The hostage negotiator Kohlrieser in his fascinating book, Hostage at the Table, describes how the idea of being a hostage can be a truly fertile metaphor for what we do as counselors. In some important sense, every client whom we have feels like they are being held hostage by forces they think they are unable to control. Basically, our job as counselors is to help that person reclaim their power and autonomy and thereby their happiness. I also sense a strong sense of victimhood pervasive among counselors.
And bonding is the first and most important act of dissolving the hostage mentality. By bonding with our clients and helping them reclaim their powers and abilities, they can once again experience the autonomy and freedom they have lost. (This is the power of Carl Rogers’ approach.) Or simply by changing their “can’t” to “wont”; their “It feels” to “I feel”; their “you make me feel” to “I choose to feel”; “you really can’t trust your feeling” to “I can trust my feeling in certain situations.” and so on, you can establish a unique bond with a client and they can once again experience and claim their ability to be in charge of their own thinking and feeling and behavior. Once again they can claim their sense of being ‘okay’.
However a pervasive and subtle sense of victimhood is often felt and expressed among us as counselors. This sense of being held hostage appears in so many ways. Although I don’t have all the solutions to these situations, I do think if we reframe them as ‘hostage’ situations, we will be able to more clearly deal with them and come up with more satisfactory outcomes as we exercise our autonomy and freedom as counselors.
As Kohlrieser points out, the keys to successful negotiations in a hostage situation are bonding, dialogue and understanding.
1. Insurance Companies: Many counselors feel like they are held hostage by insurance companies since insurance companies determine what conditions they will reimburse for, who they will reimburse, how long each condition can be treated, and reimbursement rates—all factors that seem irrelevant to the counselor’s own importance and effectiveness. Stories have been circulated about how some insurance companies intentionally try to ‘make an extra buck’ at the expense of effective counseling.
As a counselor, of course, you have a choice whether to work with insurance companies or not. If you do decide to include insurance companies as part of your practice, the best advice is to dialogue with them, form a ‘bond’ with them letting them know you understand and appreciate their goals and you are willing to work with them. Otherwise, you can quickly feel like a hostage to them by giving up your power.
2. Psychiatrists and drugs: Another way others try to hold us counselors hostage is by claiming that psychiatrists, because they are MDs who have been trained to manage drugs, are the real ‘mental health’ practitioners and we, as counselors, fulfill, at best, a supportive role. Hospitals, insurance companies, drug companies and even most licensing policies tend to promulgate this idea. How many TV ads for depression have you seen advocating counseling—even though counseling is usually more effective than medications? So in our society with such forces defining counselors as second-class health-providers, it is not easy to avoid feeling like a hostage to forces outside our control.
The reasons for these situations are obvious—MDs have had a longer history of being the professional that treats diseases with counselors being merely ‘advice givers’. They have lobbied more for government control of the practice of delivering health care, have received more government funding for research and development and have continued to protect that privileged position.
Certainly, some medications are very effective for some cases and counselors are not trained in drug management. By adjusting neurotransmitters and their receptors, the brain somehow readjusts its functioning and symptom relief occurs. However, the real causes of those symptoms are rarely addressed. No one really knows how this drug management works and for most individuals it is a matter of trial and error to find the right combination.
But as the latest research is showing, the brain is extremely plastic—it responds to what an individual intends to do, the defense mechanisms and stroking patterns, and what one actually does. If you want to learn to play the piano and begin practicing 12 hours a day like a professional, the brain begins to readjust and recruits areas from other functions to service your piano playing. Study math 12 hours a day like a professional mathematician, the brain reconfigures itself to oblige to service what you are wanting to do and what you are doing. When one part of the brain is compromised, other parts can be recruited with intentional effort to regain control. Serious OCD, ADD, PTSD and so on can be effectively cured using this mechanism of redirection.
We as counselors help our clients reconfigure their brains by working with their intentions, defense mechanisms, stroking patters, etc.--not just to readjust neurotransmitters. Psychiatrists can be an effective complement to our work but we as counselors are the ones who have the tools to help our clients redecide, reclaim themselves and readjust their thinking, feelings and acting—thereby retraining their brain. We can actually help clients be cured.
3. Genetics: Another field that often discounts what we do as counselors has to do with genetic research. Much effort over many decades has gone into trying to prove that some mental conditions are genetic. Those conditions that psychiatrists were unable to ‘cure’ were the ones that were deemed ‘incurable’ and thereby probably genetic. With the advent of gene research, this effort has moved to looking for those genes that ‘cause’ or at least ‘predispose’ an individual to some of the more ‘serious’ mental ‘diseases’ such as schizophrenia, bi-polar disease, major depression, etc.
If such a gene had been found, then we as counselors would be told that we could not treat a person with such a condition—thereby effectively holding us hostage. I have often heard such remarks made about conditions on Axis II of the DMSB. Indeed for some conditions we have a limited, albeit important, effect such as diabetes, some cancers, some heart problems, etc. but even as counselors we can ameliorate or even prevent such conditions through changing a client’s beliefs and behaviors—reconfiguring their brain.
But as a professional statistician, I have never seen a reliable study to show any gene that has a direct relationship with schizophrenia, bi-polar disease, major depression, etc. The closest relationships that have been identified are similar to saying that height has a close relationship to playing in the NBA. And the very fact that we as counselors are able to cure these conditions indicates the lack of any determinate genetic base and reaffirms the power of our skills as counselors.
4. Quantum theory: I cringe every time I read a phrase that says something like, ‘Now, contemporary quantum theory in physics is proving or at least supporting some of the ideas we counselors have been using.’ I get the feeling that the message is: “Now that one of the ‘hard sciences’ is advocating these ideas, they are thereby more believable.”
First of all, note that quantum theory is a mathematical, statistical theory which has some benefit through complex mathematical formulae in ‘explaining’ the behavior of really, really tiny particles of matter. These particles themselves are metaphorical, ‘seen’ only by machines. In order to ‘make sense’ of these complicated formulae some physicists have ‘explained’ them by borrowing metaphors from other areas—including psychology. We are the ones who have been giving ‘proof’ to their sense of reality because their former metaphors (like from Newton) were proving inadequate to interpret their new (statistical) formulae to those who are not mathematicians. So no wonder some of the ideas physicists were espousing seemed familiar—they were our ideas in the first place!
5. Everything Else: It seems like whatever the latest fad promulgated by this theory or by this new technique or that new scanner is in danger of taking us counselors hostage. Like claiming that the real reason a person is depressed is that this area of his brain shows less activity than normal. That to me is the same as concluding that the reason this person just set a record in the 100 meter dash is because his thigh muscles are larger than normal. In both cases the ‘cause’ is related to the intentions of that individual which lead to certain thinking, feelings and activities to which the body and mind respond to service these intentions. Whether the fad is multiculturalism or the latest brain imaging technique or whatever, each threatens to take us counselors hostage if we would let them.
As Kohlrieser’s experiences have taught him, the way to avoid being taken hostage is not to be defensive because that only strengthens the hostage-taker’s determination and strength. More effective is to first form a bond with them, dialogue with them and understand their needs and intentions—we are experts at those skills. And always, in that process, maintain an understanding of our role and our unique contribution in helping our clients overcome their sense of being a victim so that they can reclaim their ability to live as free, autonomous and happy individuals. Remember, we are the ‘brain changers’.
Ray McKinnis is a counselor with a special interest in 'spirituality beyond religion' and veterans 'beyond PTSD'