We counselors have an almost impossible challenge: on the one hand, if we come to a counseling session with a particular diagnosis or theory or plan, we are likely to be blind to what does not fit that diagnosis or plan; on the other hand, if we come completely ‘open’ we are likely to miss patterns that give clues to understanding our client’s problems.
I remember 2 videos from graduate school which painfully portrayed these two difficulties in the extreme. One showed Carl Rogers working with a depressed Gloria. Demonstrating Rogers’ ‘non-directive’ approach, he merely reflected back to her what she was saying. As the session progressed, I felt Gloria became more and more agitated because the counseling session consisted of the relationship between her and Rogers—and he seemed to be refusing to acknowledge the effect of his own presence. He seemed to miss the fact that she was responding to both his conscious and ulterior motives and he was not helping her very much with his verbal responses—he seemed to fail to acknowledge himself as the 900 lb gorilla in the room that she was responding to. He was responding to individual phrases, the cumulative progress of the session seemed to be lost on him. She finally gave up trying.
The other video showed William Miller demonstrating his motivational interviewing technique on a clinically seasoned substance abuse man. For the first half of the session, the client gave Miller everything he wanted to hear—clearly ‘playing Miller like a violin’ and Miller responded enthusiastically. Then the client seemed to get bored and just gave up any interest. Throughout this whole process, Miller dressed in his suit and tie sitting behind a table proceeded with his technique seeming to be completely unaware of how the client, casually dressed and physically comfortable, was responding and what the client was actually doing during the session.
If we are not aware of certain possibilities as we counsel an individual, we are likely to miss the significance of certain patterns when they occur—for example, motorcycles are often hit by cars because motorcycles are not expected in certain situations so that even when a car driver ‘sees’ a motorcycle, that driver still hits the biker because what is seen is not registered in the mind. It’s not that everyone sees the king naked and agrees not to mention it—his nakedness doesn’t even register in their minds--they don’t even see him naked because it is not expected.
However, if we are intensely focused on one task, we can easily become literally blind to other stimuli during the session. In his book, The Invisible Gorilla, the psychologist Daniel Simons discusses his experience with his famous video which shows 6 basketball players bouncing a ball to each other. The viewer is given the task to count the number of times the white-shirted players bounce the ball to each other. In the middle of the video, a woman dressed as a gorilla comes into the circle beats her chest and leaves—she is present for 9 seconds. Over half of those who watch the video focusing on counting the passes claim they saw no gorilla! When we concentrate on one thing, we can be oblivious to other significant aspects of the situation.
The implications for us as counselors are powerful. If we are told that certain conditions are due to genetics or brain functioning or childhood attachment issues or whatever, we can miss much that is happening right in front of us. On the other hand, if we don’t have some clue as to what might be going on, we could also miss the obvious. A few years ago, returning from a vacation, my wife developed an excruciating pain deep in her right hip. The next day she went to an orthopedic surgeon who did 3 days of extensive testing finding nothing in spite of a hip pain so severe that she couldn’t sleep. Finally, when the head nurse came into her room, on seeing the rash said ‘That’s shingles.’ Many skilled health-care personnel had missed the ‘obvious’ because it wasn’t expected. If that can happen with clearly identifiable physical diseases, how much more challenging it is for counselors where constellation of symptoms can be like a Rorschach Ink Blot test—an invitation to project our own stuff onto the client. Often, we have to be looking for something to see it.
This is also one of the factors that make the DSM so difficult for counselors to use—on the one hand, it puts ideas into our heads; on the other hand, it puts ideas into our heads!
However, these ways of the mind can also used as tools for helping our clients change. Milton Erickson was outstanding in using these aspects of consciousness to change patients by telling stories which, on the one hand, distracts the client’s consciousness while weaving into those stories the words and phrases and ideas with certain emphases which could effectively change the client. Magicians also use these processes effectively to fool us. In order to have a better chance of understanding what really went on in a session, Eric Berne suggested that the counselor listen to the tape at least 5 times, each time focusing on a different aspect. I would add that it would also be helpful if the counselor and client were to listen to it together.
We need to be aware of as many possibilities that a client might bring to us—this, I believe, is where exposing ourselves to as many different cultures, religions, life styles, et al as possible is important. But we also need to keep a ‘soft’ focus to pick up on patterns that may be new to us. And in every case, always, always listen to what our client is saying and doing—ask about the motive for each statement they make-- and check out with our client our hunches as to what is going on.
Ray McKinnis is a counselor with a special interest in 'spirituality beyond religion' and veterans 'beyond PTSD'