ACA Blog

Ray McKinnis
Aug 10, 2011

The First & Last Counselor Rule: Do No Harm

‘The first three to four months after he was born he was a girl. Then he became a boy,’ my mother revealed toward the end of her life. She was talking about my brother, Ralph, who was 1 year and 8 days older than I. It is the sad story behind this blog, ‘DO NO HARM’. Ralph was brilliant. An IQ measured above 150 in high school. (I don’t know exactly what it was because back in those days, it was believed that high school counselors shouldn’t reveal to parents or students their IQ test results.) For 30 years he tried to figure out who he was. Throughout junior high and high school he was interested in girls only to find out what they were like—how did they know how to dress, what where they interested in, what did they do, etc. It was his troubling secret. Clearly he had a male body—6 foot 5, broad shoulders, sang tenor in the church choir, shoe size 15. The only anomaly was he had no facial hair. He had the XY chromosomes.

Finally, when was 30 years old and working on his PhD dissertation in theoretical math at Harvard, he decided to get some help making sense of what he was experiencing about himself. He went over to the psychiatrists at Massachusetts General Hospital. They did a number on him with their theories and techniques and drugs and egos. He came out paranoid schizophrenic.

During that time, l went and spent 5 days with him living in his world and giving him strokes for who he was and affirming what he was experiencing. (I had just read ‘I’m OK; You’re OK.’ and found it amazingly healing.) Toward the end of those days he became ‘functioning’ again—he threw away his dresses and we went out grocery shopping again. He was not longer afraid that the psychiatrists were putting medicine in the cans in the grocery store.

Unfortunately, after I left, he tried again to get help wandering throughout the country including trying to get doctors at Johns Hopkins to consider him for a sex change. They admitted him to their psych ward for his efforts. Ten years later he found a social worker at the Menninger Clinical in Topeka, Kansas who understood and wrote our mother a letter saying he was essentially a woman trapped in a male body but that too much damage had already been done to him to go through a sex change. He spent the rest of his life in a half-way house in the middle of Kansas learning Arabic and Swahili and developing mathematical formulas in his own room by himself drugged so that he was not completely aware of himself or his world.

Fortunately, transgender individuals today are more and more understood and accepted. They have enough problems without psychiatrists and counselors working their craft on them.

My main point is, as counselors, DO NO HARM! Do not use your education and theories and techniques to trash individuals who you think are crazy. It once was gays and lesbians and transgender individuals. And it still is being done to those labeled with Axis II personality formations and such conditions as ADHD which might actually be survival adaptations.

Since I am interested in spirituality and counseling, I feel it is particularly important to be sensitive to those whose spirituality may seem bazaar and dysfunctional to us. What about that Nigerian student who couldn’t concentrate on studying because his tribe back home didn’t want him to be here and had put a curse on him? Or that girl who felt God was calling her to be a nurse in spite of the fact that her grades were not good enough for nursing school? Or the individual who explained that one of her previous lives was interfering with her ability to get on with this life? I believe that there are individuals who are ‘sensitives’ who ‘know’ things they have to deal with that the rest of us don’t have a clue about. In a world where no one could see, how would you counsel a person who could see? The spiritual realm is one which can be irrational but still be real.

My first rule as a counselor is always, affirm what my client is experiencing and how they are trying to make sense out of it. Affirm them as an individual and the strength and courage they have had in dealing with those forces in their life and go on from there. Set aside the psychological theories and multicultural learning and your own beliefs about what is ‘real’. Listen, try to understand, and affirm. By doing so I have found that healing occurs. Like putting a cast on a broken leg to protect it from further damage. The cast does not do the healing. The leg gets protection so that it can use its own processes to heal itself. But make sure that cast does not do further damage. Offer your client a safe place where he or she can heal themselves and in that safe place DO NO HARM.

Ray McKinnis is a counselor with a special interest in 'spirituality beyond religion' and veterans 'beyond PTSD' with a website at

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