me? I had to admit, at this point in my life, there are just some interesting anomalies with my body but nothing that restricts me much. (Except I would probably have difficulty in running a sub-4 hour marathon at this point.)
Again, in this case he listened to me and got right to the heart of the matter—what is happening now that needs attention. In counseling, certainly learning things about a client’s past might shed light on problems they are having at present and possible solutions; but if those stories are offered only because a client wants to keep us interested or invoke sympathy from us or some other reason, they may be counterproductive. Of course, if these stories suggest possible strengths that the client can use to bring about desired changes, they could be invaluable. As counselors, we need to use our listening skills to identify what impact our clients want to make on us by telling about their past. Unfortunately, too many psychological theories are presented in a developmental perspective which tends to distract us from listening to our clients.
In both of these cases, I felt like the doctor was listening to me. So that at the end when he said ‘I would suggest that you . . .” I really felt like that you was really me and not some generic person often referred to using ‘you’. And because of that, I felt the impact of his recommendations for me.
And I became a better counselor.
Ray McKinnis is a counselor with a special interest in 'spirituality beyond religion' and veterans 'beyond PTSD' with a website at counselingandcoachingforlife.com.