ACA Blog

We all know how difficult it can be for vets when they return from active duty, whether it is a return from battle field deployment, foreign country or even stateside but separated from loved ones for months or years. Many will not seek therapeutic assistance for various reasons, some will appear to return unscathed while others self medicate; all regardless of the situation, will go through some period of adjustment that will lead to either productive (positive) or potentially devastating results.

[caption id="attachment_4859" align="alignleft" width="150" caption="Jennifer Bingaman"][/caption] I began my internship this week. The first of 900 hours I must accumulate to reach my master’s degree. Being completely honest, I was looking at this pile of hours rather ominously. I’ve already come so far in my degree and yet the impending effort and time crunch of a 30-hour weekly internship made my graduation day seem so far away.

[I realize last year I wrote my ‘Last Blog’. But because Rebecca Daniel-Burke left the door open for me to offer an occasional blog and several readers responded so encouragingly to that ‘last’ blog, I have decided to use the ACA blog as a way to clear out ideas that continue to make their home in my mind--ideas that could be useful to us a counselors.] Andrew Harvey in his amazingly personally honest book, The Hope: A Guide to Sacred Activism, describes the dangers of being morally sensitive without a sense of some dimension the ‘beyond’. I would like to assert quite absolutely that it is (almost—I’m hedging) impossible for a counselor to be available to many clients honestly and accurately without some sense of a ‘spiritual’ dimension. Individuals in this world experience unimaginable brutality, cruelty, pain and suffering. We as counselors must deal with such individuals. To do so we strength and resources equal to the task in order to listen carefully, acknowledge their experiences and help clean up the mess of such, truly, unimaginable, indeed transcendent cruelty. If we don’t have that strength, we can easily either become overwhelmed, depressed or worse; or just as bad, numb ourselves and ignore the brutality that some of our clients have had to face. Psychological theories are based rational observation supported by evidence carefully collected—the cruelty I am talking about is irrational.

In the latest issue of Counseling Today there is a great article exploring counselors in transition by Lynne Shallcross, a senior writer at the publication. This cover article is a tour de force focusing on interviews with various counselors in certain phases and experiencing different transitions in their careers. As I read and thoroughly enjoyed the piece I pondered my own impending transition: that one being from the classroom to an internship in the fall - which will be the start of my final year of graduate school. Hmm, it gives me the willies just thinking about it.

People are returning to school in record numbers. Graduate counselors-in-training are no exception. According to the American Council on Education, 62% of graduate and professional students are enrolled in Master’s programs. This should really come as no surprise. The economy’s in the tank. The phrase “job security” is increasingly an oxymoron. And the advent of online education promises to let you keep your current job and acquire new skills from the comfort of home with just a laptop and a dream.

In my clinical psychology graduate program with its psychoanalytic orientation back in the 70‘s, I was taught that therapy largely was focused on uncovering how your past was still present in everyday life. The mindset at the time was that only by shedding light on deep seated issues can a person move past what had made them stuck, with increased insight and understanding. I only learned about Cognitive Behavior Therapy after graduate school, and was amazed at how just changing one’s self talk one can really change lives and happiness quotient. However, in my practice i found that even was not enough. Insight into thinking patterns alone does not change things, especially if habits are deeply ingrained. Sometimes, “knowing better” does not mean that we can actually “do better.” If so, we would all be exercising regularly and trim and fit! For many clients, some no matter how much they identify their irrational thoughts and know how they can replace them with more rational ones, they remain stuck. Why? They have no new skills to act differently!

What do you do when a client is apparently in a free fall? They report, of course, that “this time it will be different.” They will change, they are ready, and it is time. Then the next time you see them - usually just a few days later - they resemble the same blown out, angry wreckage that you spoke with just days before. How does this sit with you?

I am not sure how many clinicians by definition would be categorized as gamblers; if I had to guess I would say that few would qualify. As a whole we just don’t have a reputation for throwing caution into the wind, calling out of work for a week or two and betting our lifesavings at the track or Vegas or wherever. I personally do not even buy a lottery ticket due to the lack of probable return on my dollar. Still, sometimes in private practice or in the running of a program be it not for profit or a for profit enterprise, we find ourselves in a position where we can stay in our current familiar safety blanket that we have arguably outgrown or we can take a great risk and attempt to expand in hopes that the new program will be a great as ever, possibly greater. There is no right or wrong, just a feeling that change must come, must be defined and chances taken. Or not. “Or not” is often much safer though it runs the risk of becoming stagnant.

DSM 5 keeps missing its own deadlines and the DSM 5 publication date is fast approaching. I am afraid there is insufficient time left for thoughtful preparation or adequate public input. Here's a brief history of DSM 5's consistent failure to deliver on time:

What do you do when you are faced with adversity and feel like you are drowning in it? My previous entry discussed the subject of hope. I believe that part of finding hope is finding meaning. Various theoretical orientations include approaches that focus on shifting or changing negative cognitions to positive ones. Encouraging the client to think about what is good in his or her life and appreciate what he or she has can be a piece of strength-based perspectives as well. The crux of Victor Frankl’s Logotherapy is that finding meaning in our lives is what drives or motivates us. Soren Kierkegaard, touted as the “Father of Existentialism,” believed that people were responsible for finding meaning in their lives.